Exploración videoendoscópica con sueño inducido, utilidad clínica y revisión de la literatura / Drug-induced sleep videoendoscopy: Clinical usefulness and literature review

La exploración fibroscópica de la faringe mediante sueño inducido es una prueba que ayuda a conocer las zonas de vibración y colapso de los pacientes con trastornos respiratorios del sueño. En este artículo se realiza una revisión de la literatura disponible sobre el tema para ayudar al otorrinolaringólogo a conocer la prueba y resolver algunas controversias existentes sobre la misma (AU)

Fiberoptic examination of the pharynx under drug-induced sleep is a test that helps to detect the areas of vibration and collapse in patients with sleep-disordered breathing. This article is a review of the available literature on the subject, aimed at helping otolaryngologists to understand the procedure and to resolve some controversies surrounding it (AU)

[Drug-induced sleep videoendoscopy: clinical usefulness and literature review]. / Exploración videoendoscópica con sueño inducido, utilidad clínica y revisión de la literatura.

Fiberoptic examination of the pharynx under drug-induced sleep is a test that helps to detect the areas of vibration and collapse in patients with sleep-disordered breathing. This article is a review of the available literature on the subject, aimed at helping otolaryngologists to understand the procedure and to resolve some controversies surrounding it.

Evaluación de la vía aérea mediante laringoscopia indirecta en pacientes con hipertrofia de la amígdala lingual / Airway evaluation by indirect laryngoscopy in patients with lingual tonsillar hypertrophy

Introducción y objetivos: Se desconoce la prevalencia de la amígdala lingual hipertrófica, pero se cree que su presencia está asociada con la vía aérea difícil. Para investigarlo se realizó a los pacientes una laringoscopia indirecta en el preoperatorio y se diagnosticó esta enfermedad. Después, bajo anestesia general y laringoscopia directa estudiamos su relación con la dificultad de visión de la laringe, intubación y ventilación. Métodos: A 300 pacientes que iban a ser sometidos a anestesia general, además de realizarles en el preoperatorio los predictores demográficos y de vía aérea difícil (prueba de Mallampati, apertura bucal, distancia tiromentoniana, flexoextensión cervical y grosor del cuello), se les practicó una laringoscopia indirecta con el laringoscopio rígido de 70° y se comprobó la frecuencia de aparición de la amígdala lingual hipertrófica. Después, bajo anestesia general y laringoscopia directa verificamos si existía dificultad de visión e intubación de la laringe y de ventilación. Exploramos la relación de las 3 variables anteriores con esta enfermedad mediante la prueba de Fisher. También, se investigó la asociación de predictores demográficos y de vía aérea difícil incluyendo la laringoscopia indirecta, con la presencia de esta afección. Resultados: La prevalencia de amígdala lingual hipertrófica fue del 2%. No se encontró relación entre la aparición de esta entidad y la dificultad de visión de la laringe, intubación y ventilación. Solo la laringoscopia indirecta previno la aparición de esta enfermedad. Conclusiones: La amígdala lingual hipertrófica es una entidad relativamente frecuente. Su presencia no se asocia habitualmente con la vía aérea difícil (AU)

Introduction and objectives: Prevalence of the lingual tonsillar hypertrophy is unknown but it is believed that its presence is associated with the difficult airway. To investigate this, indirect laryngoscopy was performed on patients in the preoperative evaluation and this pathology was diagnosed. The relationship with difficulty of viewing the larynx, intubation and ventilation, under general anaesthesia and using direct laryngoscopy, was then studied. Methods: We performed the demographic variable checks and tests for predicting difficult intubation (mouth opening, thyromental distance, cervical flexion-extension, neck thickness, and Mallampati test), in the preoperative step on 300 patients who were going to be submitted to general anaesthesia. We then performed indirect laryngoscopy on them using a 70° rigid laryngoscope to ascertain the frequency of appearance of lingual tonsillar hypertrophy. Next, under general anaesthesia, we carried out direct laryngoscopy to verify whether there was difficulty in viewing the larynx and intubation and ventilation. We then investigated the association of demographic predictors of difficult intubation, including indirect laryngoscopy, with the presence of this condition. Results: Prevalence of lingual tonsillar hypertrophy was 2%. No relationship between the appearance of this entity and the difficulty of viewing the larynx, intubation and ventilation was found. Only indirect laryngoscopy was linked to the appearance of this pathology. Conclusions: Lingual tonsillar hypertrophy is a relatively frequent disorder, whose presence is not usually associated with difficult airway (AU)

Airway evaluation by indirect laryngoscopy in patients with lingual tonsillar hypertrophy.

INTRODUCTION AND OBJECTIVES: Prevalence of the lingual tonsillar hypertrophy is unknown but it is believed that its presence is associated with the difficult airway. To investigate this, indirect laryngoscopy was performed on patients in the preoperative evaluation and this pathology was diagnosed. The relationship with difficulty of viewing the larynx, intubation and ventilation, under general anaesthesia and using direct laryngoscopy, was then studied. METHODS: We performed the demographic variable checks and tests for predicting difficult intubation (mouth opening, thyromental distance, cervical flexion-extension, neck thickness and Mallampati test), in the preoperative step on 300 patients who were going to be submitted to general anaesthesia. We then performed indirect laryngoscopy on them using a 70° rigid laryngoscope to ascertain the frequency of appearance of lingual tonsillar hypertrophy. Next, under general anaesthesia, we carried out direct laryngoscopy to verify whether there was difficulty in viewing the larynx and intubation and ventilation. We then investigated the association of demographic predictors of difficult intubation, including indirect laryngoscopy, with the presence of this condition. RESULTS: Prevalence of lingual tonsillar hypertrophy was 2%. No relationship between the appearance of this entity and the difficulty of viewing the larynx, intubation and ventilation was found. Only indirect laryngoscopy was linked to the appearance of this pathology. CONCLUSIONS: Lingual tonsillar hypertrophy is a relatively frequent disorder, whose presence is not usually associated with difficult airway.

Septorrinoplastias, un estudio descriptivo / Septoplasty and rhinoplasty, a descriptive study

Introducción y objetivos: Realizamos un estudio retrospectivo de los pacientes intervenidos de septoplastia y rinoplastia en el Hospital Universitario Dr. Peset de Valencia que describiera la técnica empleada y evaluara los resultados de la intervención. Material y Métodos: Cuarenta y nueve pacientes intervenidos de septorrinoplastia y 6 de rinoplastia fueron examinados funcional y estéticamente después de la cirugía. El análisis de los resultados consta de un estudio descriptivo y uno comparativo de las variables: tipo de deformidad, edad, sexo, cirugía previa y resultados posquirúrgicos. Para establecer la relación entre las variables se empleó el test exacto de Fisher. Resultados: Después de realizar la septoplastia, el septum quedó centrado en el 91% (45) de los casos. En nuestro trabajo no hemos podido encontrar diferencias estadísticamente significativas entre el tipo de desviación septal y los resultados tras la septoplastia. En el caso de las septorrinoplastias, se obtuvo una pirámide centrada en el 76% (42) de los casos. Tampoco llegamos a la significación estadística entre el tipo de deformidad de la pirámide nasal y su estado final. El sexo femenino y los casos de septorrinoplastia secundaria predicen peores resultados tras la operación. Conclusión: La cirugía septopiramidal persigue conseguir el buen funcionamiento nasal y un resultado estético. Partiendo de los principios quirúrgicos de Cottle se han desarrollado otras técnicas más específicas orientadas a la corrección de las distintas deformidades (AU)

Introduction and objectives: This is a retrospective Study on patients who underwent septoplasty and septorhinoplasty at Dr. Peset Hospital in Valencia. Surgical procedures are described and results evaluated. Material and methods: 49 septorhinoplasties and 6 rhinoplasties were aesthetic and functionally evaluated after surgery. Variables such as type of deformity, age, gender, previous surgery and surgical results where described and compared. Fisher exact test was used to find statistic significance between variables. Results: Septum remained centred after 91% (45) of septoplasties. There was no statistical significance between type of septal deviation and results. Straight nasal pyramid was obtained after 76% (42) of septorhinoplasties and also in this procedure we did not find statistic significances between deformity and final result. Feminine gender and secondary surgery where predictive factors for worse surgical results. Conclusion: Septopyramidal surgery tries to obtain a good nasal function and aesthetic result. Starting with Cottle’s principles, more specific techniques have been developed to resolve the different deformities (AU)

[Septoplasty and rhinoplasty, a descriptive study]. / Septorrinoplastias, un estudio descriptivo.

INTRODUCTION AND OBJECTIVES: This is a retrospective study on patients who underwent septoplasty and septorhinoplasty at Dr. Peset Hospital in Valencia. Surgical procedures are described and results evaluated. MATERIAL AND METHODS: 49 septorhinoplasties and 6 rhinoplasties were aesthetic and functionally evaluated after surgery. Variables such as type of deformity, age, gender, previous surgery and surgical results where described and compared. Fisher exact test was used to find statistic significance between variables. RESULTS: Septum remained centred after 91% (45) of septoplasties. There was no statistical significance between type of septal deviation and results. Straight nasal pyramid was obtained after 76% (42) of septorhinoplasties and also in this procedure we did not find statistic significances between deformity and final result. Feminine gender and secondary surgery where predictive factors for worse surgical results. CONCLUSION: Septopyramidal surgery tries to obtain a good nasal function and aesthetic result. Starting with Cottle's principles, more specific techniques have been developed to resolve the different deformities.