[Balloon catheter dilatation in pharyngo-esophageal stenosis]. / Dilatación con sonda-balón en estenosis faringo-esofágicas.

On the scarring strictures at the level of the pharyngo-esophageal junction, for example following surgery for pharyngo-laryngeal tumours, the treatment was traditionally the use of transoral dilators, as the metallic spark plugs or olives. At present the balloon catheters are the election technique for all cases. The advantages for the balloon catheters versus the traditional methods are the smaller morbidity and mortality, the effectiveness, simplicity and little cost. We show the protocol done in our center for the dilation of these strictures.

Dilatación con sonda-balón en estenosis faringo-esofágicas / Balloon catheter dilation in pharyngo-esophageal strictures

En las estenosis cicatriciales a nivel de la unión faringoesofágica, por ejemplo tras cirugía de tumores faringolaríngeos, tradicionalmente el tratamiento se basaba en el empleo de dilatadores transorales, como las bujías o las olivas metálicas. Actualmente se emplean los catéteres de balón como técnica de elección para todos los casos. La ventaja de la sonda-balón frente a la dilatación tradicional es su menor morbilidad y mortalidad, su eficacia, sencillez y poco coste. A continuación se muestra el protocolo seguido en nuestro centro para la dilatación de estas estenosis (AU)

On the scarring strictures at the level of the pharyngo-esophageal junction, for example following surgery for pharyngo-laryngeal tumours, the treatment was traditionally the use of transoral dilators, as the metallic spark plugs or olives. At present the balloon catheters are the election technique for all cases. The advantages for the balloon catheters versus the traditional methods are the smaller morbidity and mortality, the effectiveness, simplicity and little cost. We show the protocol done in our center for the dilation of these strictures (AU)

Microsomía hemifacial o sindrome del primero y segundo arco branquial: características clínicas y consideraciones terapéuticas / Hemifacial microsomy or syndrome of first and second branchial arch: clinical characteristics and therapeutic considerations

El síndrome de microsomía hemifacial está formado por una constelación de malformaciones congénitas de las estructuras faciales provenientes del I y II arcos branquiales, en las que intervienen la primera bolsa faríngea y el primer paladar blando, junto con el núcleo del hueso temporal. Presentamos un nuevo caso de microsomía hemifacial, y revisamos sus características clínicas y posibilidades terapéuticas (AU)

The syndrome of hemifacial microsomia is formed by a constellation of congenital malformations of the originating face structures of the I and II branchial archs, in which the first pharingeal stock and the first soft palate take part to, along with the nucleus of the temporary bone. We present a new case of hemifacial microsomia, and reviewed its clinical characteristics and therapeutic possibilities (AU)

[Hemifacial microsomia or syndrome of the first and second branchial arch: clinical features and therapeutic considerations]. / Microsomía hemifacial o síndrome del primero y segundo arco branquial: características clínicas y consideraciones terapéuticas.

The syndrome of hemifacial microsomia is formed by a constellation of congenital malformations of the originating face structures of the I and II branchial archs, in which the first pharingeal stock and the first soft palate take part to, along with the nucleus of the temporary bone. We present a new case of hemifacial microsomia, and reviewed its clinical characteristics and therapeutic possibilities.

[Usefulness of preoperative coagulation tests in the prevention of post-tonsillectomy hemorrhage in children]. / Utilidad de los test de coagulación prequirúrgicos en la prevención de la hemorragia postamigdalectomía en niños.

A retrospective study was made of 266 children undergoing tonsillectomy to determine the usefulness of preoperative coagulation tests for predictin-haemorrhagic complications. A short questionnaire about haemorrhagic history identified 11 children with a positive background but no complications. Eleven children, 4.13%, had post-tonsillectomy bleeding that required a new admission or lengthened the hospital stay only one of which coagulation screening disorders. The determination of coagulation tests in every child had allowed us to diagnose 2 non-clinical cases of Von Willebrand's disease and 4 of lupus anticoagulant but did not identify high risk patients for bleeding, in spite of their medical history. Indiscriminate use of these tests brings no benefit to the patient because they don't give surgeon new information and they increase costs and delay surgery.

[A study of the incidence and hospital follow-up of epistaxis in patients treated with anticoagulant acenocoumarol]. / Estudio sobre la incidencia y seguimiento hospitalario de epistaxis en pacientes anticoagulados con acenocumarol.

Nosebleed is a common reason for emergency ENT consultations, but it is infrequent in patients anticoagulated with acenocoumarol. In a retrospective 5-year study, nosebleed was the second most frequent type of hemorrhage among anticoagulated patients. Such patients do not necessarily have prolonged coagulation times. In a comparison of patients hospitalized for nosebleed (n = 14) with a similar group with no hemostasis abnormalities, patients with nosebleed had longer hospital stays and required more control measures. The greater the tendency to hypocoagulation, the more difficult it was to manage nosebleed. Recent onset of anticoagulation therapy and previous long coagulation times favored the appearance of hard-to-manage nosebleed. Therefore, hematologists should closely control patients under anticoagulation therapy and cooperate with the ENT department when such patients are admitted for nosebleed.

[Blood viscosity disorders as an etiopathological factor in sudden deafness]. / Trastornos en la viscosidad sanguínea como factor etiopatogénico en la sordera brusca.

Because idiopathic sudden deafness is regarded as the result of a cochlear microcirculation disorder, its treatment has been based mainly on vasoactive therapy with little regard for the blood-flow conditions produced by these circumstances. In a group of 16 patients with sudden-onset deafness, we determined blood viscosity at different shear rates, as well as erythrocyte aggregability, deformability, and filterability, and other potentially influential parameters, such as hematobrit, fibrinogen, and leukocyte and platelet count. These values correlated with hearing loss and average recovery after conventional treatment. Our results showed a trend to high blood viscosity in patients in relation to a control group of persons with normal hearing, with a notorious increase in aggregability, which correlated significantly with recovery of hearing capacity, and a decrease in blood filterability, which correlated with average hearing loss. This suggests a potential etiopathogenic mechanism of the disease and an alternative treatment complementary to current treatment.