Tratamiento de la otitis secretora con AM3. Réplica / Treatment the secretory otitis with AM3. Reply

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[The effect of AM3 in the resolution of otitis media with effusion (OME) in paediatric patients]. / Efecto de AM3 sobre la resolución de la otitis media serosa (OMS) en pacientes pediátricos.

OBJECTIVE: Otitis media with effusion (OME) is one of the most frequent diseases and the main cause of hearing loss in childhood. The medical treatment for OME includes antibiotics, antihistamine-decongestant combinations, steroids and Eustachian-tube autoinflation as the Valsalva manoeuvre. METHODS: A total of 62 children aged 2 to 8 years with a diagnosis of OME were enrolled in a prospective study to assess the resolution of OME. Patients were given antibiotics treatment with or without associated AM3. RESULTS: After 2 months of treatment, the rate of complete resolution of OME was greater in AM3 treated group than in the non-AM3 treated group (57.6% vs 27.6%) with a statistically significant difference (p<0.017). CONCLUSIONS: These results show that AM3 treatment has a beneficial effect on OME resolution when it is associated to antibiotic treatment.

Efecto de AM3 sobre la resolución de la otitis media serosa (OMS) en pacientes pediátricos / The effect of AM3 in the esolution of otitis media with effussion (OME) in paediatric patients

Objetivos: La otitis media serosa (OMS) es una de las patologías más frecuentes en la infancia y la primera causa de hipoacusia. El tratamiento médico de la OMS ha consistido en antibióticos, descongestionantes y antihistamínicos, corticoides tópicos y medidas de insuflación tubárica, como maniobras de Valsalva. Material y métodos: Se realizó un estudio prospectivo en 62 pacientes con edades comprendidas entre 2 y 8 años, diagnosticados de OMS y tratados con antibiótico y AM3 o antibiótico sólo, para valorar la resolución de esta patología. Resultados: Tras dos meses de tratamiento, la inclusión de AM3 en la pauta terapéutica se asoció a un mayor porcentaje de pacientes en los que se resolvió la OMS (57,6% versus 27,6%), siendo esta diferencia estadísticamente significativa (p<0,017). Conclusiones: Los resultados de este estudio muestran que AM3 tiene un efecto beneficioso en la curación de las OMS asociado al tratamiento antibiótico (AU)

Objetive: Otitis media with effusion (OME) is one of the most frequent diseases and the main cause of hearing loss in childhood. The medical treatment for OME includes antibiotics, antihistamine-decongestant combinations, steroids and Eustachian-tube autoinflation as the Valsalva manoeuvre. Methods: A total of 62 children aged 2 to 8 years with a diagnosis of OME were enrolled in a prospective study to assess the resolution of OME. Patients were given antibiotics treatment with or without associated AM3. Results: After 2 months of treatment, the rate of complete resolution of OME was greater in AM3 treated group than in the non-AM3 treated group (57,6% vs 27,6%) with a statistically significant difference (p<0,017). Conclusions: These results show that AM3 treatment has a beneficial effect on OME resolution when it is associated to antibiotic treatment (AU)

Diagnóstico y tratamiento antimicrobiano de las sinusitis / Diagnosis and antimicrobial treatment for sinusitis

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[Surgical treatment of acquired laryngotracheal stenosis in children]. / Tratamiento quirúrgico de la estenosis laringotraqueal adquirida en niños.

Severe laryngotracheal stenosis in children is a problem of increasing incidence following the widespread adoption of prolonged endotracheal intubation for respiratory support. A variety of methods have been developed to solve the problem of extensive tracheal stenosis. Seven patients from 9 months to 14 years were treated from December 1992 to November 1994 with posterior cricoid split and hyoid bone graft. Stenting was performed in all cases with a Montgomery Silastic laryngeal stent during three weeks. All patients have been extubated.

[The septal button: an alternative to the reparative surgery of septal perforations]. / El botón septal: una alternativa a la cirugía reparadora de las perforaciones septales.

There are many surgical approaches for closure of nasal septum, most of which present technical difficulties. Moreover, the clinical results are, as yet, unsatisfactory. Prefabricated prostheses have been effective for treatment of smaller perforations, and are an excellent alternative in a great number of cases. We present an optional surgical technique to deal with this increasingly common problem.

[Surgery of the thyroid. A review of 150 cases]. / Cirugía de la glándula tiroides. Revisión de 150 casos.

We present a review of 150 partial or total thyroidectomies, only 126 of which were considered valid for this study. They were performed during the period from March 1985 to March 1990 to treat benign or malignant thyroid pathologies judged to be susceptible to surgery. Only three permanent complications resulted: a definitive hypothyroidism and two recurrent paralyses, both in cases of papillary carcinomas, one with extracapsular invasion which required the sacrifice of the nerve.

[Naso-intestinal intubation with weighted tubes. A new modification of an old technique]. / Intubación nasointestinal con sondas lastradas. Una modificación nueva a una técnica antigua.

We have studied the spontaneous transpyloric passage of 25 weighted nasointestinal tubes using a modified technique slightly different from the standard one. Instead of introducing the entire tube in the stomach in the very first moment, we have only introduced at the beginning approximately 70 cm and afterwards, with the patient in the right lateral decubitus position, each 15 minutes we continued introducing 15 cm each time for a total period of one hour. X-ray controls were done 3, 24 and 48 hours after the first introduction. Fifteen tubes (60%) had passed to the small intestine in the first 3 hours, 21 (84%) had reached it before 24 hours and 23 (92%) had passed the pylorus before 48 hours. The others two tubes did not pass the pylorus in 48 hours nor did they pass after the administration of metoclopramide. We thus conclude that this technique simplifies the intubation of the small intestine. We recommend to control the position of the tube by X-ray film 24 hours after the positioning. If after this period the tube is still in the stomach, it should be repositioned using radiological or endoscopic assistance in those cases that the delivery of an intestinal solution is desired.