[Recurrent intrathyroid abscess in children. Clinical case and review of the literature]. / Absceso recurrente intratiroideo en niños. Caso clinico y revisión de la literatura.

Recurrent thyroid abscesses in children are an uncommon clinical disorder that use to be due to 3rd or 4th branchial anomalies and pyriform sinus fistula. We are reporting the clinical case ofa 6 year-girl who was diagnosed as left thyroid lobe and istmic abscess of 3 cm, drained by general anesthesia with positive culture for St. Viridans. Four months later she was re-admitted by the same cause and we performed a new drainage, by punction, and endovenous antimicrobial therapy for aerobic and anaerobic pathogens with good evolution. The imaging tests showed no anatomical alterations.

[Paediatric tracheostomy]. / Traqueotomía pediátrica.

INTRODUCTION: Actually we are attending changes in the concept of pediatric tracheostomy. The most important of them is a change in its indications. The aim of our study is to provide our experience about pediatric tracheostomy. METHODS: We are reporting a retrospective study of 16 patients who underwent tracheotomy between 1994-May 2004, reviewing the indications, their complications and evolution. RESULTS: In our study we have only managed to close the tracheostomy in 5 patients and one is waiting surgery, in the rest the pathology has nos allowed us to close it. DISCUSSION/CONCLUSION: Actually the main indication for pediatric tracheostomy is prolonged intubation. Preterm children, the earlier age is done and the longer the intubation is increase the risk of complications but mainly it is the base illness of the patient which will determine the posterior evolution of the tracheostomy.

[Giant cells undifferentiated parotid carcinoma. Report of two cases]. / Carcinoma parotídeo indiferenciado de células grandes. Presentación de dos casos.

Tumours of the salivary glands represent a 5% of all head and neck neoplasms. Their origin is the parotid gland in about 80% of the cases. Most of them are benign. We are reporting two cases of patients diagnosed, by our ENT Department, as undifferentiated giant cells parotid carcinoma with cervical metastasis. They were operated by total parotidectomy and radical neck disection and later recieved treatment with radiotherapy. After two years-follow-up both patients are standing alive. The tumoral size is the most important pronostic factor in this histological type.

[Simultaneous bilateral sudden deafness. Report of a clinical case]. / Sordera súbita bilateral simultánea. Presentación de un caso.

Bilateral sudden deafness is uncommon and characterized by an acute sensorineural hearing loss in both ears of 30 dB or more in 3 consecutive frequencies. We report the case of a 57 yeras old female with this diagnosis who presented a right anacusia and a severe audiometric loss on left ear without vestibular pathology associated. She was admitted and treated by the protocol of medical therapy that we have performed in our E.N.T. Department (4 days EV and then 10 ones oral medication) with improvement in her audition 25-30 dB average. If sudden bilateral sensorineural deafnes is founded, we must consider an immuno-mediated inner ear disease (IMIED).

[Glossopharyngeal neuralgia. A propos of one clinical case]. / Neuralgia del glosofaríngeo. A propósito de un caso clínico.

Glossopharyngeal or the 9th cranial nerve neuralgia is an uncommon pathology characterized by severe paroxysmal attacks of pain in the base of the tongue, posterior pharynx and tonsillar fossa some times associated with pain irradiated to the ear. It's Carbamazepine is the first choice of medical treatment while the microvascular decompression is considered the main surgical procedure.

[Nasal angiofibroma in a 60 year-old female. A clinical case and literature review]. / Angiofibroma nasal en mujer de 60 años. Caso clínico y revisión de la literatura.

We are reporting an atypical and very rare clinical case of nasal angiofibroma in a 60 year-old female who presented with recurrent epistaxis and nasal blockage. The tumour was located on the right inferior turbinate C.T scans., M.R.I. and Angiography were required as complementary studies. After trying without success a previous arterial embolization, the patient underwent surgery by Functional Endoscopic Nasal Surgery (F.E.N.S.) with removal of the mass in the right nasal fossa. The anatomopathologic result confirmed the histology of angiofibroma and the clinical evolution was satisfactory. Angiofibromas in women and in general in adults are exceptional as we have verified through a literature review.

[Review of acute otomastoiditis in the paediatric population. Our cases]. / Revisión de otomastoiditis agudas en la población pediátrica. Nuestra casuística.

The introduction of antibiotics has decreased the number of acute mastoiditis as complication of otitis media in children. However, this pathology still is a serious infection. Its incidence has increased in the last years and goes on getting diagnostic and therapeutic problems. We are reporting an own review about 18 children diagnosed as acute otomastoiditis, hospitalized in a 10 years period, with ages between 10 months and 14 years. We have analysed different parameters standing out the otoscopic and radiologic findings, clinical symptoms, previous antibiotic treatment, type of surgical intervention performed and complications.

[Treatment of thyroid cancer. Retrospective study and review of the literature]. / Tratamiento del cáncer de tiroides. Estudio retrospectivo y revisión de la literatura.

We present a retrospective study about our experience in the treatment of thyroid carcinoma. For that, between 1992 and 1997, we have collected 37 malignant thyroid tumours (15%) over 250 operations on thyroid gland by our ENT Service. We analysed several variables: Age, sex, personal antecedents, clinical symptoms, results of the complementary tests (thyroid hormones, ultrasonography, scintigraphy and FNAB), type of surgery complications and number of recurrences. The thyroid carcinomas, specially differentiated tumors, are an increasing pathology with tendency to affect females. In our serie usually they are solitary thyroid nodes, scintigraphically cold ones, in which FNAB as the best test. We think that a total thyroidectomy is the best treatment and it must be made by an ENT.

[Epignathus. A case report and review of the literature]. / Epignatus. A propósito de un caso y revisión de la literatura.

Epignathus is an uncommon form of oropharyngeal teratoma that is associated with a high mortality during the neonatal period. We report the clinical case of a neonate born through cesarean in week 35, Apgar 2-4, neurologic breakdown and widespread hypotonia. The prenatal diagnosis was performed by ultrasonography; the diameter of the solid mass was 5 cm with inner calcium density. An urgent tracheostomy was carried out as it was not possible to get orotracheal intubation (IOT) and, later, we proceeded to remove the mass which was embedded in the hard palate. Our patient died three weeks later due to respiratory and heart failure. We carry out a review of the literature for this pathology.

[Acute epiglottitis in adults. Our case load in 11 years]. / Epiglotitis aguda en adultos. Nuestra casuística en 11 años.

We report a retrospective study of 20 cases of acute epiglottitis in adults admitted at our hospital between 1991 and 2001. We gather a series of variables: Patient sex, age, year and month of admission, personal history, initial clinical symptoms, complementary tests asked, given treatment, evolution and hospital average stay. We found an obvious predominance in male (19:1 with respect to female), with an average age of 45 years. The main symptoms were dysphagia-odynophagia (85%), followed by fever (55%) and pharyngocervical pain. Dyspnea was confirmed in 9 of 20 patients (45%); 5 of them required airway control with the help of intubation in one case, urgent coniotomy in three cases and tracheotomy in another one. A patient suffered from an acute mediastinitis and required assistance and medical i.v. extended treatment in UCI. We show a case of another patient who suffered sudden cardiorespiratory arrest a followed by death. He did not present previous dyspnea. Acute epiglottitis in adults is a rare pathology with a good prognosis in general, but may lead to an unpredictable and serious complication even in the absence of airway blockage. We carry out a medical literature review in this respect.

[Primary carcinoma of the trachea. Report of 2 cases]. / Carcinoma primitivo de tráquea. A propósito de dos casos.

Tumours of the trachea remain relatively rare, the incidence of tracheal carcinomata is less than 0.1 per cent. Tumours of the larynx and lungs are, respectively, 75 and 180 times more frequent than malignant lesions of windpipe. Two patients with primary tracheal tumours were evaluated. The present study was undertaken in order to describe and analyse the most pertinent clinical and pathologic features of tracheal carcinomas as they relate to treatment and prognosis.

[Early detection of hearing loss in neonates by using transient evoked otoacoustic emissions]. / Detección precoz de hipoacusia en recién nacidos mediante otoemisiones acústicas evocadas transitorias.

OBJECTIVE: A precocious diagnosis of infantile deafness is essential to avoid its implications in the family and the social and employment future of those that suffer from them. The discovery of new tests that can be used for auditory screening, such as otoacoustic emission, has opened new perspectives in this field. PATIENTS AND METHODS: Universal screening was performed including neonates born in our area. We studied 7,153 children (296 with indicators of risk) born between 1995 and 1997. Our protocol was based on transient evoked otoacoustic emissions as the screening method and brainstem auditory evoked potentials as the diagnostic procedure. RESULTS: Two out of 1000 ears studied presented serious/deep deafness and 1.39 per 100 had some type of hearing loss. The incidence of pathology was higher among ears of children with risk factors: 1.8 per 100 had serious/deep deafness and 7.59 per 100 some type of hearing loss. CONCLUSIONS: Transient evoked otoacoustic emission is an effective method when used in infantile auditory screening, since it is objective, bloodless and quick. Its correlation with auditory evoked potentials is very high, which proves their reliability. The best moment to perform this test (OAE) is when the discharge from the hospital is certified. We believe that universal screening is necessary, although a much higher incidence of deafness is encountered among children with risk factors. The establishment of programs for the precocious detection of infantile deafness should not be delayed.

[Thyroid teratomas in the adult]. / Teratomas tiroideos del adulto.

Thyroid teratomas are rare neoplasms in adults (only 19 cases have been reported in the world literature). We report the case of a 55-year-old woman with a paratracheal mass, paralysis of the recurrent nerve, dyspnea, and results of palpation suggestive of malignancy. Total thyroidectomy was performed and anatomopathological study disclosed a benign thyroid teratoma in adult. We discuss this case and review the literature on adult thyroid teratomas.

[Primary extramedullary plasmocytoma of the tongue base]. / Plasmocitoma extramedular primario de base de lengua.

Primary extramedullary plasmacytoma (PEP) are malignant neoplasm of plasma cells. They are very rare, however 80% of the cases appear in head and neck region. We reported a rare case of PEP of the base of the tongue, in a 44-year-old male with oral bleeding.

[Laryngeal paraganglioma]. / Paraganglioma laríngeo.

A case of laryngeal paraganglioma in a 65-year-old male was treated by supraglotic laryngectomy. This controversial tumor is analyzed and guidelines are given for its clinical and histological (immunohistochemical) diagnosis and treatment.