Tumor de saco endolinfático como causa infrecuente de síndrome de Ménière / Endolymphatic sac tumour as an infrequent cause of Ménière's syndrome

Los tumores del saco endolinfático son tumores raros. Se han clasificado como adenocarcinomas de grado bajo de malignidad y hasta la fecha no se ha documentado metástasis. Presentamos a una paciente con enfermedad de Von Hippel-Lindau y síndrome de Ménière con un tumor de saco endolinfático. El diagnóstico y tratamiento precoz son esenciales para conservar la audición, por lo que se recomienda, ante una clínica sugestiva, realizar un seguimiento durante años (AU)

Endolymphatic sac tumours are uncommon. They have been classified as adenocarcinomas with a low degree of malignancy and no metastases have yet been documented. We report on a female patient with Von Hippel-Lindau disease and Ménière's syndrome suffering from an endolymphatic sac tumour. Diagnosis and early treatment are essential to preserve hearing, so long-term monitoring is recommended when this clinical combination is encountered (AU)

[Endolymphatic sac tumour as an infrequent cause of Ménière's syndrome]. / Tumor de saco endolinfático como causa infrecuente de síndrome de Ménière.

Endolymphatic sac tumours are uncommon. They have been classified as adenocarcinomas with a low degree of malignancy and no metastases have yet been documented. We report on a female patient with Von Hippel-Lindau disease and Ménière's syndrome suffering from an endolymphatic sac tumour. Diagnosis and early treatment are essential to preserve hearing, so long-term monitoring is recommended when this clinical combination is encountered.

[EXIT procedure in the management of severe foetal airway obstruction. the paediatric otolaryngologist's perspective]. / Procedimiento EXIT en el manejo de fetos con severo compromiso respiratorio. La perspectiva del otorrinolaringólogo pediátrico.

The ex-utero intrapartum treatment (EXIT) procedure is a technique designed to allow partial foetal delivery via caesarean section with establishment of a safe foetal airway by either intubation, bronchoscopy, or tracheostomy while foetal oxygenation is maintained through utero-placental circulation. The most common indication for the EXIT procedure is the presence of foetal airway obstruction, which is usually caused by a prenatal diagnosed neck mass. We report three cases of head and neck tumours with airway obstruction treated by means of EXIT and with different solutions in the management of the airway. With the involvement of Paediatric Otolaryngologists in EXIT, new indications and select variations from the standard EXIT protocol should be considered.

Procedimiento EXIT en el manejo de fetos con severo compromiso respiratorio. La perspectiva del otorrinolaringólogo pediátrico / EXIT procedure in the management of severe foetal airway obstruction. The paediatric otolaryngologist's perspective

El ex-utero intrapartum treatment (EXIT) es una técnica diseñada para permitir un parto fetal parcial a través de una cesárea y el establecimiento de una vía aérea fetal segura a través de intubación, broncoscopia o traqueotomía mientras la oxigenación fetal se mantiene a través de la circulación uteroplacentaria. La indicación más frecuente de EXIT es la obstrucción de la vía aérea fetal, habitualmente causada por una masa cervical diagnosticada prenatalmente. Presentamos 3 casos de tumoraciones de cabeza y cuello con compromiso de la vía aérea tratados mediante EXIT y con diferentes soluciones en el manejo de la vía aérea. Con la implicación de los otorrinolaringólogos pediátricos en el EXIT, aparecerán nuevas indicaciones y podrán valorarse variaciones del protocolo básico

The ex-utero intrapartum treatment (EXIT) procedure is a technique designed to allow partial foetal delivery via caesarean section with establishment of a safe foetal airway by either intubation, bronchoscopy, or tracheostomy while foetal oxygenation is maintained through utero-placental circulation. The most common indication for the EXIT procedure is the presence of foetal airway obstruction, which is usually caused by a prenatal diagnosed neck mass. We report three cases of head and neck tumours with airway obstruction treated by means of EXIT and with different solutions in the management of the airway. With the involvement of Paediatric Otolaryngologists in EXIT, new indications and select variations from the standard EXIT protocol should be considered

[Morphometric study of the mastoid segment of the facial nerve]. / Estudio morfométrico del tercer segmento del nervio facial.

OBJECTIVE: Our study emphasizes the relationship between the temporal bone structures and the mastoid portion of the facial nerve. MATERIAL AND METHODS: Thirty-two temporal bones taken from adult cadavers of both sexes subjected to tympanoplastic procedure were used to make reference measures of the mastoid portion of the facial nerve. Appropriate instruments were used for measurement and statistic analysis was subsequently performed. RESULTS: The digastric ridge presented a positive correlation with the stylomastoid foramen in comparison with the sigmoid sinus (P=.03). There was a correlation between the position of the short apophysis of the incus and the position of the facial nerve (P=.001). The distance from the sigmoid sinus to the mastoid portion of the facial nerve presents a positive linear relationship throughout its length (P< .001). The tympanic membrane presented a positional correlation with the distal portion of the facial nerve (P< .008). CONCLUSIONS: The mastoid portion of the facial nerve is proportional to reference structures in the temporal bone and this may help us to define measures prior to surgical otologic procedures.

Estudio morfométrico del tercer segmento del nervio facial / Morphometric Study of the Mastoid Segment of the Facial Nerve

Objectivo: Enfatizamos en este estudio la relación entre las estructuras de referencia del hueso temporal y su relación con la tercera porción del nervio facial. Material y método: Nuestro estudio se ha realizado con 32 huesos temporales humanos, provenientes de cadáveres de adultos de ambos sexos a los que se practicó timpanoplastia con el objetivo de hacer mediciones de referencia de la porción mastoidea del nervio facial. Luego se las midió con instrumentos adecuados y se practicó análisis estadístico. Resultados: La cresta digástrica presenta una relación positiva con el agujero estilomastoideo en relación con el seno sigmoideo (p = 0,03). Existe relación entre la posición de la apófisis corta del yunque y la posición del nervio facial (p < 0,001). La distancia del seno sigmoideo respecto a la tercera porción del nervio presenta una relación lineal positiva por todo su recorrido (p < 0,001). La membrana timpánica presenta una relación de posición con la porción distal de nervio facial (p < 0,008). Conclusiones: La porción mastoidea del nervio facial presenta relación proporcional con estructuras de referencia del hueso temporal, lo que nos ayudará a definir medidas previas a intervenciones quirúrgicas otológicas

Objective: Our study emphasizes the relationship between the temporal bone structures and the mastoid portion of the facial nerve. Material and methods: Thirty-two temporal bones taken from adult cadavers of both sexes subjected to tympanoplastic procedure were used to make reference measures of the mastoid portion of the facial nerve. Appropriate instruments were used for measurement and statistic analysis was subsequently performed. Results: The digastric ridge presented a positive correlation with the stylomastoid foramen in comparison with the sigmoid sinus (P=.03). There was a correlation between the position of the short apophysis of the incus and the position of the facial nerve (P=.001). The distance from the sigmoid sinus to the mastoid portion of the facial nerve presents a positive linear relationship throughout its length (P<.001). The tympanic membrane presented a positional correlation with the distal portion of the facial nerve (P<.008). Conclusions: The mastoid portion of the facial nerve is proportional to reference structures in the temporal bone and this may help us to define measures prior to surgical otologic procedures

Roncopatia cronica: Sindrome da apneia obstrutiva do sono (O.S.A.S.) / Chronic rhoncopathy - obstructive sleep apnea syndrome

Os autores tecem consideracoes acerca da O.S.A.S. (Obstrutive sleep apnea syndrome), abrangendo a possivel etiopatogenia, seu quadro clinico, investigacao diagnostica e as alternativas de tratamento para um tema pouco difundido. Procuram alertar para o seu diagnostico o mais precoce possivel, onde as possibilidades de resolucao serao quase totais.