Brief guideline for the prevention of COVID-19 infection in head and neck and otolaryngology surgeons.

IMPORTANCE: Anatomically, viral density is greater in the nasal cavity and the nasopharynx. It is to be expected that instrumentation in or through those areas will entail a higher risk of transmission. That's why head and neck and otolaryngologist surgeons are among the most vulnerable health professionals. OBSERVATIONS: Surgeons should essentially perform procedures they require. Surgeries should be performed with personal protective equipment suitable for the high risk of aerosolization: goggles, N95 face mask, facial mask, blood-repelling gown and gloves. It is advisable to have the cooperative COVID-19 test in all patients. Telemedicine is a useful resource if resources allow it. CONCLUSIONS AND RELEVANCE: Otolaryngologists and related specialists are among the groups at higher risk when performing surgeries and upper airway examinations. There are no emergencies in a pandemic. The care of health professionals is crucial to combating this health situation.

Scutumplasty: costal cartilage versus bone paté.

This study was carried out to evaluate the anatomical and hearing results of the reparation of attic defects in closed tympanoplasty. Reparation was carried out in 194 patients by using a costal cartilage allograft, and in 159 patients with a bone pate autograft. The follow-up was from 1 to 5 years. The study was not truly randomized owing to an occasional lack of allogenic costal cartilage. In the group 'costal cartilage' a partial resorption was observed in 5.7% and a complete resorption in 4.7% of the cases. In the group 'bone pate', partial resorption was observed in 5.5% and total resorption in 2.7% of the patients. Satisfactory hearing results were obtained in 86% of the patients of the group 'costal cartilage' and in 82% of the patients of the group 'bone paté'. Both graft materials may be recommended for repairing erosions caused by the cholesteatoma in the wall of the external auditory canal.

[Cholesterol granuloma of the petrous apex]. / Granuloma colesterínico de la punta del peñasco.

Cholesterol granuloma of the petrous apex is a relatively rare tumor, and usually is not associated with middle ear pathology. Precise assessment of the diagnosis and extension allows the surgeon to plan the most appropriate and functional strategy. The advent of magnetic resonance imaging has helped, showing a high signal in T1 and T2 without enhancement after the administration of intravenous paramagnetic contrast. The occipito-temporal approach provides direct access to the anterior and posterior petrous apex without opening the dura, which preserves the facial and the cochlear-vestibular functions.

[Reconstruction of the tympanic membrane using Parmatymp bioprosthetic material. Summary of 20 years of experience]. / La reconstrucción de la membrana timpánica con bioprótesis Parmatymp. Síntesis de veinte años de experiencia.

Autogenous temporal fascia is the material most frequently used for the reconstruction of the tympanic membrane, in spite of certain drawbacks: 1) it is obtained by enlarging the incision or by a supplemental incision; 2) it may be insufficient or absent for reinterventions; 3) it tends to adhere to the middle ear, and 4) it retracts easily when the Eustachian tube is not functioning. This is the synthesis of 20 years of experience with Parmatymp (jugular bovine vein xenograft), a material that is easily available, resistant and suitable for all types of ear surgery.

[Total reconstruction of the posterior wall of the external ear canal with allogenic rib cartilage. Technique and results]. / La reconstrucción total de la pared posterior del conducto auditivo externo con cartílago costal alogénico. Técnica y resultados.

Middle-ear reconstruction using a closed surgical technique has the same surgical stages as in combined-approach tympanoplasty. The only special feature is the reconstruction of the posterior canal wall and scutum, an essential step. This reconstruction process is carried out with allogenic costal cartilage affixed to two deep bony slots with fibrin glue. In 90% of cases surgery is done in two stages.

Sinusitis por pseudallescheria boydii / Sinusitis for pseudallescheria boydii

Paciente de sexo femenino, 48 años, sin antecedentes clínicos de importancia presenta obstrucción nasal, rinorrea y poliposis. La tomografía axial computadorizada revela masa heterogénea en cavidad maxilar y paranasal derechas, fosa nasal con desviación del tabique y erosión ósea. Se efectúa sinusotomía maxilar derecha y del material se aísla pseudallescheria boydii. Recibe tratamiento con anfotericina B 975 mg hasta tipificación del agente etiológico; continúa con itraconazol 200 mg/día hasta la fecha (9 meses) sin recidivas

Sinusitis por pseudallescheria boydii / Sinusitis for pseudallescheria boydii

Paciente de sexo femenino, 48 años, sin antecedentes clínicos de importancia presenta obstrucción nasal, rinorrea y poliposis. La tomografía axial computadorizada revela masa heterogénea en cavidad maxilar y paranasal derechas, fosa nasal con desviación del tabique y erosión ósea. Se efectúa sinusotomía maxilar derecha y del material se aísla pseudallescheria boydii. Recibe tratamiento con anfotericina B 975 mg hasta tipificación del agente etiológico; continúa con itraconazol 200 mg/día hasta la fecha (9 meses) sin recidivas (AU)

Differential changes in CNS phosphatase activities during seizures.

Neutral and alkaline phosphatase activities were studied in small synaptosomes isolated from rat brain and cerebellum after administration of the convulsant 3-mercaptopropionic acid (MP). Cerebral cortex phosphatase activity assayed at pH 7.2 in the presence of K+ increased both during and after seizures; when it was assayed at pH 7.2 in the absence of K+ it decreased at both stages. The enzyme activity determined in cortical fractions at pH 9.0 with or without K+ decreased in seizure and postseizure states. After MP treatment, cerebellum enzyme activity assay at pH 7.2 was higher than in controls throughout; phosphatase activity assayed at pH 9.0 decreased following MP administration except during seizures when the enzyme was assayed in the presence of K+. Such changes following MP treatment may well be related to seizure-induced alteration of phosphate ester levels or protein-kinase activities.

A study of 5'-nucleotidase activity in subcellular fractions of rat cerebellum after the administration of the convulsant 3-mercaptopropionic acid.

The activity of 5'-nucleotidase in cerebellum subcellular fractions after the administration of the convulsant 3-mercaptopropionic acid was studied. This membrane enzyme presented an increase in its activity in certain fractions containing nerve endings and microsomes (Mic20, Mic100) in seizure and postseizure periods. 5'-nucleotidase activity in nuclear and myelin fractions did not show differences between the control and treated fractions. On the other hand, a decreased activity in the crude mitochondrial fraction and in a nuclear subfraction was found. It is suggested that the changes in the enzyme activity in some cerebellum fractions might be related to structural alterations previously observed in this laboratory and with the anticonvulsant actions of adenosine.

Increase of 5?-nucleotidase activity in some brain subcellular fractions after the administration of the convulsant 3-mercaptopropionic acid.

5?-Nucleotidase activity was studied in subcellular fractions isolated from rat brain after the administration of the convulsant 3-mercaptopropionic acid. The results obtained showed that the activity of this membrane enzyme increased in the fractions of the cerebral cortex containing nerve endings and microsomes (Mic(20) and Mic(100)) isolated during the seizure, but not in the post-seizure period. This increase could be observed at pH 7.2 and 9.0 but not at pH 6.5. 5?-Nucleotidase activity in nuclear and myelin fractions did not differ between fractions from control and treated animals. It is suggested that the alteration in enzyme activity found in some brain fractions might be involved in the actions of adenosine during the convulsive seizure.