[Validation parameters of otoemissions with Echocheck]. / Parámetros de validación de otoemisiones con el Echocheck.

GOALS: There are several papers that support the use of Echocheck system to exclude neonatal hypoacusis, but none of them compare it with the ILO systems, neither compare the internal parameters obtained versus those from a colour coded system. We are trying to demonstrate that both techniques are equivalent and valid. METHODS: Acoustic otoemissions were studied in four hundred and ninety four (494) newborn ears using Echocheck. They were classified as Normal, Not valid, No EOAEs and Invalid using a colour coded system. After this they were compared with the internal results registered by the system. On the other hand, otoemissions were obtained using both methods (Echocheck and ILO-88) in 135 ears and the results compared. RESULTS: The correlation between the results obtained through the colour coded system and those obtained from the internal register was absolute for those parameters previously determined. For the comparison between both systems, results did coincide in all cases except for two, in which there were only results with ILO and not with Echocheck. CONCLUSIONS: The validity of the test using this new system as well as the comparison of the results with those obtained from ILO systems has been demonstrated, therefore its use has been recommended for the early detection of hypoacusis in newborn due to the fact that it is simple to perform.

Parámetros de validación de otoemisiones con el Echocheck® / Eoaes (evoked oto acoustic emissions) validation parameters with Echocheck®

Objetivos: Aunque existen trabajos que demuestran la utilidad del Echocheck® en el despistaje de la hipoacusia en neonatos, ninguno lo compara con los sistemas ILO® ni tampoco han sido cotejados los resultados que el aparato muestra mediante un código de colores con los parámetros internos que genera. Se pretende demostrar que ambas técnicas son equivalentes y válidas. Métodos: Se estudiaron mediante otoemisiones acústicas 494 oídos de recién nacidos vivos usando el sistema Echocheck. Se clasificaron en Normales, No Válidos, Falta e Inválidos según un código de colores. Posteriormente se cotejaron con los resultados internos registrados por el aparato. Por otra parte se detectaron las otoemisiones en 135 oídos con ambos sistemas y se compararon los resultados obtenidos. Resultados: La correlación entre los resultados externos determinados mediante el código de colores y los registros internos fue absoluta según los parámetros previamente determinados. En la comparación mediante los dos sistemas, los resultados coincidieron excepto en dos pruebas en las que faltaron las otoemisiones con el Echocheck estando presentes con el ILO. Conclusiones: Queda demostrada la validez de la prueba con este nuevo sistema, así como la equiparación de sus resultados con los obtenidos por los sistemas ILO®, recomendándose su uso para la detección precoz universal de todos los recién nacidos vivos por la sencillez de su manejo (AU)

GOALS: There are several papers that support the use of Echocheck system to exclude neonatal hypoacusis, but none of them compare it with the ILO systems, neither compare the internal parameters obtained versus those from a colour coded system. We are trying to demonstrate that both techniques are equivalent and valid. METHODS: Acoustic otoemissions were studied in four hundred and ninety four (494) newborn ears using Echocheck. They were classified as Normal, Not valid, No EOAEs and Invalid using a colour coded system. After this they were compared with the internal results registered by the system. On the other hand, otoemissions were obtained using both methods (Echocheck and ILO-88) in 135 ears and the results compared. RESULTS: The correlation between the results obtained through the colour coded system and those obtained from the internal register was absolute for those parameters previously determined. For the comparison between both systems, results did coincide in all cases except for two, in which there were only results with ILO and not with Echocheck. CONCLUSIONS: The validity of the test using this new system as well as the comparison of the results with those obtained from ILO systems has been demonstrated, therefore its use has been recommended for the early detection of hypoacusis in newborn due to the fact that it is simple to perform (AU)

[Bladder transitional cell carcinoma with metastasis to the maxillary sinus as first symptom]. / Carcinoma de células transicionales vesicales con metástasis en seno maxilar como primer síntoma.

Maxillary sinus metastasis are very uncommon tumors (fifty have been reported). The most frequent ones are renal adenocarcinoma, breast and lung tumors. Up to now there is only a reported case of bladder carcinoma in maxillary sinus. We report a 67 years old male with a right maxillary tumor two months ago. FNA demonstrated a transitional cell bladder tumor. The treatment was chemotherapy. The patient died two months later. We reported some considerations about metastatic tumors of paranasal sinus.

[Parapharyngeal space tumor syncope syndrome]. / Síndrome del síncope del tumor del espacio parafaríngeo.

There are several causes of syncopal attacks because of carotid sinus alterations. Recently parapharyngeal tumours have been implicated in its etiology. We reported a man with a cavum tumour who had several syncopes and an haemodynamical angina because of severe bradyarrhythmias. Implicated clinical entities in parapharyngeal space lesions syncope-syndrome, its physiopathological characteristics and differential diagnosis are discussed.

Carcinoma de células transicionales vesicales con metástasis en seno maxilar como primer síntoma / Transitional vesical cell carcinoma with maxillary sinus metastasis as first presentation symptom

Las metástasis sinusales son tumores extremadamente raros. Se han descrito unos 50 casos localizados en el seno maxilar. Las más frecuentes son las del adenocarcinoma renal, seguidas de los tumores de mama y pulmón. Hasta la fecha sólo se había descrito un caso a nivel mundial de metástasis en senos paranasales de un carcinoma de vejiga. Presentamos un paciente de 67 años que debutó con una tumoración maxilar derecha de 2 meses de evolución, que mediante PAAF se encontraba que era una neoplasia de células transicionales cuyo origen se demostró en la vejiga urinaria. Se instauró tratamiento con quimioterapia paliativa falleciendo el paciente al poco tiempo. Efectuamos algunas consideraciones sobre los procesos metastáticos en senos paranasales (AU)

Maxillary sinus metastasis are very uncommon tumors (fifty have been reported). The most frequent ones are renal adenocarcinoma, breast and lung tumors. Up to now there is only a reported case of bladder carcinoma in maxillary sinus. We report a 67 years old male with a right maxillary tumor two months ago. FNA demonstrated a transitional cell bladder tumor. The treatment was chemotherapy. The patient died two months later. We reported some considerations about metastatic tumors of paranasal sinus (AU)

[Otoacoustic emissions screening as early identification of hearing loss in newborns]. / Otoemisiones acústicas como prueba de cribado para la detección precoz de la hipoacusia en recién nacidos.

The aim of this study was to examine the results of transient evoked otoacoustic emissions (TEOAE) as screening test for hearing impairment in newborn infants. We examined 9.951 of 11.405 infants born in our city from January 1st, 1995, to December 31st, 1998. A TEOAE test was performed prior to discharge and repeated one week later in cases who failed the first TEOAE. In case of suspected hearing loss auditory brainstem response (ABR) was performed 3 months later. Hearing loss was defined as ABR threshold > 20 dB. 157 infants (1.5%) were identified with hearing loss. Screening with TEOAE was sufficiently sensitive in identification of congenital hearing impairment and the efficacy increased with the experience.

Síndrome del síncope del tumor del espacio parafaríngeo / Parapharyngeal space cancers syndrome

Aunque son varias las causas que pueden desencadenar cuadros sincopales por alteraciones sobre el seno carotídeo, es reciente su asociación a tumores del espacio parafaríngeo. Notificamos el caso de un paciente con un tumor de cavum que presentó sucesivos síncopes por bradicardias severas y angor hemodinámicos secundarios al mismo. Se discuten las posibles entidades clínicas implicadas en el síndrome del espacio parafaríngeo, así como sus características fisiopatológicas y los diagnósticos diferenciales necesarios (AU)

There are several causes of syncopal attacks because of carotid sinus alterations. Recently parapharyngeal tumours have been implicated in its etiology. We reported a man with a cavum tumour who had several syncopes and an haemodynamical angina because of severe bradyarrhythmias. Implicated clinical entities in parapharyngeal space lesions syncope-syndrome, its physiopathological characteristics and differential diagnosis are discussed (AU)

[Syncope due to parapharyngeal space lesions syncope-syndrome]. / Síncope secundario a síndrome del espacio parafaríngeo.

The clinic association between tumors in the neck and syncopal attacks has been well documented but uncommon. The pathogenesis of this type of syncope has been attributed to an specific sinus node disfunction and several diseases that affect pacemaker activity, cardiac output and blood supply to the brain are able to produce it. The most common reflex cardiovascular sindromes linked to the IX nerve are carotid sinus syndrome and glossopharyngeal neuralgia-asystole syndrome. Some patients with a pathological involvement of the parapharyngeal space also suffers from syncope but the clinical picture of these patients differs so greatly from the other two syndromes, which suggests specific aetiological, clinical and therapeutical features so the term "parapharyngeal space lesiones syncope-syndrome" has been proposed for this entity. We report a case of a patient with a neck tumor in the parapharyngeal space with syncope as the major symptom.

Otoemisiones acústicas como prueba de cribado para la detección precoz de la hipoacusia en recién nacidos / Otoacoustic emissions screening in early identification of hearing loss in newborn

El objetivo de este trabajo fue presentar los resultados de las otoemisiones acústicas evocadas transitorias (OEAT) al utilizarlas como test de cribaje para la detección de hipoacusias en recién nacidos. Nosotros estudiamos 9.951 de los 11.405 recién nacidos en nuestra ciudad, desde el 1 de enero de 1995 al 31 de diciembre de 1998. Se realizaron OEAT a los neonatos antes del alta hospitalaria y se les repitieron a la semana si fallaron las primeras OEAT. Aquellos niños con sospecha de hipoacusia fueron sometidos a potenciales evocados auditivos del tronco cerebral (PEATC) a los 3 meses. Se consideró hipoacusia cuando no se detectó en los PEATC onda V a 20 dB. Ciento cincuenta y siete niños (1,5 por ciento) tuvieron déficit auditivo. El cribaje con OEAT fue suficientemente sensible en la identificación de hipoacusias congénitas, aumentando la eficacia de la prueba conforme mejoraba la experiencia del explorador (AU)

The aim of this study was to examine the results of transient evoked otoacoustic emissions (TEOAE) as screening test for hearing impairment in newborn infants. We examined 9.951 of 11.405 infants born in our city from January 1st, 1995, to December 31st, 1998. A TEOAE test was performed prior to discharge and repeated one week later in cases who failed the first TEOAE. In case of suspected hearing loss auditory brainstem response (ABR) was performed 3 months later. Hearing loss was defined as ABR threshold > 20 dB. 157 infants (1.5%) were identified with hearing loss. Screening with TEOAE was sufficiently sensitive in identification of congenital hearing impairment and the efficacy increased with the experience (AU)

[Neonatal hearing loss screening using otoacoustic emission with Echocheck]. / Detección precoz de hipoacusias en recién nacidos mediante otoemisiones acústicas con Echocheck.

OBJECTIVES: Few studies have been published on neonatal hearing loss screening using the Echocheck system (a new and easy method for detecting otoacoustic emissions). The aim of this study was to demonstrate how, in combination with auditory evoked potentials, this system can be used with satisfactory results for universal screening of all live births. METHODS: Otoacoustic emissions in the 1,000 infants born in our hospital during a 10-months period were checked by Echocheck. According to a preestablished protocol, neonates who failed the first screening test were sent for diagnosis by auditory brainstem responses. RESULTS: Coverage of the test was 99.3%. In 25% of the patients the test was repeated. Deafness was found in eight infants (only in two infants at high risk). The results obtained with this new method were compared with published results for the ILO systems. CONCLUSIONS: Echocheck provides more data than the standard recommended for neonatal hearing loss screening which, together with the results obtained in previous studies, suggests that Echocheck can be used like other systems for neonatal screening programmes. Since it is easy to use and cheaper than screening programmes, this system facilitates universal screening.

Detección precoz de hipoacusias en recién nacidos mediante otoemisiones acústicas con Echocheck / Neonatal hearing loss screening using otoacoustic emission with echocheck

Objetivos: Son escasos los trabajos publicados usando el Echocheck(r), un sistema de fácil uso para detectar otoemisiones acústicas (OEA) para la detección de la hipoacusia infantil de recién nacidos. Se pretende demostrar que, combinado con los potenciales evocados auditivos, este sistema puede ser utilizado para el cribado universal de todos los nacidos vivos con resultados adecuados. Métodos: Se estudiaron mediante la detección de OEA todos los nacidos vivos (1.000 niños) en un período de 10 meses usando el sistema Echocheck(r). Aquellos que no pasaron este cribado, siguiendo un protocolo preestablecido, se remitieron para diagnóstico a potenciales evocados auditivos. Resultados: La cobertura de la prueba fue del 99,3%. Se repitieron en el 25% de los casos. Se diagnosticaron 8 casos de hipoacusias (sólo en 2 niños de alto riesgo). Los resultados de este nuevo método se comparan con los publicados con los sistemas ILO. Conclusiones: Los datos obtenidos superan a los estándares recomendados para los programas de detección precoz de hipoacusia infantil, lo cual, unido a los resultados obtenidos en trabajos precedentes, avalan al Echocheck(r) para ser utilizado de forma idéntica a otros sistemas de detección de OEA, pues su fácil manejo y sus menores requerimientos sin perder por ello efectividad, posibilitan el cribado de los recién nacidos de forma universal (AU)

[Pleomorphic adenoma of the nasal septum. A case report]. / Adenoma pleomorfo de septum nasal. A propósito de un caso.

We report a case of pleomorphic adenoma of the nasal septum in a 66 year-old male. The tumor was treated by subperichondral excision. The tumor was analyzed and guidelines for its clinical and histological (immunohistochemical) diagnosis and treatment are established.

[ENT emergencies in a regional hospital]. / Consideraciones de las urgencias ORL en un hospital comarcal.

Ear, nose and throat emergencies seen at our hospital in a year were studied. The results were compared with the scant literature available. Massive use of hospital emergency services by patients was analyzed.

Adenoma pleomorfo de septum nasal. A propósito de un caso / Pleomorphic adenoma of the nasal septum. A case report

Presentamos un caso de adenoma pleomorfo de tabique nasal de un varón de 66 años que fue tratado mediante excisión subpericóndrica. Efectuamos un análisis de este controvertido tumor, así como establecemos pautas de diagnóstico clínico e histológico (inmunohistoquímico) y de tratamiento con el fin de unificar criterios (AU)

We report a case of pleomorphic adenoma of the nasal septum in a 66 year-old male. The tumor was treated by subperichondral excision. The tumor was analyzed and guidelines for its clinical and histological (immunohistochemical) diagnosis and treatment are established (AU)

Consideraciones de las urgencias ORL en un hospital comarcal / ENT emergencies in a regional hospital

Estudiamos las urgencias de Otorrinolaringología acontecidas en nuestro hospital en un período de un año. Se comparan con las escasas publicaciones existentes hasta el momento y se analiza el porqué de la afluencia masiva de los pacientes a los servicios de urgencias hospitalarias (AU)

Ear, nose and throat emergencies seen at our hospital in a year were studied. The results were compared with the scant literature available. Massive use of hospital emergency services by patients was analyzed (AU)

[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.