Anales otorrinolaringologicos ibero-americanos最新文献

This is the case of a middle-aged male with a slow growing lateral cervcal painful tumour, and without previous history of local trauma. Radiological testing reveals an ossifying soft tissue lesion without any osseous compromise. The lesion is completely resected, and the histological result is of ossifying myositis. It is an osseous tumour non neoplastic that originates within muscle and in particular the flexors of the inferior extremities and thigs or in the soft tissues. The incidence within the head and neck region is low (20%). There is an hereditary progressive form, Munchmeyer's disease, and another circumscribed, which can be subdivided in traumatic or atraumatic.

The complexity of the embriologic development of the neck and the possible abnomarlies in this process, with the consequent posterior manifestations make necessary the knowledge of the embriologic anatomy of the neck. In the possible manifestations that can be of the anomalies of the development of the branchial archs are the abnomarlies of the first branchial archs. They are, in the anomalies of the development of the branchial archs infrequent and are intimately related with the facial nerve. We present a clinic case of a seven years old boy affected by this pathology and revise its more important aspects.

Mucosal melanomas of the nasal cavity and paranasal sinuses are rare and agresive neoplasms and carries a bad prognosis. The diagnosis may require confirmatory immunohistochemical stains (S-100 protein, HMB-45, vimentin and cytokeratine). The clinical records of 6 patients with the diagnosis of sinonasal melanomas between 1991 and 2005 were retrospectively reviewed. The mean age was 70 years (range 51 to 83 years), there were 2 men and 4 women. Surgery was performed in four patients, adjuvant radiation therapy was used in one patient after local recurrence and chemotherapy in three patients. Three of four patients (75%) had a recurrence after previous treatment (surgery). The actuarial disease-free survival for this group of 6 is 33.3% (2 of 6). Mucosal melanoma of the head and neck remains a difficult disease to treat, with high locoregional recurrence rates and poor prognosis.

Mucoceles are strictly defined as chronic, expanding, mucosa-lined lesions of the frontal sinus and containing insipissated secretion. We present a 48-years-old female who complains right periorbital and frontal swelling of approximately 1,5 years duration. Radiological and exploratory findings confirm the diagnosis of infected mucocele (pyomucocele). Under general anesthesia an endoscopic sinus surgery was performed. One year later, the patient is alive and well with no evidence of primary disease.

Tonsillectomy is one of the more frequent surgical techniques in the otolaryngological practice. In the first century A. D., Cornelius Celsus in Rome described the removal of the tonsils. Since them, devices used for tonsillectomy included a wide variety of instruments as snares, guillotines, scalpels ("cold" and ultrasonic), forceps and lasers. Likewise, the improvement of the anesthetic procedures and the perioperative management have contributed greatly to success with this surgical procedure. To sum up, the instruments and procedures used for tonsillectomy have evolved to render it a precise operation.

Inflammatory myofibroblastic tumors (IMT) of the larynx are uncommon lesions that easily may be misinterpreted as malignant epithelial or mesenchymal spindle cell neoplasms. When located in the upper airway, IMTs tend to be less aggressive, but have the potential for local invasion and recurrence. The authors describe a rare case of IMT in a 47 year old man, occurring in the vocal fold who underwent surgical treatment five times, because of its higher recurrence rate.

Oto cerebrospinal fluid leakage occurs frequently in skull base fractures but it is not always recognized which may produce potentially serious consequences on the prognosis. The aim of this study is to present a case of an extended skull base fracture with bad defined symptoms. A male in coma was admitted to our hospital following a road accident. Imaging revealed a fracture that transversally crossed the squamous occipital bone and petrous portions of temporal bone on the right, the sphenoid bone, and the left zygomatic bone. Ten days later the patient regained consciousness presenting symptoms of right complete hearing loss, cephalalgia and fever. Lumbar puncture showed a Gram negative germ growth. After specific antibiotic treatment he underwent surgery with exclusion of the middle ear and the mastoid from outside by obliterating the Eustachian tube, sealing the surgical cavity (subtotal petrosectomy) with abdominal fat and closing the external auditory canal as a blind sac. At the same time, nasal fibroendoscopy was also performed to close the fistulas in the sphenoid region. Since the cephalalgia persisted further CT examination was performed and revealed another fracture rima in the ethmoid bone. Nasal fibroendoscopy was performed again to close this fistula. The symptoms thus disappeared and the patient has continued to be symptom-free during the two years follow-up. Skull base fractures may involve various bone structure (petrous portion of temporal bone, ethmoid, sphenoid, parietal bone). As a result of the complex anatomy of the skull base, the fracture may damage numerous vital structures (cranial nerves, internal carotid artery, cavernous sinus, jugular vein etc) and the dura mater, causing cerebrospinal fluid leak. When the fracture in the petrous bone is transversal, it is highly important not to delay surgery. In fact the otic capsule does not repair but the bone step is covered by a thin layer of fibrous tissue. For this reason patients, with clear damage to the otic capsule, risk meningitis. Fistulas in the ethmoid are the most difficult to diagnose and the easiest to underestimate. It is fundamental to follow the appropriate diagnostic procedure.

We report the case of a 86 years old male who, in the course of a coughing attack, refers spontaneous cervical and pharyngeal pain in addition to hoarness, dysphagia and some dyspnea. His exploration revealed a small right neck hematoma but with infiltration of the orohypopharynx and right hemilarynx for spreading later to posterior pharyngeal wall and left aryepiglottic fold. The patient was sent to ICU although he did not required a control of airway by intubation or tracheotomy finally.

It's defined tinnitus as an auditive perception of internal origin that it does not answer to vibratory external action. The rest of the sounds are considered as real biological noises and not properly as tinnitus. Tinnitus is a very common symptom in our practice. It is important to determine what causes it, since medical treatment is effective in some cases and prevents serious complications, severe bleeding and neurological consequence if any surgical treatment is carried out. We present two cases of tinnitus of vascular origen, the first caused by venous malformation and the second by an arterial one. We review the literature of this entity.

Introduction: Mechanical stapling devices have long been used in the operating room and have been extensively discussed in the literature of laparoscopic surgery, abdominal surgery and gynecologic surgery. However, this technique has not been commonly used in Oral and Maxillofacial surgery.

Objective: To explain the application of stapling devices in head and neck surgery. Their use may help to reduce total operative time and reduce postoperative morbidity. We present the use of staplers in some patients.