Anales otorrinolaringologicos ibero-americanos最新文献

We report the case of a 14 years old girl patient with recurrent tonsillitis who had been diagnosed and admitted previously with Plaut-Vincent's angina. Six weeks after leaving the hospital she was assited in Emergencies by an infectious mononucleosis associated to unilateral tonsillar necrotizing ulceration from which a sample was taken to microbiological exam finding the fusospirochaetal complex Borrelia vincenti and Fusobacterium necrophorum. A literature review at the respect of such association and its treatment is performed.

Cartilaginous tumors of the larynx are rare. Only a 2-5% of all chondrosarcomas arise on head and neck area while the laryngeal forms represent less than 1% of the malignant neoplasms in that location. Laryngeal chondrosarcoma is three times more frequent in men than in women with average age of presentation about the 6th - 7th decades. Most of them are originated on cricoid (70-75%) followed by the thyroid cartilage (10-20%) as in the case that we are reporting. Its growth often is very slow with delayed clinic being hoarseness, dyspnea and dysphagia the most common symptoms. Laryngeal chondrosarcomas use to be tumors with low-grade of malignancy and their elective treatment is surgery preserving the laryngeal function. Local and late recurrences are frequent and the definitive diagnosis is the anatomopathological exam.

We report the clinical case of a 39 years old female diagnosed as a chronic lymphocytic tiroiditis by F.N.A.B. with multinodular goiter of long evolution. The patient was operated by total thyroidectomy and her final anatomopathologic result was papillary carcinoma diffuse sclerosing variant. During the surgical act several cervical nodes were detected and removed being informed the most of them as metastasic. A review of the literature at respect of this malignant neoplasm is performed.

Introduction: Peritonsillar infections are the most frequent deep infections in head and neck. The estimated annual incidence is 30 cases per 100.000 inhabitants.

Patients and methods: A retrospective study was undertaken in 132 patients with peritonsillar infection. A diagnostic and therapeutic protocol was used consisting on diagnostic needle aspiration, incision and drainage and intravenous antibiotic and steroids.

Results: 35,6% were peritonsillar phlegmons and 64,4% were abscesses. The median of hospital monitoring was 9,2 hours. Only 25,8% were admitted to the hospital. Six patients had recurrences of the symptoms during the study.

Discussion: The needle aspiration is useful in differential diagnosis between phlegmons and abscesses. Bacteriologic studies are not necessary in the routine management of peritonsillitis. Surgical treatment of these patients is controversial. Incision and drainage seems to be appropiated in the management of this pathology. Admission to the hospital is not always necessary if a correct outpatient control is possible.

Retropharyngeal phlegmons and abscesses in the adult are uncommon nowdays. We report the case of a 48 years old male diagnosed as retropharyngeal phlegmon of idiopatic cause because no reasons were able to justify the clinical symptoms. Cervical CT was negative for purulent collection and the patient was treated by endovenous antibiotics and steroids until the resolution of his process. The final hospital stay was 12 days and after 10 years follow-up he has not been readmitted due to that pathology.

We report the case of a female patient who consulted to the Room Emergencies due to abundant watery otorrea of 3 months without another symptom or apparent cause. The studys confirmed the presence of cerebrospinal fluid (CSF) and the imaging tests (CT and MRI) demonstrated the existence of a communication between the right ear and middle cerebral fossa through tegmen timpani. The woman was operated by ORL (closing the fistula) and neurosurgery (placing an external lumbar drainage) with good postsurgical evolution.

About 25%-30% of the primary malignant melanomas occur in the head and neck region and of these less than 10% arise on the external ear, mainly on helix and the lobule of the pinna. Melanoma thickness and nodal or distant metastases are advers factors for its prognosis. We report a case of a tumor that affected the right pinna and was removed by our ENT, department with good evolution, being the patient free of disease after 5 years follow-up.

Berger's disease, so called IgA nephropathy, is a mesangioproliferative glomerulonephritis characterized by recurrent episodes of gross hematuria in relation with ENT infections like tonsillitis. We report a clinical case which presented that association and make a review of the literature about the possible advantages of tonsillectomy on the evolutive course and prognosis of the nephropathy.

Presbycusis is characterised by a sensorineural hearing loss, mainly in high frequencies, symmetrical and progressive and poor understanding. Recuritment, typical in cochlear hearing loss, would be present in cases of sensorial presbycusis which runs mainly in cochlear pathologies. We analyse variables and their possible interrelations with recruitment in 241 presbycusic patients.

The obstructive sleep apnea syndrome (OSAS) is frequent in infancy and childhood. It is caused by a prolonged upper respiratory airway obstructioon during sleep, and adenotonsillar hypertrophy is the most important cause. OSAS may have an impact on physical and cognitive development, but syntoms in children are subtle and may pass unrecognised. Polysomnography is the gold standard technique for OSAS diagnosis and surgical approach with adenotonsillectomy is the most frequently treatment indicated. Early diagnosis and treatment and adequate follow up are important to prevent physical disturbances secondary to chronic hypoxemia and to avoid cognitive deficits associated with disrupted sleep architecture.