Anales otorrinolaringologicos ibero-americanos最新文献

Tuberculosis is the chronic granulomatose most common infection of the larynx. It appears generally from pulmonary tuberculosis. It prevails in men. The most habitual symptomatology includes dysphony, odinophagy, referred otalgy and sometimes dispnea. The majority of patients use to have radiological pulmonary affectation to the diagnosis. The nodular exophitic or ulcerous lesions can be confused with carcinoma, therefore in these cases the anatomopathologic study is essential. The diagnosis is made with positive spit samples, specific characteristics of the thorax radiography and the positive biopsies of acid-alcohol resistant bacillus. We present the patients diagnosed with laryngeal tuberculosis in our hospital between 1994 and 2004. We describe the diagnostic procedures realised and the adopted therapeutic attitude in every case and results.

Churg-Strauss Sindrome or allergic granulomatosis is a small vessel systemic vasculitis characterized by asthma, hypereosinophilia and necrotizing vasculitis with extravascular eosinophil granulomas. We describe a case assisted in our hospital who presented pulmonary infiltrates, fever, peripherical neuropathy, weight loss, myalgia, rhinosinusitis, with antecedents of nasal polyposis, and facial edema. Our aim is to review the main otolaryngologic manifestations of this rare illness that is treated with oral corticosteroids, immunosupresor drugs like ciclofosfamide and plasmapheresis.

The more common symptoms of the jugulotympanic paragangliomas are hearing loss, tinnitus and palsy of cranial nerves. Diagnosis is often delayed due to the slow growth of the tumour. We report one case with affectation of jugular foramen which clinically debuted as a peripheral vertigo and the diagnosis was made by CT, IRM and angiography. The patient was treated by Neurosurgery using Gamma Knife (radiosurgery) with good result.

We report an atypical case of sudden and unspecific cervical cellulitis in a 74 yaers old woman with psoriasis as the only remarkable antecedent. After the initial exploration and successive ones we did not find any etiological causes for her symptoms. CT showed an increase of soft parts on the left side of the neck with displacemnet of the upper airway without purulent collection or abscess. The patient was admitted in IUC and was treated endovenously with cloxaciline and imipenem with good response and satisfactory evolution.

The rabdomiosarcoma (RMS) are infrequent tumors. They are principally described in infancy and located in 35% of the cases in head and neck. The nasopharynx localisation is relatively rare, being in these cases the tongue, palate and oral mucosa the preferent places of establishment. Classically the patient presented very low standard healing with surgery and radiotherapy. The introduction in the middle 70 of systematic chimiotherapy as complementary treatment, improved the survival rate in large scale. In this article the case of an adolescent patient, who presented a RMS at the level of the soft palate, the diagnostic procedure and the therapeutic decision adopted, after revision of the last studies at this respect, are described.

Primary ciliary dyskinesia is a disorder characterized by the presence of recurrent infections of the superior and inferior respiratory tract. It is caused by a recessive autosomic genetic disorder. Its diagnosis is often given late, because other diagnostic possibilities are thought of first. It is common to find many previous visits to the ENT specialist in a medical record. The final diagnosis is given by electronic microscopy observing the ciliary defect, which is frequently due to the absence or anomalies of dineine in the arms and in the structures of the microtubule pairs responsible of movement. The mucus to study is usually obtained from the inferior nasal concha. In the rest of cases the mucus of the tracheobronchial apparatus is only studied if a fibrobronchoscopy is necesary in order to evaluate bronchial compromise or when the nasal sample is not sufficient. The ENT specialist must be alert in order to be able to think of this entity. The genetic advice is the best way to prevent it.

Objective: To evaluate the utility of rapid or turbo intraoperative parathyroid (PTH) assay in the surgery of hyperparathyroidism. Since 2000 to july 2004 we have used this test on 39 patients. 24 of them corresponded to primary hyperparathyroidisms and 15 to secondary forms. Our results showed a PTH decreasing percentage >70% at 15 minutes in 92.3% of the cases. Only in two patients (5.1%) persisted the hypercalcemia after the surgery and one was reoperated with good clinic evolution. As advantages we stand out the reduction of surgical time, permitting unilateral parathyroid exploration instead a bilateral in primary HPT, and the prediction of success by confirming the excision of all hyperfunctionating parathyroid tissue in patients with multiple gland hyperplasia.

This is a retrospective study of 8 patients with postseptal orbital cellulitis (stages II-V of Chandler) caused by sinusitis during 1999-2003. The variables analyzed in this study included age, sex, delay in diagnosis, aetiology, imaging studies, microbiology specimens collected and treatment. Delays in diagnosis were frecuent. CT was the best radiologic study. Polymicrobial infections were the rule, including anaerobes. 4 patients of 8 needed surgical drainage. A general guideline for the management of periorbital and orbital cellulitis according to the clinical staging of the process is presented.

Amyotrophic lateral sclerosis is a progressive degenerative neuromuscular disease of insidious onset. It involves upper and lower motor neurons and causes both spastic and atrophic muscular symptoms. More than one fourth of patients have complaints relating to the head and neck (bulbar palsy); thus, the otolaryngologist may be the first physician to see them. In bulbar forms of Amyotrophic Lateral Sclerosis, voice and/or swallowing difficulties are often the initial signs of disturbance. Predominant symptoms are slurred speech, hoarseness, dysphagia, and dyspnea. Muscular weakness, atrophy, and fasciculation are noted on examination. We show a case and revise bibliography.

The most feared complication for the ENT specialists in the adenotonsillectomy is the immediate or mediate haemorrhage after surgery. We revise the literature and contrast experiencies with other colleage. We have found an astringent substance (bismuth subgallate), which helps us give an exact intraoperative diagnosis of the bleeding spot by the colour contrast it shows, and serves us also as a hemostatic, since it activates the XII factor in coagulation. We revise this product regarding its origen, prentation, applications and toxic effects.