Anales otorrinolaringologicos ibero-americanos最新文献

A case of severe miastenia beginning with dyspnea, secondary to a bilateral larynx paralysis in aduction is presented. During the evolution of the severe miastenia the affectation of the larynx musculature does not result infrequent, but however, after having realized a bibliographic revision, the infrequency resulting in this disease of the beginning through a bilateral larynx paralysis in aduction was verified. A wide exposition of the clinic case, methods of exploration to obtain the diagnosis of severe miastenia, and the different treatment options actually in use to control these disease, are realized.

Lobular capillary hemangioma or pyogenic granuloma is a benign lesion with a focal reactive development of fibrovascular tissue and endotelial proliferation. It can appear to any age in different locations and usually has the aspect of a pediculate mass with or without ulceration zones on the area. Its treatment is the simple surgical removal and the control of the traumatic and infectious influential factors. We report a case of pyogenic granuloma on the floor of the mouth making a literature review at respect of that common clinical entity.

The treatment ofparotid masses is generally surgery. The presurgical assesment is made by clinical examination, radiology and fine needle aspiration (FNA). FNA has been applied for the last decades and has been the subject of many reviews. It is a safe, rapid and economic procedure that can be made as an ambulatory procedure. In this study we have reviewed the parotidectomies performed in our institution during the years 1998 - 2003 where a preoperative FNA was available. The sensitivity of FNA in our hands is 40% and specifity 96.3%. We have also calculated the utility of clinical examination and radiology in the assessment of parotid masses.

The neuroendocrine cervicofacial tumors are proliferative infrequent process in head and neck but no exceptional. They possess a common origin from the cells derivided from the neural crest, that today gathered on the term of neuroendocrine diffuse system (SNED). Incidentally several associated tumors appear, synchronically or metachronically and some of them possess secretor character. We present the clinic cases of 6 patients, with 6 different types of tumor in head and neck, with the common link to belong to SNED. We analyse their clinical diagnostic characteristics, evolution and treatment.

We report a review about 10 cases of phlegmons-abscesses in the floor of mouth (Ludwig's angina) treated by our Service analyzing the following variables: Age, sex, time of evolution, personal antecedents, E.N.T. exploration, clinical symptoms, type of treatment and clinical evolution. This pathology represents one of the most severe forms of cervicofacial diffuse cellulitis; it requires an early diagnosis and therapy which can include an urgent tracheostomy ifthe airway is compromised.

Retropharingeal abscess is a potentially lethal but infrequent infection of the retropharyngeal space, thanks to the use of antibiotics. Caused by a suppurative lymphadenitis secondary to a locoregional infection of the head and neck, it is the most frequent abscess in Paediatric age. It must be present in our differential diagnosis when facing a torpid development of head and neck infectious processes accompanied by adenitis. A cervical lateral X-Ray should be done without delay and in case of doubt, a CAT--scan is mandatory. We protocolise its diagnosis and treatment in order to avoid its serious complications.

The Ludwig angina is an infection of the base of the mouth and submandibular region, frecuently after a dental extraction or a piece in bad state. When it surpassees the milohioid muscle it extends dissecting the superficial aponeurotic planes, and can evolve to a necrotisant fascitis. We present the case of a 67 years old man with a painful tumefaction of the mouth base and submandibular region. The CT reflected an heterogenous submaxilar lesion that extended by the deep cervical fascia introducing itself in the thorax. Under antibiotic treatment the pus was drained by cervicotomy, with daily cures during 3 weeks.

The pathologic processes involving the parotid gland include a vast group of lesions, acute and chronic inflammations, benign and malign tumors, traumas or degenerative processes. We report the case of a 55 years old male diagnosed as left parotid phlegmon with involvement of both lobes, especially the deep one, who required admission and endovenous medical treatment for 6 days up to the resolution of the symptoms.

Unlabelled: The thyrogloss cysts present themselves usually as unique tumorations in the anterior cervical zone, more frequently in the second decade of life and affecting equally the two sexs. They move typically with the movements of deglution and can increase its volume with infections processes. In seldom occasions, the thyrogloss cysts can present symptoms as dysphonia, dysphagia or dyspnea facts that can suggest its laryngeal extension.

Methods: We present a case of a patient affected by dysphonia of long evolution, associated to the presence of a cervical mass. The CT showed a cervical cyst with extension to the left preepiglottic and paraglottic space with compression of the left thyroid wing. Although the clinic impression was a laryngeal neoplasia, the CT helped to realize the diagnosis ofthyrogloss cyst. During the surgery the thyrogloss cyst was removed with success, with the technique of Sistrunk and the patient recovered the voice.

Conclusions: We present this case and realize a bibliographic revision on thyrogloss cysts, with atypical symptoms. We discuss also the role of CT in the diagnostic process in these types of processes.

Laryngeal cysts represent a defined group of benign lesions with an actual not well know pathogenesis although fibrosis and glandular obstruction or congenital origin are presumed rather than new growths. When such cysts occur, as a general rule, with the exception of some particular locations, they develop with very few symptoms until very large size is reached or a fast growth is produced due to bleeding or infection. Under these conditions, these cysts may represent a potential treatening lesion and so surgery is recommended under any circunstance and anaesthetic procedure should be case-addapted. A case of an impressive large epiglottic cyst is presented and a revision and discusion on the controversies and available literature are provided.