Francisco J. Avilés Jurado

Importancia del diagnóstico diferencial en rinología: hamartoma respiratorio adenoepitelial

INTRODUCTION Respiratory epithelial adenomatoid hamartoma (REAH) is an uncommon lesion of the nasal and paranasal sinuses. It was first described in 1995 by Wenig and Heffner, and only about 60 cases have been published since then. MATERIAL AND METHODS We present 6 case studies of nasal cavity hamartoma diagnosed and treated at our institution between 2005 and 2010. We also conducted a literature review and comprehensive study of the differential diagnosis of this condition, both clinical and pathological. RESULTS The male-female ratio was 5:1, with a mean age of 63.1 years. The most frequent symptoms were nasal obstruction, rhinorrhea and loss of smell. All cases were treated with endoscopic sinus surgery, without recurrences in the follow-up period (28.2 months; SD=11.5 months). CONCLUSION We suggest that differential diagnosis should be made on the basis of nasal polyps, antrochoanal polyps, inverted papilloma and low-grade adenocarcinoma. This review of published cases is of equal interest to both pathologists and otorhinolaryngologists.

Miringoplastia: seguimiento auditivo y estudio de factores pronósticos

Resumen Objetivo Realizar un estudio a 5 anos de la audicion de los pacientes sometidos a miringoplastia a fin de probar si la restitucion timpanica tiene correlacion con la mejora auditiva. Se investigan tambien posibles factores predisponentes al fracaso y averiguar si podemos describirlos como factores pronosticos. Material y metodo Se realiza estudio tipo serie de casos y una revision de las miringoplastias realizadas en nuestro centro en los anos 2000, 2001 y 2002. Se revisaron 83 historias y se estudio el cierre de la perforacion, la funcion auditiva prequirurgica, posquirurgica y a 5 anos, asi como diferentes factores relacionados. Resultados Se obtiene un cierre de la perforacion en el 75,9 % de los casos. En cuanto a la funcion auditiva, obtenemos una ganancia sin significacion estadistica de 1,5 dB a los 5 anos. La evolucion auditiva presenta una mejora posquirurgica y un empeoramiento posterior, ambos estadisticamente significativos. Se ha obtenido una relacion estadistica en el tamano de la perforacion y el estado del oido contralateral. Conclusiones Se presenta un resultado de cierre de la perforacion acorde con la mayoria de las series. El estado patologico del oido contralateral y la extension de la perforacion son factores de mal pronostico de la miringoplastia.

[Myringoplasty: auditory follow-up and study of prognostic factors].

Abstract Objective To perform a 5-year study of hearing evolution in patients undergoing myringoplasty to determine whether eardrum repair correlates with improved hearing. We also studied factors that might predispose to failure and their usefulness as prognostic factors. Material and method In a serial case study, we reviewed all myringoplasties performed at our centre during 2000, 2001, and 2002. We reviewed 83 case histories and studied the closure of the perforation, auditory function pre-operatively, post-operatively and after 5 years, as well as different associated factors. Results The perforation was closed in 75.9% of cases. The mean gain of auditory function was 1.5 dB at 5 years, without statistical significance. The hearing evolution presented a postsurgical improvement and a subsequent deterioration, both statistically significant. We found a statistically significant relationship between the size of the perforation and the condition of the contralateral ear. Conclusions Perforation closure in our series (75.9%) is similar to that reported in the literature. We found contralateral ear pathology and the perforation extension to be associated with poor prognosis after myringoplasty.

Stapedotomy Outcomes in the Treatment of Otosclerosis: Our Experience

Objective The main objective of our study is to identify whether there is measurable audiometric deterioration in patients undergoing stapedotomy with a follow-up of more than 8 years. Material and method We conducted a retrospective clinical study in which we reviewed a total of 150 case histories of patients with stapedotomy at our department between 1993 and 1997, with a successful initial audiological assessment using tone audiometry in the first 3 months after surgery and later audiometrical follow-up. Results We obtained a significant mean post-operative hearing impairment of 1.02 dB per year, with a pre-operative mean PTAof 51.45 dB, going on to early post-operative mean PTAof 26.71 dB, and later post-operative mean PTAof 35.42 dB, with all these changes turning out to be statistically significant. Conclusions The auditory level obtained after surgery worsens as the years go by, but always without exceeding the hearing loss prior to surgery.

Abnormal internal carotid artery in the middle ear and severe otorrhagia after myringotomy

Abstract We present a clinical-surgical case of a 72-year-old woman referred from another hospital due to presentation of otorrhagia following myringotomy. We later determined by means of imaging studies that it was a case of an aberrant internal carotid artery. All masses in the middle ear, especially pulsing masses, must be studied by imaging methods such as computerized tomography and, preferably, magnetic resonance angiography.

Arteria carótida aberrante. A propósito de un caso

Los autores presentan un caso clinico-quirurgico de una mujer de 72 anos de edad, remitida desde otro centro hospitalario por una otorragia grave tras una miringotomia. Mediante estudios de imagen se determino que se trataba de un caso de arteria carotida aberrante de oido derecho. Toda masa en oido medio, especialmente las que son pulsatiles, deben ser estudiadas mediante pruebas de imagen como tomografia computarizada y, preferentemente, angiografia por resonancia magnetica.

Clasificación de las resecciones transorales en la orofaringe : propuesta del grupo de trabajo de la Sociedad Catalana de Otorrinolaringología

INTRODUCTION AND GOALS There has been a very significant increase in the use of minimally invasive surgery has in the last decade. In order to provide a common language after transoral surgery of the oropharynx, a system for classifying resections has been created in this area, regardless of the instrumentation used. METHODS From the Oncology Working Group of the Catalan Society of Otorhinolaryngology, a proposal for classification based on a topographical division of the different areas of the oropharynx is presented, as also based on the invasion of the related structures according to the anatomical routes of extension of these tumours. RESULTS The classification starts using the letter D or I according to laterality either right (D) or left (I). The number of the resected area is then placed. This numbering defines the zones beginning at the cranial level where area I would be the soft palate, lateral area II in the tonsillar area, area III in the tongue base, area IV in the glossoepiglottic folds, epiglottis and pharyngoepiglottic folds, area V posterior oropharyngeal wall and VI the retromolar trigone. The suffix p is added if the resection deeply affects the submucosal plane of the compromised area. The different proposed areas would, in theory, have different functional implications. CONCLUSIONS Proposal for a system of classification by area to definedifferent types of transoral surgery of the oropharynx, and enable as sharing of results and helps in teaching this type of technique.

Resultados de la estapedotomía en el tratamiento de la otosclerosis: nuestra experiencia

Objetivo Nos propusimos valorar el deterioro audiometrico de los pacientes intervenidos de estapedotomia, con un seguimiento mayor de 8 anos. Material y metodo Realizamos un estudio clinico retrospectivo en el que revisamos un total de 150 historias de pacientes intervenidos de estapedotomia entre los anos 1993 y 1997 en nuestro servicio, con buen resultado audiologico inicial valorado mediante audiometria tonal en los primeros 3 meses tras la cirugia y con seguimiento audiometrico posterior. Resultados Obtuvimos una media de deterioro auditivo postoperatorio significativa (1,02 dB por ano), con una media auditiva preoperatoria de 51,45 dB, que pasa a una media de 26,71 dB en el postoperatorio temprano, y una media de 35,42 dB en el postoperatorio tardio; todos estos cambios son estadisticamente significativos. Conclusiones El nivel auditivo obtenido tras la cirugia empeora con el paso de los anos; pero siempre sin sobrepasar la perdida auditiva previa a la cirugia.