Natércia Silvestre

Sarcoma mieloide del hueso temporal

A 69-year-old male previously diagnosed with acute myeloblastic leukemia secondary to myelodysplastic syndrome (LMA with dysplasia, karyotype 46XY, and no cytogenetics abnormalities) refractory to treatment (hydroxyurea, cytarabine, mitoxantrone, and azacitidine) presented with right-side otalgia, otorrhea, and deafness with 2 months progression. He had been treated with oral ciprofloxacin, eardrops with dexamethasone + neomycin + polymyxin B and ibuprofen without success. Otoscopy showed polypoid tissue in the concha of the auricle, otorrhea, and tympanic membrane purple bulging (Fig. 1). Patient was hospitalized with the suspicion of malignant external otitis, and intravenous ciprofloxacin, ceftazidime, and meropenem were prescribed. Investigations revealed hemoglobin 8.6 g/dL, leucocytes 43.2 × 10 g/L, platelets of 24 × 10 g/L, and negative blood cultures. Head computerized tomography (CT) demonstrated tissue fullness of right antrum, mastoid, and

Granulomatosis de Wegener del oído

Wegener’s granulomatosis (WG) is a systemic vasculitic disease characterized by necrotizing granulomas and vasculitis of small vessels. Upper airway tract involvement is frequent over the course of the disease. Cytoplasmatic pattern antineutrophil cytoplasmic antibodies (c-ANCA) are highly specific for WG in the active phase. Proteinase 3-ANCA (PR3-ANCA) positivity is usually associated to progression from localized to systemic disease.

Type II and Type III Tympanoplasties: A 10-Year Revision

Objective: Portmann’s type II (T2) and III (T3) tympanoplasties are often performed for the treatment of chronic ear pathology. This study aims to assess the epidemiological and functional differences between type II and III tympanoplasties, trying to find functional predictors of success. Method: Observational retrospective study of 171 patients undergoing a T2 or T3 surgery in a tertiary hospital between 2000 and 2009. Age, gender, side, surgical technique, type of prosthesis, disease activity, malleus presence, type and use of cartilage, preoperative and postoperative air-bone gap (ABG), and pure tone average (PTA) were recorded. Results: A total of 171 cases (119 T2 and 52 T3) were pooled with a mean age of 38.6 ± 16.0 years. T2 had a preoperative ABG of 28.1 ± 8.5 dB and PTA of 47.1 ± 15.2 dB, while T3 showed a 32.8 ± 8.0 dB ABG and a 51.4 ± 20 dB PTA (P < .05), suggesting that preoperative ABG and PTA are predictors of the type of surgery to perform. The average improvement was 9.69 ± 13.8 dB and 7.0 ± 11.8 dB for tympanoplasty type II and III, respectively (P < .05). Functional success was significantly different between T2 (82%) and T3 (63%, P < .05). We found no predictors of functional success relatively to epidemiological factors or otological characteristics in the multivariate analysis. Conclusion: Our data suggest that the preoperative ABG and PTA are predictors of the type of what tympanoplasty to perform as well as predictors of functional success in both T2 and T3. Functional success is greater in T2 rather than T3.