Biomedical subjects
Publications and source records attributed to A Clarós.
We present an 8 years patient old with a giant dilatation of the vestibular aqueduct associated with profound and progressive bilateral sensorineural hearing loss. The patient received a cochlear implant and during the surgery a pulsatile clear fluid via the cochleostomy was observed, without gusher. We present all the problems, and offer some advices for this kind of surgery.
We expose our experience in obstructive sleep apnea syndrome (OSAS) in the pediatric population and review the literature. Forty-six nocturnal respiratory polygraphies were performed using a portable device (Eden Trace II Plus) that measures heart rate, chest wall impedance, nasal/oral airflow and oxygen saturation. Seven children have been studied before and six weeks after Adenotonsillectomy. All this children experienced an immediate and important improvement of their obstructive symptoms. After Adenotonsillectomy the number of obstructive sleep apneas disminished up to 87.25% and the number of hypoapneas disminished up to 73.3. The arterial oxygen saturation during the night normalized in the seven patients. The initial treatment of OSAS in children should be the Adenotonsillectomy, although the diagnostic criteria of OSAS in children have to be defined more precisely in the future.
Topical drug use can produce locally adverse effects by direct action or systemic effects as a result of drug absorption. Local tolerance of topically-administered ciprofloxacin (ear drops) and serum antibiotic levels after 7-10 days of treatment were evaluated in 30 children with tympanic membrane perforation and suppuration. There were no signs of local intolerance or ototoxicity and significant serum ciprofloxacin levels were not detected. We conclude that ciprofloxacin ear drops can be safely used in children with suppurative otitis media and tympanic perforation.
Agenesis, aplasia and hypoplasia of the internal carotid arteries (ICA) are rare congenital disorders with few descriptions in the otorhinolaryngological literature. We present two cases of major abnormalities of the ICA, one with isolated hypoplasia and another with agenesis associated with ear malformation and facial palsy. We briefly review the normal anatomy and discuss the main aspects of these malformations.
Langerhans' cell histiocytosis is a rare pathology that implies an abnormal proliferation of these kind of cells associated with granular infiltration that affects different structures of the human body, including the temporal bone. The middle ear and the mastoid are mostly involved (61%). The inner ear is more resistant to the destruction caused by the granulation tissue, but when occurs, an irreversible neurosensorial hearing loss appears. The early diagnose and the choice of the therapeutical sequences are essential to avoid these lesions.
Nasal gliomas are neurologic malformations that should be considered in the presence of a congenital nasal mass. Appropriate pre-operative examination must be performed to identify a possible connection with CNS, which is present in 15-20% of the cases. This examination should determine whether initial craniotomy is necessary. Here, we report five cases and review the main characteristics and management of this pathology.
PTFE-e patches were used in nasal augmentation in 14 patients with a four-year follow-up. This material was chosen because it is inert and biologically compatible with human tissue. None of the patients in which this material was used had intolerance reaction, skin changes, material extrusion, or signs of infection. A review of the world literature showed no cases of poor results with PTFE-e. It is concluded that the best material for nasal augmentation is autologous material, but if not available or difficult to obtain, PTFE-e is the most acceptable synthetic material and produces good results.
Primary localized amyloidosis of the nasopharynx is a rare disease. We present the case of a 13-year-old girl, to our knowledge only the second pediatric case reported in the literature. Symptoms were nasal obstruction and bleeding from the oral cavity. Physical examination revealed a mass in the nasopharynx and left side of the soft palate. The diagnosis was made by biopsy and histopathologic study of the surgical specimen. Immunohistochemical study revealed amyloid light chains (AL). The main treatment was surgical. At follow-up 9 months later, no recurrence had developed. While rare, localized amyloidosis should be considered in the differential diagnosis of nasal obstruction, epistaxis and glue ear, and must be recognized and understood by the otolaryngologist to allow appropriate diagnostic and therapeutic planning.
We present a case of an intranasal encephalocele in a 6-year old girl, that appears as an intranasal mass with CSF rhinorrhea. The surgical treatment is described, specially the extracranial step through a paralateronasal via. The embryogenesis, classification, diagnosis and management of these rare congenital lesions are discussed.
A case of recurrent meningitis associated with spontaneous cerebrospinal fluid (CSF) rhinorrhea and left sensorineural hearing loss in a 4-year-old boy was found to be due to simultaneous congenital defects. High resolution CT examination clearly showed an anterior fossa defect and an inner ear malformation, including demineralization in the region of the footplate of the stapes, and thus provided clear guidance for the surgeon.
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A male patients, two months of age, was affected by a rapidly growing tumor on the left side of the mandible. There were no other clinical or pathological signs. A thorough examination, as well as radiographic, tomographic and tomodensitometric tests showed the presence of a tumor on the maxilla. It was of low density, encapsulated and shifting the germinal teeth. Surgical removal revealed a melanotic neuroectodermal tumor typical of that in children. The tumor recurred in the same location and was actually larger, less than a month after the operation. A new screening was done for vanilmandelic acid and radiographies of the skull base and skeletal series were negative. The patient was operated on again, with the same histological diagnosis. The diagnosis and treatment are discussed.
The recurrent meningitis associated with spontaneous CSF rhinorrhea in a 4-year-old boy was found to be due to simultaneous congenital defects. There was a dehiscence of the anterior fossa associated with congenital changes in the temporal bone, the petrous bone and the stapes. All these defects were visible including demineralization of the footplate stapes region. The high-resolution X-ray CT served as a clear guide to the surgeon.
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A preparation of interferon-alpha 2C of high purity formed by recombinant DNA technology was used as adjuvant therapy following removal of laryngeal papillomas by cauterization or laser vaporization. Preliminary data on 20 patients are reported and include 11 complete and 7 partial responses. Side-effects included initial temperature elevation, but this subsided and other side-effects were uncommon. No antibodies to the interferon preparation were found in any of the patients.
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Explore the source record for details and available documents.