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C Morales-Angulo

Publications and source records attributed to C Morales-Angulo.

At least 19 recordsLinked to original sources

[Open rhinolalia, a typical symptom of velo-cardio-facial syndrome].

The Velocardiofacial (VCF) syndrome is a relatively frequent cromosomopathy that usually associates various otorhinolaryngological features, as hipenasal speech, typical facies and auricular anomalies. We report a patient with VCF syndrome that before being diagnosed had undergone adenoidectomy with a postoperative worsening in speech. Otorhinolaryngological clinical features of the VCF syndrome are discussed and a diagnostic protocol is proposed to achieve an early diagnosis and to prevent iatrogenic interventions in these patients.

Child↗

[Prevalence of the 35delG mutation in the GJB2 gene, del (GJB6-D13S1830) in the GJB6 gene, Q829X in the OTOF gene and A1555G in the mitochondrial 12S rRNA gene in subjects with non-syndromic sensorineural hearing impairment of congenital/childhood onset].

INTRODUCTION: The most frequent mutations responsible for non-syndromic hearing impairment in the Spanish population are the 35delG mutation in the connexin 26 gene (GJB2), the del(GJB6-D13S1830) deletion in the connexin 30 gene (GJB6), the Q829X mutation in the otoferlin gene (OTOF), and the A1555G mutation in the 12S rRNA gene of the mitochondrial genome. PATIENTS AND METHODS: Screening for these mutations was performed on 38 patients from Cantabria with non-syndromic sensorineural hearing impairment of congenital/childhood onset. RESULTS: The A1555G mutation was detected in homoplasmy in 9 patients (23.7%). Three individuals were heterozygous for the 35delG mutation (7.9%). The heterozygous del(GJB6-D13S1830) deletion was present in one case (2.6%). One subject was homozygous for the Q829X mutation (2.6%). CONCLUSIONS: These four mutations are present in 36.8% of all cases of non-syndromic hearing impairment in our population.

Adolescent↗

[Etiology of severe/profound, pre/perilingual bilateral hearing loss in Cantabria (Spain)].

OBJECTIVE: To know the etiology of preiperlingual bilateral hearing loss in children. MATERIALS AND METHODS: All the patients diagnosed with bilateral severe/profound, pre or perilingual hearing loss at Sierrallana and Marqués de Valdecilla Hospitals (Cantabria, Spain) during the last 20 years were included in this study. RESULTS: A hundred patients were diagnosed with bilateral severe/profound pre/perilingual hearing loss. The most frequent etiology was hereditary (49%), followed by severe perinatal hypoxia (11%), ototoxicity (5%), meningitis (3%), hyperbilirubinemia (3%) and rubella (2%). In 21% of cases was not known. CONCLUSIONS: The two most frequent etiologies found in severe/profound hearing loss in children in our area were hereditary and non infectious perinatal problems. Infectious disease were scarce. Will decrease when genetic test were used as clinical basis.

Female↗

[Evaluation of a family with sensorineural hearing loss due to the Q829X mutation in the OTOF gene].

OBJECTIVE: To determine the features of hearing loss due to the Q829X mutation in the OTOF gene, the third most frequent mutation causing prelingual deafness reported so far in the Spanish population. MATERIALS AND METHODS: We carried out genetic characterisation of 16 individuals from a consanguineous family from Cantabria, in which 4 members were affected by deafness. RESULTS: All 4 hearing impaired individuals were homozygous for the Q829X mutation in the OTOF gene. The auditory defect was a profound, bilateral, symmetrical, sensorineural hearing loss of prelingual onset. No other clinical alterations were observed. Individuals heterozygous for the Q829X mutation were unaffected. CONCLUSIONS: The Q829X mutation in the OTOF gene causes severe to profound sensorineural hearing loss of prelingual onset. Early detection of individuals carrying this mutation is important for the application of palliative treatment and special education.

Adolescent↗

[Prevalence of the A1555G mutation in the mitochondrial DNA in patients with cochlear or vestibular damage due to aminoglycoside-induced ototoxicity].

OBJECTIVE: To determine the frequency of the A1555G mutation in the mitochondrial genome among Spanish patients with aminoglycoside-induced ototoxicity. PATIENTS AND METHODS: We screened 25 unrelated cases, totalling 39 individuals with cochlear or vestibular damage due to aminoglycoside-induced ototoxicity. This group was made up of 18 subjects from 4 unrelated families with a history of aminoglycoside ototoxicity in more than one relative, 8 subjects from 8 families that also had other relatives with hearing loss in absence of aminoglycoside exposure, and 13 sporadic cases. Among the 13 sporadic cases, there were 3 patients with vestibular involvement. Detection of the A1555G mutation was seen by mean of techniques for molecular diagnosis. RESULTS: The A1555G mutation was identified in all of the individuals from 4 families with aminoglycoside-induced cochlear damage and in 6 of 8 individuals with familial hearing loss. None of the sporadic cases carried the mutation. CONCLUSIONS: A high proportion of patients with cochlear damage due to aminoglycoside ototoxicity and having a familial history of hearing loss, related or not to aminoglycoside exposure, harbor the A1555G mutation.

Adolescent↗

[Incidence of A1555G mutations in the mitochondrial DNA and 35delG in the GJB2 gene (connexin-26) in families with late onset non-syndromic sensorineural hearing loss from Cantabria].

INTRODUCTION: Sensorineural deafness is a very common disorder in humans, which affects approximately 10% of the population. Genetic causes are suggested to be responsible for more than half of the cases. The A1555G mutation in the mitochondrial 12S rRNA gene and the 35delG mutation in the GJB2 gene are the most common mutations for sensorineural deafness in the Spanish population. METHODS: A genetic study was carried out in order to determine the frequency of the mutations A1555G in the mitochondrial DNA and 35delG in the connexin-26 gene in 21 patients from 21 non-consanguineous unrelated families affected by late-onset bilateral non-syndromic sensorineural hearing loss from Cantabria. RESULTS: The A1555G mutation was found in 6 patients. Five of these 6 patients had been treated with aminoglycosides. In all of them the auditory impairment affected mainly the high frequencies. The 35delG mutation was not found in any of the patients. CONCLUSIONS: The A1555G mutation in the mitochondrial DNA has been found to be the most common amongst the Cantabrian population. The A1555G mutation should be suspected in those members of families affected by sensorineural hearing impairment with a maternal inheritance pattern and ototoxicity from treatment with aminoglycoside antibiotics. The 35delG mutation in the GJB2 gene does not seem to be a major cause of deafness in families with late-onset non-syndromic sensorineural hearing loss in our area.

Adolescent↗

[Major ambulatory surgery in otorhinolaryngology].

In the last years we have witnessed a great increase of major ambulatory surgery procedures in our specialty. Some of them are very common as adenoidectomies, tonsillectomies and also the insertion of transtympanic tubes. Nevertheless there is no agreement about which of the procedures should be realized through AMS. The aim of this work is to do a review on the most important features involved in AMS entlightening what kind of operations can be included i such programmes.

Ambulatory Surgical Procedures↗

[Early diagnosis of nasopharyngeal carcinoma].

For making an early diagnosis of nasopharyngeal carcinoma it is fundamental to fulfill three requirements. First a high suspicion index based in the knowledge of symptoms and signs of the malady. Secondly it is necessary the routinely use in the consulting room of a nasopharyngoscope. An in third place is to make, in doubtful cases, an enlarged biopsy under endoscopic control and local anesthesia.

Aged↗

[Hypoglossal nerve palsy and infectious mononucleosis].

Neurologic manifestations are infrequent in infectious mononucleosis and specially hypoglossal nerve involvement is very rare. To the best of our knowledge only 6 cases have been previously reported. We describe herein the case of a 20-years-old man who presented an unilateral hypoglossal nerve palsy secondary to infectious mononucleosis. He was treated i.v. steroids without recovery, but the palsy resolved spontaneously 2 months after the onset.

Adult↗

[Head and neck abscesses].

OBJECTIVE: To review the clinical, microbiological and therapeutic characteristics of all head and neck abscess seen in a Community Hospital. MATERIALS AND METHODS: Medical records of all patients admitted to Sierrallana Hospital (Torrelavega, Cantabria) from January 1995 till June 1998, because of head and neck abscess were reviewed. RESULTS: Fyfty-seven head and neck abscess of 54 patients were considered. Age of patients ranged from 14 to 78-year-old. Periamygdaline region was the most frequent location, where as tonsillar and dental infections were the origins of the abscess in the large majority of cases. Most of the abscess cultures yield mixed flora. Intravenous penicillin was used in 77.3 percent of patients and surgical drainage was required in almost 80 percent of cases. Treatment response was good with no serious complications in any case. CONCLUSIONS: Head and neck abscess are a relative common cause of hospital admissions. Among them periamygdaline abscess are frequently found. The treatment is surgical drainage with local or general anesthesia (depending of location) and simultaneous i.v. course of antibiotic (Penicillin G sodium salt) efficacious in the great number of patients. Serious complications are very rare.

Abscess↗

[Usefulness of the flexible fibroscope with working channel in the treatment of pedunculated polyps of the vocal cords].

INTRODUCTION: Suspension laryngoscopy by general anesthesia is the universally method of performing microlaryngeal surgery for the treatment of vocal cord polyps. Recently a new technique using a flexible endoscope with working channel has been introduced and popularized in Spain for treating these lesions. MATERIAL AND METHODS: A prospective study was undertaken to asses the efficacy of this technique, something modified, for removal either pedunculated vocal cord polyps or with minute implantation basis. RESULTS: Twenty-six consecutive patients with pedunculated cord polyps were surgically removed, at the ENT-Department of Sierrallana Hospital (Torrelavega, Cantabria) from January 1995 till September 1996. In 4 patients with strong gang reflexes the procedure could not be finished. Twenty-two patients improved their voice and were satisfied with the result. In 2 other cases, of the group, the voice regain was not complete, but owing to the feelings of the individuals no more surgical procedures were scheduled. No postoperative aftermath were observed. One year later all cases were checked and all proclaimed their well-being. CONCLUSIONS: We suggest that removal of pedunculated polyps of the vocal cord employing the fibroendoscope with working channel and local anesthetic should be the choix procedure for the lot of patients suffering this pathology, and the microsurgery with general anesthesia must be reserved for failure cases or for those patients using voice professionally.

Adult↗

[Ambulatory septoplasty].

The AA. admit that the septoplasty under general anaesthesia is a surgical procedure that can be realized ambulatory, without added risks to patient. With viewpoint they have done a retrospective survey of the whole group of septoplasties performed under general anaesthesia at Torrelavega Hospital (Santander) in two years, between April 1995 and August 1997. The total number of cases amounted 56 (49 men and 7 women), lasting the procedure, more or less, one hour; postanaesthesia recovery also about 86 minutes and the hospital permanence about six hours and a half. Readmitted were 14 cases, because vomiting (7), for laryngeal spasm (2), bleeding (1), retention of urine (1) and other because vertigo (1), fever (1) and headache (1).

Adolescent↗

[Ambulatory laryngeal microsurgery].

OBJECTIVE: The aim of the present study was to determine if laryngeal microsurgery (LMS) under general anesthesia is a safe and convenient procedure when carried out on an outpatient basis in selected patients. MATERIAL AND METHODS: Seventy-eight adult patients (60 men and 18 women) were scheduled for outpatient LMS under general anesthesia between February 1995 and December 1996. RESULTS: Their age range was 19 to 77 years (mean 48 years). Forty-four (56.4%) were ASA I, 32 (41%) ASA II, and 2 (2.6%) ASA III. Laryngeal biopsy was performed in 40 cases (51.3%), polypectomy in 30 cases (38.5%), excision of Reinke's edema in 5 cases (6.4%), and cyst excision in 3 cases (3.8%). The mean stay in the Day Hospital was 7 hours (range 2.5-10 h). Seven patients (9%) had immediate postoperative complications. Three patients were admitted overnight. No patient had to be readmitted to the hospital after discharge. CONCLUSIONS: Outpatient laryngeal microsurgery is an appropriate and safe alternative to inpatient surgery in carefully selected patients, who are kept under strict observation in the immediate postoperative period.

Adolescent↗

[Diagnosis and treatment of cervical esophageal perforation in adults].

OBJECTIVE: To evaluate the management of cervical esophageal perforation in adult patients. MATERIAL AND METHODS: A retrospective clinical review was made of all cervical esophageal perforations diagnosed in adult patients in the ear, nose and throat department of Marqués de Valdecilla Hospital (Santander, Spain) between January 1989 and December 1996. Age, sex, symptoms, cause of perforation, time to diagnosis, diagnostic studies, treatment, and evolution were obtained from the clinical records. RESULTS: Eleven patients with perforation of the cervical esophagus, age range 38 to 84 years, were seen in the study period. In 8 cases, perforation was caused by a foreign body and 3 cases were iatrogenic (after rigid esophagoscopy). The most frequent symptoms of presentation were cervical pain and odinophagia. Nine patients were treated with broad-spectrum intravenous antibiotic therapy and no oral feeding. Two patients were treated surgically. There were no complications or need for further surgery in any case. CONCLUSIONS: Small perforations of the cervical esophagus in adult patients produced by foreign body impaction or rigid esophagoscopy can be managed by observation, restricted oral intake, and intravenous antibiotics. Neck exploration should be reserved for patients with signs and symptoms of cervical or mediastinal infection.

Adult↗

Prognostic factors in supraglottic laryngeal carcinoma.

We carried out a retrospective study of patients with supraglottic carcinomas who were treated surgically at the Marques de Valdecilla Hospital (Santander, Spain) between 1978 and 1987 and who were followed up for at least 5 years. The Kaplan-Meier survival curves were calculated for 24 clinical, histologic, and morphometric parameters. Multivariate analysis was then performed by means of the Cox regression model. In the univariate analysis, survival was related to presence of capsule rupture of the involved lymph nodes (p = 0.00001), number of metastatic lymph nodes (p = 0.0002), postoperative TNM stage (p = 0.004), grade of cell differentiation (p = 0.001), presence of intratumoral necrosis (p = 0.01), and type of invasion (p = 0.04). The nuclear area did not have an influence on survival. Only the presence or absence of capsule rupture of the metastatic lymph nodes and the grade of cell differentiation were included in the final Cox model and proved to be parameters with independent prognostic significance.

Aged↗

[Auricular pseudocyst].

Two cases of auricular pseudocyst in men are presented. In both cases, the pseudocyst was located on the anterior surface of the upper part of the outer ear. Conservative treatment with repeated aspirations in one case, and incision and drainage in the other, were curative and produced good esthetic results.

Adult↗