Biomedical subjects

E Rejas Ugena

Publications and source records attributed to E Rejas Ugena.

At least 19 recordsLinked to original sources

PubMed2006

[Utility of the surgical treatment for severe epistaxis by endoscopic approach of sphenopalatine and ethmoidal arteries].

INTRODUCTION: To evaluate the efficacy and cost-effectiveness of the treatments used for controlling epistaxis, particularly compared with the surgical endoscopic ligation or cauterization of sphenopalatine (SP) and anterior ethmoid (AE) arteries, a intervention prospective-retrospective study is presented with the aim of assessing the feasibility of these surgical techniques as an alternative to conventional treatments. PATIENTS AND METHODS: 184 consecutive patients admitted in the ENT ward between the years 1997 and 2005 were included in the study, and distributed into three groups depending on the last treatment applied to control their bleeding: AP group.- anterior packing (n=98); PP group.- posterior packing (n=66), and ES group.- endoscopic ligation and/or cauterization of SP or AE (n=20). RESULTS: Highly significant differences were found between the groups, not only regarding the efficacy (90% for surgical treatment compared with 41.3% for AP and 63.1% for PP), but also the length of postreatment hospital stay (AP.- 4.92 days; PP.- 6.3 days; ES.- 2.15 days). DISCUSSION AND CONCLUSIONS: The lack of efficacy of conventional treatment and the increasing risk factors that condition nasal bleeding, together with the advance of endoscopic and anesthesic procedures have brought along the possibility of a surgical solution for these patients. Our results demonstrate the feasibility of these techniques as alternative for nasal packing in the treatment of posterior epistaxis, and even its ethical and economical convenience as a substitutive to posterior packing.

Aged↗

PubMed2006

[Practical aspects regarding endoscopic treatment for epistaxis].

INTRODUCTION: A prospective study is presented to evaluate some practical and financial aspects regarding surgical endoscopic ligation or cauterization of sphenopalatine (SP) and anterior ethmoidal (AE) arteries performed to control posterior nasal bleeding. PATIENTS AND METHODS: 35 patients admitted at the ENT ward between 2004 and 2006 were included in the study, and distributed into two groups depending on the protocol applied in each case. Until March 2005 the surgery was performed if there was failure or insecurity of the posterior packing, and since that date a substitutive surgical protocol (not including posterior packing) was applied. RESULTS: 82.9% of the patients were male, with a mean age of 55.74 years and a left bleeding in a 60% of the cases. Ligature/cauterization was performed on SP in 28 (80%) patients, on AE in 4 (11.4%), and on both arteries in 3 cases (8.6%). 38.7% of the SP approach only one sphenopalatine foramen was observed, through which an only branch of the artery passed; 42% of the cases two branches passed through an only foramen, and in 19.3% two or more branches were present, breaking into the nose through two or more independent clefts. AE was intradural in 3 cases, intranasal attached to the cranial base in other 3 and intranasal detached to the cranial base in 1 patient. Besides, highly significant differences were found between the two protocols, observing a mean reduction of hospital stay of 3.1 days, which throws up savings of 939.3 euros per patient. DISCUSSION AND CONCLUSIONS: Surgical treatment for epistaxis has proved to be effective (91.2% in our experience) and safe, determining an important reduction in hospital stay and avoiding the morbility of posterior packing. Accurate knowledge of the anatomy of the arteries implied and specific actuation upon the correct bleeding territory are essential to perform this surgery.

Adult↗

PubMed2006

[Congenital hemangioma arising of internal orbitary edge. Importance of ENT exploration and treatment options].

Hemangiomas are the most common tumors in children. It id reported the case of 11 months girl with congenital hemangioma at internal orbitary edge. ENT exploration is essential to rule out the affectation of nose and paranasal sinuses as well as other associated similar injuries in head and neck. As complementary tests we asked for CT and IRM to delimit the tumoration whose classic treatment are oral corticoids in high doses. Surgery usually is reserved for refractory cases to the medical therapy although the present exposition is changing due to different factors that we expose in the final discussion.

Brain↗

PubMed2006

[Plaut-Vincent's acute necrotizing ulcerative fusospirillum tonsillitis associated to infectious mononucleosis].

We report the case of a 14 years old girl patient with recurrent tonsillitis who had been diagnosed and admitted previously with Plaut-Vincent's angina. Six weeks after leaving the hospital she was assited in Emergencies by an infectious mononucleosis associated to unilateral tonsillar necrotizing ulceration from which a sample was taken to microbiological exam finding the fusospirochaetal complex Borrelia vincenti and Fusobacterium necrophorum. A literature review at the respect of such association and its treatment is performed.

Acute Disease↗

PubMed2006

[Otogenic cerebrospinal fistula. Report of an atypical case].

We report the case of a female patient who consulted to the Room Emergencies due to abundant watery otorrea of 3 months without another symptom or apparent cause. The studys confirmed the presence of cerebrospinal fluid (CSF) and the imaging tests (CT and MRI) demonstrated the existence of a communication between the right ear and middle cerebral fossa through tegmen timpani. The woman was operated by ORL (closing the fistula) and neurosurgery (placing an external lumbar drainage) with good postsurgical evolution.

Aged↗

PubMed2005

[Granular cell tumor of the tongue (Abrikossoff's tumor). Report of a case and review of the literature].

Granular cell tumor, myoblastoma or Abrikossoff's tumor is an uncommon benign lesion, usually of slow-growing, that shows a predilection for the oral cavity, especially the tongue. Its real etiopathogenia remains still controversial and in it's histogenesis have been implicated several cell types. We report the case of a 18 years old woman with that diagnosis, confirmed in AP, who was operated by removal of the tumoration that was located in the left half-tongue. After 28 months she has not suffered any recurrences.

Adolescent↗

PubMed2005

[Glossopharyngeal neuralgia. A propos of one clinical case].

Glossopharyngeal or the 9th cranial nerve neuralgia is an uncommon pathology characterized by severe paroxysmal attacks of pain in the base of the tongue, posterior pharynx and tonsillar fossa some times associated with pain irradiated to the ear. It's Carbamazepine is the first choice of medical treatment while the microvascular decompression is considered the main surgical procedure.

Aged↗

PubMed2005

[Simultaneous bilateral sudden deafness. Report of a clinical case].

Bilateral sudden deafness is uncommon and characterized by an acute sensorineural hearing loss in both ears of 30 dB or more in 3 consecutive frequencies. We report the case of a 57 yeras old female with this diagnosis who presented a right anacusia and a severe audiometric loss on left ear without vestibular pathology associated. She was admitted and treated by the protocol of medical therapy that we have performed in our E.N.T. Department (4 days EV and then 10 ones oral medication) with improvement in her audition 25-30 dB average. If sudden bilateral sensorineural deafnes is founded, we must consider an immuno-mediated inner ear disease (IMIED).

Female↗

PubMed2005

[Postraumatic massive epistaxis. An indication for selective arterial embolization].

We report a 38 years old male admitted to our hospital with massive epistaxis secondary to nasal trauma which required to perform a posterior packing, transfusion and embolization of the internal maxillary artery for stopping the nosebleed. Then we made a FENS (Functional Endoscopic Nasal Surgery) by cauterization of several bleeding points on nasal septum following an anterior packing that was removed after 48 hours without new epistaxis. In a patient like this we think that an angiography with selective embolization is the main choice when other options have failed.

Adult↗

PubMed2005

[Recurrent and severe epistaxis secondary to nasal trauma. Report of an atypical case in a 22-year-old male].

We report the case of a 22-year-old male who presented a diferred, recurrent and severe epistaxis after nasal trauma which required several admissions in our hospital and different treatments. Concretely by chronological order it has been practiced anterior tamponades, endoscopic ligature-cauterization of the sphenopalatine artery, classic posterior packing and finally a new FENS with cauterization of anterior ethmoidal artery. Besides it was necessary a transfusion to go up the anemia suffered by the patient whose global stay was 16 days. Recurrent postraumatic epistaxis are very rare but can be represent a difficult problem to solve.

Adult↗

PubMed2004

[Review of acute otomastoiditis in the paediatric population. Our cases].

The introduction of antibiotics has decreased the number of acute mastoiditis as complication of otitis media in children. However, this pathology still is a serious infection. Its incidence has increased in the last years and goes on getting diagnostic and therapeutic problems. We are reporting an own review about 18 children diagnosed as acute otomastoiditis, hospitalized in a 10 years period, with ages between 10 months and 14 years. We have analysed different parameters standing out the otoscopic and radiologic findings, clinical symptoms, previous antibiotic treatment, type of surgical intervention performed and complications.

Acute Disease↗

PubMed2004

[Idiopathic supraclavicle abscess with extension to the cervico-thoracic intersection].

The incidence of deep neck abscesses has clearly decreased thanks to antibiotic therapy. In most of the cases we can find an odontogenic or pharyngotonsillar cause and the infection can extend from its origin to deep cervical spaces or mediastinum. We are reporting the clinical case of a 71 year-male diagnosed as right supraclavicle and idiopatic abscess that reaches the cervico-thoracic intersection. The patient was urgently operated by drainage of the purulent collection being carried later to ICU where he suffered an adult respiratory distress syndrome (ARDS) which required a change on the treatment up to the resolution.

Abscess↗

PubMed2004

[Severe dysphagia secondary to Plummer-Vinson Syndrome. Report of a case and review of the literature].

The Plummer-Vinson Syndrome is characterized by the presence of dysphagia, iron deficiency anemia and esophageal webs. We report the clinical case of a 67 year-female who was admitted with aphagia, glositis and important sialorrea. After performing a digestive endoscopy we found a double membrane located on Killiam region (upper esophageal tract) and proceeded, under general anestesia, to neumatic dilatation. The patient followed periodic controls yearly by Digestive Department and Internal Medicine with a significant clinical improvement.

Aged↗

PubMed2004

[Hyperparathyroidism due to chronic renal failure. Analysis of 32 operated patients].

We report our study of 32 patients diagnosed as hyperparathyroidism due to chronic renal failure (27 secondary forms and 5 tertiary ones), between June 1990 and 2003, that were sent from Nefrology Department for to surgical intervention. The following parameters have been analysed: Age, sex, clinical symptoms, kind of surgery performed, postoperative complications and anatomopathologic result (AP). On 64 nerves exposed, there were no recurrent nerve palsies. 12 patients suffered a symptomatic hypocalcemia (37,5%) although only one was permanent. The control of calcium, phosporus and calcitriol is essential to try to avoid a hyperplasia of the parathyroid glands.

Adult↗

PubMed2004

[Lingual tonsillitis. Report of 3 cases and literature review].

Lingual tonsillitits is a relatively uncommon pathology that affects specially patients with previous palatine tonsillectomy and its clinical behaviour is even more notorious than an acute tonsillitis. We report 3 cases hospitalized by our ENT Department analysing the initial symptoms, complementary tests, treatment and clinical evolution. In one of the patients that diagnosis probably was secondary to a complication due to an infectious mononucleosis and finally he was operated by surgical cauterization the lingual tonsils.

Adult↗

PubMed2004

[Facial palsy caused by otitis media with effusion in a 9-year old child].

We report the case of a 9 years old child diagnosed as right otitis media with effusion associated to homolateral and peripherical facial palsy, fact very uncommon in the reviewed literature. The patient was treated by miringotomy and insertion of transtympanic drainage recovering his facial function totally after 9 weeks.

Anti-Bacterial Agents↗

PubMed2003

[Epignathus. A case report and review of the literature].

Epignathus is an uncommon form of oropharyngeal teratoma that is associated with a high mortality during the neonatal period. We report the clinical case of a neonate born through cesarean in week 35, Apgar 2-4, neurologic breakdown and widespread hypotonia. The prenatal diagnosis was performed by ultrasonography; the diameter of the solid mass was 5 cm with inner calcium density. An urgent tracheostomy was carried out as it was not possible to get orotracheal intubation (IOT) and, later, we proceeded to remove the mass which was embedded in the hard palate. Our patient died three weeks later due to respiratory and heart failure. We carry out a review of the literature for this pathology.

Humans↗

PubMed2003

[The use of scintigraphy and fine needle aspiration biopsy (FNAB) in thyroid surgery and review of literature].

Our aim is to know the usefulness of gammagraphy and FNAB (fine-needle aspiration biopsy) in thyroid surgery done in our ENT-Department during 12 years lapse. In this period of time are considered the outcomes of 461 thyroid gammagraphies and 469 FNAB for diagnostic comparison with the final anatomopathological (AP) issues. We emphasize the 42.3% of cold nodules most of which (21.5%) were thyroid carcinomas (80.95% papillary Ca; 14.28% follicular Ca and the remainder medullary Ca). Between 319 folliculary proliferations according of FNAB only 17 were malignant tumours and when the aspiration puncture informed about positive malignant etiology (51 cases), 5 cases final diagnosis were benign pathology and the other 2 the pathology was of malignancy, but different to that of the initial diagnosis. We considerer that the sensibility of this test is about 86.28% in our series. Finally, our results are compared with those of other publications.

Biopsy, Needle↗