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Biomedical subjects

G Plaza Mayor

Publications and source records attributed to G Plaza Mayor.

At least 19 recordsLinked to original sources

[Neuro-otological manifestations as presentacion of type I Chiari malformation].

The type I Chiari malformation consists of an caudal descent of the cerebellar tonsils through the foramen magno towards the spinal cervical channel. The usual clinical presentation are occipital headaches and cervical pain, as well as some otoneurological symptoms. Among them are common dizziness and crisis of central positional vertigo in which down beating nystagmus can be observed. We present our experience with three cases presenting with neurotological manifestations in which MRI showed a type I Chiari malformation. Case 1: a patient of 24 years that had frequent instability, and common crisis ofpositional vertigo. It was possible to see the presence of positional down-beating nystagmus, of central characteristics, that improved after neurosurgical treatment. Case 2: patient of 11 years who suffered from occasional headaches, dizziness and positional vertigo, without severe handicap, and did not need surgery. Case 3: lady of 63 years who had common episodes of vertigo with head tilt, and unsteadiness during walks. Due to the coexistence of hydrocephalus and syringomyelia, surgery was indicated. A revision is done on otoneurological presentation of type I Chiari malformation, especially as differential diagnosis on central positional vertigo.

Adult↗

[Pseudohypertrophy of the ventricular bands due to deformation of the thyroid cartilage].

Hoarseness due to phonation by the false cords (dysphonia plicae ventricularis) is a common cause of functional dysphonia, in relation to excessive muscular tension in the larynx area. Nevertheless, a mechanic cause can be observed in some cases with dysphonia plicae ventricularis, which is usually due to deformation of the thyroid cartilage. We report a case with hypertrophy of the ventricular bands which was treated by vocal rehabilitation followed by suspension laryngoscopy with partial removal of the ventricular bands, without further improvement. This failure was related to a pseudohypertrophy of the ventricular bands, due to deformation of the thyroid cartilage, which was confirmed by computed tomography.

Aged↗

[Otalgia as presentation of primary nasopharynx tuberculosis].

We report a case of a 63-year-old woman who presented with left otalgia during more than six months. On examination, otoscopy was normal, whereas flexible nasopharyngoscopy revealed an asymmetry in the nasopharynx. CT scans confirmed the presence of a left nasopharyngeal mass. A transnasal endoscopic removal of the nasopharyngeal lesion was performed. Necrotizing granulomatosis was found. Tuberculosis of the nasopharynx was considered the final diagnosis, but oral treatment was not started. After 36 months of follow-up, nasal endoscopy and CT images show no sign of recurrence. Discussion is focused on the inclusion of nasopharyngeal diseases in otalgia differential diagnosis, histopathological diagnosis of granulomas and the need of any further treatment for these limited cases of extrapulmonary tuberculosis.

Antitubercular Agents↗

[Olfaction disturbances in general ORL practice].

Analysis of smell disturbances in the ENT outpatients department of in a General Hospital. A retrospective and descriptive study. We include all patients with olfactory alterations as the main reason for consultation. The sample was 38 patients. Viral, postraumatic, toxic, drug-induced and inflammatory. We performed anamnesis, nasal endoscopic and scan images on all patients. Olfactory disturbances were more frequent in women older than 55 (2:1). The viral cause was the most frequent aethiology (55.3%). Nasal endoscopic exploration was normal in 68.4% patients. The CT scan was the main imaging study used (68.4%). The younger patients recovered better than the older ones. Smell disorders provoked by virus, toxic and medical drugs do have a better.

Adult↗

[The neck cysts and infectious mononucleosis due to cytomegalovirus].

Infectious mononucleosis is usually produced as primoinfection by Epstein-Barr virus, but the second most common cause is cytomegalovirus. Clinical presentation of infectious mononucleosis is a pharyngitis and tonsillitis, associated to neck nodes, fever and general malaise, as well as haematological features such as an absolute lymphomonocytosis. Occasionally it is the neck node that is more severe, even without initial lymphomonocytosis. We report a deep neck abscess within a neck node as subacute presentation of infectious mononucleosis by cytomegalovirus. We review the clinical presentation of infectious mononucleosis, specially due to cytomegalovirus, as well as the importance that this disease could have while dealing with diagnosis and management of neck masses.

Adult↗

[Pediatric temporal bone fractures].

Temporal bone trauma are more common nowadays related to sports. We report 2 cases with temporal bone fractures in patients younger than 14 years. They were two male, 9 and 12-year-old respectively, that presented traumatism after accidental falls from lowe height. The first case had a longitudinal temporal bone fracture without hypoacusia or vertigo, whereas the second one had an oblique fracture involving the otic capsule, provoking permanent neurosensorial hearing loss, as well as vertigo and unsteadiness that resolved later, related to a vestibular hyporreflexia. Neither case had facial paresia or paralysis. CT scanning was essential to determine the importance of the trauma. Despite the otic capsule rupture, hearing loss in the second case was only significant over 2 KHz, suggesting a selective cochlear trauma. We present clinical and imaging findings, as well as correlation of audiological and vestibular alterations, reviewing the clinical presentation of temporal bone trauma in children.

Cerebrospinal Fluid Otorrhea↗

[The use of magnetic resonance in the study of sensorineural hearing loss in children].

Although newborn screening of congenital hearing loss through otoacustic emissions allow prompt recognition, imaging techniques, such as CT and MRI are needed to get a morphological diagnosis. Furthermore they can be very useful in unilateral cases, whose clinical presentation is belated and more insidious. Our aim is to show the utility of MRI in the study of inner ear congenital anomalies, whose presentation is belated. Thus from a series of 88 consecutive patients in which a MRI was performed as screening of assymetric sensorineural hearing loss, we selected 6 cases aged between 6 and 20. Four of them showed an inner ear anomaly on MRI. We present these anomalies commenting the findings on CT and MRI. Imaging techniques are required to start hearing rehabilitation programs early on patients with bilateral inner ear anomalies. But also they are very useful in the evaluation of unilateral assymetric sensorineural hearing loss, in young patients, even if only some frequencies are damned, to determine the nature of hearing loss.

Adolescent↗

Is conservative treatment of deep neck space infections appropriate?

BACKGROUND: A 31-patient prospective series on deep neck infections, managed at Hospital Ramón y Cajal in Madrid, Spain, is presented. METHODS: A prospective study was conducted from January 1994 to December 1997, including all parapharyngeal or retropharyngeal infections. Clinical and radiologic findings and length of stay in the hospital were registered. Medical treatment was instituted with broad-spectrum antibiotics, and surgery was reserved for those patients not responding to medical treatment. RESULTS: Twenty-four patients (77.42%) had parapharyngeal, 3 (9.68%) retropharyngeal and 4 (12.90%) mixed infections. On the basis of clinical and CT findings, 19 cases (61.29%) were considered abscesses and 12 (38.71%) cellulitis. Medical treatment was successful in all but 3 cases (90.32%), with no major complications. All the patients were discharged from the hospital within 20 days after admission (mean, 8.09 days). CONCLUSIONS: Despite the wide use of antibiotics, deep neck space infections are commonly seen. Although most reports are based on surgical treatment followed by antibiotics, medical treatment could be as successful as open surgical drainage in most cases.

Adult↗

[Post-tracheotomy pneumothorax. Is thoracic radiography required after each tracheotomy?].

Pneumothorax complicating a tracheotomy is a rare event, but it should be clinically considered in order to the early treatment, mostly in urgent or pediatric cases. We report 2 cases in which pneumothorax complicated postoperatively the tracheotomy and required early clinic and radiologic diagnosis followed by a promptly and satisfactorily evacuated. We review the need to perform a chest X-Ray after every tracheotomy or only following those cases found to be at risk, as well some effective preventive measures.

Female↗

[Congenital anomalies of the first branchial cleft. Retrospective study].

Anomalies of the first branchial cleft are occasional problems putting up diagnostic and therapeutic difficulties, because the imperfect settlement of reminders of this cleft, which can appear as cysts or branchial fistula, among patients of any age. Though there are several recommended classifications in order to achieve a precious diagnosis and a total surgical removal, sometimes is laborious to correlate the clinical and the histological findings. We report a sequence of congenital periauricular anomalies operated in our Department during a ten-years-term and compare our findings of those quoted after the literature series.

Adolescent↗

[Torticollis after unnoticed pharyngeal perforation: suspected retropharyngeal abscess].

Pharyngeal perforations due to foreign bodies are severe when retropharyngeal space infection develops into an abscess. Although the common clinical presentation is sore throat and fever, when the perforation remains occult, torticollis can be a significant symptom. Palatopharyngeal lesions, caused by rigid objects' impactation through the mouth, are common in childhood. Most are not important, but all have the potential hazard of pharyngeal perforation with development of a retropharyngeal abscess. It must be suspected specially when air is shown in the retropharyngeal space on a lateral radiography of the neck, which should always be done. We report a 9-years old boy who had cervical stiffness and torticollis and elevation of the right shoulder, without previous known trauma. Air was shown in the retropharyngeal space on a lateral radiography of the neck in relation to a possible pharyngeal perforation which was later confirmed by a CT scan. We review the literature about diagnosis and treatment of retropharyngeal abscess in childhood.

Child↗

[Maxillary mucocele: two case reports and review of literature].

Mucoceles are benign expansive conditions, chronically evolving, from paranasal sinuses. Most frequent localized in the ethmofrontal area and related with sinusal ostial drainage. Maxillary mucoceles are rarer and related with traumatic, tumoral or surgical pathologies, particularly with the Caldwell-Luc incision. These mucoceles demand an aggressive treatment als those etmofrontals in order to achieve a radical exeresis through an outer incision. We report 2 cases of maxillary mucocele. The first was a big one of idiopathic type, the other was associated to an inverted papilloma sitting in the external wall of the affected nasal cavity. Review of the literature in regard of pathogenesis, radiological diagnosis and management of these cases.

Adolescent↗

[Pott's puffy tumor].

Between the complications of frontal sinusitis orbital or intracranial are the most frequent encountered (meningitis, abscesses and empyemas). All are secondary to thrombophlebitis of veins communicating the intracranial cavity with the frontal sinus. Frontal osteomyelitis secondary to sinusitis, the so-called Pott's puffy tumor, is a much more rare aftermath in the antibiotic epoch. Pott's puffy tumor must be suspected in patients with frontal headache followed by frontal oedema. Concerning the diagnosis clinical suspicion is essential and must be settled throughout computerized tomography and/or magnetic resonance or even bone scintiscan. The paper report 2 cases, one an orbital periostitis, at the beginning of the disease, which was recovered with medical antibiotic treatment and another one, an osteomyelitis somewhat evolved requiring surgery through frontal osteoplasty. Perusal of etiology, pathogenesis, diagnosis and treatment of this complication.

Adult↗

[Thyroglossal cyst: retrospective study of 58 cases. Results of the Sistrunk operation].

Cysts of the thyroglossal duct are one of the most common causes of benign neck masses. They generally occur in young patients and are caused by a defect in thyroglossal duct closure, which sometimes is in close contact with the hyoid. Often several tracts are present. The most effective surgical procedure was originally described by Sistrunk in 1920 and modified in 1928. This technique is based on the removal of the central portion of the hyoid bone. This procedure has successfully reduced the number of recurrences compared to local excision of the cyst. A retrospective review was made of 58 cases to evaluate surgical results, especially recurrence rate, in relation to the resection or preservation of the hyoid bone. Results were compared with published series.

Adolescent↗

[Nasal encephalocele: differential diagnosis with nasal glioma].

Congenital nose neoplasms are infrequent, between them neurogenic tumors of the middle line include nasal gliomata (glial ectopies) and nasal encephaloceles, according to an existing or lacking communicating link with the intracranial cavity. We report one congenital naso-encephalocele case in a 16-year-old girl suffering from repeated meningitis events after several nasal polypectomies performed in other departments. She underwent complete removal through fronto-neurosurgical and paralateronasal approach, being the young woman asymptomatic for 3 years. We discuss about both intranasal gliomata and encephaloceles, certainly of not easy pathologic identification, stressing the decisive value of imaging techniques, as magnetic resonance, in order to clearcut both the diagnosis and the therapeutical planning.

Adolescent↗

[Nasopharyngeal cysts. Report of four cases and literature review].

Nasopharyngeal cysts although common are not completely understood. They are classified according to their localization and pathogenesis in congenital or acquired and medial or lateral. We report 4 cases: a branchiogenic causing serious otitis, a Tornwaldt's cyst also producing otitis serosa, another asymptomatic Tornwaldt's cyst and a retention cyst which produce an obstructive apnea syndrome. All but the asymptomatic one were operated on transoral, by grasping the cyst and its implantation site. They all remain till now asymptomatic. We review the chapter of nasopharyngeal cysts, discussing their clinicopathological classification, their diagnosis and treatment.

Adult↗

[Laryngeal tuberculosis and laryngeal cancer].

Account of 2 synchronic cases of tuberculosis and laryngeal carcinoma. Apart from bacteriostatic drugs one of them underwent a cordectomy the other one a total laryngectomy and neck dissection. Despite the great majority of laryngeal cancer it is compulsory to take in account the differential diagnosis with the tuberculosis, because of its possible coexistence. Perusal of national and international literature, having found only 11 of similar instances reported.

Carcinoma, Squamous Cell↗