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Biomedical subjects

J Basterra

Publications and source records attributed to J Basterra.

At least 19 recordsLinked to original sources

Electrosurgical endoscopic cordectomy with microdissection electrodes: a comparative study with CO2 laser.

Microdissection electrodes (MEs) have previously been used to perform endoscopic cordectomies. We designed a prospective study in order to compare the ME with the CO2 laser technique. Over two years, 20 patients with T1 glottic carcinoma were operated on with CO2 laser and 20 with MEs. The device was chosen alternatively for each new patient. Two patients in both treatment groups had slight glottic incompetence. Three patients in each group showed web formation. The only granuloma was observed in a CO2 laser patient. Seven of the ME patients developed slight dysphonia, 10 developed medium grade dysphonia and three developed severe dysphonia. Seven of the CO2 laser patients developed slight dysphonia, seven developed medium grade dysphonia and six developed severe dysphonia. No statistically significant differences were observed on comparing the grade of dysphonia with patient age, T stage, type of cordectomy or surgical device. We consider the ME to be a useful and inexpensive alternative to CO2 laser.

Adult↗

[Influence of the nasogastric tube in the pathology of the maxillary sinus].

INTRODUCTION: Nasoesophageal tube (NT) is very often used by the ear, nose and throat specialists in head and neck oncological surgery. It is well known the irritative effect that it has on the nasosinusal mucosa. The aim of this study is to analyze the relationship between the use of the NT and the pathology of the maxillary sinuses. MATERIAL AND METHOD: The study was carried out in 25 patients treated in our department who had been fed by NT, after surgery. A plain sinus X-ray was performed in the pre-operatory period and a control radiograph in the post-operatory period, and the results have been analyzed. RESULTS AND CONCLUSIONS: No sinusitis had been observed whatever length of time the NT remained in situ.

Adult↗

Upper lateral cartilage transposition in the surgical management of nasal valve incompetence.

INTRODUCTION: The treatment of nasal valve dysfunction is very controversial and many otorhinolaryngologists do not always take surgery into consideration. The purpose of this paper is to present the author's surgical technique and the description of 13 patients on which it may work. MATERIAL AND METHOD: Thirteen cases presenting with nasal obstruction secondary to nasal valve dysfunction are reviewed. All of the patients presented with internal valvulary incompetence and in three of them an alar collapse was associated. Diagnosis was achieved by means of the clinical findings and physical examination. An open rhinoplasty approach was employed. The surgical technique consisted in a transposition of the upper lateral cartilage over the alar cartilage. In the three patients with alar collapse a fixation graft from the septal cartilage was also employed. RESULTS: Nasal obstruction and valvular incompetence seemed improved in all of the cases. CONCLUSION: Upper lateral cartilage transposition seems to be an adequate method to solve the nasal valve incompetence.

Adult↗

[Intelligent system to perform a diagnostic protocol for lymphatic invasion in laryngeal cancer].

Laryngeal carcinoma is the most frequent malignant tumour in head and neck. Node invasion is known to be one of the most important prognostic factors. The aim of this study has been to design an intelligent system to perform a diagnostic algorithm of metastasic neck nodes. 122 clinical reports of patients diagnosed of laryngeal carcinoma in our department have been reviewed. The compiled data have been: tumor site, T stage, N stage (clinical, after CT scan and post-surgery). The method used to design the intelligent system has been the ID3, which is able to generate a minimal decision tree. Palpation has been the variable that has given more information about node invasion. CT has proved to be more efficient in supraglottic tumours. ID3 method has shown to be useful in performing diagnostic algorithms, specially when the number of cases and diagnostic tests are high.

Adult↗

Inverted papilloma of the sphenoid sinus.

Inverted nasosinusal papilloma is a benign tumor accounting for less than 4% of all nasal masses. The lesion originates in the mucosa lining the nasal cavities, the locations in decreasing order of frequency being the lateral wall of the nasal fossa, ethmoid sinus, and maxillary sinus; the sphenoid sinus is only rarely affected. Despite its benign histology, the tumor shows aggressive behavior and can be associated to carcinomas. Surgery is therefore indicated in such cases.

Aged↗

Arteriovenous haemangioma of the pterygoid process. Report of a case.

Arteriovenous haemangioma is a benign tumor which in ear, nose and throat practice is generally found in the soft tissues of the oral cavity. Bone involvement is very uncommon. These lesions typically manifest themselves in infancy, with a tendency towards spontaneous resolution. The management options comprise simple observation, embolization or surgical removal--depending on the location of the tumour and its symptoms. A correct diagnosis is essential to ensure the adoption of adequate measures during surgery. The present case describes an exceptional location of arteriovenous hemangioma of the pterygoid process, and discusses the associated diagnostic and treatment problems.

Adult↗

Magnetic resonance imaging of the pharynx in OSA patients and healthy subjects.

Obstructive sleep apnoea (OSA) occurs because of recurrent narrowing and occlusion of the velopharynx (VP) during sleep. The specific cause of OSA is unknown. Cephalometric radiography, fibreoptic nasopharyngoscopy, acoustic reflection techniques, and computerized tomography have limitations (dynamic and tridimensional evaluation) in the mechanism of occlusion investigation. Static and dynamic examination of the soft tissue structures surrounding the upper airway during the respiratory cycle in wakefulness and sleep, can lead to a better understanding of the process. Ultrafast magnetic resonance imaging (one image per 0.8 s) was used to study the upper airway and surrounding soft tissue in 17 patients with OSA during wakefulness and sleep, and in eight healthy subjects whilst awake. The major findings of this investigation in the 25 subjects were as follows: 1) the VP was smaller in apnoeic patients, only during part of the respiratory cycle; 2) the variation in VP area during the respiratory cycle was greater in apnoeic patients than in controls, particularly during sleep, suggesting an increased compliance of the VP in these patients; 3) VP narrowing was similar in the lateral and anterior-posterior dimensions, both in controls and apnoeic patients while awake; apnoeic patients during sleep have a more circular VP upon reaching the minimum area; 4) there was an inverse relationship between dimensions of the lateral pharyngeal walls and airway area, probably indicating that lateral walls are passively compressed or stretched as a result of changes in the airway calibre; and 5) soft palate and parapharyngeal fatpads were larger in apnoeic patients, although their role in the genesis of OSA is uncertain. It was concluded that changes in the velopharynx area and diameter during the respiratory cycle are greater in apnoeic patients than in normal subjects, particularly during sleep. This suggests that apnoeic patients have a more collapsible velopharynx, this being the main mechanism of obstruction.

Adult↗

[Prognostic factors in supraglottic laryngeal cancer: a review of 74 cases].

Laryngeal carcinoma is a frequent neoplasm in Spain, constituting about 5.6% of all malignant tumors. The supraglottic location is more frequent than either glottic or subglottic sites. Prognostic factors were analyzed in a series of 74 supraglottic laryngeal carcinomas. Two statistical methods were used. Firstly, Cox regression, a multivariate analysis that defines a survival function of the patients, was used to detect variables with prognostic influence. Secondly, mortality tables were studied for all of them. This univariate method is used to determine the number of patients for every option of a study variable and their survival. The most important prognostic variables in our series were: tracheostomy before surgery, pathological study of the cervical nodes, time from surgery to radiotherapy, type of biopsy, and alcohol use.

Adult↗

Contribution of artificial intelligence to the knowledge of prognostic factors in laryngeal carcinoma.

Many studies have investigated prognostic factors in laryngeal carcinoma, with sometimes conflicting results. Apart from the importance of environmental factors, the different statistical methods employed may have influenced such discrepancies. A program based on artificial intelligence techniques is designed to determine the prognostic factors in a series of 122 laryngeal carcinomas. The results obtained are compared with those derived from two classical statistical methods (Cox regression and mortality tables). Tumor location was found to be the most important prognostic factor by all methods. The proposed intelligent system is found to be a sound method capable of detecting exceptional cases.

Aged↗

[Infantile facial paralysis: diagnostic and therapeutic features].

This paper deals with a series of 11 cases of peripheral unilateral facial paralyses affecting children under 15 years. Following parameters are reviewed: age, sex, side immobilized, origin, morbid antecedents, clinical and neurophysiological explorations (electroneurography through magnetic stimulation) and the evolutive course of the cases. These items are assembled in 3 sketches in the article. Clinical assessment of face movility is more difficult as the patient is younger, nevertheless electroneurography was possible in the whole group. Clinical restoration was complete, excepting one complicated cholesteatomatous patient. Some aspects concerning the etiology, diagnostic explorations and management of each pediatric case are discussed.

Adolescent↗

[Our management protocol and surgical technique in cerebrospinal fluid rhinorrhea treated with an endonasal approach].

Five patients with cerebrospinal fluid fistula (CFF) have been treated with intratecal fluoresceine, 2 cc at 2%, and endoscopic nasal surgery. In 3 patients CFF was postraumatic; one case spontaneous and another case iatrogenic. In all the cases CFF have been solved in the first time. Postoperatory follow-up vary from 8 to 14 months, and no recurrence was observed. Fluorescein must be managed adequately for prevent neural complications.

Adult↗

[Progression of profound perceptive deafness in children].

We have studied 340 cases of deep neurisensorial deafness in children and their evolution along a 7.2 years term. Conventional audiometry has been used as commonest method for assessing the auditive function. In a considerable number of cases (15.9%) hearing loss was progressive and some relation referring to sex, the bearing of hearing aids and the etiology is statistically contemplated.

Audiometry, Pure-Tone↗

[The blink reflex in the electrophysiologic exploration of Bell's palsy and its prognostic value].

Conventional electrophysiology of the facial nerve gives only information about the functional condition of its extracranial segment. The blink-reflex triggered for the electric stimulation of supraorbital nerve allows the study of the whole nerve path, even the intraosteal, where the great majority of its pathology settles. We have realized this tests in 43 Bell's palsy cases (at the beginning of the paralysis and three weeks later) and correlated the results with the clinic course, in order to set up the pronostic value of the procedure. The cases with shorter tendency of blink reflex along the three first week have a better outcome.

Adolescent↗

Pull-through oropharyngectomy in advanced stage malignant tumours.

Surgery is the first therapeutic option in extensive oropharyngeal carcinomas. An operation to treat these tumours is described, based on the hemiglossopelvectomy without mandibulectomy technique. Tumours located in the oropharynx are resected downwards by a modified pull-through approach, performing the resection of the oropharyngeal tumour in monoblock with the ipsilateral neck dissection, avoiding any action upon the mandible. The operation has been performed in 14 consecutive patients. By avoiding either mandibulotomy or mandibulectomy, morbidity and post-operative recovery are improved.

Humans↗

Nasal mucociliary transport and ciliary ultrastructure in cystic fibrosis. A comparative study with healthy volunteers.

Cystic fibrosis (CF) is a deadly hereditary disease that produces an abnormally thick, viscous and abundant secretion in the respiratory tract. This secretion in turn leads to the development of recurrent respiratory infections and irreversible lung damage. We have studied nasal mucociliary transport by means of an isotopic technique in 12 patients with CF and in 12 healthy volunteers. Nasal mucociliary transport was repeated at 12-18 months in the patients. In five randomly selected patients ciliary ultrastructure was studied. The velocity of nasal mucociliary transport was significantly slower than in healthy persons (P < 0.001) and no significant differences were observed in both studies (P < 0.05). No significant differences were either observed in the CF group between the homo- and heterozygotes (P < 0.5), or in those six patients infected by Pseudomonas aeruginosa (P < 0.05). Ciliary ultrastructure was normal in one patient. In another patient the sample showed no cilia, while the remaining three exhibited changes similar to those observed in chronic respiratory infections: supernumerary peripheral tubules, ciliary disorientation and ciliary complexes.

Adolescent↗