Biomedical subjects
Publications and source records attributed to J Fraile Rodrigo.
We present one case of a neuroendocrine carcinoma of nasal fossa and paranasal sinuses, of aggressive behavior, which has been controlled with chemo-radiotherapy after a double postsurgical recurrence. We do a literature revision emphasizing the anatomopathologic differentiation of these tumors with the olfactory neuroblastomas, and the therapeutic controversies in advanced stages.
Stapedectomy, with its most innovatory variations, constitutes the treatment of choice for otoesclerosis. Short term results are spectacular, getting GAP closures of less than 5 dB approximatelly in 94% patients, variations depending on the authors. Long term follow up check results show a gradual auditory deterioration. The aim of this study is to audiometric evolution of patients operated of stapedectomy 7 to 10 years ago in our department and to correlate the results with those obtained by other authors, in an attempt to unify conclusions.
In the majority of patients suffering of Ménière's disease, medical treatment is sufficient to control symptoms, albeit, in a small number of them, the high intensity and frequency of vertigo spells makes necessary to adopt more aggressive measures, like intratympanic or general aminoglycoside administration, as well as surgical procedures. We present a prospective and longitudinal descriptive study with the results of intratympanic gentamycin in 24 patients labeled of Ménière's disease in the Otolaryngology Department of "Miguel Servet Hospital" in the last two years, after a follow-up period of more than a year, during which controlled medical treatment had been proved unsuccesfull. We go over the efficacy in terms of frequency of vertigo crisis, audition average, logoaudiometry and functional level. We obtained good results over vertigo control (types A and B of the objective criteria based in the improvement index after treatment) in 16 out of the 24 patients (66.6%), (13 were type A with total absence of crisis and 3 were type B) and an acceptable result (type C) in three of them (12.5.%). In the other five patients (20.83%) results were disappointing (types D and E) compelling to apply surgical treatment. We have tried to evaluate intratympanic gentamycin as an alternative treatment to more aggressive technics and we consider it to be a good option, with a low risk and scarce complications in the no pharmacologically controlled Ménière's disease patients.
Enlarged vestibular aqueduct syndrome is a clinical condition characterized for a progressive perceptive deafness linked to a broadening of vestibular aqueduct greater than 1.5 mm without other otic abnormal structures. We report the case of a 2-year-old child with such congenital malformation. We have reviewed the actual literature and point out its clinical and physiopathologic features as well treatment possibilities of these cases.
The association of non syphilitic interstitial keratitis with vestibulo-auditory symptoms was first described by Cogan in 1945. Owing to the rarity of this condition our opportunity of dealing with one of such cases is the reason for this paper, in which are contemplated besides the review of the published literature other points concerning the etiopathogenesis, the treatment and the follow-up of the disease.
A case of metastatic Merkel-cell carcinoma to lymph nodes on the left side of the neck nad left parotid is described. Neuroendocrine cutaneous carcinoma, also called Merkel cell carcinoma (MCC), is an uncommon primary skin tumor most often seen in elderly. Literature is reviewed and comment about more important features of these lesions, like differential diagnosis, prognosis and treatment.
The temporo-mandibular joint is directly related to the anterior wall of the external ear canal. Therefore, defects in this wall may lead to herniation of the soft tissues of the temporo-mandibular joint into the external ear canal. Such herniation usually is secondary to external injuries, iatrogenic trauma, neoplasms, and so on, but it may also be congenital. We report a well-documented case of temporo-mandibular joint herniation into the external ear canal of probable congenital origin.
Chordoma is an uncommon neoplasia with very aggressive behavior and very high local recurrence rate. It remains a difficult problem for the surgeon. A case of cervical chordoma in a 30 years old woman is reported. The patient had a retropharyngeal mass and changes in the quality of speech. A transoral approach was used to obtain complete removal. The biological, clinical and diagnostic characteristic of cervical chordomas are reviewed.
OBJECTIVE: Assessment of the incidence, diagnosis and treatment of three patients afflicted of extramedullary plasmacytoma located in the Waldeyer's ring, and one case afflicted of maxillary sinus disease. PATIENTS: The localization of the masses was the palatine amygdala in two cases, and the rhinopharynx and maxillary sinus in the remaining two patients. Major symptoms were dysphagia respiratory failure with closed rhinolalia, and headache. Diagnosis was made by histological study of biopsied tissue. In every case, general illness or other site of localization were ruled out. RESULTS: In our casuistic, the incidence of primary extramedullary plasmacytoma in Waldeyer's ring is 1.2%. The patient's age were 45, 50, 62, and 73 years respectively, and the male/female ratio was 1. In those cases located in the tonsils, a bilateral tonsillectomy was performed. In the case located at the maxillary sinus, a sinus trepanation was performed according the Caldwell-Luc's technique, followed by local radiotherapy at doses of 40 Gy. In the case located at the rhinopharynx, radiotherapy was the only choice. These three different therapeutical procedures led to the disappearance of the disease, and, after a 12 to 53 month-period, patients remain asymptomatic. A patient died due to other causes not related to the illness.
Cystic lymphangiomas are abnormalities derived from lymphatic vessels that are characterized by the formation of cysts. The are located generally in head and neck and occur most frequently in children. They rarely appear in adults. We present a case of lymphangioma and review the disorder.
Otogenic intracranial complications are now rare. Meningitis is the most frequent, followed by cerebral abscess. In spite of diagnostic and therapeutic advances, cerebral abscess has a high mortality. We report four cases seen in our service over the last five years and their treatment. The subject is reviewed.