Biomedical subjects
Publications and source records attributed to P López Villarejo.
Staphiloccocal Toxic Shock Syndrome is a potentially fatal multisystem disease associated to nasal packing, catheter insertion, retention of foreign materials and uneffective sterile techniques. It is usually developed in the immediate postoperative period (first 48 hours) with hypotension, skin rash, fever, multisystemic failure and shock. We report a case in a 24-year-old man secondary to nasal surgery.
We present one case of a 14 years old girl, diagnosed of fibrous displasia of the temporal bone, who developed a conductive hearing loss of progressive character. We analyse the clinic manifestations, radiologic and histopathologic study, and therapeutic indications of this disease.
OBJECTIVE: The early glottic carcinoma can be approached by different therapeutic options. We analyze the results obtained by means of cordectomy opened up by laryngofissure. MATERIAL AND METHOD: We design a descriptive retrospective study including 75 patients with glottic carcinoma T1N0M0 handled by means of cordectomy by laryngofissure (72 males and 3 females). The anaesthetic technique was locoregional and sedation. Tumor T1a, 62 patients (82.66%); T1b, 13 patients (17.33%). RESULTS: The specific survival rate at three, five and ten years was 100, 96.8 and 85.2% respectively; the global survival was 98.66, 90.47 and 52.17% respectively to three, five and ten years. There were ten recurrences (13.3%). Following treatment, 50% of the relapsed patients died. The probability of survival free of illness to three, five and ten years was considered in 0.9322, 0.9172 and 0.7093 respectively. CONCLUSIONS: This technique means good control of the illness and technical easiness. When doing it without a tracheostomy it is tolerated better and it generates lower costs per patient.
OBJECTIVES: To assess quality of life in patients diagnosed with epidermoid carcinoma of the larynx, after supracricoid partial laryngectomy (SCPL) with cricohyoidoepiglottopexy (CHEP). To examine how quality-of-life may be associated to the treatment received: neck dissection, decannulation and radiotherapy. PATIENTS AND METHOD: A descriptive, observational, cross-sectional study was conducted involving 26 patients out of a group of 51. They were all males with an average age of 61.7 years at the time of the interview. We used the disease-specific quality of life questionnaire devised by the University of Michigan: the Head and Neck Cancer-specific Quality of life instrument (HNQOL). RESULTS: During an average follow-up period of 83.65 months, 2 patients (3.92%) suffered a recurrence. Estimated survival after 3, 5 and 10 years was 95.83%. Communication and overall disturbances caused by treatment were found to be the two quality-of-life domains mainly affected. Generally speaking, patients who had received radiotherapy, those who had not had their tracheal cannula removed or those that had undergone neck dissection were the most affected. CONCLUSIONS: SCPL with CHEP as a surgical technique allows good control of the condition and has a low impact on the patient's quality of life.
Juvinile nasopharyngeal angiofibromas are highly vascular benign tumors but with an agressive behaviour with invasion of skull base and vital structures. Our study includes 11 male patients that underwent surgery for angiofibromas between 1992-2002 with an endoscopic surgical approach and embolization before surgery. The average age was 14.7 years old. Using Fisch staging, 8 patients were stage II. All cases achieved symptomatic remission, with no complications but the recurrence was 36.3%. The endoscopic excision is a safe and effective minimally invasive surgical treatment in patients in stage I and II. It should be considered as a first-choice option for these cases.
Mucormycosis is an opportunistic infection caused by molds Mucoraceae of the family Phycomycetes. This invasive FS is found in debilitated hosts, most frequently in patients with hematologic malignancies, burn patients and diabetes mellitus. There are several differents forms: rhino-cerebral, pulmonary or disseminated. We describe a case of invasive fungal sinusitis (FS): Rhino-orbital-cerebral mucormycosis, treated at our hospital with radical surgery and medical treatmen We reviewed the clinical presentation of the different types.
We have made a study about different cases of non-invasive fungal sinusitis (FS) treated at our hospital with surgery (endoscopic sinus approach) and medical treatment. We review two cases: Mycetoma and allergic fungal sinusitis, following the recent classification based on physiopathology, treatment and prognosis. We review the clinical presentation of the different types.
The advances in endoscopic instruments have eased the approach to the sellar region through the nasal cavity. We carry out an analysis of the surgical results on 20 patients that underwent surgery for sellar tumours through a transeptal-transphenoidal approach in the last 2 years in our hospital. The average was 45.6 years old, and 75% were females. 30% of cases were pituitary adenomas and another 30% acromegaly, 25% Cushing's disease and 10% prolactinomas. No complications were encountered during surgery being the most common postoperative complications, diabetes insipida in two cases (10%) and CSF leak in one case. At present 2 patients are having hormonal treatment for panhypopituitarism. No patients developed a septal perforation, nasal deformity, epistaxis, meningitis, lip numbness or oronasal fistula. The rest did have good results noith no recurrence and hormonal values back to normal.
We made a retrospective descriptive study reviewing 92 patients with cervical lymph node metastases from unknown primary tumour. The study was accomplished during 6 years. (January 1996 to December 2001) in the Department of Otorhinolaryngology of the Hospital Reina Sofia, Córdoba. The median age was 61.7 years old, male 96.7% and heavy smoker (89.1%) and drinkers most of them. According to TNM categories, 72.2% patients were in phase N2a and half of them were localized Level II. Squamous cell carcinoma was the predominant histologic type. The patients were treated with surgery in 70.6% of the cases with or without radiation therapy and/or chemotherapy.
The diffuse idiopathic skeletal hyperostosis (DISH) or Forestier's disease is characterized by an hyperostosis of the anterolateral margin of the vertebral bodies. It is an uncommon cause of dysphagia in old patients. In the differential diagnosis of mechanical dysphagia we must have present this disease. Cervico-dorsal spine radiographies reveal large anterior osteophytes creating pharyngeal encroachment.
Extramedullary plasmacytomata (EMP) are rare malignant neoplasms composed of plasma cells, 90 percent of which occur in the neck and head area, but generally representing only 1 percent of tumors of that location. The paper report a case of extramedullary plasmacytoma of the larynx, in a 62-year-old man. We also review the different malignant plasma cell dyscrasias, paying special attention to the EMP, given its predilection for the upper aerodigestive tract.
The rate of occurrence of neoplasma arising from the parapharyngeal space is scarce, about 0.5 percent of neck and face tumors. In the paper is reported our 10-year experience on its clinical diagnosis and therapeutical management as well. We have found 13 percent (3/23) malignancies and 87 percent (20/30) benign growth. 35 percent were paragangliomas and 22 percent represent salivary tumors. Diagnostic procedures, ways of approach and surgical complications are considered.
The localization of Leishmania spp. in the larynx is rare but it has recently been described in patients infected by human immunodeficiency virus (HIV). The normal treatment given is antimonials. We describe a case of isolated leishmaniasis in the larynx which was cured by surgery. Our patient was a 47-year-old man who had suffered visceral leishmaniasis in his childhood with no immunosuppression.
We present a case of intracranial Tuberculoma of the cerebellopontine angle and discuss the problems to set up the preoperative etiological diagnosis. Finally we make a review of the literature of the subject.
A new surgical technique for the treatment of cholesteatoma is reported. The technique involves auto-exclusion for exteriorization of the attic and tympanic box only. The resulting cavity is rather small. The technique allows visual post-operative control of the attic and tympanic membrane. There is no visual access to the mastoid cavity which, however, is the most unlikely site for occurrence of a residual cholesteatoma. The proposed technique was applied to 102 patients and both the anatomic and functional results obtained are reported.
Idiopathic brain herniation into the middle ear and the mastoid process is an infrequent condition. There are only 29 cases reported in the world literature covering the last 40 years. The paper inform on one of those cases, a man, of spontaneous encephalocele and deals with the pathogenesis, the clinical features and the suitable surgical approach.
The AA. present a review of the expansive processes of the cerebellopontine angle (CPA) diagnosed at their Department, during the six last years. Emphasis is made upon the clinic findings gained through neuro-otological explorations and imaging, both helpful for preoperative diagnosis of the nature of the tumor.
We present a case of rhinocerebral mucormycosis in a 47 years old woman without diabetic or immunodepression past. The diagnosis was confirmed through a histological study of the material obtained after surgery. The treatment with amphotericin B and radical surgery showed ineffective. The patient died two weeks after entrance. We make an evaluation of the etiopathological, clinical and therapeutic aspects and also a revision of the relevant literature.