Biomedical subjects
Publications and source records attributed to S Santos Pérez.
The pleomorphe adenomas (PA) of the tongue base are rare (there are only 6 cases published until now) We present one case of a male 42 years old with a PA of the tongue base very big but with few symptoms. The FNAB and MRI were the key for the diagnosis and therapy. The treatment was surgical with a trans oral resection. The patient is free of tumor after seven years.
Literature about normal parameters of Craniocorpography (CCG) is scant and poorly documented. Its results are variable according to the series. Our aim is to reach a criteria of normality for CCG in our reference population. We have prospectively made Romberg and Unterberger tests to 72 healthy volunteers (mean age 34.7 years old, SD 17.07, 55.6% men) using a computerized method of measurement and making its estimation by means of a statistical model widely accepted. All the studied variables observe the conditions of Gaussian distribution. The normal limits for lateral and antero-posterior oscillation were 9 centimeters, 12 centimeters for lateral sway and 59 degrees to the right and 46 degrees to the left for angular deviation. The computerized method of analysis has facilitated the detection of the limits of the light tracings, which together with the careful design of our study guarantees the validity of the results.
We performed a prospective study to evaluate the efficacy of three physical treatments for benign paroxysmal positional vertigo: Brandt & Daroff habituation exercises, the Semont manoevre (intended as a statoconia-detachment maneuver), and the Epley maneuver (intended as a statoconia-repositioning maneuver). A total of 106 BPPV patients were randomly assigned to one of the three treatment groups, and responses were evaluated one week, one month and three months after the initial treatment. At the one-week follow-up, similar cure rates were obtained with the Semont and Epley maneuver (74% and 71% respectively), both cure rates being significantly higher than that obtained with Brandt & Daroff exercises (24%). By the three-month follow-up, the cure rate obtained with the Epley maneuver was higher (93%) than that obtained with the Semont maneuver (77%), though both remained higher than that obtained with the Brandt & Daroff maneuver (62%). However, the proportion of initially responding patients showing subsequent relapse was lower among patients treated by the Semont maneuver than among patients treated by the Epley maneuver. In view of these findings, we propose a treatment algorithm for patients with BPPV.
The spread on Otoneurologic Units are increasing in number, because of the specific pathologic subjects it deals. But there are scanty epidemiologic studies on patients concurrent to these Unities. We report the data from a descriptive statistic pertaining to the Otoneurological Unit of our Hospital, in the wholly 1996. During this period of time 914 patients were attended, middle-aged 49.55, and the relation men/women being 0.61. The majority housewives, living in rural districts, prevailing the married women patients. The two ways of sanitary access more employed in so cases were: the otologist of the Social Security or reporting to the Urgency-Units of Hospitals. And the more complaining trouble was imbalance. Diagnosis more repeated was labyrinthine pathology due to ischemia and secondary vestibular conditions because cervical muscles contractures. We consider the profile of our patient group enhances the special risk in order to endure otoneurological pathology. And also we point out the fact that the most diagnosis are not related specially to vestibular pathology, but to other clinical entities not directly linked to an Otoneurologic dispensary.
Vocal cord dysfunction is a respiratory condition characterized by anomalous adduction of the vocal cords during inspiration, causing significant air flow limitation in the larynx. Few such cases have been described in which dysfunction is triggered by exercise. We report the case of a young women with severe dyspnea appearing as a result of physical activity. We first deal with issues of differential diagnosis in relation to several other diseases, particularly exercise-induced asthma and then discuss therapeutic approaches.
Kaposi's Sarcoma is a malignant neoplasty originated in vascular endothelial cells. Such medical case appears as its classical type located in the tongue and inferior limbs. The therapy consisted of intralesional injections of interferon alfa, leading into better clinic and macroscopic conditions of the injuries.
A retrospective study was made of 170 patients diagnosed as Bell's palsy in a 7-year period (August 1990 to April 1997). We evaluated two prognostic factors: stapedial reflex and electroneurography findings. The condition was classified by nerve affection into three types: less than 10%, 10 to 30%, and over 30%. The evolution of our patients was: complete recovery in 86.4%, slight impairment in 2.9%, major impairment in 3.5%, and unknown in 7%. The stapedial reflex was present in 87 patients, absent then present in 26 patients, and absent in 5 patients. Electroneurography revealed less than 10% nerve involvement in 5 patients, 10-30% in 18 patients, and over 30% in 63 patients.
The increasing number of intracranial complications of otic origin seen by the AA. in the previous 6 years, prompted them to make a survey of the respective files. In all, 9 patients were included in the group, with ages ranging from 18 to 72 years. Everyone showed marginal tympanic perforations with cholesteatoma. At their first visit to the office neurologic symptoms were present (mean time from beginning was 12 days) as an aftermath of chronic otitis. Meningitis, brain (temporo-parietal, temporal) and cerebellar abscesses of the implicated side were the diagnosis. Decisive for diagnosis was the CAT examination, being much better than the NMR (done once). Cases were managed in cooperation with the neurosurgical team. The mean time of hospitalization was 1 month. Eight cases did well (2 with neurologic sequels); the follow-up of the ninth patient is unknown.
By the moment, craniocorpographic record of the Romberg test has been scarcely used in clinical practice. Since craniocorpography is a method for recording oscillations of the head and shoulders, it can show characteristic patterns in patients with vertigo caused by increased muscle tension in the neck. In order to confirm this hypothesis, a prospective comparative study was performed with 329 patients. They were included in three different groups: patients with cervical vertigo, patients with vestibular pathology and a healthy control group. Movements of the head (with static shoulders) are more usual in patients with cervical vertigo (67%) than in those with vestibular pathology (27%) and healthy subjects (31%). With regard to the kind of head oscillations, front-back flexions and oscillations in all directions were the most frequent (36% and 34%, respectively). Nevertheless, the only movements previously reported (cervical rotation or torsion) only were 3% of total head movements in our study. We concluded that static craniocorpography is an useful method in diagnosing vertigo secondary to increased muscle tension in the neck.
UNLABELLED: The widespread use of gadolinium-enhanced MRI (Gd-MRI) in our hospitals has supposed an increase in detection of asymptomatic acoustic neuromas (AN) as incidental finding. Concurrent primary intracranial tumors of different cell types are extremely uncommon. CLINICAL CASE: A 23 year-old woman complained of irregular menstrual cycles and galactorrhea for two years. A Gd-MRI scan showed a pituitary macroadenoma and an AN of 1.4 cm. with intracanalicular and cisternal extension. The patient did not have any otologic or neuro-otologic symptoms or signs. Audiograms revealed bilateral normal hearing. The results of acoustic reflex test and electronystagmographic caloric tests were normal. The AN underwent radiosurgery treatment. DISCUSSION: The literature about atypical AN is reviewed, giving a particular concern on asymptomatic cases. We only have found one case of association between AN and pituitary adenoma. The real prevalence of AN in general population is discussed.