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Biomedical subjects

A Blasco Huelva

Publications and source records attributed to A Blasco Huelva.

At least 19 recordsLinked to original sources

[Utility of the surgical treatment for severe epistaxis by endoscopic approach of sphenopalatine and ethmoidal arteries].

INTRODUCTION: To evaluate the efficacy and cost-effectiveness of the treatments used for controlling epistaxis, particularly compared with the surgical endoscopic ligation or cauterization of sphenopalatine (SP) and anterior ethmoid (AE) arteries, a intervention prospective-retrospective study is presented with the aim of assessing the feasibility of these surgical techniques as an alternative to conventional treatments. PATIENTS AND METHODS: 184 consecutive patients admitted in the ENT ward between the years 1997 and 2005 were included in the study, and distributed into three groups depending on the last treatment applied to control their bleeding: AP group.- anterior packing (n=98); PP group.- posterior packing (n=66), and ES group.- endoscopic ligation and/or cauterization of SP or AE (n=20). RESULTS: Highly significant differences were found between the groups, not only regarding the efficacy (90% for surgical treatment compared with 41.3% for AP and 63.1% for PP), but also the length of postreatment hospital stay (AP.- 4.92 days; PP.- 6.3 days; ES.- 2.15 days). DISCUSSION AND CONCLUSIONS: The lack of efficacy of conventional treatment and the increasing risk factors that condition nasal bleeding, together with the advance of endoscopic and anesthesic procedures have brought along the possibility of a surgical solution for these patients. Our results demonstrate the feasibility of these techniques as alternative for nasal packing in the treatment of posterior epistaxis, and even its ethical and economical convenience as a substitutive to posterior packing.

Aged↗

[Practical aspects regarding endoscopic treatment for epistaxis].

INTRODUCTION: A prospective study is presented to evaluate some practical and financial aspects regarding surgical endoscopic ligation or cauterization of sphenopalatine (SP) and anterior ethmoidal (AE) arteries performed to control posterior nasal bleeding. PATIENTS AND METHODS: 35 patients admitted at the ENT ward between 2004 and 2006 were included in the study, and distributed into two groups depending on the protocol applied in each case. Until March 2005 the surgery was performed if there was failure or insecurity of the posterior packing, and since that date a substitutive surgical protocol (not including posterior packing) was applied. RESULTS: 82.9% of the patients were male, with a mean age of 55.74 years and a left bleeding in a 60% of the cases. Ligature/cauterization was performed on SP in 28 (80%) patients, on AE in 4 (11.4%), and on both arteries in 3 cases (8.6%). 38.7% of the SP approach only one sphenopalatine foramen was observed, through which an only branch of the artery passed; 42% of the cases two branches passed through an only foramen, and in 19.3% two or more branches were present, breaking into the nose through two or more independent clefts. AE was intradural in 3 cases, intranasal attached to the cranial base in other 3 and intranasal detached to the cranial base in 1 patient. Besides, highly significant differences were found between the two protocols, observing a mean reduction of hospital stay of 3.1 days, which throws up savings of 939.3 euros per patient. DISCUSSION AND CONCLUSIONS: Surgical treatment for epistaxis has proved to be effective (91.2% in our experience) and safe, determining an important reduction in hospital stay and avoiding the morbility of posterior packing. Accurate knowledge of the anatomy of the arteries implied and specific actuation upon the correct bleeding territory are essential to perform this surgery.

Adult↗

[Otolaryngologic manifestations of Churg-Strauss sindrome. Report of a case and review of the literature].

Churg-Strauss Sindrome or allergic granulomatosis is a small vessel systemic vasculitis characterized by asthma, hypereosinophilia and necrotizing vasculitis with extravascular eosinophil granulomas. We describe a case assisted in our hospital who presented pulmonary infiltrates, fever, peripherical neuropathy, weight loss, myalgia, rhinosinusitis, with antecedents of nasal polyposis, and facial edema. Our aim is to review the main otolaryngologic manifestations of this rare illness that is treated with oral corticosteroids, immunosupresor drugs like ciclofosfamide and plasmapheresis.

Adult↗

[Paraganglioma of the jugular foramen presenting with initial isolated vertigo].

The more common symptoms of the jugulotympanic paragangliomas are hearing loss, tinnitus and palsy of cranial nerves. Diagnosis is often delayed due to the slow growth of the tumour. We report one case with affectation of jugular foramen which clinically debuted as a peripheral vertigo and the diagnosis was made by CT, IRM and angiography. The patient was treated by Neurosurgery using Gamma Knife (radiosurgery) with good result.

Adult↗

[Advantages of the determination of parathyroid hormone (PTH) intraoperatively in hyperparathyroidism surgery].

OBJECTIVE: To evaluate the utility of rapid or turbo intraoperative parathyroid (PTH) assay in the surgery of hyperparathyroidism. Since 2000 to july 2004 we have used this test on 39 patients. 24 of them corresponded to primary hyperparathyroidisms and 15 to secondary forms. Our results showed a PTH decreasing percentage >70% at 15 minutes in 92.3% of the cases. Only in two patients (5.1%) persisted the hypercalcemia after the surgery and one was reoperated with good clinic evolution. As advantages we stand out the reduction of surgical time, permitting unilateral parathyroid exploration instead a bilateral in primary HPT, and the prediction of success by confirming the excision of all hyperfunctionating parathyroid tissue in patients with multiple gland hyperplasia.

Female↗

[Pontine cavernous angioma (cavernoma) with initial ENT manifestations].

We report the case of a 22 years old female who consulted us for facial parestesias, hearing loss in right ear and sudden tinnitus. Her audiometry showed an unilateral discreet sensorineural hipoacusia and the cranial IRM, a mass of 20 mm diameter in right pontine region and bulbus informed as cavernous angioma with signs of recent bleeding. The patient was sent to Neurosurgery but she refused the intervention. The risk of hemorrhage in the cavernomas is estimated at 0.25% to 1.6% per year and represents the main reason to advise a surgical treatment.

Adult↗

[Suppurative bacterial acute parotitis in adults. Clinic and microbiological findings in 10 admitted patients].

We report the clinic and microbiological findings that were obtained in 10 adult patients admitted by our ENT Service with diagnosis of suppurative bacterial acute parotitis. S. aureus and Streptococcus sp were the most isolated organisms. All the patients were treated by hidratation, endovenous antibiotic therapy sometimes modified according to the antibiogram results, analgesics and antiinflammatories with success. In 3 times it was necessary to drain the purulent collection and in one of them there was a retroauricular abscess secondary to sialoadenitis.

Acute Disease↗

[Relationship between repeating tonsillitis and Berger's disease. Report of A case and review of the literature].

Berger's disease, so called IgA nephropathy, is a mesangioproliferative glomerulonephritis characterized by recurrent episodes of gross hematuria in relation with ENT infections like tonsillitis. We report a clinical case which presented that association and make a review of the literature about the possible advantages of tonsillectomy on the evolutive course and prognosis of the nephropathy.

Adult↗

[Congenital hemangioma arising of internal orbitary edge. Importance of ENT exploration and treatment options].

Hemangiomas are the most common tumors in children. It id reported the case of 11 months girl with congenital hemangioma at internal orbitary edge. ENT exploration is essential to rule out the affectation of nose and paranasal sinuses as well as other associated similar injuries in head and neck. As complementary tests we asked for CT and IRM to delimit the tumoration whose classic treatment are oral corticoids in high doses. Surgery usually is reserved for refractory cases to the medical therapy although the present exposition is changing due to different factors that we expose in the final discussion.

Brain↗

[Arachnoid cyst of cerebellar-pontine angle clinically mimicking Meniere's disease].

Arachnoid cysts represent about 1% of all intracranial space-occupying lesions. Usually they are located in the middle cranial fossa while their localization in the posterior fossa is uncommon and generally remain asymptomatic or those are non-specific. The case of a 51 years old female is reported who was diagnosed by IRM of a 4,5 x 2 cm arachnoid cyst, situated on the left cerebello-pontine angle, with tinnitus, hearing loss and vertigo that mimicked a Meniere's attack. We think thees benign tumors must be included in the differential diagnosis of Meniere's disease because they can be indistinguishable from it clinically.

Arachnoid Cysts↗

[Plaut-Vincent's acute necrotizing ulcerative fusospirillum tonsillitis associated to infectious mononucleosis].

We report the case of a 14 years old girl patient with recurrent tonsillitis who had been diagnosed and admitted previously with Plaut-Vincent's angina. Six weeks after leaving the hospital she was assited in Emergencies by an infectious mononucleosis associated to unilateral tonsillar necrotizing ulceration from which a sample was taken to microbiological exam finding the fusospirochaetal complex Borrelia vincenti and Fusobacterium necrophorum. A literature review at the respect of such association and its treatment is performed.

Acute Disease↗

[Bogorad syndrome or crocodile tears after Ramsay-Hunt].

Crocodile tears or Bogorad Syndrome describes a complication or sequel after facial palsy with incomplete recovery characterized by an excessive hyperlacrimation during the food ingestion. We report the case of a 50 years old female with that pathology associated to facial syncinesias secondary to suffer a right Ramsay-Hunt syndrome. Its pathogenesis and different treatment modalities are analysed.

Female↗

[Cervical abscess by Streptococcus anginosus-milleri after foreign body ingestion and suspicion of esophageal perforation].

We report a case of cervical abscess after the ingestion of foreign body (chicken bone) secondary to probable esophageal perforation that it was sent to us with suspicion of mediastinal complication. The girl, 17 years-old, nothing else to arrive our hospitalary center required entrance in ICU due to her severe clinical process: High fever, intense neck-thoracic pain, laterocervical diffuse and progressive left inflammation and bad general state. The CT showed the presence of a well defined abscess and abundant aerial component that dissected the cervical muscles that made necessary to perform drainage verifying intraoperatively no mediastinal involvement. The culture of the purulent collection revealed Streptococcus anginosus/milleri resistant to clindamicine but sensible to penicilina and derivatives. We exposed a serie of considerations at respect of such microorganism and its clinical signification.

Abscess↗

[Unspecific cervical cellulitis of sudden appearance. Report of an atypical case].

We report an atypical case of sudden and unspecific cervical cellulitis in a 74 yaers old woman with psoriasis as the only remarkable antecedent. After the initial exploration and successive ones we did not find any etiological causes for her symptoms. CT showed an increase of soft parts on the left side of the neck with displacemnet of the upper airway without purulent collection or abscess. The patient was admitted in IUC and was treated endovenously with cloxaciline and imipenem with good response and satisfactory evolution.

Aged↗

[Laryngeal chondrosarcoma of low grade of malignancy. Report of a case located on thyroid cartilage].

Cartilaginous tumors of the larynx are rare. Only a 2-5% of all chondrosarcomas arise on head and neck area while the laryngeal forms represent less than 1% of the malignant neoplasms in that location. Laryngeal chondrosarcoma is three times more frequent in men than in women with average age of presentation about the 6th - 7th decades. Most of them are originated on cricoid (70-75%) followed by the thyroid cartilage (10-20%) as in the case that we are reporting. Its growth often is very slow with delayed clinic being hoarseness, dyspnea and dysphagia the most common symptoms. Laryngeal chondrosarcomas use to be tumors with low-grade of malignancy and their elective treatment is surgery preserving the laryngeal function. Local and late recurrences are frequent and the definitive diagnosis is the anatomopathological exam.

Chondrosarcoma↗

[Adenoid cystic carcinoma of the larynx-hypopharynx. A case report and review of the literature].

Laryngeal or hypopharyngeal localization of adenoid cystic carcinoma is rare due to the poor distribution of the accesory salivary glands in this area. We report one case of such neoplasm on that area, with its diagnosis confirmed histologically. The required a total laryngectomy with later reoperations because of hemorrhage and pharyngeal fistula. One year after the surgery and in spite of postoperative radiotherapy multiple pulmonary metastasis were detected causing the death of the patient. We review the literature of this tumor whose prognosis is much worse than epidermoid or scamous carcinoma.

Carcinoma, Adenoid Cystic↗

[Diffuse sclerosing papillary carcinoma mimicking chronic lymphocytic thyroiditis. A unusual neoplasm variant].

We report the clinical case of a 39 years old female diagnosed as a chronic lymphocytic tiroiditis by F.N.A.B. with multinodular goiter of long evolution. The patient was operated by total thyroidectomy and her final anatomopathologic result was papillary carcinoma diffuse sclerosing variant. During the surgical act several cervical nodes were detected and removed being informed the most of them as metastasic. A review of the literature at respect of this malignant neoplasm is performed.

Adult↗

[Parotid phlegmon with involvement of both lobes. Report of a case].

The pathologic processes involving the parotid gland include a vast group of lesions, acute and chronic inflammations, benign and malign tumors, traumas or degenerative processes. We report the case of a 55 years old male diagnosed as left parotid phlegmon with involvement of both lobes, especially the deep one, who required admission and endovenous medical treatment for 6 days up to the resolution of the symptoms.

Amoxicillin-Potassium Clavulanate Combination↗