Biomedical subjects
Publications and source records attributed to D Morais.
The osteomas of the mastoids are slow growing benign tumors, made predominantly of mature bone. Clinically these tumors are asymptomatic, except for cosmetic deformities, and they are usually casual radiological findings. Surgical treatment is indicated for symptomatic osteomas. In Spain only sixteen cases of extracanalicular osteoma have been described in the literature. Two new cases are reported and a review of the literature is presented.
These are the results of the first year of the application of a universal programme for the early detection of neonatal deafness. Our objective is making a diagnosis of all the unilateral or bilateral cases of hearing loss above 35 dB HL, before the age of 6 months. The detection strategy has 2 screening phases with transient evoked otoacoustic emissions (TEOAE) and one diagnostic phase with auditory brain stem response (ABR). The ABR were carried out both on those patients that failed the TEOAE screening and on the neonates with hearing loss risk factors. Of the 1,277 living newborn babies (NB), we evaluated 94%. 3.3% of the NB showed hearing loss risk factors. 90% of the NB passed the first TEOAE in both ears and, after the second TEOAE, only 2.5% of the NB reached the diagnostic phase. We provided early detection and treatment of 0.58% of cases of bilateral severe-deep hearing loss. Finally, the results obtained are examined together with the importance of planning universal hearing screening.
In coordination with the Paediatrics Department, we drew up a protocol for the "Early Detection of Hearing Loss in High-Risk Neonates" based fundamentally on the sequential application of impedanciometry and the Auditory Brain Stem Response (ABR). These are the results obtained from October 1994 to March 2001. Of the 240 children examined, we found 36 cases (15%) of severe-to-profound bilateral sensorineural hearing loss (> 60 dBs HL). 55% was associated with risk factors. However, we diagnosed only 2 of these cases of hearing loss (5.5%) using the protocol (sent by the neonatology department due to the fact that they showed hearing loss risk factors), since the rest (94.5%) came as a result of suspected hearing loss, which resulted in an average age for diagnosis of 3 years. Although the procedure used is highly sensitive and is diagnostically specific, in the light of these results, we consider it necessary to extend hearing screening to all newborn infants in order to evaluate its effectiveness in the early detection of infant deafness.
In a previous report, we showed the efficacy of the submucous sclerosant therapy with Etoxiesclerol (Polidocanol) in two patients with Rendu-Osler-Weber disease. We confirm, in this present study, the advantages of Etoxiesclerol in the treatment of the epistaxis in the Rendu-Osler disease, in six patients, 3 males and 3 females and likewise in two patients with non-specific granuloma of nasal septum and another patient with cavernous hemangioma of soft palate.
Vascular malformations of the jaws can lead to disastrous complications, but there seems to be no consensus as to their treatment. The literature presents the pathophysiology and clinical aspects of these lesions, as well as the divergent views of the authors. Treatment by catheterization and embolization, with direct transosseous injection of cyanoacrylate, appears to be the least harmful and most permanent treatment in certain conditions, as evidenced by the case of this 9-year-old patient having a high-flow mandibular vascular malformation
A case report of pilomatrixoma, benign neoplasy, originated of the skin annexes, which localisation force us to rule out a parotid tumor. Our intention is to include the pilomatrixoma among the possible differential diagnosis of calcified masses inside the growths of the parotid gland.
The unilateral abscess of the anterior portion of the tongue is an extremely rare occurrence. We report a case in which we have used the ultrasonography in the diagnosis, and discuss, as etiologic hypothesis the participation of Blandin-Nühn glands in the genesis of these abscess.
Tumoral disease of the arteries is uncommon. It is possible that, in tumoral reoperations affecting cervical structures, periarterial fibrosis due to radiotherapy and previous surgery and metastatic adherences to the arterial wall makes radical surgery difficult. We present a case where the surgical treatment of a regional relapse from laryngeal neoplasm needed the removal of the common carotid artery and its reconstruction with autologous patent superficial femoral artery. Surgical technique included a PTFE graft interposition in the leg.
Cementifying fibroma is a benign fibro-osseous lesion with dental origin. We describe a case of cementifying fibroma of the maxillary sinus, an unusual location for this tumor.
The symptomatology sometimes due to a giant styloid process can be very troublesome and at the same time unspecific, raising differential diagnosis problems with a large group of pathologies. We report a clinical case of elongated styloid syndrome, stylalgia or Eagle's syndrome, that forced our team to the exeresis of the anomalous process. We emphasizes the relative simplicity of the diagnosis and its treatment as well, especially when the intrabucal approach is followed.
A case of nasopharyngeal fibrous diaphragm of unknown origin is reported. In view of the scarcity of publications about this disorder, this new case is interesting. A differential diagnosis is made with choanal atresia and nasopharyngeal stenosis. Aspects of the etiology, clinical manifestations, and treatment are discussed.
Metastatic carcinoma of the tonsil is rare with only some 100 cases having been reported in the literature, of which nine have resulted from stomach carcinoma. Tonsillar metastases rarely become apparent before the diagnosis of the primary neoplasm. We describe here the clinical and histopathological findings of a case of unilateral palatine tonsil metastasis as the first sign of a signet-ring cell carcinoma of the stomach. This has not been reported previously.
The AA. present one case in which the air-way was severely compromised because of the causative vertebral ankylosing hyperostosis, the so-called Forestier-Rotés's malady. Only 7 of resembling cases are recorded in the consulted literature. Survey of the related bibliography and comments about pathogenic criteria and diagnostic and therapeutic questions as well.
The AA. having had the opportunity to diagnose and treat one of those cases, of low degree, sitting in the nasal cavity, discuss about its classification either in the nose or in the sinuses. Their opinion is coincidental with that of other reporters regarding to the complexity and varieties of a grouping system. They propose an other one, not original at all, but having perhaps the advantage that could make easier the comprehension and the clinical orientation when dealing with these growths.
The form of the anterior mandible in 45 patients was assessed before, immediately after, and 1 year after genioplasty. A specific, consistent pattern of bone apposition and resorption was observed after advancement genioplasty. A consistent but inverse apposition-resorption pattern was observed after reduction genioplasty. In view of the observed pattern of bony change, it is recommended that fixation devices for genioplasty be placed in areas of future bone deposition.
The AA. report the case of a 79 years-old patient suffering an esophageal stenosis managed with intubation (Celestin's tube). This instance shows the good tolerance of the prosthesis by the patient as well as the undue of its stay. And by the way, the simplicity of its removal with a rigid esophagoscope, as was the present case. The paper contemplates a brief review of the indications for esophageal intubation and possible complications when dealing with organic stenosis of the esophagus.
Quinsy cases following tonsillectomy are very rare indeed, as proved by the scarce publications related to the subject. And all of them presented after a long term of years elapsed. From the perusal of the bibliography done by the AA. none of the cases presented close to the operation. The chance to see and treat one case starting from the fourth postoperative day compelled the AA. to report it.