RESUMEN
A retrospective study of 142 patients that had previous surgery for carcinoma of the tongue or floor of mouth looking into the factors that affect significantly the evolution of our patients and in which circumstances we could benefit from new therapeutic techniques. Cause specific survival at 3 and 5 years was 63.4% and 56.9% respectively. Recurrences were found locally in 32 patients (22.5%), regional in 32 (22.5%) and metastasis in 11 (7.4%). T staging had no did impact on local recurrence, but the presence of positive margins (p = 0.0323). Regional control for N0/N1 was 85% (90/106) versus 55.5% (20/36) for N2/N3 (p = 0.001). Regional control by N staging was 84.5% (73/86) for N0, 85% (17/20) for N1, 57% (30/35) for N2 and 0% for N3 (0/1). Both, N staging and number of positive nodes had a significant impact in specific survival. Positive margins and the presence of positive nodes have the greatest impact on survival and regional control. Adjuvant postoperative radiotherapy did not increase survival, but not prospective random selection was performed. To evaluate this.
Asunto(s)
Carcinoma de Células Escamosas/mortalidad , Suelo de la Boca , Neoplasias de la Lengua/mortalidad , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/terapia , Humanos , Persona de Mediana Edad , Suelo de la Boca/efectos de la radiación , Suelo de la Boca/cirugía , Estadificación de Neoplasias , Estudios Retrospectivos , Tasa de Supervivencia , Neoplasias de la Lengua/patología , Neoplasias de la Lengua/terapiaRESUMEN
Hemos realizado un estudio retrospectivo de 142 pacientes intervenidos de carcinoma de lengua móvil o suelo de boca buscando qué factores afectan de forma significativa la evolución de nuestros pacientes y en qué circunstancias podríamos beneficiarnos de nuevas modalidades terapéuticas. La supervivencia causa específica a 3 y 5 años fue de 63,4 por ciento y 56,9 por ciento respectivamente. Se detectó una recidiva local en 32 pacientes (22,5 por ciento), regional en 32 (22,5 por ciento) y a distancia en 11 (7,4 por ciento). No se ha encontrado influencia del T en la incidencia de recidiva local pero sí lo tiene la presencia de márgenes positivos (p=0,0323). El control regional en N0/N1 fue de un 85 por ciento (90/106) frente a un 55,5 por ciento (20/36) en los N2/N3 (p=0,001). El control regional, especificado por estadio N fue de 84,5 por ciento (73/86) en los N0, 85 por ciento (17/20) en los N1, 57 por ciento (30/35) para los N2 y 0 por ciento para los N3 (0/1). Tanto el estadio N como el número de ganglios mostró una significativa repercusión en la supervivencia específica. En nuestra experiencia los factores que mayor impacto tienen en el control del cáncer de cavidad oral y suelo de boca son la presencia de bordes quirúrgicos infiltrados y el estado del cuello. El empleo de radioterapia adyuvante no implicó un incremento en la supervivencia, si bien no se hicieron grupos aleatorios para su valoración (AU)
A retrospective study of 142 patients that had previous surgery for carcinoma of the tongue or floor of mouth looking into the factors that affect significantly the evolution of our patients and in which circumstances we could benefit from new therapeutic techniques. Cause specific survival at 3 and 5 years was 63.4% and 56.9% respectively. Recurrences were found locally in 32 patients (22.5%), regional in 32 (22.5%) and metastasis in 11 (7.4%). T staging had no did impact on local recurrence, but the presence of positive margins (p = 0.0323). Regional control for N0/N1 was 85% (90/106) versus 55.5% (20/36) for N2/N3 (p = 0.001). Regional control by N staging was 84.5% (73/86) for N0, 85% (17/20) for N1, 57% (30/35) for N2 and 0% for N3 (0/1). Both, N staging and number of positive nodes had a significant impact in specific survival. Positive margins and the presence of positive nodes have the greatest impact on survival and regional control. Adjuvant postoperative radiotherapy did not increase survival, but not prospective random selection was performed. To evaluate this (AU)
Asunto(s)
Persona de Mediana Edad , Adulto , Anciano de 80 o más Años , Anciano , Humanos , Suelo de la Boca , Carcinoma de Células Escamosas/mortalidad , Neoplasias de la Lengua/mortalidad , Tasa de Supervivencia , Estudios Retrospectivos , Estadificación de NeoplasiasRESUMEN
La cirugía mayor ambulatoria es una actividad con tendencia creciente en la otorrinolaringología. Numerosos estudios han validado la utilidad de algunas intervenciones, como la septoplastia y la cirugía endoscópica nasosinusal realizadas de forma ambulatoria, sin embargo no se han comparado los resultados de la septorrinoplastia ambulatoria frente a cirugía con ingreso, pese a ser una práctica común. Se presenta un estudio sobre los resultados estéticos y funcionales y la incidencia de complicaciones en 40 septoplastias y 40 septorrinoplastias realizadas mediante cirugía sin ingreso en un período de dos años y se las compara con el mismo número de intervenciones realizadas con ingreso. Asimismo, se realiza un cuestionario sobre la satisfacción del paciente tras la cirugía. No se han presentado complicaciones graves en ninguno de los grupos. El número de complicaciones, los resultados funcionales y estéticos y el grado de satisfacción de los pacientes no difirieron en ninguno de los dos grupos. La cirugía septopiramidal (septoplastias y septorrinoplastias) puede ser realizada con poco riesgo deforma ambulatoria, manteniendo la misma calidad en los resultados (AU)
Outpatient surgery is an activity that increases constantly in Otolaryngology. There are studies about some nasal surgery techniques, such as septoplasty or endonasal endoscopic performed as outpatient surgery, but so far nobody has reported any comparative analysis on the results of outpatient septorhinoplasty, although this is a frequent practice. We report our experience with 40 cases of outpatient septoplasty and 40 outpatient septorhinoplasty, performed by the same surgeon, and we make a comparative study with the same number of operations performed on in-patients with traditional surgical techniques. Aesthetic and functional results and satisfaction level in postoperative interviews were compared in both cases. No serious complications were present in either group. The number of complications, the functional and aesthetic results and the degree of patients satisfaction were similar in both groups. Septopyramidal surgery (septoplasty and septorhinoplasty) is suitable to be performed on outpatient with the same quality as in-patients (AU)
Asunto(s)
Persona de Mediana Edad , Adolescente , Adulto , Humanos , Satisfacción del Paciente , Procedimientos Quirúrgicos Ambulatorios , Rinoplastia/métodos , Tabique Nasal/cirugía , Resultado del TratamientoRESUMEN
With improved loco-regional control of cancer of the head and neck, second primary tumors (SPT) have an increasingly negative impact on survival. The appearance of SPT depends on the location and extension of the primary and is associated with lower survival. SPT were studied in a series of 1493 previously untreated patients with carcinoma of the head and neck and a minimum follow-up of 2 years. SPT occurred in 6.3% (96/1493). SPT were associated with the following primary tumor sites: 10.8% (57/727) larynx, 4% (6/153) hypopharynx, 4% (16/404) oral cavity, and 4% (6/153) oropharynx. Forty-three percent (42.7%) of SPT were carcinomas of the head and neck, 27% bronchogenic carcinomas, and 17.7% esophageal carcinomas. Survival at 6 months, 1 year, 3 years, and 5 years of patients diagnosed as SPT was 62%, 43%, 21%, and 16%, respectively.
Asunto(s)
Carcinoma de Células Escamosas/terapia , Neoplasias de Cabeza y Cuello/terapia , Neoplasias Primarias Secundarias/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Terapia Combinada , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Análisis de SupervivenciaRESUMEN
Con la mejora en el control loco-regional del cáncer de cabeza y cuello la aparición de los segundos tumores primarios (STP) es un factor que condiciona el incremento de la supervivencia. Presentamos los STP que aparecieron en una serie de 1.493 pacientes con carcinomas de cabeza y cuello, con un seguimiento mínimo de 3 años. El índice de STP fue del 6,3 por ciento (9611.493). La localización del tumor primario que más se asoció con la aparición de un STP fue la laringe con un 10,8 por ciento (571727), seguido de la hipofaringe 4 por ciento (61153), cavidad oral 4 por ciento (161404) y orofaringe 4 por ciento (61153). El 42,7 por ciento de los STP *correspondieron a carcinomas de cabeza y cuello, un 27 por ciento a carcinomas bronquiogénicos y un 17,7 por ciento a carcinomas de esófago. La tasa de supervivencia a los 6 meses, 1 año, 3 años y 5 años de diagnosticado el STP fue de 62 por ciento, 43 por ciento, 21 por ciento y 16 por ciento, respectivamente (AU)
With improved loco-regional control of cancer of the head and neck, second primary tumors (SPT) have an increasingly negative impact on survival. The appearance of SPT depends on the location and extension of the primary and is associated with lower survival. SPT were studied in a series of 1493 previously untreated patients with carcinoma of the head and neck and a minimum follow-up of 2 years. SPT occurred in 6.3% (96/1493). SPT were associated with the following primary tumor sites: 10.8% (57/727) larynx, 4% (6/153) hypopharynx, 4% (16/404) oral cavity, and 4% (6/153) oropharynx. Forty-three percent (42.7%) of SPT were carcinomas of the head and neck, 27% bronchogenic carcinomas, and 17.7% esophageal carcinomas. Survival at 6 months, 1 year, 3 years, and 5 years of patients diagnosed as SPT was 62%, 43%, 21%, and 16%, respectively (AU)
Asunto(s)
Persona de Mediana Edad , Adulto , Anciano de 80 o más Años , Anciano , Masculino , Femenino , Humanos , Carcinoma de Células Escamosas , Neoplasias Primarias Secundarias/epidemiología , Neoplasias de Cabeza y Cuello/terapia , Análisis de Supervivencia , Incidencia , Terapia CombinadaRESUMEN
Outpatient surgery is an activity that increases constantly in Otolaryngology. There are studies about some nasal surgery techniques, such as septoplasty or endonasal endoscopic performed as outpatient surgery, but so far nobody has reported any comparative analysis on the results of outpatient septorhinoplasty, although this is a frequent practice. We report our experience with 40 cases of outpatient septoplasty and 40 outpatient septorhinoplasty, performed by the same surgeon, and we make a comparative study with the same number of operations performed on in-patients with traditional surgical techniques. Aesthetic and functional results and satisfaction level in postoperative interviews were compared in both cases. No serious complications were present in either group. The number of complications, the functional and aesthetic results and the degree of patients satisfaction were similar in both groups. Septopyramidal surgery (septoplasty and septorhinoplasty) is suitable to be performed on outpatient with the same quality as in-patients.
Asunto(s)
Procedimientos Quirúrgicos Ambulatorios , Tabique Nasal/cirugía , Satisfacción del Paciente , Rinoplastia/métodos , Adolescente , Adulto , Humanos , Persona de Mediana Edad , Rinoplastia/efectos adversos , Rinoplastia/psicología , Resultado del TratamientoRESUMEN
Nasal septal perforations are anatomical defects of the nasal septum, causing dynamic alterations in nasal physiology which may lead to variable symptoms and otolaryngological referral. Repair of nasal septal perforations continues to remain a difficult surgical problem, and nowadays there is no definitive solution for their successful surgical closure. Thirty patients with small- or medium-sized anterior nasal septal perforations were treated with a simple technique of backwards extraction-reposition of the quadrangular cartilage. Prior nasal septal surgery and repeated cautery were the most common cause of perforation. After a minimum follow-up of two years the success rate for relief of symptoms and closure of the perforation was 87 per cent. This technique showed very good results in small-sized and selected cases with medium-sized perforations, but the mucosal dissection employed is not suitable for medium to large perforations.
Asunto(s)
Tabique Nasal/lesiones , Tabique Nasal/cirugía , Deformidades Adquiridas Nasales/cirugía , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Rinoplastia/métodos , RoturaRESUMEN
The relationship between emergency tracheotomy (ET) and stomal recurrence (SR) was evaluated in 369 patients who underwent surgery for laryngeal cancer. Emergency tracheostomy was performed in 31 patients. Age, sex, primary location, T stage, pN stage, histological grading, and time from emergency tracheotomy to definitive treatment were examined. Stomal recurrence occurred in 2.1% overall; in 1.2% of the tracheotomy-free group, and in 13% (4/31) of the emergency tracheotomy group (p < 0.0001). Recurrences were significantly more frequent in subglottic (p = 0.00007) and T3 lesions (p < 0.0001). Emergency tracheostomy often is needed in patients who have primary subglottic tumors or tumors than invade the subglottis. The relationship between ET and SR appears to be more circumstantial than causal. Aggressive local treatment is recommended in patients with subglottic lesions or subglottic tumor extension to prevent SR.
Asunto(s)
Traqueostomía , Traqueotomía , Adulto , Anciano , Carcinoma de Células Escamosas/cirugía , Urgencias Médicas , Femenino , Humanos , Neoplasias Laríngeas/cirugía , Laringe/cirugía , Masculino , Persona de Mediana Edad , Recurrencia , Estudios RetrospectivosRESUMEN
Retrospective study about 10 verrucous carcinomas of the larynx surgically treated in a 20-year-term. This variety accounted por the 1.9 percent of the cancers seen in that period of time. Tabagism and alcoholism predominated in 8 and 6 patients respectively. Glottis was the localization and dysphony the paramount symptom. In the paper are emphasized the most important histologic features. Koilocytosis was present in 6 cases. Four patients developed a second tumor of epidermoid carcinoma type. No one exitus due to the verrucous growth. Only in 3 the death was attributed to the second malignancy.
Asunto(s)
Carcinoma Verrugoso/patología , Neoplasias Laríngeas/patología , Laringe/patología , Adulto , Anciano , Carcinoma Verrugoso/radioterapia , Carcinoma Verrugoso/cirugía , Humanos , Neoplasias Laríngeas/radioterapia , Neoplasias Laríngeas/cirugía , Laringe/cirugía , Masculino , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
Presenting a study about Human Papillomavirus (HPV) determination by immunohistochemistry and "in situ" hybridization, in 25 samples of squamous cell papillomata (15 tonsilar and 10 laryngeal lesions). Five cases resulted positive for HPV: 2 of them for immunohistochemical probes, other 2 for "in situ" hybridization and only 1 cas showed its positivity for both techniques. All these samples belonging to laryngeal cases. No significant differences were found in antecedents, clinical and histological features related with results obtained. Two patients developed a laryngeal carcinoma after papilloma and they had positive "in situ" hybridization. Literature about diagnosis of HPV-infection was revised.
Asunto(s)
Neoplasias Laríngeas/virología , Papiloma/virología , Papillomaviridae/aislamiento & purificación , Neoplasias Tonsilares/virología , Adulto , ADN Viral/análisis , Femenino , Humanos , Inmunohistoquímica , Hibridación in Situ , MasculinoRESUMEN
BACKGROUND: Cytomegalovirus (CMV) infection is a common opportunistic pathogen in transplant recipients; however, cytomegaloviral laryngitis is extremely rare. METHODS: We present a case of disseminated CMV infection and ulcerating necrotizing laryngitis situated in the subglottis of an immunocompromised patient with a renal and cardiac transplant. The patient was initially seen with discomfort in the throat. RESULTS: Physical examination of the head and neck, fiberoptic laryngoscopy, and CT scan of the larynx were normal. Histopathology of a laryngeal ulcer in the subglottic region showed intranuclear and intracytoplasmic bodies. Immunoperoxidase stain and in situ hybridization studies were positive for CMV. CONCLUSIONS: In immunosuppressed patients with persistent throat symptoms, the systematic exploration of larynx and bronchus is necessary to rule out the presence of opportunistic infections.
Asunto(s)
Infecciones por Citomegalovirus/complicaciones , Laringitis/virología , Adulto , Resultado Fatal , Trasplante de Corazón , Humanos , Terapia de Inmunosupresión/efectos adversos , Trasplante de Riñón , Masculino , Infecciones Oportunistas/virologíaRESUMEN
The incidence of p53 antigen and human papillomavirus (HPV) expression in archival formalin-fixed, paraffin-embedded tissue sections from verrucous carcinoma of the larynx was determined using immunohistochemistry. The p53 oncoprotein was detected in four of 10 tissue samples (40 per cent). The same number of tumours had HPV antigen, and three cases had both p53 oncoprotein and HPV antigen. All positive cases were from heavy smokers and drinkers. After surgical treatment, no tumour recurrence was present in our series. Four patients developed a second head and neck neoplasm and death occurred in three. Three of the patients with second tumour had p53 positive immunoreactivity and two had p53 and HPV expression. Verrucous carcinoma of the larynx presented with overexpression of p53 antigen in a similar percentage to other head and neck cancers. The p53 immunohistochemical determination is well correlated with HPV detection and could have prognostic value in these tumours, but no statistical evidence was present.
Asunto(s)
Antígenos Virales/análisis , Carcinoma Verrugoso/virología , Neoplasias Laríngeas/virología , Papillomaviridae/inmunología , Proteína p53 Supresora de Tumor/análisis , Adulto , Anciano , Consumo de Bebidas Alcohólicas/efectos adversos , Biomarcadores de Tumor/análisis , Carcinoma Verrugoso/química , Carcinoma Verrugoso/etiología , Neoplasias de Cabeza y Cuello/química , Neoplasias de Cabeza y Cuello/etiología , Neoplasias de Cabeza y Cuello/virología , Humanos , Inmunohistoquímica , Neoplasias Laríngeas/química , Neoplasias Laríngeas/etiología , Masculino , Persona de Mediana Edad , Neoplasias Primarias Secundarias/química , Neoplasias Primarias Secundarias/etiología , Neoplasias Primarias Secundarias/virología , Fumar/efectos adversosRESUMEN
The clinical, diagnostic, and therapeutic features of 257 papillomas of the ear, nose and throat were studied. These tumors were found in a population of about 500,000 inhabitants over a 20-year period (1973-1992). The clinical manifestations of papillomas were varied and more dependent on location than on the size or number of lesions. The most frequent symptom was a foreign body sensation. Twenty-four percent of cases were asymptomatic and the diagnosis was made during a general physical examination; such diagnoses were most frequent in the pharynx. The mean duration of symptoms before visiting a physician was 10 months (longer in papilloma of the oral cavity and shorter in the pharynx). The initial clinical diagnosis was correct in 63% of cases. Lesions of the oral cavity presented most diagnostic problems and those of the pharynx the least. A clinical diagnosis of cancer was made most often in the larynx. Treatment was surgical in every case. Twenty percent required more than one operation to remove the papilloma.
Asunto(s)
Neoplasias Laríngeas/diagnóstico , Laringe/patología , Neoplasias de la Boca/diagnóstico , Papiloma/diagnóstico , Neoplasias Faríngeas/diagnóstico , Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Neoplasias Laríngeas/patología , Neoplasias Laríngeas/cirugía , Laringe/cirugía , Masculino , Persona de Mediana Edad , Boca/patología , Boca/cirugía , Neoplasias de la Boca/patología , Neoplasias de la Boca/cirugía , Papiloma/patología , Papiloma/cirugía , Neoplasias Faríngeas/patología , Neoplasias Faríngeas/cirugía , Faringe/patología , Faringe/cirugíaRESUMEN
A case of giant amyloidoma in the left tonsil with extensive osseous metaplasia and a scanty and patchy monoclonal population of IgG Kappa plasma cells, is presented. Localized tumoral amyloidosis is a rare, benign tumour of the upper aerodigestive tract. Organ-limited amyloidosis has been shown to be confined to various systems but, since the lesion was first described, only four cases situated in the tonsils have been reported in the English literature, and none of these had either osseous metaplasia or a monoclonal population of IgG Kappa plasma cells.
Asunto(s)
Amiloidosis/patología , Tonsila Palatina/patología , Anciano , Humanos , Masculino , Enfermedades Faríngeas/patologíaRESUMEN
Prospective study covering 38 cases of Sjögren's syndrome (S.S.) diagnosed after early clinical suspicion awaken for xerostomy and xerophtalmy, once excluded those cases which pathology was previously known. Thirty-two cases pertaining to primary malady (P.S.S.) being secondary (S.S.S.) the others. The clinical E.N.T.-symptomatology stand out in our series, because the throat dryness and taste and olfactory alterations. The 53 percent of patients have consulted with other specialists without actualizing the diagnosis. The AA. discuss complementary diagnostic methods (Schirmer's test, rose bengal stain, sialometry, auto-antibodies and biopsy of minor salivary glands) and diagnostic criteria, and fix the otolaryngologist role in the management of these patients.
Asunto(s)
Glándulas Salivales/fisiopatología , Síndrome de Sjögren/diagnóstico , Síndrome de Sjögren/fisiopatología , Adulto , Anciano , Anticuerpos Antinucleares , Autoanticuerpos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , XeroftalmiaRESUMEN
Thirty-seven lip biopsies of minor salivary glands from patients with suspected Sjögren syndrome (SS) and no other known disease were studied. Two cases were excluded for not meeting disease criteria (one had histologic findings of sarcoidosis). Of 35 SS cases, 4 were considered secondary to associated disease. In 24 cases the Daniels technique was used and in 11, an elliptical excision. In 3 elliptical excisions (27.3%) the biopsy did not contain glands (p = 0.002 compared with the Daniels technique). The mean number of glands per biopsy was 7.7 (2-16) with the Daniels technique and 5 (0-15) by elliptical excision (no significant difference). Focal lymphoid sialoadenitis was present in all 32 gland-bearing specimens. Multiple inflammatory foci were found in 28 (87.5%), 8(25%) of which had a diffuse infiltrate. SS presented more frequently as xerostomy in patients with diffuse infiltrate (p = 0.09). In 11 lip biopsies from controls with other diseases of the oral cavity, 7 (63.6%) showed changes suggestive of SS.
Asunto(s)
Biopsia , Glándulas Salivales/ultraestructura , Síndrome de Sjögren/diagnóstico , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Glándulas Salivales/fisiopatología , Síndrome de Sjögren/fisiopatología , Xerostomía/diagnósticoRESUMEN
We present a study of the incidence of squamous cell papillomas on the otorhinolaryngological field, in a population of approximately 500,000 inhabitants between 1973 and 1992. We have reviewed 234 papillomas. The overall incidence of ENT papillomas was 2.4737 x 10(5) inhabitants per year. The most frequent location was the pharynx, followed by oral cavity, larynx and sinonasal tract. In the ear these lesions were very rare. No significant increase in incidence rates were found over the four year periods, except for pharyngeal papillomas. The median age at onset of ENT papillomas was 47.11 years (range = 4 to 83 years). Only 7,3% of papillomas were of juvenile type. The male to female ratio was 2,1. Male preponderance occurred in pharyngeal and laryngeal papillomas. Only lesions of the ear were most frequent in the female population. 54,9% of patients were smokers. The highest incidence of smoking habit was found in laryngeal papillomas. Only two patients in our series had HIV infection, and in both cases the papillomas were located in the oral cavity. This study shows that the incidence of ENT papillomas has remained constant and that adult preponderance is more marked in our population than in others reported previously. The pathogenesis of the ENT squamous papillomas in our population is related with an acquired HPV infection without clear relation to genital disease.
Asunto(s)
Neoplasias de Oído, Nariz y Garganta/epidemiología , Papiloma/epidemiología , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Humanos , Masculino , Persona de Mediana Edad , España/epidemiologíaRESUMEN
A review was made of 150 cases of chronic otitis media caused by cholesteatoma that were operated consecutively; no complications or active otorrhea was present. In 61.3% of cases, prophylactic antibiotic (PA) treatment was given on the basis of the surgeon's criteria, which probably reflected the presence or absence of risk factors. Most patients were given a penicillin or penicillin derivative (amoxi-ampicillin followed by cephalosporins). Antibiotic administration was prolonged longer than necessary (mean 3.4 days). PA was not associated with important complications. Postoperative infection occurred in 10.7% of cases, usually infection of the surgical wound, most commonly by Staphylococcus aureus. Otorrhea occurred in 7.3% of cases in the 15 days after surgery and was more frequent in patients treated via an endomeatal approach and in those who had ossicular prosthesis. Prophylactic antibiotic treatment produced no benefit to our patients in the form of any reduction in number of surgical infections, postoperative otorrhea or mean hospital stay. Therefore, PA is not recommended in surgery for uncomplicated cholesteatoma. When risk factors are present, a suitable and complete antibiotic treatment may be indicated.
Asunto(s)
Antibacterianos/uso terapéutico , Colesteatoma/cirugía , Otitis Media/tratamiento farmacológico , Otitis Media/cirugía , Penicilinas/uso terapéutico , Adulto , Antibacterianos/administración & dosificación , Otorrea de Líquido Cefalorraquídeo/etiología , Colesteatoma/complicaciones , Femenino , Humanos , Masculino , Otitis Media/etiología , Penicilinas/administración & dosificación , Complicaciones Posoperatorias , Estudios Retrospectivos , Staphylococcus aureus/aislamiento & purificación , Infección de la Herida Quirúrgica/microbiología , Infección de la Herida Quirúrgica/prevención & controlRESUMEN
Sialadenoma papilliferum is a rare, benign, exophytic tumour of the salivary glands. The prognosis is exceptionally good. Since the lesion was first described, 30 cases have been reported in the English literature, and only one of these is known to have recurred. A case of sialadenoma papilliferum occurring in the buccal mucosa with recurrence three years after local excision, is presented. The literature is briefly discussed.
Asunto(s)
Mucosa Bucal/patología , Neoplasias de las Glándulas Salivales/patología , Anciano , Femenino , Humanos , Recurrencia Local de Neoplasia/patología , Glándulas Salivales Menores/patologíaRESUMEN
The AA. present a retrospective study regarding their experience, in the last 20 years (1973-1993), on diagnosis and management of tumors localized in the parapharyngeal space. In this interval 16 patients, carrying on 17 parapharyngeal tumors, were diagnosed. The incidence was similar in both sexes, the ages ranging widely, the clinic inspecific and the diagnosis confirmed late. They advise the CT with opaque media, nowadays associated to NMR, as suitable diagnostic routine. Fine needle biopsy is not recommended as regular procedure. The great deal of cases carried benign tumors, though individually metastatic epidermoid carcinomas were the most prevalent, followed by salivary and neurogenic growths. 15 individuals underwent surgery. In all but one the cervical approach without mandibulotomy--supposed to be the selective procedure--was done. No one was tracheotomized. Four postoperative nervous complications presented: 2 corresponding to malingnancies. Neither major complications nor perioperative mortality resulted.