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Introducción: La eficacia de la trombectomía mecánica en territorio carotídeo en las primeras 24 horas se ha probado con trabajos publicados recientemente. Métodos: Revisión retrospectiva a partir de un registro prospectivo en nuestro centro de referencia de ictus para valorar la eficacia y seguridad del tratamiento endovascular realizado más allá de las 6 horas de evolución de los síntomas en pacientes con ictus isquémico agudo y oclusión de gran vaso en territorio carotídeo, entre noviembre de 2016 y abril de 2019. Resultados: Se recopilaron datos de 59 pacientes (55,9% mujeres, mediana de edad 71 años). Treinta y tres pacientes fueron detectados al despertar. El 57,6% de los casos fueron traslados secundarios. La mediana de NIHSS basal fue 16. La mediana del ASPECTS fue 8 y el 94,9% de los pacientes presentó > 50% de tejido salvable. El 88,1% de los pacientes logró una recanalización satisfactoria, en 5 pacientes después de 24 horas de evolución. El 67,8% de los casos logró la independencia funcional a los 90 días de seguimiento. Los pacientes que no lograron la independencia funcional presentaban mayor edad, mayor proporción de fibrilación auricular, mayor tiempo punción-recanalización y mayor puntuación NIHSS, tanto basal como al alta. Conclusión: En nuestra experiencia la trombectomía mecánica después de las 6 horas se asoció con buenos resultados de funcionalidad a los 90 días. La edad, la puntuación NIHSS, el tiempo punción-recanalización y la prevalencia de fibrilación auricular fueron factores determinantes en el pronóstico funcional. La eficacia de este tratamiento por encima de las 24 horas merece ser estudiada.(AU)

Introduction: Thrombectomy in the carotid artery territory was recently shown to be effective up to 24 hours after symptoms onset. Methods: We conducted a retrospective review of a prospective registry of patients treated at our stroke reference centre between November 2016 and April 2019 in order to assess the safety and effectiveness of mechanical thrombectomy performed beyond 6 hours after symptoms onset in patients with acute ischaemic stroke and large vessel occlusion in the carotid artery territory. Results: Data were gathered from 59 patients (55.9% women; median age, 71 years). In 33 cases, stroke was detected upon awakening; 57.6% of patients were transferred from another hospital. Median baseline NIHSS score was 16, and median ASPECTS score was 8, with 94.9% of patients presenting > 50% of salvageable tissue. Satisfactory recanalisation was achieved in 88.1% of patients, beyond 24 hours after onset in 5 cases. At 90 days of follow-up, 67.8% were functionally independent; those who were not were older and presented higher prevalence of atrial fibrillation, greater puncture-to-recanalisation time, and higher NIHSS scores, both at baseline and at discharge. Conclusion: In our experience, mechanical thrombectomy beyond 6 hours was associated with good 90-day functional outcomes. Age, NIHSS score, puncture-to-recanalisation time, and presence of atrial fibrillation affected functional prognosis. The efficacy of the treatment beyond 24 hours after onset merits study.(AU)

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INTRODUCTION: Thrombectomy in the carotid artery territory was recently shown to be effective up to 24 hours after symptoms onset. METHODS: We conducted a retrospective review of a prospective registry of patients treated at our stroke reference centre between November 2016 and April 2019 in order to assess the safety and effectiveness of mechanical thrombectomy performed beyond 6 hours after symptoms onset in patients with acute ischaemic stroke and large vessel occlusion in the carotid artery territory. RESULTS: Data were gathered from 59 patients (55.9% women; median age, 71 years). In 33 cases, stroke was detected upon awakening; 57.6% of patients were transferred from another hospital. Median baseline NIHSS score was 16, and median ASPECTS score was 8, with 94.9% of patients presenting > 50% of salvageable tissue. Satisfactory recanalisation was achieved in 88.1% of patients, beyond 24 hours after onset in 5 cases. At 90 days of follow-up, 67.8% were functionally independent; those who were not were older and presented higher prevalence of atrial fibrillation, greater puncture-to-recanalisation time, and higher NIHSS scores, both at baseline and at discharge. CONCLUSION: In our experience, mechanical thrombectomy beyond 6 hours was associated with good 90-day functional outcomes. Age, NIHSS score, puncture-to-recanalisation time, and presence of atrial fibrillation affected functional prognosis. The efficacy of the treatment beyond 24 hours after onset merits study.

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PURPOSE: The benefit of intravenous alteplase is well established for patients with disabling stroke symptoms regardless of age, although data on outcomes in centenarian patients are scarce. We present our experience in patients beyond 100 years. METHODS: Descriptive study including centenarians from our single-centre prospective registry who underwent intravenous thrombolysis with alteplase for acute ischemic stroke in our tertiary university hospital. Clinical variables and functional outcome at 3 months were collected. RESULTS: Four patients, all women, functionally independent (mRS ≤ 2) were included. Treatment with alteplase was applied within 4.5 h of stroke onset. One patient complicated with pneumonia and died. Two patients were functionally independent (mRS ≤ 2) at discharge, while the third was partially dependent (mRS of 3 at discharge), improving after 3 months, (mRS 2). No serious hemorrhagic or systemic adverse events were registered. CONCLUSION: In our experience, intravenous thrombolysis may be beneficial and should be considered in patients over 100 years old with no previous disability.

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INTRODUCTION: Thrombectomy in the carotid artery territory was recently shown to be effective up to 24hours after symptoms onset. METHODS: We conducted a retrospective review of a prospective registry of patients treated at our stroke reference centre between November 2016 and April 2019 in order to assess the safety and effectiveness of mechanical thrombectomy performed beyond 6hours after symptoms onset in patients with acute ischaemic stroke and large vessel occlusion in the carotid artery territory. RESULTS: Data were gathered from 59 patients (55.9% women; median age, 71 years). In 33 cases, stroke was detected upon awakening; 57.6% of patients were transferred from another hospital. Median baseline NIHSS score was 16, and median ASPECTS score was 8, with 94.9% of patients presenting>50% of salvageable tissue. Satisfactory recanalisation was achieved in 88.1% of patients, beyond 24hours after onset in 5 cases. At 90 days of follow-up, 67.8% were functionally independent; those who were not were older and presented higher prevalence of atrial fibrillation, greater puncture-to-recanalisation time, and higher NIHSS scores, both at baseline and at discharge. CONCLUSION: In our experience, mechanical thrombectomy beyond 6hours was associated with good 90-day functional outcomes. Age, NIHSS score, puncture-to-recanalisation time, and presence of atrial fibrillation affected functional prognosis. The efficacy of the treatment beyond 24hours after onset merits study.

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BACKGROUND AND PURPOSE: The existence of contraindications to intravenous thrombolysis (IVT) is considered a criterion for direct transfer of patients with suspected acute stroke to thrombectomy-capable centers in the prehospital setting. Our aim was to assess the utility of this criterion in a setting where routing protocols are defined by the Madrid - Direct Referral to Endovascular Center (M-DIRECT) prehospital scale. METHODS: This was a post hoc analysis of the M-DIRECT study. Reported contraindications to IVT were retrospectively collected from emergency medical services reports and categorized into late window, anticoagulant treatment and other contraindications. Final diagnosis and treatment rates were compared between patients with and without reported IVT contraindications and according to anticoagulant treatment or late window categories. RESULTS: The M-DIRECT study included 541 patients. Reported IVT contraindications were present in 227 (42.0%) patients. Regarding final diagnosis no significant differences were found between patients with or without reported IVT contraindications: ischaemic stroke (any) 65.6% vs. 62.1%, ischaemic stroke with large vessel occlusion (LVO) 32.2% vs. 28.3%, hemorrhagic stroke 15.4% vs. 15.6%, stroke mimic 18.9% vs. 22.3% respectively. Amongst patients with LVO, endovascular thrombectomy (EVT) was performed less often in the presence of IVT contraindications (56.2% vs. 74.2%). M-DIRECT-positive patients had higher rates of LVO and EVT compared with M-DIRECT-negative patients independent of reported IVT contraindications. CONCLUSIONS: Reported IVT contraindications alone do not increase EVT likelihood and should not be considered to determine routing in urban stroke networks.

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Introducción: Las disecciones de arteriales cervicales (DAC) provocan hasta el 20% de los ictus isquémicos en menores de 45 años. El beneficio de los tratamientos de reperfusión en fase aguda no está plenamente clarificado. Métodos: Revisión retrospectiva de pacientes con DAC ingresados en un centro terciario de ictus desde 2010 hasta 2015. Recogemos las características basales, clínicas, los tratamientos, el pronóstico funcional y la mortalidad. Resultados: Se registraron 35 DAC (23 carotídeas/12 vertebrales). La edad media fue de 43,5 ± 9,5 años y el 67,7% fueron varones. En 10 casos (32,3%) hubo antecedente de un traumatismo. Los factores de riesgo más frecuentes fueron la hipertensión arterial (29%) y el tabaquismo (35,5%). La presentación clínica más frecuente fue el infarto cerebral en 29 pacientes (93,5%). La mediana de puntuación National Institute of Health Stroke Scale basal fue de 6 (0-41). El método diagnóstico más empleado fue la angio-TC (74,2%), seguido de resonancia magnética (64,5%) y arteriografía cerebral (45,6%). Siete pacientes (22,6%) fueron tratados con fibrinólisis intravenosa y 11 (35,5%) con tratamiento endovascular (TEV) ± fibrinólisis intravenosa. A los 3 meses, la independencia funcional (escala de Rankin 0-2) fue del 57,1% y del 63,6%, respectivamente. Falleció un paciente (3,2%). Conclusiones: La forma de presentación más frecuente de la DAC fue el infarto cerebral. Estos casos pueden beneficiarse de terapias de reperfusión, con un pronóstico similar al resto de enfermos con ictus isquémicos. Se requieren registros más extensos para conocer mejor la respuesta a los tratamientos de reperfusión en fase aguda en este grupo de pacientes

Introduction: Cervical artery dissection (CAD) is responsible for up to 20% of all ischaemic strokes in patients younger than 45. The benefits of acute-phase reperfusion therapy in these patients have yet to be confirmed. Methods: We conducted a retrospective review of patients with CAD admitted to a comprehensive stroke centre between 2010 and 2015. We recorded baseline clinical characteristics, treatments, functional outcomes, and mortality. Results: We identified 35 cases of CAD (23 carotid/12 vertebral); mean age was 43.5 ± 9.5 years and 67.7% were men. Ten patients (32.3%) had a history of trauma. The most frequent risk factors were arterial hypertension (29%) and smoking (35.5%). The most common clinical presentation was ischaemic stroke (29 patients, 93.5%). The median baseline National Institute of Health Stroke Scale score was 6 (range, 0-41). The most frequently used diagnostic method was CT angiography (74.2%), followed by MRI (64.5%) and digital subtraction angiography (45.6%). Seven patients (22.6%) were treated with intravenous fibrinolysis and 11 (35.5%) with endovascular treatment plus intravenous fibrinolysis; at 3 months, functional independence (modified Rankin Scale scores 0-2) was achieved by 57.1% and 63.6% of these cases, respectively. One patient died (3.2%). Conclusions: In our sample, the most common form of presentation of CAD was ischaemic stroke. Reperfusion therapy seems to be a safe and effective option for these patients, and outcomes resemble those of other patients with ischaemic stroke. Larger comparative studies are necessary to better assess response to reperfusion therapy in acute ischaemic stroke

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INTRODUCTION: Cervical artery dissection (CAD) is responsible for up to 20% of all ischaemic strokes in patients younger than 45. The benefits of acute-phase reperfusion therapy in these patients have yet to be confirmed. METHODS: We conducted a retrospective review of patients with CAD admitted to a comprehensive stroke centre between 2010 and 2015. We recorded baseline clinical characteristics, treatments, functional outcomes, and mortality. RESULTS: We identified 35 cases of CAD (23 carotid/12 vertebral); mean age was 43.5 ± 9.5 years and 67.7% were men. Ten patients (32.3%) had a history of trauma. The most frequent risk factors were arterial hypertension (29%) and smoking (35.5%). The most common clinical presentation was ischaemic stroke (29 patients, 93.5%). The median baseline National Institute of Health Stroke Scale score was 6 (range, 0-41). The most frequently used diagnostic method was CT angiography (74.2%), followed by MRI (64.5%) and digital subtraction angiography (45.6%). Seven patients (22.6%) were treated with intravenous fibrinolysis and 11 (35.5%) with endovascular treatment plus intravenous fibrinolysis; at 3 months, functional independence (modified Rankin Scale scores 0-2) was achieved by 57.1% and 63.6% of these cases, respectively. One patient died (3.2%). CONCLUSIONS: In our sample, the most common form of presentation of CAD was ischaemic stroke. Reperfusion therapy seems to be a safe and effective option for these patients, and outcomes resemble those of other patients with ischaemic stroke. Larger comparative studies are necessary to better assess response to reperfusion therapy in acute ischaemic stroke.

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Beaches are dynamic transitional environments subject to numerous natural and anthropic alterations. In these ecosystems, the infralittoral-sublittoral macrofauna communities play a key role in the food web. The objective of this study was to compare macrofauna communities on six beaches on the Gulf of Cádiz coast, which were classified according to the anthropic alterations they support, and evaluate the influence of abiotic factors on the species distribution. Sampling was done in the infralittoral-sublittoral zone of each beach using a modified manual dredge. Five perpendicular transects of 25 m, each separated by 10 m, were performed per beach, with a total sample area of 43.75 m2 per beach. A total of 27 species were found, of which Donax trunculus, Diogenes pugilator, and Tritia grana were the most abundant. Anthropogenic effects are appreciable in the infralittoral-sublittoral although they are areas that are permanently submerged and less exposed than the intertidal. Beach nourishments carried out with large volumes of sand can alter the grain size, the most influential parameter on the distribution of the species, and consequently, affect the macrofauna community that inhabits these beaches.

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INTRODUCTION: Central pontine myelinolysis (CPM) is a disease characterized by the destruction of the myelin in the brainstem, generally associated with alcoholism, rapid correction of hyponatremia and other electrolytic alterations. The clinical symptoms, etiopathogenic factors, neuroimaging and evolution of the series of patients diagnosed of central pontine/extrapontine myelinolysis (CPEM) are described. METHODS: Review of all the clinical histories with diagnoses of CPM made in our hospital since 1989. All the cases were reviewed, ruling out those having a magnetic resonance or clinical picture not clearly consistent with the diagnosis. Age, symptoms, comorbidity, associated metabolite alterations and clinical evolution were analyzed. RESULTS: 13 cases whose ages ranged from 28 to 81 years were identified. Hyponatremia was identified during the clinical course in six patients, with neurological worsening associated to its correction in 3 of them. No sodium disorders were identified in 7 patients. Seven of the patients had associated alcoholism. Hyperintense lesions were found in all the cases in T2 sequences and FLAIR in the brainstem consistent with the typical pattern of the osmotic demyelinization syndrome. The severity of the clinical picture identified varied from a symptomatic patient to coma in 9 cases. In regards to the clinical course, four patients completely recovered, eight had residual symptoms with different severity and one patient died. CONCLUSIONS: The series is representative of the clinical and etiopathogenic spectrum of the osmotic demyelinization syndrome. Most of the clinically symptomatic patients improve if the secondary complications are controlled.

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Introducción. La mielinolisis central pontina (MCP) es una entidadcaracterizada por la destrucción de mielina en la base de la protuberancia,generalmente asociada con enolismo, corrección rápidade la hiponatremia y otras alteraciones electrolíticas. Se describe laclínica, factores etiopatogénicos, neuroimagen y evolución de unaserie de pacientes con diagnóstico de mielinolisis central pontina/extrapontina(MCP/E).Métodos. Revisión de todas las historias clínicas con diagnósticode MCP realizados en nuestro hospital desde el año 1989. Se revisarontodos los casos descartando aquellos con resonancia magnéticao cuadros clínicos no claramente compatibles con el diagnóstico.Se analizó la edad, clínica, comorbilidad, alteraciones metabólicasasociadas y evolución clínica.Resultados. Se identificaron 13 casos con edades comprendidasentre los 28 y 81 años. Se identificó hiponatremia durante el cursoclínico en 6 pacientes, produciéndose en 3 de ellos un empeoramientoneurológico asociado a la corrección de la misma. En 7 pacientesno se identificaron trastornos del sodio. Siete de los pacientes presentabanenolismo asociado. En todos los casos se reconocieron lesioneshiperintensas en secuencias T2 y FLAIR en la protuberanciacompatibles con el patrón típico del síndrome de desmielinizaciónosmótica. La gravedad del cuadro clínico identificado varió desde unpaciente asintomático hasta el coma en 9 casos. En cuanto a la evoluciónclínica, 4 pacientes se recuperaron completamente, 8 presentaronsintomatología residual de distinta severidad y 1 paciente falleció.Conclusiones. La serie es representativa del espectro clínico yetiopatogénico del síndrome de desmielinización osmótica. La mayoríade los pacientes clínicamente sintomáticos mejoran si las complicacionessecundarias son controladas (AU)

Introduction. Central pontine myelinolysis (CPM) is a diseasecharacterized by the destruction of the myelin in the brainstem,generally associated with alcoholism, rapid correction ofhyponatremia and other electrolytic alterations. The clinicalsymptoms, etiopathogenic factors, neuroimaging and evolutionof the series of patients diagnosed of central pontine/extrapontinemyelinolysis (CPEM) are described.Methods. Review of all the clinical histories with diagnosesof CPM made in our hospital since 1989. All the cases were reviewed,ruling out those having a magnetic resonance or clinicalpicture not clearly consistent with the diagnosis. Age, symptoms,comorbidity, associated metabolite alterations and clinical evolutionwere analyzed.Results. 13 cases whose ages ranged from 28 to 81 yearswere identified. Hyponatremia was identified during the clinicalcourse in six patients, with neurological worsening associated toits correction in 3 of them. No sodium disorders were identifiedin 7 patients. Seven of the patients had associated alcoholism.Hyperintense lesions were found in all the cases in T2 sequencesand FLAIR in the brainstem consistent with the typical pattern ofthe osmotic demyelinization syndrome. The severity of the clinicalpicture identified varied from a symptomatic patient to comain 9 cases. In regards to the clinical course, four patients completelyrecovered, eight had residual symptoms with different severityand one patient died.Conclusions. The series is representative of the clinical andetiopathogenic spectrum of the osmotic demyelinization syndrome.Most of the clinically symptomatic patients improve if thesecondary complications are controlled (AU)

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Multifrequency tympanometry scans pressures and frequencies from 226 to 2000 Hz to analyze the resonant frequency of the middle ear, which determines the balance between stiffness and mass. We studied 143 patients (a total of 200 ears) diagnosed as otosclerosis at the E.N.T. Service of Santiago de Compostela University Hospital Complex, and 136 control subjects. The mean age of patients was 47.7 years; women were predominant (female/male ratio 2.25:1). The mean duration of the disease was 10.4 years. Using the Virtual model 310 tympanometer, we calculated the resonant frequency through the susceptance tympanogram, corresponding to the minimal frequency at which the central notch of the tympanograrn was equal to or less than the negative tail. The mean resonant frequency was 1230 Hz, the tympanometric amplitude was 88.32 daPa, and the admittance of the middle ear was 0.63 cc. We confirmed an increase in the resonant frequency in patients with otosclerosis compared with normal subjects (1132.33 Hz), and a decrease in the admittance of the middle ear. The relation between the two values was significant.

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Multifrequency tympanometry studies consist of tympanography using probe tone frequencies ranging from 200 to 2000 Hz, improving the study of acoustic transmission through the tympano-ossicular system because then two components of admittance, conductance and susceptance, can be separated. The resonance frequency is the frequency at which mass and spring elements of the middle ear cancel each other out, leaving only the friction component. This measurement has been found to be more sensitive to the presence of pathologies that affect the tympano-ossicular system, such as otosclerosis and rheumatoid arthritis. It is necessary to know normal pattents of tympanometric parameters to improve the study of these diseases. Multifrequency tympanometry performed on 136 patients, 91 women and 45 men, age range 11-78 years. The mean resonant frequency of the middle ear was 1132.33 Hz, mean static admittance 0.76 dapa, and mean tympanometric amplitude 94.31 mmhos ac. Age showed no systematic effect of age on any of these measures in this population, and no significant association was found between static admittance or tympanometric amplitude and resonance frequency.

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Recent publications show an increase in the frequency of laryngeal carcinoma in women. Previous studies of patients in our health district (1875-1994) showed a male/female ratio of 56/1. However, a retrospective study of all laryngeal carcinomas diagnosed in a recent year (June 1997-May 1998) showed an overall male/female ratio of 10/1. Women are older at time of diagnosis than men (mean 70.33 years). None of the women was a regular drinker and only one smoked. Glottic location and absence of metastatic lymph node enlargement predominated at time of diagnosis.

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La timpanometría de multifrecuencia realiza un barrido de presiones y de frecuencias desde los 226 Hz a los 2. 000 Hz, permitiendo analizar la frecuencia de resonancia del oído medio, que determina el equilibrio entre la rigidez y la masa del mismo. Hemos estudiado 143 pacientes diagnosticados de otosclerosis en el Servicio de Otorrinolaringología del Complejo Hospitalario Universitario de Santiago de Compostela, con un total de 200 oídos estudiados, así como 136 personas normales como controles. La edad media de los pacientes al diagnóstico fue de 47,71 años, con un predominio del sexo femenino (relación mujer/varón de 2,25: 1), con una duración media de la enfermedad de 10,4 años. Utilizamos el timpanómetro Virtual modelo 310, calculando lafrecuencia de resonancia a través del timpanograma de susceptancia, correspondiendo a la mínima frecuencia en la que la muesca central del timpanograma es igual o inferior al extremo negativo del mismo. De esta forma, la frecuencia media de resonancia fue de 1.230 Hz, la amplitud timpanométrica de 88,32 daPa y la admitancia del oído medio de 0,63 cc. Hemos comprobado un incremento de la frecuencia de resonancia en los pacientes con otosclerosis, al compararlos con los valores de normalidad (1.132,33 Hz), así como una disminución de la admitancia del oído medio, existiendo entre los dos valores una relación significativa (AU)

Multifrequency tympanometry scans pressures and frequencies from 226 to 2000 Hz to analyze the resonant frequency of the middle ear, which determines the balance between stiffness and mass. We studied 143 patients (a total of 200 ears) diagnosed as otosclerosis at the E.N.T. Service of Santiago de Compostela University Hospital Complex, and 136 control subjects. The mean age of patients was 47.7 years; women were predominant (female/male ratio 2.25:1). The mean duration of the disease was 10.4 years. Using the Virtual model 310 tympanometer, we calculated the resonant frequency through the susceptance tympanogram, corresponding to the minimal frequency at which the central notch of the tympanograrn was equal to or less than the negative tail. The mean resonant frequency was 1230 Hz, the tympanometric amplitude was 88.32 daPa, and the admittance of the middle ear was 0.63 cc. We confirmed an increase in the resonant frequency in patients with otosclerosis compared with normal subjects (1132.33 Hz), and a decrease in the admittance of the middle ear. The relation between the two values was significant (AU)

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La timpanometría de multifrecuencia realiza un barrido timpanométrico entre 226 y 2000 Hz, mejorando el análisis de la transmisión del sonido a través del sistema tímpano-osicular, ya que posibilita el estudio independiente de los dos componentes de la admitancia del oído medio, la susceptancia y la conductancia. La frecuencia de resonancia del oído medio es la frecuencia en la que los elementos distensibles y de masa de la caja timpánica están en equilibrio; por tanto este parámetro se muestra útil en el estudio de patologías que alteren las características del sistema tímpano osicular como la otosclerosis y la artritis reumatoide. Es preciso conocer los parámetros de normalidad con el objeto de poderlos comparar con estas patologías. Realizamos la timpanometría de multifrecuencia a 136 pacientes entre 11 y 78 años. La frecuencia de resonancia media de oído medio fue de 1132.33 Hz, la admitancia estática media de 0, 76 dapa, y la amplitud timpanométrica media de 94,31 nmohs ac. Ninguno de estos parámetros mostró variaciones significativas en los distintos grupos de edad, y tampoco observamos asociación entre la frecuencia de resonancia de oído medio y la admitancia estática o la amplitud timpanométrica (AU)

Multifrequency tympanometry studies consist of tympanography using probe tone frequencies ranging from 200 to 2000 Hz, improving the study of acoustic transmission through the tympano-ossicular system because then two components of admittance, conductance and susceptance, can be separated. The resonance frequency is the frequency at which mass and spring elements of the middle ear cancel each other out, leaving only the friction component. This measurement has been found to be more sensitive to the presence of pathologies that affect the tympano-ossicular system, such as otosclerosis and rheumatoid arthritis. It is necessary to know normal pattents of tympanometric parameters to improve the study of these diseases. Multifrequency tympanometry performed on 136 patients, 91 women and 45 men, age range 11-78 years. The mean resonant frequency of the middle ear was 1132.33 Hz, mean static admittance 0.76 dapa, and mean tympanometric amplitude 94.31 mmhos ac. Age showed no systematic effect of age on any of these measures in this population, and no significant association was found between static admittance or tympanometric amplitude and resonance frequency (AU)

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Recientes publicaciones muestran un incremento en la incidencia del carcinoma de laringe en mujeres. Estudios previos llevados a cabo en pacientes de nuestra área sanitaria (1975-1994) muestran una relación hombre/mujer de 5611. Realizamos un estudio retrospectivo de todos los carcinomas de laringe diagnosticados en un año (junio, 1997-mayo, 1998), obteniendo una relación global hombre/mujer de 1 10/1. En las mujeres la edad al momento del diagnóstico es mayor que en los hombres (Media: 70,33 años), ninguna de ellas era bebedora habitual y sólo una era fumadora. Predomina la localización glótica y la ausencia de adenopatías metastásicas al momento del diagnóstico (AU)

Recent publications show an increase in the frequency of laryngeal carcinoma in women. Previous studies of patients in our health district (1875-1994) showed a male/female ratio of 56/1. However, a retrospective study of all laryngeal carcinomas diagnosed in a recent year (June 1997-May 1998) showed an overall male/female ratio of 10/1. Women are older at time of diagnosis than men (mean 70.33 years). None of the women was a regular drinker and only one smoked. Glottic location and absence of metastatic lymph node enlargement predominated at time of diagnosis (AU)

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