RESUMEN

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)

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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.

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Between January 1980 and April 1995, 57 treatment-naive patients diagnosed as glottic epidermoid T1 carcinoma were treated in the ear, nose and throat department of Juan Canalejo Hospital of La Coruña, Spain. Seventy-nine percent (79%) (45/57) had T1a lesions and 21% (12/57) had T1b. All patients were treated by the radiotherapy department of the Regional Oncological Center with Co60 at doses ranging from 50 Gy to 70 Gy. Local control was achieved in 74.5% (43/57). Cause-specific survival was 96% at 3, 5, and 10 years. The larynx was preserved in 96.5% (55/57). The local recurrence rate was significantly lower for T1a (16.8%) than for T1b (57.8%) (p < 0.05). No significant differences were found in local control or survival with different dosing regimens.

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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)

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Entre Enero de 1980 y Abril de 1995, se trataron mediante radioterapia 57 pacientes diagnosticados de carcinoma epidermoide TI glótico, en el Servicio de Otorrinolaringología del Hospital Juan Canalejo de La Coruña. El 79 por ciento (45/57) correspondían a lesiones T1 y 21 por ciento (12/57) T1b. Todos los pacientes fueron tratados en el Servicio de Radioterapia del Centro Oncológico Regional mediante Co60, con dosis que oscilaron entre los 5.000 y los 7.000 cGy. El control local fue del 74,5 por ciento (43/57). La supervivencia causa-específica fue de 96 por ciento a los 3,5 y 10 años. El índice de preservación de la laringe fue del 96,5 por ciento (55/57). El índice de recidiva local fue significativamente inferior en los T1a (16,8 por ciento) frente a los T1b (57,8 por ciento) (p < 0,5). No se encontraron diferencias significativas ni en el control local ni en la supervivencia en función de la dosis empleada (AU)

Between January 1980 and April 1995, 57 treatment-naive patients diagnosed as glottic epidermoid T1 carcinoma were treated in the ear, nose and throat department of Juan Canalejo Hospital of La Coruña, Spain. Seventy-nine percent (79%) (45/57) had T1a lesions and 21% (12/57) had T1b. All patients were treated by the radiotherapy department of the Regional Oncological Center with Co60 at doses ranging from 50 Gy to 70 Gy. Local control was achieved in 74.5% (43/57). Cause-specific survival was 96% at 3, 5, and 10 years. The larynx was preserved in 96.5% (55/57). The local recurrence rate was significantly lower for T1a (16.8%) than for T1b (57.8%) (p < 0.05). No significant differences were found in local control or survival with different dosing regimens (AU)

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RESUMEN

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.

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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.

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