Carcinoma ex Pleomorphic Adenoma in Nasal Cavity: An Unusual Diagnosis

Evolution of otosclerosis to cochlear implantation.

Abstract Introduction Otosclerosis is an osteodystrophy of the labyrinthine capsule producing conductive hearing loss. If the process invades the cochlea, a sensorineural hearing loss usually takes place. The cochlear implant is a good alternative in these patients. Objective To ascertain the behaviour of cochlear implantation (CI) in otosclerosis. Material and methods We reviewed a database of 250 patients who underwent CI, performing a retrospective study of 13 patients with clinical, audiological and/or imaging findings of bilateral otosclerosis. The 26 ears were studied as to their natural history, previous surgeries, evolution to profound hearing loss, computed tomography (CT) images, …

Effects of Omalizumab Treatment in Patients With Recalcitrant Nasal Polyposis and Mild Asthma: A Multicenter Retrospective Study

Background Chronic rhinosinusitis with nasal polyps (CRSwNP) is a clinical entity with specific features that impacts significantly on patient quality of life (QoL). CRSwNP is often associated with asthma and is difficult to control and manage despite pharmacological and/or surgical treatment. Omalizumab, a monoclonal anti-IgE antibody, has emerged as a putative therapeutic option. Objective To evaluate the effects of omalizumab on nasal polyp (NP) size and QoL assessed by Sino-Nasal Outcome Test-22 (SNOT-22) in patients with recalcitrant CRSwNP and mild asthma. Methods A multicenter retrospective analysis of patient data from the Community of Valencia (Spain) was performed. Adult patients …

Evolución clínica y radiológica de un grupo de neurinomas del acústico no tratados

Resumen Introduccion El neurinoma del acustico es un tumor benigno que se origina en la rama vestibular del viii par craneal. Su tratamiento de eleccion es quirurgico, pero muchos autores defienden que en pacientes de edad avanzada o en neurinomas de pequeno tamano se puede optar por simple vigilancia. Metodos Estudio retrospectivo, del 2007 al 2013, que incluye a 27 pacientes diagnosticados de neurinoma del acustico que no fueron tratados, bien por el tamano del tumor, por la edad y las comorbilidades asociadas, o por decision del paciente. Se evaluaron el estado general, los umbrales auditivos, el grado de paresia canalicular y las posibles alteraciones a nivel central. Resultados A los 6…

Initial experience with the Sophono Alpha 1 osseointegrated implant.

In the last several years, bone anchored hearing aids have proven to be useful in treating conductive and mixed unilateral or bilateral hearing loss, as well as for sensorineural unilateral hearing loss. The Sophono Alpha 1 model has the advantage of not requiring an abutment, with it being coupled by magnetism instead. We report the cases of 3 infants with congenital malformations of external and middle ear. Audiometry showed conductive hearing loss. All 3 patients were implanted with Alpha 1 model (Sophono). Patients evolved satisfactorily. After 30 days we applied the processor and the control audiometry showed a marked improvement of hearing thresholds, although without a complete closu…

Vestibular Decruitment

Torok studied the ratio obtained between the responses to two different heat stimulation intensities of the same temperature. A decrease in response to the strong stimulus (i.e., a diminished ratio) was called "vestibular decruitment," and was regarded as a topodiagnostic indicator of central vestibular lesion, reflecting "adaptation" or "fatigue." The authors studied the reliability of vestibular decruitment obtained by Torok's technique in the indication of central vestibular pathology. Twenty-eight normal individuals and 30 patients previously diagnosed by other methods with diffuse pathology of the central nervous system were evaluated. The results obtained show that the two stimuli use…

Primeras experiencias con el dispositivo osteointegrado Ponto™ SuperPower

Resumen Los dispositivos auditivos osteointegrados (DAO) Power y SuperPower presentan indicaciones para umbrales en via osea de 55 y 65 dB, respectivamente. Realizamos un estudio observacional prospectivo de una serie de 6 casos con hipoacusia mixta en los que se realizo implantacion del DAO Ponto™ SuperPower. Se realizaron previo a la implantacion y 6 meses tras la adaptacion valoraciones tonales y verbales sin y con ruido de fondo (HINTS). Todos los participantes mostraron mejoria en los resultados tonales y verbales, variando segun el grado de hipoacusia contralateral. Cabe destacar los resultados verbales con ruido de fondo donde la mayoria de los pacientes obtuvieron una relacion senal…

Relación entre el video head impulse test (vHIT) y la prueba calórica en el estudio evolutivo de pacientes con neuritis vestibular

Resumen Introduccion y objetivos La prueba calorica es hasta ahora la prueba de referencia para el diagnostico y el examen de una hipofuncion vestibular unilateral. El video head impulse test (vHIT) valora el reflejo vestibulo-oculomotor, mediante el registro videoasistido de la maniobra impulsiva. Se pretende comparar la variacion de los resultados del vHIT y la prueba calorica en pacientes con neuritis vestibular respecto a su estado inicial en diferentes puntos de su evolucion, y comprobar su grado de correlacion entre si y con el test Dizziness Handicap Inventory (DHI). Metodos Exploracion en la misma sesion mediante vHIT y prueba calorica de 20 pacientes con neuritis vestibular. Valora…

Extra-tympanic electrocochleography in a normal population. A descriptive study.

Abstract Introduction and objectives Extra-tympanic electrocochleography is an electrophysiological register obtained after stimulating the cochlea with an audible stimulus. This stimulus is applied using an earphone over the external auditory canal, while the electrical activity is registered by surface electrodes. There are few studies that analyse normal electrocochleography in our environment. Thus, the main objective of our study was to regularise the values obtained with electrocochleography in ears without any otoneurological diseases. We explain in detail the process of obtaining the register. Methods Sixty healthy ears were studied by extratympanic electrocochleography. Statistical…

Audiologic and Subjective Evaluation of Baha ® Attract Device

We included 9 patients implanted with Baha® Attract. All our patients were evaluated by free field tonal audiometry, free field verbal audiometry and free field verbal audiometry with background noise, all the tests were performed with and without the device. To evaluate the subjective component of the implantation, we used the Glasgow Benefit Inventory (GBI) and Abbreviated Profile of Hearing Aid Benefit (APHAB). The auditive assessment with the device showed average auditive thresholds of 35.8dB with improvements of 25.8dB over the previous situation. Speech reception thresholds were 37dB with Baha® Attract, showing improvements of 23dB. Maximum discrimination thresholds showed an average…

Cortical neuroplasticity in children after early cochlear implantation

Hearing is crucial to learn and use language. Loss of hearing in children affects the development of speech, language and cognitive abilities, and severely impairs social capabilities. Thus, efforts to restore auditory perception are determinative and research should be focused on factors likely to bring about the best prognosis. Numerous experimental observations demonstrate that there is a sensitive or critical period for cochlear implantation. Implantations performed in prelingually deaf children in this period are associated with better results in terms of speech recognition and language acquisition. This is the time period in which brain plasticity shows its highest level of developmen…

Relationship between video head impulse test (vHIT) and caloric test in patients with vestibular neuritis.

Abstract Introduction and objectives The caloric test is the gold standard for the loss of vestibular function diagnosis. The video head impulse test (vHIT) assesses the same reflex by using a video-assisted examination of the impulsive manoeuvre. We intend to compare the variation of results of the vHIT and the caloric test in patients with vestibular neuritis with respect to their initial condition at two different moments of their evolution and to check the level of correlation between them and with that of the DHI test. Methods We explored 20 patients with neuritis by using both vHIT and the caloric test on the same day. We assessed the correlation between these two tests and with the D…

Effectiveness of mandibular advancement appliances in treating obstructive sleep apnea syndrome: A systematic review

Objectives/Hypothesis Mandibular advancement devices are an alternative to continuous positive airway pressure for patients with mild or moderate obstructive sleep apnea/hypopnea syndrome (OSAHS). The main aim of this review was to assess the effectiveness of different devices in treating OSAHS, based on polysomnographic measurements such as the apnea/hypopnea index (AHI) and oxygen saturation, and on changes in the upper airway and improvements in the most common symptoms: snoring and somnolence. Their adverse effects were also noted. Study Design Systematic review. Methods Following an exhaustive search in the Medline, Scopus, and Cochrane Library databases, 22 articles published in the p…

First Experiences With the Ponto⢢ SuperPower Osseointegrated Device

Osseointegrated hearing devices Power and SuperPower present indications for bone thresholds of 55 and 65 dB respectively. We conducted a prospective observational study of a series of six cases with mixed hearing loss for whom implantation of the DAO Ponto™ Super-Power was performed. Tonal and verbal evaluations without and with background noise (HINTS) were performed prior to implantation and six months after adaptation. All the participants showed improvement in tonal and verbal results, varying according to the degree of contralateral hearing loss. The verbal results with background noise were noteworthy, where most of the patients obtained a signal-to-noise ratio between 2 and 4 dB. Th…

Electrococleografía extratimpánica en una población normal. Estudio descriptivo

Resumen Introduccion y objetivos La electrococleografia extratimpanica es un registro elecrofisiologico que refleja la actividad electrica acontecida en la coclea tras un estimulo sonoro. Se obtiene mediante la aplicacion del estimulo en el conducto auditivo externo y el registro de la actividad electrica mediante electrodos de superficie. Dada la escasa literatura existente acerca de la exploracion electrococleografica normal en nuestro medio, este estudio busca regularizar los valores obtenidos mediante esta exploracion en sujetos sin enfermedad otoneurologica y explicar detalladamente el proceso mediante el cual se obtiene el registro. Metodos Exploracion mediante electrococleografia ext…

Dimensional analysis of the upper airway in obstructive sleep apnoea syndrome patients treated with mandibular advancement device: A bi‐ and three‐dimensional evaluation

BACKGROUND The efficiency of the mandibular advancement device (MAD) in patients with obstructive sleep apnoea syndrome (OSAS) has been demonstrated. Nevertheless, the behaviour of the upper airway once MAD is placed and titrated, and its correlation with the apnoea-hypopnoea index (AHI) is still under discussion. OBJECTIVES To analyse the morphological changes of the upper airway through a bi- and three-dimensional study and correlate it with the polysomnographic variable, AHI. METHODS Patients were recruited from two different hospitals for the treatment of OSAS with a custom-made MAD. A cone-beam computer tomography and a polysomnography were performed at baseline and once the MAD was ti…

[Double second branchial cleft anomaly].

Second branchial cleft anomalies are the most common of this type of neck masses. They can be classified in four types (Bailey/Proctor classification) according to their location. Type II is the most common, and related to vital neck structures such as the carotid artery and jugular vein. Cysts are the most frequent among them. Management consists of surgical excision of the cyst and tract by cervicotomy to avoid recurrence. We present an extremely rare case of a 32-year-old male who presented a sudden appearance of a right lateral neck mass that was identified by an image study as a double branchial cleft cyst. A review of simultaneous branchial cleft cyst in the literature is also made.

sj-pdf-1-ajr-10.1177_1945892420972326 - Supplemental material for Effects of Omalizumab Treatment in Patients With Recalcitrant Nasal Polyposis and Mild Asthma: A Multicenter Retrospective Study

Supplemental material, sj-pdf-1-ajr-10.1177_1945892420972326 for Effects of Omalizumab Treatment in Patients With Recalcitrant Nasal Polyposis and Mild Asthma: A Multicenter Retrospective Study by Miguel Armengot-Carceller MD, PhD María José Gómez-Gómez MD, PhD Carmen García-Navalón MD Encarna Doménech-Campos Muñoz- Noelia Fernández MD, PhD MD, PhD Ainhoa García-Lliberós de Miguel MD, PhD Jaime Marco-Algarra MD, PhD Marta Palop-Cervera MD Alfonso García Piñero MD, PhD in American Journal of Rhinology & Allergy

[Clinical and radiological evolution of a group of untreated acoustic neuromas].

Abstract Introduction The acoustic neuroma is a benign tumour that originates in the vestibular branch of the eighth cranial nerve. The main treatment is surgery, but many authors suggest that with elderly patients or in small neuromas we can opt for watchful waiting. Methods This was a retrospective study from 2007 to 2013 that included 27 patients diagnosed of acoustic neuroma that had not been treated due to the size of the tumour, age and comorbidities, or by patient choice. We evaluated overall condition, hearing thresholds, degree of canal paresis and central disorders. Results After 6 years of follow up, clinical manifestations of 18 patients remained unchanged, 5 patients underwent …

Epidermoid Septal Carcinoma, A Rare and Singular Tumor: Case Report and Review

Aim: To describe our casuistic and the way we manage these tumors with their differential behavior. Background: Septal epidermoid carcinoma is a rare tumor that accounts for only 9% of tumors of the nasal fossa. This tumor presents histological, clinical, and prognostic characteristics that differentiate it from other nasal cavity tumors, mainly its anterior location that leads to an early diagnosis in incipient stages. Case description: We present a series of six patients diagnosed with nasal squamous cell carcinoma as well as the clinic referred by the patients to the diagnosis, the associated risk factors, and their clinical and therapeutic approach. Conclusion: The majority of cases (4/…

Valoración audiológica y subjetiva del dispositivo Baha ® Attract

Resumen Se incluyeron en el estudio 9 pacientes implantados con el dispositivo Baha® Attract. A todos los pacientes se les realizo, con y sin el dispositivo, una audiometria tonal en campo libre, una audiometria verbal en campo libre, y una audiometria verbal con ruido de fondo, asi como la aplicacion de los cuestionarios Glasgow Benefit Inventory (GBI) y Abbreviated Profile of Hearing Aid Benefit (APHAB). Las valoraciones audiologicas con el dispositivo mostraron unos umbrales auditivos promedios de 35,8 dB, con ganancias medias de 25,8 dB. El umbral de recepcion verbal promedio con el dispositivo se situo en 37 dB, mostrando una ganancia de 23 dB. Los resultados promedio del umbral de dis…

Evolución de la otosclerosis hacia la implantación coclear

Resumen Introduccion La otosclerosis es una osteodistrofia de la capsula laberintica que produce hipoacusia de conduccion. Si el proceso invade la coclea, aparece una hipoacusia neurosensorial, siendo el implante coclear una buena alternativa en estos pacientes. Objetivo Conocer el comportamiento de la otosclerosis en la implantacion coclear. Material y metodos Se reviso una base de datos de 250 pacientes intervenidos de implante coclear realizando un estudio retrospectivo sobre 13 pacientes con criterios clinicos, audiologicos y/o de imagen de otosclerosis bilateral. Se estudian los 26 oidos analizando la historia natural, cirugias previas, evolucion hacia hipoacusia profunda, hallazgos en…

Doble anomalía de la segunda hendidura branquial

Las anomalias de la segunda hendidura branquial son las mas comunes. Hay 4 tipos (clasificacion de Bailey/Proctor) segun su localizacion. El tipo II, que es el mas comun, esta en contacto con los grandes vasos. Su forma de presentacion es diversa, aunque la mas frecuente es la quistica. El tratamiento es quirurgico con extirpacion completa por cervicotomia para evitar recidivas. Presentamos el caso clinico extremadamente raro de un varon de 32 anos con debut brusco de tumoracion laterocervical derecha, con estudio de imagen que demuestra la presencia de doble quiste branquial. Revisamos en la literatura casos de simultaneidad de quistes branquiales.

Experiencia inicial con el implante osteointegrado Alpha 1 de Sophono

En los ultimos anos los implantes osteointegrados han probado su utilidad en el tratamiento de la hipoacusia de transmision mixta, uni o bilateral, y la neurosensorial unilateral. El implante Alpha 1 de Sophono ofrece una ventaja sustancial, la falta de acoplador externo y su union al receptor por medio de magnetismo. Presentamos el caso de 3 ninos que padecen malformaciones de oido externo y medio de origen congenito. Los estudios audiometricos revelan hipoacusias de transmision de caracter moderado. En los 3 pacientes se propuso la colocacion del implante Alpha 1 de Sophono. Los pacientes evolucionaron de forma satisfactoria. A los 30 dias se les aplico el procesador, y en las audiometria…

Carcinoma ex adenoma pleomorfo en fosas nasales: un diagnóstico inusual