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Showing 1 - 200 of 3043 Journals sorted alphabetically
AASRI Procedia     Open Access   (Followers: 15)
Academic Pediatrics     Hybrid Journal   (Followers: 20, SJR: 1.402, h-index: 51)
Academic Radiology     Hybrid Journal   (Followers: 18, SJR: 1.008, h-index: 75)
Accident Analysis & Prevention     Partially Free   (Followers: 83, SJR: 1.109, h-index: 94)
Accounting Forum     Hybrid Journal   (Followers: 23, SJR: 0.612, h-index: 27)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 27, SJR: 2.515, h-index: 90)
Achievements in the Life Sciences     Open Access   (Followers: 4)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 5, SJR: 0.338, h-index: 19)
Acta Astronautica     Hybrid Journal   (Followers: 331, SJR: 0.726, h-index: 43)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 3)
Acta Biomaterialia     Hybrid Journal   (Followers: 25, SJR: 2.02, h-index: 104)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription   (Followers: 1)
Acta de Investigación Psicológica     Open Access   (Followers: 2)
Acta Ecologica Sinica     Open Access   (Followers: 8, SJR: 0.172, h-index: 29)
Acta Haematologica Polonica     Free   (SJR: 0.123, h-index: 8)
Acta Histochemica     Hybrid Journal   (Followers: 3, SJR: 0.604, h-index: 38)
Acta Materialia     Hybrid Journal   (Followers: 211, SJR: 3.683, h-index: 202)
Acta Mathematica Scientia     Full-text available via subscription   (Followers: 5, SJR: 0.615, h-index: 21)
Acta Mechanica Solida Sinica     Full-text available via subscription   (Followers: 9, SJR: 0.442, h-index: 21)
Acta Oecologica     Hybrid Journal   (Followers: 9, SJR: 0.915, h-index: 53)
Acta Otorrinolaringologica (English Edition)     Full-text available via subscription   (Followers: 1)
Acta Otorrinolaringológica Española     Full-text available via subscription   (Followers: 3, SJR: 0.311, h-index: 16)
Acta Pharmaceutica Sinica B     Open Access   (Followers: 2)
Acta Poética     Open Access   (Followers: 4)
Acta Psychologica     Hybrid Journal   (Followers: 23, SJR: 1.365, h-index: 73)
Acta Sociológica     Open Access  
Acta Tropica     Hybrid Journal   (Followers: 6, SJR: 1.059, h-index: 77)
Acta Urológica Portuguesa     Open Access  
Actas Dermo-Sifiliograficas     Full-text available via subscription   (Followers: 4)
Actas Dermo-Sifiliográficas (English Edition)     Full-text available via subscription   (Followers: 3)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 4, SJR: 0.383, h-index: 19)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 2)
Actualites Pharmaceutiques     Full-text available via subscription   (Followers: 5, SJR: 0.141, h-index: 3)
Actualites Pharmaceutiques Hospitalieres     Full-text available via subscription   (Followers: 4, SJR: 0.112, h-index: 2)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 3)
Ad Hoc Networks     Hybrid Journal   (Followers: 11, SJR: 0.967, h-index: 57)
Addictive Behaviors     Hybrid Journal   (Followers: 15, SJR: 1.514, h-index: 92)
Addictive Behaviors Reports     Open Access   (Followers: 5)
Additive Manufacturing     Hybrid Journal   (Followers: 8, SJR: 1.039, h-index: 5)
Additives for Polymers     Full-text available via subscription   (Followers: 20)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 128, SJR: 5.2, h-index: 222)
Advanced Engineering Informatics     Hybrid Journal   (Followers: 11, SJR: 1.265, h-index: 53)
Advanced Powder Technology     Hybrid Journal   (Followers: 16, SJR: 0.739, h-index: 33)
Advances in Accounting     Hybrid Journal   (Followers: 9, SJR: 0.299, h-index: 15)
Advances in Agronomy     Full-text available via subscription   (Followers: 15, SJR: 2.071, h-index: 82)
Advances in Anesthesia     Full-text available via subscription   (Followers: 25, SJR: 0.169, h-index: 4)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 3)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 6, SJR: 1.054, h-index: 35)
Advances in Applied Mechanics     Full-text available via subscription   (Followers: 10, SJR: 0.801, h-index: 26)
Advances in Applied Microbiology     Full-text available via subscription   (Followers: 22, SJR: 1.286, h-index: 49)
Advances In Atomic, Molecular, and Optical Physics     Full-text available via subscription   (Followers: 16, SJR: 3.31, h-index: 42)
Advances in Biological Regulation     Hybrid Journal   (Followers: 4, SJR: 2.277, h-index: 43)
Advances in Botanical Research     Full-text available via subscription   (Followers: 3, SJR: 0.619, h-index: 48)
Advances in Cancer Research     Full-text available via subscription   (Followers: 25, SJR: 2.215, h-index: 78)
Advances in Carbohydrate Chemistry and Biochemistry     Full-text available via subscription   (Followers: 9, SJR: 0.9, h-index: 30)
Advances in Catalysis     Full-text available via subscription   (Followers: 5, SJR: 2.139, h-index: 42)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 12)
Advances in Chemical Engineering     Full-text available via subscription   (Followers: 24, SJR: 0.183, h-index: 23)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10, SJR: 0.665, h-index: 29)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 10, SJR: 1.268, h-index: 45)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 28, SJR: 0.938, h-index: 33)
Advances in Colloid and Interface Science     Full-text available via subscription   (Followers: 18, SJR: 2.314, h-index: 130)
Advances in Computers     Full-text available via subscription   (Followers: 16, SJR: 0.223, h-index: 22)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 11)
Advances in Digestive Medicine     Open Access   (Followers: 4)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 5)
Advances in Drug Research     Full-text available via subscription   (Followers: 22)
Advances in Ecological Research     Full-text available via subscription   (Followers: 41, SJR: 3.25, h-index: 43)
Advances in Engineering Software     Hybrid Journal   (Followers: 25, SJR: 0.486, h-index: 10)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 7)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 40, SJR: 5.465, h-index: 64)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 3)
Advances in Fluorine Science     Full-text available via subscription   (Followers: 8)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 47, SJR: 0.674, h-index: 38)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 15)
Advances in Genetics     Full-text available via subscription   (Followers: 15, SJR: 2.558, h-index: 54)
Advances in Genome Biology     Full-text available via subscription   (Followers: 11)
Advances in Geophysics     Full-text available via subscription   (Followers: 6, SJR: 2.325, h-index: 20)
Advances in Heat Transfer     Full-text available via subscription   (Followers: 21, SJR: 0.906, h-index: 24)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 0.497, h-index: 31)
Advances in Human Factors/Ergonomics     Full-text available via subscription   (Followers: 25)
Advances in Imaging and Electron Physics     Full-text available via subscription   (Followers: 2, SJR: 0.396, h-index: 27)
Advances in Immunology     Full-text available via subscription   (Followers: 35, SJR: 4.152, h-index: 85)
Advances in Inorganic Chemistry     Full-text available via subscription   (Followers: 9, SJR: 1.132, h-index: 42)
Advances in Insect Physiology     Full-text available via subscription   (Followers: 3, SJR: 1.274, h-index: 27)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 5)
Advances in Intl. Accounting     Full-text available via subscription   (Followers: 4)
Advances in Life Course Research     Hybrid Journal   (Followers: 8, SJR: 0.764, h-index: 15)
Advances in Lipobiology     Full-text available via subscription   (Followers: 2)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 9)
Advances in Marine Biology     Full-text available via subscription   (Followers: 16, SJR: 1.645, h-index: 45)
Advances in Mathematics     Full-text available via subscription   (Followers: 10, SJR: 3.261, h-index: 65)
Advances in Medical Sciences     Hybrid Journal   (Followers: 6, SJR: 0.489, h-index: 25)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 5)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 4, SJR: 1.44, h-index: 51)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 22)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 10)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 7, SJR: 0.324, h-index: 8)
Advances in Nanoporous Materials     Full-text available via subscription   (Followers: 4)
Advances in Oncobiology     Full-text available via subscription   (Followers: 3)
Advances in Organometallic Chemistry     Full-text available via subscription   (Followers: 15, SJR: 2.885, h-index: 45)
Advances in Parallel Computing     Full-text available via subscription   (Followers: 7, SJR: 0.148, h-index: 11)
Advances in Parasitology     Full-text available via subscription   (Followers: 7, SJR: 2.37, h-index: 73)
Advances in Pediatrics     Full-text available via subscription   (Followers: 24, SJR: 0.4, h-index: 28)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 13)
Advances in Pharmacology     Full-text available via subscription   (Followers: 15, SJR: 1.718, h-index: 58)
Advances in Physical Organic Chemistry     Full-text available via subscription   (Followers: 7, SJR: 0.384, h-index: 26)
Advances in Phytomedicine     Full-text available via subscription  
Advances in Planar Lipid Bilayers and Liposomes     Full-text available via subscription   (Followers: 3, SJR: 0.248, h-index: 11)
Advances in Plant Biochemistry and Molecular Biology     Full-text available via subscription   (Followers: 8)
Advances in Plant Pathology     Full-text available via subscription   (Followers: 5)
Advances in Porous Media     Full-text available via subscription   (Followers: 4)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 18)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 19, SJR: 1.5, h-index: 62)
Advances in Psychology     Full-text available via subscription   (Followers: 60)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 5, SJR: 0.478, h-index: 32)
Advances in Radiation Oncology     Open Access  
Advances in Small Animal Medicine and Surgery     Hybrid Journal   (Followers: 2, SJR: 0.1, h-index: 2)
Advances in Space Research     Full-text available via subscription   (Followers: 343, SJR: 0.606, h-index: 65)
Advances in Structural Biology     Full-text available via subscription   (Followers: 8)
Advances in Surgery     Full-text available via subscription   (Followers: 7, SJR: 0.823, h-index: 27)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 30, SJR: 1.321, h-index: 56)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 15)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 13)
Advances in Virus Research     Full-text available via subscription   (Followers: 5, SJR: 1.878, h-index: 68)
Advances in Water Resources     Hybrid Journal   (Followers: 43, SJR: 2.408, h-index: 94)
Aeolian Research     Hybrid Journal   (Followers: 5, SJR: 0.973, h-index: 22)
Aerospace Science and Technology     Hybrid Journal   (Followers: 307, SJR: 0.816, h-index: 49)
AEU - Intl. J. of Electronics and Communications     Hybrid Journal   (Followers: 8, SJR: 0.318, h-index: 36)
African J. of Emergency Medicine     Open Access   (Followers: 5, SJR: 0.344, h-index: 6)
Ageing Research Reviews     Hybrid Journal   (Followers: 8, SJR: 3.289, h-index: 78)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 405, SJR: 1.385, h-index: 72)
Agri Gene     Hybrid Journal  
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 15, SJR: 2.18, h-index: 116)
Agricultural Systems     Hybrid Journal   (Followers: 30, SJR: 1.275, h-index: 74)
Agricultural Water Management     Hybrid Journal   (Followers: 38, SJR: 1.546, h-index: 79)
Agriculture and Agricultural Science Procedia     Open Access  
Agriculture and Natural Resources     Open Access   (Followers: 1)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 53, SJR: 1.879, h-index: 120)
Ain Shams Engineering J.     Open Access   (Followers: 5, SJR: 0.434, h-index: 14)
Air Medical J.     Hybrid Journal   (Followers: 5, SJR: 0.234, h-index: 18)
AKCE Intl. J. of Graphs and Combinatorics     Open Access   (SJR: 0.285, h-index: 3)
Alcohol     Hybrid Journal   (Followers: 9, SJR: 0.922, h-index: 66)
Alcoholism and Drug Addiction     Open Access   (Followers: 6)
Alergologia Polska : Polish J. of Allergology     Full-text available via subscription   (Followers: 1)
Alexandria Engineering J.     Open Access   (Followers: 1, SJR: 0.436, h-index: 12)
Alexandria J. of Medicine     Open Access  
Algal Research     Partially Free   (Followers: 8, SJR: 2.05, h-index: 20)
Alkaloids: Chemical and Biological Perspectives     Full-text available via subscription   (Followers: 3)
Allergologia et Immunopathologia     Full-text available via subscription   (Followers: 1, SJR: 0.46, h-index: 29)
Allergology Intl.     Open Access   (Followers: 4, SJR: 0.776, h-index: 35)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 7, SJR: 0.158, h-index: 9)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 48, SJR: 4.289, h-index: 64)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 5)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 3)
American Heart J.     Hybrid Journal   (Followers: 48, SJR: 3.157, h-index: 153)
American J. of Cardiology     Hybrid Journal   (Followers: 45, SJR: 2.063, h-index: 186)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 38, SJR: 0.574, h-index: 65)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 6, SJR: 1.091, h-index: 45)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 16, SJR: 1.653, h-index: 93)
American J. of Human Genetics     Hybrid Journal   (Followers: 31, SJR: 8.769, h-index: 256)
American J. of Infection Control     Hybrid Journal   (Followers: 24, SJR: 1.259, h-index: 81)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 33, SJR: 2.313, h-index: 172)
American J. of Medicine     Hybrid Journal   (Followers: 46, SJR: 2.023, h-index: 189)
American J. of Medicine Supplements     Full-text available via subscription   (Followers: 3)
American J. of Obstetrics and Gynecology     Hybrid Journal   (Followers: 191, SJR: 2.255, h-index: 171)
American J. of Ophthalmology     Hybrid Journal   (Followers: 54, SJR: 2.803, h-index: 148)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 3)
American J. of Orthodontics and Dentofacial Orthopedics     Full-text available via subscription   (Followers: 6, SJR: 1.249, h-index: 88)
American J. of Otolaryngology     Hybrid Journal   (Followers: 23, SJR: 0.59, h-index: 45)
American J. of Pathology     Hybrid Journal   (Followers: 26, SJR: 2.653, h-index: 228)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 21, SJR: 2.764, h-index: 154)
American J. of Surgery     Hybrid Journal   (Followers: 34, SJR: 1.286, h-index: 125)
American J. of the Medical Sciences     Hybrid Journal   (Followers: 12, SJR: 0.653, h-index: 70)
Ampersand : An Intl. J. of General and Applied Linguistics     Open Access   (Followers: 5)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.066, h-index: 51)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 55, SJR: 0.124, h-index: 9)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 10)
Anales de Cirugia Vascular     Full-text available via subscription  
Anales de Pediatría     Full-text available via subscription   (Followers: 2, SJR: 0.209, h-index: 27)
Anales de Pediatría (English Edition)     Full-text available via subscription  
Anales de Pediatría Continuada     Full-text available via subscription   (SJR: 0.104, h-index: 3)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 2, SJR: 2.577, h-index: 7)
Analytica Chimica Acta     Hybrid Journal   (Followers: 38, SJR: 1.548, h-index: 152)
Analytical Biochemistry     Hybrid Journal   (Followers: 162, SJR: 0.725, h-index: 154)
Analytical Chemistry Research     Open Access   (Followers: 8, SJR: 0.18, h-index: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 11)
Anesthésie & Réanimation     Full-text available via subscription   (Followers: 1)
Anesthesiology Clinics     Full-text available via subscription   (Followers: 22, SJR: 0.421, h-index: 40)
Angiología     Full-text available via subscription   (SJR: 0.124, h-index: 9)
Angiologia e Cirurgia Vascular     Open Access  
Animal Behaviour     Hybrid Journal   (Followers: 157, SJR: 1.907, h-index: 126)
Animal Feed Science and Technology     Hybrid Journal   (Followers: 5, SJR: 1.151, h-index: 83)
Animal Reproduction Science     Hybrid Journal   (Followers: 5, SJR: 0.711, h-index: 78)
Annales d'Endocrinologie     Full-text available via subscription   (Followers: 1, SJR: 0.394, h-index: 30)
Annales d'Urologie     Full-text available via subscription  
Annales de Cardiologie et d'Angéiologie     Full-text available via subscription   (SJR: 0.177, h-index: 13)
Annales de Chirurgie de la Main et du Membre Supérieur     Full-text available via subscription  
Annales de Chirurgie Plastique Esthétique     Full-text available via subscription   (Followers: 2, SJR: 0.354, h-index: 22)
Annales de Chirurgie Vasculaire     Full-text available via subscription   (Followers: 1)

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Journal Cover Acta Otorrinolaringológica Española
  [SJR: 0.311]   [H-I: 16]   [3 followers]  Follow
   Full-text available via subscription Subscription journal
   ISSN (Print) 0001-6519
   Published by Elsevier Homepage  [3043 journals]
  • Surgical treatment of nasal septal perforations: SIR (Italian Society of
           Rhinology) experts opinion
    • Authors: Desiderio Passali; Maria Carla Spinosi; Lorenzo Salerni; Michele Cassano; Hugo Rodriguez; Francesco Maria Passali; Luisa Maria Bellussi
      Pages: 191 - 196
      Abstract: Publication date: July–August 2017
      Source:Acta Otorrinolaringológica Española, Volume 68, Issue 4
      Author(s): Desiderio Passali, Maria Carla Spinosi, Lorenzo Salerni, Michele Cassano, Hugo Rodriguez, Francesco Maria Passali, Luisa Maria Bellussi
      Background and aim The aim of our study has been to investigate the perception of aspects related to nasal perforation among experts in Rhinology and ENT surgeons. Our aim was reporting the situations in different Countries to improve the knowledge of colleagues interested in this topic. Methods A panel of experts prepared a 20-question questionnaire regarding nasal perforations and their surgical repair, that were emailed to all the members of SIR (Società Italiana di Rnologia – Italian Society of Rhinology). Results Data obtained from their answers showed that Cottle technique (64%) is the most common technique to perform septoplasty worldwide. 37% of the sample reported an occurrence of nasal septal perforation in less than 1% of patients and 75% attributed this occurrence to the skill of the surgeon, to infections, to drug use and to septal deformity. Trauma, pressure and Wegener's granulomatosis were also mentioned. The most common closure technique is the mucosal flap (75%), followed by the cartilage grafts (11%). Much less common were oral flaps, septal buttons and others. The majority agreed not to suggest septal perforation surgery in minimal (less than 3–4mm) perforations (73.5%), or limiting it to symptomatic patients (43.5%). The contraindications to repair surgery were reported to be: Wegener's granulomatosis, drug abuse, non-symptomatic perforation, its dimension and age of the patient. Septal deviation, atrophic rhinitis, smoke epistaxis and systemic diseases were also claimed. Failure in repair surgery has been observed to occur in less than 30% of cases. Discussion and conclusions Given the great difficulty to make random studies about controversial topics and obtain statistically significant data related to that, expert opinion shall be of great value (expert opinion, level of evidence 5)

      PubDate: 2017-07-12T09:19:10Z
      DOI: 10.1016/j.otorri.2016.10.001
  • Contralateral Occlusion Test: The effect of external ear canal occlusion
           on hearing thresholds
    • Authors: Luis Roque Reis; Paulo Fernandes; Pedro Escada
      Pages: 197 - 203
      Abstract: Publication date: July–August 2017
      Source:Acta Otorrinolaringológica Española, Volume 68, Issue 4
      Author(s): Luis Roque Reis, Paulo Fernandes, Pedro Escada
      Introduction and goals Bedside testing with tuning forks may decrease turnaround time and improve decision making for a quick qualitative assessment of hearing loss. The purpose of this study was to quantify the effects of ear canal occlusion on hearing, in order to decide which tuning fork frequency is more appropriate to use for quantifying hearing loss with the Contralateral Occlusion Test. Methods Twenty normal-hearing adults (forty ears) underwent sound field pure tone audiometry with and without ear canal occlusion. Each ear was tested with the standard frequencies. The contralateral ear was suppressed with by masking. Ear occlusion was performed by two examiners. Results Participants aged between 21 and 30 years (25.6±3.03 years) showed an increase in hearing thresholds with increasing frequencies from 19.94dB (250Hz) to 39.25dB (2000Hz). The threshold difference between occluded and unoccluded conditions was statistically significant and increased from 10.69dB (250Hz) to 32.12dB (2000Hz). There were no statistically significant differences according to gender or between the examiners. Conclusion The occlusion effect increased the hearing thresholds and became more evident with higher frequencies. The occlusion method as performed demonstrated reproducibility. In the Contralateral Occlusion Test, 256Hz or 512Hz tuning forks should be used for diagnosis of mild hearing loss, and a 2048Hz tuning fork should be used for moderate hearing loss.

      PubDate: 2017-07-12T09:19:10Z
      DOI: 10.1016/j.otorri.2016.11.011
  • Electrocauterización endoscópica para el tratamiento de las fístulas
           congénitas del seno piriforme en pediatría. Serie de casos
    • Authors: Giselle Cuestas; Flavia Doormann; Verónica Rodríguez; Patricio Bellia Munzón; Gastón Bellia Munzón
      Pages: 220 - 225
      Abstract: Publication date: July–August 2017
      Source:Acta Otorrinolaringológica Española, Volume 68, Issue 4
      Author(s): Giselle Cuestas, Flavia Doormann, Verónica Rodríguez, Patricio Bellia Munzón, Gastón Bellia Munzón
      Las fístulas del seno piriforme son anomalías infrecuentes de los arcos branquiales. La mayoría se localizan en el lado izquierdo y se extienden desde el ápex del seno piriforme de la hipofaringe hasta la glándula tiroides o el espacio peritiroideo. El diagnóstico se sospecha ante la presencia de tiroiditis aguda supurada o abscesos cervicales laterales recurrentes, y se confirma mediante la visualización endoscópica del orificio de la fístula. El tratamiento clásico consiste en la exéresis del trayecto fistuloso por vía cervical, con o sin lobectomía tiroidea. Sin embargo, se han desarrollado alternativas menos invasivas y con menos riesgos de complicaciones que obliteran el trayecto de la fístula, como la electrocauterización endoscópica. Describimos nuestra experiencia con 7 pacientes que presentaban esta afección, tratados con cauterización endoscópica utilizando electrobisturí de radiofrecuencia, y evaluamos la eficacia y la seguridad del tratamiento realizado. Pyriform sinus fistulas are rare anomalies of the branchial arches. Most of them are located on the left side. They extend from the apex of the pyriform sinus of the hypopharynx to the thyroid gland or adjacent tissues. The diagnosis is suspected in the presence of acute suppurative thyroiditis or recurrent cervical abscesses, and is confirmed by endoscopic visualization of the fistula hole. The traditional treatment consists of excision of the fistulous tract, with or without thyroid lobectomy, by cervical approach. However, less invasive alternatives that obliterate the path of the fistula have been developed, such as endoscopic electrocautery. We describe our experience with 7 patients with this condition, who were treated with endoscopic cauterization using radiofrequency electrocautery, and we evaluate the effectiveness and safety of the treatment performed.

      PubDate: 2017-07-12T09:19:10Z
      DOI: 10.1016/j.otorri.2016.08.004
  • Consenso español para el tratamiento de los tumores nasosinusales
    • Authors: Fernando López; Juan José Grau; José Antonio Medina; Isam Alobid
      Pages: 226 - 234
      Abstract: Publication date: July–August 2017
      Source:Acta Otorrinolaringológica Española, Volume 68, Issue 4
      Author(s): Fernando López, Juan José Grau, José Antonio Medina, Isam Alobid
      Los tumores nasosinusales son neoplasias poco frecuentes. Su epidemiología, histopatología y características clínicas son diferentes a las del resto de neoplasias malignas de cabeza y cuello. El diagnóstico y tratamiento de estos tumores plantea diversos desafíos debido a su escasa incidencia, su diversidad histológica, la producción de sintomatología inespecífica en los estadios precoces y por tener un pronóstico variable en función de su histología, lugar de origen y estadificación. Su localización centrofacial y la proximidad de estructuras como la órbita y la base del cráneo hacen que su tratamiento sea difícil y complejo, conllevando una elevada morbimortalidad. La cirugía seguida de radioterapia es el tratamiento de elección en la mayor parte de los casos. Para conseguir unos buenos resultados se requiere de equipos multidisciplinares altamente especializados. En este artículo se expone un protocolo de consenso para el tratamiento de los tumores nasosinusales realizado por la Sociedad Española de Otorrinolaringología en colaboración con la Sociedad Española de Oncología Médica y la Sociedad Española de Oncología Radioterápica. Sinonasal tumors are rare neoplasms with distinctive clinical, aetiological and pathological features. The diagnosis and treatment of these tumours is challenging because of their low incidence, histological diversity and production of non-specific symptoms in the early stages. They have a variable prognosis depending on their histology, origin and staging. Their location, close to neurocritical structures, which are of special relevance to surgery and postoperative treatment, makes their treatment difficult and complex, leading to high morbidity and mortality. Surgery followed by radiotherapy is the mainstay of treatment. To provide the best possible care, patients with sinonasal cancer should be treated in clinical referral centres specializing in skull-base pathologies. Such centres should include a multidisciplinary team led by otolaryngologist surgeons. This article outlines a consensus protocol for the management of these tumours devised by the Spanish Society of Otolaryngology in collaboration with the Spanish Society of Medical Oncology and the Spanish Society for Radiation Oncology.

      PubDate: 2017-07-12T09:19:10Z
      DOI: 10.1016/j.otorri.2016.07.001
  • Siringocistoadenoma papilífero del conducto auditivo externo. Serie de
           casos y revisión bibliográfica
    • Authors: Gloria Guerra-Jiménez; Rocío González Aguado; Alejandra Arenas Rodríguez; Ángel Ramos Macías
      Pages: 235 - 237
      Abstract: Publication date: July–August 2017
      Source:Acta Otorrinolaringológica Española, Volume 68, Issue 4
      Author(s): Gloria Guerra-Jiménez, Rocío González Aguado, Alejandra Arenas Rodríguez, Ángel Ramos Macías

      PubDate: 2017-07-12T09:19:10Z
      DOI: 10.1016/j.otorri.2016.06.005
  • Alveolar sarcoma of the parapharyngeal space: A case report
    • Authors: Sarina Navarro; Jose F. Carrillo; Dorian Yarih Garcia Ortega; Kuauhyama Luna-Ortiz
      Pages: 241 - 243
      Abstract: Publication date: July–August 2017
      Source:Acta Otorrinolaringológica Española, Volume 68, Issue 4
      Author(s): Sarina Navarro, Jose F. Carrillo, Dorian Yarih Garcia Ortega, Kuauhyama Luna-Ortiz

      PubDate: 2017-07-12T09:19:10Z
      DOI: 10.1016/j.otorri.2016.11.002
  • Tendinitis calcificante del músculo largo del cuello
    • Authors: Alberto Sierra Solís; Luis Fernández Prudencio
      Pages: 244 - 245
      Abstract: Publication date: July–August 2017
      Source:Acta Otorrinolaringológica Española, Volume 68, Issue 4
      Author(s): Alberto Sierra Solís, Luis Fernández Prudencio

      PubDate: 2017-07-12T09:19:10Z
      DOI: 10.1016/j.otorri.2016.04.001
  • Absceso intratonsilar, rara causa de odinofagia
    • Authors: Blidy N. Añaguari; Juan Rebollo; Cristina Montes
      Pages: 246 - 247
      Abstract: Publication date: July–August 2017
      Source:Acta Otorrinolaringológica Española, Volume 68, Issue 4
      Author(s): Blidy N. Añaguari, Juan Rebollo, Cristina Montes

      PubDate: 2017-07-12T09:19:10Z
      DOI: 10.1016/j.otorri.2016.05.004
  • Sorpresa diagnóstica en síndrome menièriforme: Bulbo
           yugular dehiscente
    • Authors: Christian E. Calvo-Henriquez; Xenia I. Mota-Rojas; Andrés Soto-Varela
      Pages: 248 - 249
      Abstract: Publication date: July–August 2017
      Source:Acta Otorrinolaringológica Española, Volume 68, Issue 4
      Author(s): Christian E. Calvo-Henriquez, Xenia I. Mota-Rojas, Andrés Soto-Varela

      PubDate: 2017-07-12T09:19:10Z
      DOI: 10.1016/j.otorri.2016.06.002
  • Ossiculoplasty in chronic otitis media: Surgical results and prognostic
           factors of surgical success
    • Authors: Ana Castro Sousa; Vânia Henriques; Jorge Rodrigues; Rui Fonseca
      Pages: 131 - 137
      Abstract: Publication date: May–June 2017
      Source:Acta Otorrinolaringológica Española, Volume 68, Issue 3
      Author(s): Ana Castro Sousa, Vânia Henriques, Jorge Rodrigues, Rui Fonseca
      Background and objectives The goal of ossiculoplasty is to improve hearing. Successful ossiculoplasty depends on several factors. This retrospective study was carried out to analyze hearing results of ossiculoplasty in ears with chronic otitis media (COM) and evaluate clinical outcomes and factors predictive of hearing improvement. Subjects and methods We reviewed the results of 153 patients with COM (with cholesteatoma (COMC) and without cholesteatoma (COMWC)) who underwent ossiculoplasty between January of 2002 to December of 2011. Several potential prognostic factors were evaluated: cholesteatoma present vs absent; type of surgical procedure, state of the middle ear mucosa, state of the ossicular chain, type of prosthesis. Results We analyzed 153 ossiculoplasties: 96 patients presented COMWC and 57 patients presented COMC. The ossiculoplasties were performed using autologous ossicles for the most part. All ossiculoplasties were carried out in one-stage surgery. In 38% of cases ossiculoplasty was combined with mastoidectomy; in the remaining 62% of cases, ossiculoplasty was performed without mastoidectomy. Ossiculoplasty was successfully achieved in 113 patients (74%). The presence of the stapes superstructure and normal mucosa were significant predictive factors of surgical success. Conclusion The majority of the ossiculoplasties improved hearing status satisfactorily. Multivariate analysis should be performed to investigate prognostic factors of favorable short-term hearing outcomes after ossiculoplasty. Better knowledge of these predictive factors may contribute to the surgeon's judgment and the information given to patients.

      PubDate: 2017-05-04T08:33:38Z
      DOI: 10.1016/j.otorri.2016.06.006
  • Tumores primarios del espacio parafaríngeo
    • Authors: Gianluigi Grilli; Vanessa Suarez; María Gabriela Muñoz; María Costales; José Luis Llorente
      Pages: 138 - 144
      Abstract: Publication date: May–June 2017
      Source:Acta Otorrinolaringológica Española, Volume 68, Issue 3
      Author(s): Gianluigi Grilli, Vanessa Suarez, María Gabriela Muñoz, María Costales, José Luis Llorente
      Introducción y objetivos El objetivo de este estudio es presentar nuestra experiencia en el diagnóstico y tratamiento de los tumores parafaríngeos. Pacientes y método Realizamos un estudio retrospectivo de 90 pacientes, diagnosticados y tratados quirúrgicamente de una tumoración parafaríngea entre 1984 y 2015. Fueron excluidos los pacientes cuyos tumores no eran primarios, sino que invadían esta región por contigüidad, los tumores originados en el lóbulo profundo de la parótida y las metástasis de otros tumores de cabeza y cuello. Resultados El 74% de las neoplasias del espacio parafaríngeo fueron de naturaleza benigna y el 26% maligna. Los adenomas pleomorfos fueron los tumores más frecuentes (27%), seguido por los paragangliomas (25%), un grupo de tumores de origen misceláneo de naturaleza maligna (16%), los tumores de origen neurogénico (12%), un grupo de tumores de origen misceláneo de naturaleza benigna (10%) y los tumores malignos de glándulas salivales (10%). El tratamiento fue quirúrgico en todos los casos. Se realizó un abordaje transcervical en 56 pacientes, un abordaje cervical-transparotídeo en 15 pacientes, un abordaje infratemporal tipo A en 13 pacientes, un abordaje transmandibular en 4 pacientes y en 2 casos un abordaje transoral. Las complicaciones más frecuentes fueron las derivadas de lesiones de estructuras nerviosas. Conclusiones La mayoría de los tumores localizados en el espacio parafaríngeo son subsidiarios de ser tratados de forma quirúrgica con una baja tasa de complicaciones y recurrencias. El abordaje transcervical es el más utilizado. Introduction and objectives The aim of this study is to present our experience with the diagnostic and therapeutic approaches for parapharyngeal space tumours. Patients and method This study is a retrospective review of 90 patients diagnosed with tumours of the parapharyngeal space and treated surgically between 1984 and 2015. Patients whose tumours were not primary but invaded the parapharyngeal space expanding from another region, tumours originating in the deep lobe of the parotid gland and head and neck metastasis were excluded from this study. Results 74% percent of the parapharyngeal space neoplasms were benign and 26% were malignant. Pleomorphic adenoma was the most common neoplasm (27%), followed by paragangliomas (25%), miscellaneous malignant tumours (16%), neurogenic tumours (12%), miscellaneous benign tumours (10%), and malignant salivary gland tumours (10%). The transcervical approach was used in 56 cases, cervical-transparotid approach in 15 cases, type A infratemporal fossa approach in 13 cases, transmandibular approach in 4 cases and transoral approach in 2 cases. The most common complications were those deriving from nervous injuries. Conclusions Most parapharyngeal space tumours can be removed surgically with a low rate of complications and recurrence. The transcervical approach is the most frequently used.

      PubDate: 2017-05-04T08:33:38Z
      DOI: 10.1016/j.otorri.2016.06.003
  • Evaluación de la obstrucción nasal mediante rinomanometría y escalas
           subjetivas y medición del éxito terapéutico médico y quirúrgico
    • Authors: Hugo Lara-Sánchez; Candelas Álvarez Nuño; Elisa Gil-Carcedo Sañudo; Agustín Mayo Iscar; Luis Ángel Vallejo Valdezate
      Pages: 145 - 150
      Abstract: Publication date: May–June 2017
      Source:Acta Otorrinolaringológica Española, Volume 68, Issue 3
      Author(s): Hugo Lara-Sánchez, Candelas Álvarez Nuño, Elisa Gil-Carcedo Sañudo, Agustín Mayo Iscar, Luis Ángel Vallejo Valdezate
      Introducción y objetivos Estudio prospectivo de pacientes con obstruccción nasal (ON) a fin de cuantificar el éxito terapéutico mediante una rinomanometría anterior activa (RAA), la escala de Evaluación de los Síntomas de Obstrucción Nasal (NOSE) y la Escala Visual Análoga (EVA), y determinar la correlación que existe entre las pruebas. Métodos Realizamos RAA y valoración subjetiva mediante las escalas NOSE y EVA a pacientes con ON antes y después del tratamiento médico (corticoides tópicos) o quirúrgico (septoplastia, turbinoplastia o septoturbinoplastia). Comparamos y analizamos los resultados de las puntuaciones obtenidas en ambas escalas subjetivas (NOSE y VAS) con las mediciones en la RAA. Resultados Un total de 102 pacientes cumplieron los criterios de selección. Los resultados muestran que la mejoría de la ON, tras tratamiento quirúrgico, es evaluada más positivamente si la herramienta de medición es la RAA. Por el contrario, el tratamiento médico mejora el flujo nasal medido con la RAA, pero sin significación estadística (p=0,1363). Medimos la correlación entre RAA, escalas NOSE y EVA y hallamos solo una correlación positiva entre las escalas NOSE y EVA (r=0,83327). Conclusiones Los pacientes quirúrgicamente tratados por ON presentan mejores resultados cuando estos se evalúan mediante RAA o con escalas subjetivas. No existe una correlación significativa entre RAA y las escalas NOSE y EVA; esto se considera debido a que la RAA y las escalas subjetivas son complementarias y miden diferentes aspectos de ON. La RAA y las escalas subjetivas son instrumentos útiles para emplearlos de forma conjunta en el seguimiento de pacientes con ON. Introduction Prospective study of patients with nasal obstruction (NO) in order to measure therapeutic success by anterior active rhinomanometry (AAR), Nasal Obstruction Symptom Evaluation (NOSE) scale and Visual Analogue Scale (VAS) and to establish the correlation between these tests. Methods Patients with NO, on whom we performed an AAR, NOSE and VAS scales at baseline and after medical treatment (topical nasal steroid) or surgery (septoplasty, turbinoplasty or septoplasty and turbinoplasty). The nasal flow obtained by the AAR and the score of both subjective scales (NOSE and VAS) were compared and analyzed. Results A total of 102 patients were included in the study. Surgical treatment resulted in statistically significant differences with the AAR and the subjective scales. While in patients with medical treatment there was an increase in the AAR nasal flow but without statistical significance (P=.1363). The correlation between the AAR, the NOSE and VAS scales was measured finding a strong correlation between the NOSE and VAS scales only (r=.83327). Conclusions The patients with NO treated surgically have better results when these are evaluated by AAR or with subjective scales. There is no significant correlation between AAR, NOSE and VAS scales, this is considered to be because the AAR and subjective scales are complementary and measure different aspects of NO. The AAR and subjective scales are useful tools to be used together for the follow up ...
      PubDate: 2017-05-04T08:33:38Z
      DOI: 10.1016/j.otorri.2016.06.007
  • Bone Anchored Hearing Aid (BAHA) in children: Experience of a tertiary
           referral centre in Portugal
    • Authors: Francisco Rosa; Ana Silva; Cláudia Reis; Miguel Coutinho; Jorge Oliveira; Cecília Almeida e Sousa
      Pages: 151 - 156
      Abstract: Publication date: May–June 2017
      Source:Acta Otorrinolaringológica Española, Volume 68, Issue 3
      Author(s): Francisco Rosa, Ana Silva, Cláudia Reis, Miguel Coutinho, Jorge Oliveira, Cecília Almeida e Sousa
      Objectives The aim of this study is to describe the experience of a tertiary referral centre in Portugal, of the placement of BAHA in children. Methods The authors performed a retrospective analysis of all children for whom hearing rehabilitation with BAHA was indicated at a central hospital, between January 2003 and December 2014. Results 53 children were included. The most common indications for placement of BAHA were external and middle ear malformations (n =34, 64%) and chronic otitis media with difficult to control otorrhea (n =9, 17%). The average age for BAHA placement was 10.66±3.44 years. The average audiometric gain was 31.5±7.20dB compared to baseline values, with average hearing threshold with BAHA of 19.6±5.79dB. The most frequent postoperative complications were related to the skin (n =15, 28%). There were no major complications. Conclusions This study concludes that BAHA is an effective and safe method of hearing rehabilitation in children.

      PubDate: 2017-05-04T08:33:38Z
      DOI: 10.1016/j.otorri.2016.07.002
  • Evaluación de la historia familiar de hipoacusia permanente en la
           infancia como factor de riesgo en el cribado universal
    • Authors: Mercedes Valido Quintana; Ángeles Oviedo Santos; Silvia Borkoski Barreiro; Alfredo Santana Rodríguez; Ángel Ramos Macías
      Pages: 157 - 163
      Abstract: Publication date: May–June 2017
      Source:Acta Otorrinolaringológica Española, Volume 68, Issue 3
      Author(s): Mercedes Valido Quintana, Ángeles Oviedo Santos, Silvia Borkoski Barreiro, Alfredo Santana Rodríguez, Ángel Ramos Macías
      Introducción y objetivo El 60% de las hipoacusias prelinguales tienen un origen genético. Entre los factores de riesgo se encuentra el antecedente familiar de hipoacusia permanente en la infancia. El objetivo del estudio es conocer la relación entre este factor de riesgo y la hipoacusia, evaluándose características clínico-epidemiológicas y si existe variación genética no sindrómica relacionada. Material y método Estudio retrospectivo, transversal, descriptivo y observacional de los recién nacidos entre enero de 2007 y diciembre de 2010 con factor de riesgo de antecedente familiar de hipoacusia mediante otoemisiones acústicas provocadas transitorias y potenciales evocados auditivos de tronco cerebral. Resultados Nacieron 26.717 niños. Ochocientos cincuenta y siete (3,2%) tenían antecedente familiar. Cincuenta y siete (0,21%) no pasan segundas otoemisiones. Un 29,1% (n=16) tenían otro antecedente de riesgo añadido. Un 17,8% (n=9) tenían factor de riesgo no clásico. Ningún factor de riesgo tenía relación con la hipoacusia, excepto la cardiopatía. Según potenciales, el 76,4% tenían normoaudición y el 23,6%, hipoacusia. La media de familiares hipoacúsicos es de 1,25. En test genéticos el 82,86% son homocigosis normal, el 11,43% heterocigosis para mutación 35delG del gen de la Conexina 26, el 2,86% heterocigosis R143W del mismo gen y el 2,86% homocigosis mutante 35delG. No se encuentra relación entre hipoacusia y tener un alelo mutado. Conclusiones El porcentaje de niños con antecedente familiar diagnosticado de hipoacusia es superior a lo esperado en la población general. Es necesaria la actualización del perfil genético para esclarecer la relación encontrada entre hipoacusia con cardiopatía, el número de familiares afectos y la baja prevalencia en las mutaciones analizadas. Introduction and objective Sixty percent of prelingual hearing loss is of genetic origin. A family history of permanent childhood hearing loss is a risk factor. The objective of the study is to determine the relationship between this risk factor and hearing loss. We have evaluated clinical and epidemiological characteristics and related nonsyndromic genetic variation. Material and method This was a retrospective, descriptive and observational study of newborns between January 2007 and December 2010 with family history as risk factor for hearing loss using transient evoked otoacoustic emissions and auditory brainstem response. Results A total of 26,717 children were born. Eight hundred and fifty-seven (3.2%) had family history. Fifty-seven(0.21%) failed to pass the second test. A percentage of 29.1 (n=16) had another risk factor, and 17.8% (n=9) had no classical risk factor. No risk factor was related to the hearing loss except heart disease. Seventy-six point four percent had normal hearing and 23.6% hearing loss. The mean of family members with hearing loss was 1.25. On genetic testing, 82.86% of homozygotes was normal, 11.43% heterozygosity in Connexin 26 gene (35delG), 2.86% R143W heterozygosity in the same gene and 2.86% mutant homozygotes (35delG). We found no relationship between hearing loss and mutated allele.
      PubDate: 2017-05-04T08:33:38Z
      DOI: 10.1016/j.otorri.2016.08.001
  • Carcinoma nasofaríngeo familiar en zona no endémica.
           Presentación de 3 familias
    • Authors: Leydy Mallerling Paredes-Durán; Elvira del Barco-Morillo; María Jesús Baldeón-Conde; Soledad Medina-Valdivieso; María Cecilia Guillen-Sacoto; Juan Jesús Cruz-Hernández
      Pages: 164 - 168
      Abstract: Publication date: May–June 2017
      Source:Acta Otorrinolaringológica Española, Volume 68, Issue 3
      Author(s): Leydy Mallerling Paredes-Durán, Elvira del Barco-Morillo, María Jesús Baldeón-Conde, Soledad Medina-Valdivieso, María Cecilia Guillen-Sacoto, Juan Jesús Cruz-Hernández
      El carcinoma nasofaríngeo es el tumor más frecuente que surge en la nasofaringe. Su etología es multifactorial, considerándose como factores de riesgo la distribución racial y geográfica, la infección por el virus de Epstein-Barr (VEB), así como la exposición ambiental a determinas sustancias. Esta afección es endémica en algunas zonas asiáticas, donde se han encontrado predisposición genética en su oncogénesis. Existe una fuerte susceptibilidad entre el carcinoma de nasofaríngeo y el HLA, donde se han encontrado haplotipos relacionados específicos. En zonas donde la incidencia es baja, existen pocos casos publicados sobre familias afectadas. Reportamos 3 casos de familias con carcinoma de nasofaringe entre hermanos, en población no asiática, probablemente relacionada con la infección por el VEB. Nasopharyngeal carcinoma is the predominant tumour type arising in the nasopharynx. Its aetiology is multifactorial; racial and geographical distribution, EBV infection and environmental exposure to specific substances are considered risk factors. This condition is endemic in some Asian areas, where a genetic predisposition in its oncogenesis has been established. There is a strong susceptibility between nasopharyngeal carcinoma and HLA, where related specific haplotypes have been found. In areas where the incidence is low, there are few reported cases of families affected. We report 3 cases of families with nasopharyngeal carcinoma among siblings, in the non-Asian population, probably related to EBV infection.

      PubDate: 2017-05-04T08:33:38Z
      DOI: 10.1016/j.otorri.2016.07.006
  • Lesiones otorrinolaringológicas secundarias al sexo oral
    • Authors: Claudia Fernández-López; Carmelo Morales-Angulo
      Pages: 169 - 180
      Abstract: Publication date: May–June 2017
      Source:Acta Otorrinolaringológica Española, Volume 68, Issue 3
      Author(s): Claudia Fernández-López, Carmelo Morales-Angulo
      Introducción En los últimos años han aumentado de manera significativa las manifestaciones orales y faríngeas secundarias a la práctica de sexo oral. Sin embargo, no hemos encontrado ningún artículo de revisión relacionado con el tema en la literatura médica. El objetivo de nuestro estudio fue identificar las manifestaciones otorrinolaringológicas asociadas al contacto orogenital/oroanal tanto en pacientes adultos como en niños en el contexto de sexo consentido o de abusos sexuales. Métodos Se realizó una revisión de la bibliografía de la patología otorrinolaringológica asociada a la realización de sexo oral en la base de datos PubMed publicada en los últimos 20 años. Resultados Las manifestaciones otorrinolaringológicas secundarias a práctica de sexo oral en adultos pueden ser infecciosas, tumorales o traumáticas. Las manifestaciones infecciosas más frecuentes encontradas en la literatura son la infección por el virus del papiloma humano (sobre todo, condilomas acuminados y papilomas), sífilis oral o faríngea, faringitis gonocócica, faringitis por Chlamydia trachomatis e infecciones por el virus del herpes simple. Por otra parte, ha aumentado de forma alarmante la incidencia de carcinoma orofaríngeo secundario al virus del papiloma humano. En niños, fuera del periodo neonatal, la presencia de condilomas acuminados, sífilis, gonococia o equimosis en el paladar (esta última no justificada por otras causas) nos deben hacer sospechar la presencia de abusos sexuales. Conclusiones El cambio de los hábitos sexuales en países occidentales ha dado lugar a la aparición de patologías otorrinolaringológicas excepcionales previamente, por lo que es importante su conocimiento por parte de los médicos de atención primaria para realizar un correcto diagnóstico y tratamiento posterior. Por otra parte, algunos casos de abusos sexuales en niños pueden ser sospechados gracias al conocimiento de las manifestaciones características orofaríngeas secundarias a los mismos. Introduction Over the last few years, oral and pharyngeal signs and symptoms due to oral sex have increased significantly. However, no review articles related to this subject have been found in the medical literature. The objective of our study was to identify otorhinolaryngological manifestations associated with orogenital/oroanal contact, both in adults and children, in the context of consensual sex or sexual abuse. Methods We performed a review of the medical literature on otorhinolaryngological pathology associated with oral sex published in the last 20 years in the PubMed database. Results Otorhinolaryngological manifestations secondary to oral sex practice in adults can be infectious, tumoral or secondary to trauma. The more common signs and symptoms found in the literature were human papillomavirus infection (above all, condyloma acuminata and papilloma/condyloma), oral or pharyngeal syphilis, gonococcal pharyngitis, herpes simplex virus infection and pharyngitis from Chlamydia trachomatis. The incidence of human papillomavirus -induced oropharyngeal carcinoma has dramatically increased. In children past the neonatal period, the presence of condyloma acuminatus, syphilis, gonorrhoea or palatal ecchymosis (the last one, unless justified by other causes) should make us suspect sexual abuse.
      PubDate: 2017-05-04T08:33:38Z
      DOI: 10.1016/j.otorri.2016.04.003
  • Metástasis bilateral en conducto auditivo interno de melanoma maligno
    • Authors: M. Francisca Ropero Carmona; Joaquín J. Cabrera Rodríguez; Juan Quirós Rivero; Julia L. Muñoz García
      Pages: 181 - 182
      Abstract: Publication date: May–June 2017
      Source:Acta Otorrinolaringológica Española, Volume 68, Issue 3
      Author(s): M. Francisca Ropero Carmona, Joaquín J. Cabrera Rodríguez, Juan Quirós Rivero, Julia L. Muñoz García

      PubDate: 2017-05-04T08:33:38Z
      DOI: 10.1016/j.otorri.2016.05.001
  • Neuropatía auditiva autosómica dominante y variante DIAPH3
    • Authors: Ana Sánchez-Martínez; José I. Benito-Orejas; Juan J. Tellería-Orriols; María J. Alonso-Ramos
      Pages: 183 - 185
      Abstract: Publication date: May–June 2017
      Source:Acta Otorrinolaringológica Española, Volume 68, Issue 3
      Author(s): Ana Sánchez-Martínez, José I. Benito-Orejas, Juan J. Tellería-Orriols, María J. Alonso-Ramos

      PubDate: 2017-05-04T08:33:38Z
      DOI: 10.1016/j.otorri.2016.06.004
  • Isolated osteoma of the sphenoid sinus
    • Authors: Ramanuj Sinha; Neeraj Aggarwal; Mainak Dutta
      Pages: 186 - 187
      Abstract: Publication date: May–June 2017
      Source:Acta Otorrinolaringológica Española, Volume 68, Issue 3
      Author(s): Ramanuj Sinha, Neeraj Aggarwal, Mainak Dutta

      PubDate: 2017-05-04T08:33:38Z
      DOI: 10.1016/j.otorri.2016.02.011
  • Síndrome trófico trigeminal: causa infrecuente de
           ulceración nasal
    • Authors: Carlos Morales-Raya; Esther García-González; Lidia Maroñas-Jiménez
      Pages: 188 - 189
      Abstract: Publication date: May–June 2017
      Source:Acta Otorrinolaringológica Española, Volume 68, Issue 3
      Author(s): Carlos Morales-Raya, Esther García-González, Lidia Maroñas-Jiménez

      PubDate: 2017-05-04T08:33:38Z
      DOI: 10.1016/j.otorri.2016.02.009
  • Análisis experimental mediante vibrometría láser doppler en huesos
           temporales de cadáver fresco de una nueva prótesis de
    • Authors: Luis A. Vallejo; María T. Manzano; Antonio Hidalgo; Alberto Hernández; Juan Sabas; Hugo Lara; Elisa Gil-Carcedo; David Herrero
      Pages: 69 - 79
      Abstract: Publication date: March–April 2017
      Source:Acta Otorrinolaringológica Española, Volume 68, Issue 2
      Author(s): Luis A. Vallejo, María T. Manzano, Antonio Hidalgo, Alberto Hernández, Juan Sabas, Hugo Lara, Elisa Gil-Carcedo, David Herrero
      Introducción y objetivos Confirmar en temporales frescos de cadáver el comportamiento óptimo teórico (previamente determinado en un modelo computadorizado del oído medio humano) de una nueva prótesis de sustitución osicular total así como objetivar la facilidad de colocación de la misma. Finalmente comprobamos su estabilidad tras ser colocada puesto que el diseño de esta nueva prótesis evita, teóricamente, su movilización o extrusión al anclarse directamente en el mango del martillo. Material y métodos En el estudio analizamos, mediante vibrometría láser doppler, el comportamiento mecanoacústico de una nueva prótesis de recambio osicular total en el oído medio humano utilizando 10 huesos temporales de cadáver fresco. Resultados El diseño de la prótesis impide su desplazamiento o extensión y facilita su colocación en el oído medio. La función de transferencia de los temporales a quienes se implantó la nueva prótesis se superpone con la del oído medio intacto antes de la colocación de la prótesis lo que sugiere un comportamiento mecanoacústico óptimo de la misma. Conclusiones La prótesis de titanio evaluada en este estudio presenta un comportamiento mecanoacústico superponible al del oído medio intacto, lo que se suma a la facilidad de colocación y estabilidad posquirúrgica conviertiéndola en un diseño de prótesis a tener en cuenta ante una reconstrucción osicular total. Introduction and objectives One of the problems with total ossicular replacement prostheses is their stability. Prosthesis dislocations and extrusions are common in middle ear surgery. This is due to variations in endo-tympanic pressure as well as design defects. The design of this new prosthesis reduces this problem by being joined directly to the malleus handle. The aim of this study is to confirm adequate acoustic-mechanical behaviour in fresh cadaver middle ear of a new total ossicular replacement prosthesis, designed using the finite elements method. Methods Using the doppler vibrometer laser, we analysed the acoustic-mechanical behaviour of a new total ossicular replacement prosthesis in the human middle ear using 10 temporal bones from fresh cadavers. Results The transfer function of the ears in which we implanted the new prosthesis was superimposed over the non-manipulated ear. This suggests optimum acoustic-mechanical behaviour. Conclusions The titanium prosthesis analysed in this study demonstrated optimum acoustic-mechanical behaviour. Together with its ease of implantation and post-surgical stability, these factors make it a prosthesis to be kept in mind in ossicular reconstruction.

      PubDate: 2017-03-12T02:19:09Z
      DOI: 10.1016/j.otorri.2016.03.001
  • Osteocondroma del seno maxilar, una localización infrecuente
    • Authors: Ana Belén Gil Guerra; Esther Gómez San Martín; María Isabel Jiménez Cuenca
      Abstract: Publication date: Available online 10 August 2017
      Source:Acta Otorrinolaringológica Española
      Author(s): Ana Belén Gil Guerra, Esther Gómez San Martín, María Isabel Jiménez Cuenca

      PubDate: 2017-08-16T15:13:22Z
      DOI: 10.1016/j.otorri.2017.04.003
  • Erosión ósea del canal carotídeo. Síndrome de
    • Authors: Aina Brunet-Garcia; M. Virginia Barrios-Crispi; Marta Faubel-Serra
      Abstract: Publication date: Available online 10 August 2017
      Source:Acta Otorrinolaringológica Española
      Author(s): Aina Brunet-Garcia, M. Virginia Barrios-Crispi, Marta Faubel-Serra

      PubDate: 2017-08-16T15:13:22Z
      DOI: 10.1016/j.otorri.2017.04.008
  • Evaluación de la capacidad formativa del libro del residente de
           Otorrinolaringología español (FORMIR) como portafolio electrónico
    • Authors: Juan Manuel Maza Solano; Gustavo Benavente Bermudo; Francisco José Estrada Molina; Jesús Ambrosiani Fernández; Serafín Sánchez Gómez
      Abstract: Publication date: Available online 10 August 2017
      Source:Acta Otorrinolaringológica Española
      Author(s): Juan Manuel Maza Solano, Gustavo Benavente Bermudo, Francisco José Estrada Molina, Jesús Ambrosiani Fernández, Serafín Sánchez Gómez
      Introducción y objetivos Evaluar la capacidad formativa del libro del residente español como portafolio electrónico para alcanzar los objetivos de aprendizaje de los MIR de Otorrinolaringología (ORL). Métodos Se realizó una investigación cualitativa multimétodo de características tranversal, temporal y de orientación retrospectiva sobre los MIR de ORL mediante un cuestionario estructurado y una entrevista semiestructurada, sobre la aplicación informática web FORMIR. Resultados Participaron el 56,5% de los MIR de ORL de alguno de los 63 hospitales españoles acreditados para impartir formación en ORL entre 2009 y 2012. Los resultados obtenidos demostraron que los MIR de ORL que utilizaban el portafolio electrónico eran capaces de autoguiar mejor su aprendizaje, conocían mejor sus objetivos de aprendizaje, cumplían más eficientemente el programa de formación, identificaban más claramente las causas de sus carencias en el aprendizaje y consideraban que FORMIR como portafolio electrónico constituía una herramienta formativa idónea para sustituir al libro del residente en formato papel. Conclusiones Los MIR de ORL apreciaban de forma muy relevante las prestaciones formativas de FORMIR como portafolio electrónico, especialmente su interfaz, el feedback numérico y automático sobre la adquisición de competencias, su capacidad de almacenamiento de evidencias y su capacidad de visualizarse como logbook de la Unión Europea de Médicos Especialistas o como un curriculum vitae estándar. Este feedback automático facilita el aprendizaje autoguiado. Todo esto hace de FORMIR una herramienta formativa y evaluativa que supera las prestaciones y aceptación de instrumentos similares puestos a disposición de los residentes, que no dudan en proponerlo como el libro del residente más idóneo para facilitar su formación especializada. Background and objectives We have evaluated the training capacity of the Spanish resident training book as an electronic portfolio to achieve the learning objectives of otorhinolaryngology (ENT) residents. Methods A multi-method qualitative investigation with transversal characteristics, temporal and retrospective guidance was performed on Spanish ENT residents using a structured questionnaire, a semi-structured interview, and a computer application on the FORMIR website. Results A 56.5% of ENT-residents specialising in one of the 63 accredited Spanish hospitals between 2009-2012 participated in the study. The results obtained show that the ENT residents who used the e-portfolio were better able to implement self-guided study, were more aware of their learning objectives, fulfilled the training programme more efficiently, identified the causes of learning gaps more clearly, and considered FORMIR in e-portfolio format to be an ideal training tool to replace the resident training book in paper format. Conclusions The ENT residents greatly appreciated the training benefits of FORMIR as an e-portfolio, especially its simple and intuitive interface, the ease and comfort with which they could record their activities, the automatic and numeric feedback on the acqui...
      PubDate: 2017-08-16T15:13:22Z
      DOI: 10.1016/j.otorri.2017.04.001
  • Arteria lusoria: A rare cause of tracheal compression
    • Authors: Ana Nóbrega-Pinto; Isabel Carvalho; Cecília Almeida-Sousa
      Abstract: Publication date: Available online 10 August 2017
      Source:Acta Otorrinolaringológica Española
      Author(s): Ana Nóbrega-Pinto, Isabel Carvalho, Cecília Almeida-Sousa

      PubDate: 2017-08-16T15:13:22Z
      DOI: 10.1016/j.otorri.2017.04.004
  • Seudotumor inflamatorio subglótico en un niño de 3 años
    • Authors: Javier Cervera Escario; Sara Sirvent Cerdá; Saturnino Santos Santos; Adolfo Sequeiros González
      Abstract: Publication date: Available online 10 August 2017
      Source:Acta Otorrinolaringológica Española
      Author(s): Javier Cervera Escario, Sara Sirvent Cerdá, Saturnino Santos Santos, Adolfo Sequeiros González

      PubDate: 2017-08-16T15:13:22Z
      DOI: 10.1016/j.otorri.2017.04.007
  • Primary tuberculosis of the nasal septum: The non-ulcerated form
           presenting as septal thickening
    • Authors: Neeraj Aggarwal; Mainak Dutta; Ramanuj Sinha
      Abstract: Publication date: Available online 10 August 2017
      Source:Acta Otorrinolaringológica Española
      Author(s): Neeraj Aggarwal, Mainak Dutta, Ramanuj Sinha

      PubDate: 2017-08-16T15:13:22Z
      DOI: 10.1016/j.otorri.2017.05.004
  • Cranio-cervical junction cerebrospinal fluid leak after
           microdebrider-assisted adenoidectomy – A rare case report
    • Authors: Karthikeyan Ramasamy; Hemanth Vamanshankar; Sunil Kumar Saxena; Vignesh Karunakaran; Arun Alexander
      Abstract: Publication date: Available online 9 August 2017
      Source:Acta Otorrinolaringológica Española
      Author(s): Karthikeyan Ramasamy, Hemanth Vamanshankar, Sunil Kumar Saxena, Vignesh Karunakaran, Arun Alexander

      PubDate: 2017-08-16T15:13:22Z
      DOI: 10.1016/j.otorri.2017.01.006
  • Cirugía de implante de estimulador de nervio hipogloso en el síndrome de
           apnea obstructiva del sueño: nuestra experiencia preliminar
    • Authors: Peter Baptista; Octavio Garaycochea; Laura Álvarez-Gómez; Juan Alcalde; Manuel Alegre; Elena Urrestarazu
      Abstract: Publication date: Available online 26 July 2017
      Source:Acta Otorrinolaringológica Española
      Author(s): Peter Baptista, Octavio Garaycochea, Laura Álvarez-Gómez, Juan Alcalde, Manuel Alegre, Elena Urrestarazu
      El objetivo de esta comunicación es presentar nuestros resultados preliminares en la cirugía de estimulación de la vía aérea mediante el implante de estimulador de nervio hipogloso para el síndrome de apnea obstructiva del sueño. Presentamos 4 casos en los que se valoraron los resultados de la cirugía empleando la escala de Epworth, el índice de apneas-hipopneas, SatO2 mínima, SatO2 promedio y la intensidad del ronquido. En los 4 casos se evidenció una disminución significativa de los valores de la escala de Epworth y el índice de apneas-hipopneas (p < 0,05). La saturación de oxígeno mínima y promedio tuvo mejores valores en el posquirúrgico; sin embargo, la diferencia no fue estadísticamente significativa. La severidad de los ronquidos medida de forma subjetiva pasó de «intensa» en todos los casos a «ausente». Los resultados preliminares obtenidos ponen en evidencia una mejora tanto objetiva como subjetiva tras la activación del implante. The objective of this communication is to describe our preliminary results in upper airway stimulation surgery via hypoglossal nerve stimulation implantation for obstructive sleep apnoea. We describe 4 cases and the outcomes of the surgery were analysed using the Epworth scale, apnoea-hypopnoea index, minimal O2 Sat, average O2 Sat and snoring intensity. In all cases a significant reduction in Epworth scale values and apnoea-hypopnoea index were obtained (P<.05). The minimum and average oxygen saturation had better values after the surgery, however, there was no statistically significant difference. The snoring severity measured subjectively changed from «intense» to «absent» in all cases. The preliminary results obtained with the upper airway stimulation surgery via hypoglossal nerve stimulation showed objective and subjective improvement after the implant activation.

      PubDate: 2017-07-28T12:12:27Z
      DOI: 10.1016/j.otorri.2017.02.005
  • Spontaneous laryngeal abscess causing dysphagia
    • Authors: Ata
      Abstract: Publication date: July–August 2017
      Source:Acta Otorrinolaringológica Española, Volume 68, Issue 4
      Author(s): Nurdoğan Ata, İrfan Fırat Özcan

      PubDate: 2017-07-12T09:19:10Z
  • Amianto. Cáncer de laringe
    • Authors: Luis
      Abstract: Publication date: July–August 2017
      Source:Acta Otorrinolaringológica Española, Volume 68, Issue 4
      Author(s): Luis Sánchez Galán

      PubDate: 2017-07-12T09:19:10Z
  • Cierre endoscópico de las perforaciones septales
    • Authors: Isam Alobid
      Abstract: Publication date: Available online 27 May 2017
      Source:Acta Otorrinolaringológica Española
      Author(s): Isam Alobid
      Introducción El cierre quirúrgico de las perforaciones septales sintomáticas a menudo conduce a resultados no satisfactorios. El conocimiento de la irrigación vascular es de suma importancia para el éxito. Objetivo El manejo de las perforaciones septales constituye un reto para el cirujano. Hay descritas una gran variedad de técnicas quirúrgicas, con distintas vías de abordaje. No existen pruebas científicas que avalen un abordaje en concreto. El objetivo de esta revisión es presentar una guía práctica sobre la técnica de elección para cada caso de perforación septal. Discusión La inspección de la mucosa nasal, el tamaño de la perforación, la localización y, sobre todo, el soporte osteocartilaginoso son los pilares para lograr el éxito de la cirugía. Para los colgajos de deslizamiento o rotación de la mucosa del tabique es fundamental haber estudiado previamente si es posible la elevación del mucopericondrio o mucoperiosteo del septum, de lo contrario, el uso de estos colgajos no estaría indicado. Los colgajos de la pared lateral o del suelo nasal son la alternativa. El colgajo pericraneal podría estar indicado en perforaciones totales o casi totales. Conclusión El remanente del septum nasal y el estado del soporte osteocartilaginoso son los factores determinantes en el manejo de las perforaciones septales. Cada caso debe valorarse individualmente y la elección del abordaje se realiza según el tamaño y la localización de la perforación, la calidad de la mucosa, los antecedentes personales, la cirugía previa y la experiencia del cirujano. Objective The management of septal perforations is a challenge for the surgeon. A wide variety of surgical techniques have been described, with different approaches. There is no scientific evidence to support a particular approach. The objective of this review is to present a practical guide on the technique of choice for each case of septal perforation. Discussion Inspection of the nasal mucosa, the size of the perforation, the location and especially the osteo-cartilaginous support, are the pillars of a successful surgery. For the sliding or rotating flaps of the mucosa of the septum it is essential to know in advance if the elevation of the mucopericondrio or mucoperiosteo of the septum is possible, otherwise the use of these flaps would not be indicated. The flaps of the lateral wall or nasal floor are the alternative. The pericranial flap may be indicated in total or near total perforations. Conclusion The remnant of the nasal septum and status of osteo-cartilaginous support are the determining factors in the management of septal perforations. Each case should be evaluated individually and the approach chosen according to the size and location of the perforation, mucosal quality, personal history, previous surgery and the experience of the surgeon.

      PubDate: 2017-05-29T14:48:25Z
      DOI: 10.1016/j.otorri.2017.02.001
  • Epidemiología de los trastornos vestibulares en la consulta de
    • Authors: Gloria Guerra-Jiménez; Alejandra Arenas Rodríguez; Juan Carlos Falcón González; Daniel Pérez Plasencia; Ángel Ramos Macías
      Abstract: Publication date: Available online 23 May 2017
      Source:Acta Otorrinolaringológica Española
      Author(s): Gloria Guerra-Jiménez, Alejandra Arenas Rodríguez, Juan Carlos Falcón González, Daniel Pérez Plasencia, Ángel Ramos Macías
      Introducción y objetivos El conjunto de síntomas relacionados con los trastornos del sistema de equilibrio son comunes en la población general. Sin embargo, hay pocos estudios que cuantifiquen la frecuencia de inicio de los diversos trastornos vestibulares que se presentan en unidades especializadas de otoneurología. El objetivo de este estudio es establecer la epidemiología de los trastornos vestibulares,La forma de presentación y la carga de atención esperada en una clínica especialista en otoneurología. Material y métodos Estudio descriptivo observacional retrospectivo sobre los pacientes remitidos a la consulta de Otoneurología de un centro hospitalario de tercer nivel entre el 1/1/2015 y el 31/12/2015. Resultados Fueron valorados 174 pacientes (121 mujeres y 53 hombres) con una media de edad de 53±17 años. Durante el periodo de estudio se valoraron 43 individuos por cada 100.000 habitantes. Los pacientes fueron remitidos en su mayoría desde consultas externas de Otorrinolaringología (36,8%) y desde Atención Primaria (28,7%). El motivo de consulta más frecuente fue inestabilidad (40,2%), seguido de vértigo (31%). Los diagnósticos más frecuentes fueron vértigo posicional paroxístico benigno (28,2%) y migraña vestibular (28,2%) —definida (59%) o probable (41%)—, seguidos de enfermedad de Ménière (13.8%), trastornos de origen vascular (5.7%), mareo subjetivo crónico (4,6%) y neuritis vestibular (4%). Conclusiones Disponer de información precisa acerca de la prevalencia e impacto de los trastornos vestibulares es importante para la correcta planificación de los servicios sanitarios con el objetivo de responder satisfactoriamente a la demanda asistencial esperada en la comunidad. El trastorno más frecuentemente diagnosticado en una consulta de Otoneurología es el vértigo posicional paroxístico benigno y la migraña vestibular. Para la comparación de resultados es indispensable la utilización de terminología sistemática. Introduction and objectives The set of symptoms relating to disorders of the balance system are common in the general population. However, there are few studies quantifying the frequency of onset of the various vestibular disorders that present in specialist otoneurology units in the Spanish population. The aim of this study is to establish the epidemiology of vestibular disorders, their form of presentation, and the expected care burden in a specialist otoneurology clinic. Material and methods A retrospective, descriptive, observational study of patients referred to the otoneurology unit of a third level hospital between 1/1/2015 and 31/12/2015. Results One hundred and seventy-four patients were assessed (121 women and 53 men) with a mean age of 53±17 years. Forty-three individuals per 100,000 inhabitants were assessed over the study period. The patients were referred in the majority from external ENT (36.8%) and primary care (28.7%) clinics. The most frequent reason for consultation was dizziness (40.2%) followed by vertigo (31%). The most frequent diagnoses were benign paroxysmal positional vertigo (28.2%) and vestibular migraine (28.2%) —defined (59%) or probable (41%)—, followed by Ménière's disease (13.8%), vascular disorders (5.7%), chronic subjective dizziness (4.6%) and vestibular neuritis (4%).
      PubDate: 2017-05-24T13:21:54Z
      DOI: 10.1016/j.otorri.2017.01.007
  • Findings from the experience with the punch technique for auditory
    • Authors: Alfonso Bonilla; Carlos Magri; Eulalia Juan
      Abstract: Publication date: Available online 23 May 2017
      Source:Acta Otorrinolaringológica Española
      Author(s): Alfonso Bonilla, Carlos Magri, Eulalia Juan
      Objective To compare the punch technique and linear incision with soft tissue reduction for the placement of auditory osseointegrated implants (AOI) and analyze results of osseointegration obtained with the punch technique as measured with the Implant Stability Quotient (ISQ). Methods Case review of 34 patients who received auditory osseointegrated implants between January 2010 and July 2015 and were divided into two groups according to the surgical technique: 18 with the punch technique (PT) and 16 with the linear incision technique (LI). Minimum follow-up was four months (mean: 24 months; range 4–64 months). Included in the analysis were patient profiles and records of the demographic data, surgical indications, surgical technique, implant placement, surgical time, intraoperative complications, as well as postsurgical complications (Holgers classification) and implant stability quotients (ISQ). Results Use of larger abutments was significantly greater in the PT group (PT, 10mm; LI, 6mm, p <0.001). The PT technique resulted in a shorter procedure than the LI (PT, 20min; LI, 45min, p <0.001). Holgers classification scores identified significantly fewer skin complications one week after surgery for the PT group; however, only small differences were seen between the two groups at the one- and three-month control visits. Conclusions As shown for our cohort, the punch technique for surgical placement of AOI is faster and presents fewer immediate postoperative complications when compared to the linear incision technique. The clinical application of the ISQ is a useful, easy method to demonstrate the status of osseointegration and, thus, the stability of the device.

      PubDate: 2017-05-24T13:21:54Z
      DOI: 10.1016/j.otorri.2017.01.005
  • Enfermedad de Castleman cervical pediátrica
    • Authors: Cristina Marco Martin; Roberto Méndez Gallart; Carlos Aliste Santos; Máximo Francisco Fraga Rodriguez; Adolfo Bautista Casasnovas
      Abstract: Publication date: Available online 17 May 2017
      Source:Acta Otorrinolaringológica Española
      Author(s): Cristina Marco Martin, Roberto Méndez Gallart, Carlos Aliste Santos, Máximo Francisco Fraga Rodriguez, Adolfo Bautista Casasnovas

      PubDate: 2017-05-19T11:34:12Z
      DOI: 10.1016/j.otorri.2017.03.003
  • Impacto de la laringectomía total en la situación laboral
    • Authors: Jose Miguel Costa; Montserrat López; Jacinto García; Xavier León; Miquel Quer
      Abstract: Publication date: Available online 17 May 2017
      Source:Acta Otorrinolaringológica Española
      Author(s): Jose Miguel Costa, Montserrat López, Jacinto García, Xavier León, Miquel Quer
      Introducción La laringectomía total es una de las cirugías oncológicas más mutilantes. No existen estudios específicos que evalúen el retorno laboral después de la misma. Pacientes y métodos Se realizó un estudio transversal de una muestra de 116 pacientes laringectomizados que se hallaban libres de enfermedad y con un seguimiento mínimo de 2 años desde la laringectomía total. Se les realizó una encuesta dirigida a conocer la situación laboral, tanto previa como posterior. En el momento de la cirugía 62 (53%) estaban activos laboralmente, 40 (35%) estaban jubilados y 14 (12%) tenían una situación de invalidez. Resultados El 60% tenía profesiones con bajo grado de cualificación, siendo el grupo más numeroso los trabajadores de la construcción. De los 62 pacientes laboralmente activos en el momento de la laringectomía total 29 pasaron a inactivos y 33 (53%) mantuvieron la actividad laboral. Los factores más importantes para mantener la actividad laboral fueron el nivel de cualificación profesional y el método de rehabilitación vocal. El 80% de los pacientes con cualificación alta-intermedia mantuvieron su trabajo, frente al 35% en los de cualificación profesional baja (p<0,001). El 70% de los pacientes con prótesis fonatoria mantuvo la actividad laboral, frente a un 31% de los pacientes rehabilitados con erigmofonía (p=0,004). La regresión logística confirmó estas variables como independientes para seguir trabajando. Conclusiones Este es el primer estudio que analiza el impacto de la laringectomía total en la situación laboral. Los factores más importantes para volver a trabajar fueron tener un trabajo cualificado alto-intermedio y la utilización de prótesis fonatoria como método de rehabilitación vocal. Introduction Total laryngectomy is one of the most mutilating oncological operations. There are no specific studies evaluating return to work after this surgery. Patients and methods A cross-sectional study was performed on a sample of 116 laryngectomized patients who were disease- free and had a minimum follow-up of 2 years from total laryngectomy. A survey was conducted to find out their employment situation before and after surgery. At the time of surgery, 62 (53%) were working, 40 (35%) were retired and 14 (12%) were in a disability situation. Results 60% had professions with low qualification requirements, the largest group being construction workers. Of the 62 patients active at the time of total laryngectomy, 29 became inactive and 33 (53%) maintained their work activity. The most important factors in maintaining work activity were the level of professional qualification and the method of vocal rehabilitation. Eighty percent of the patients with high-intermediate qualification maintained their jobs, compared to 35% of those with low professional qualifications (P <.001). Seventy percent of the patients with voice prostheses maintained their work activity, compared to 31% of the patients rehabilitated with oesophageal voice (P =.004). Logistic regression confirmed these as independent variables for continuing to work. Conclusions
      PubDate: 2017-05-19T11:34:12Z
      DOI: 10.1016/j.otorri.2017.02.006
  • Does calcemia influence the onset of myringosclerosis after myringotomy
           with the insertion of ventilation tubes'
    • Authors: Carla Branco; João Paço
      Abstract: Publication date: Available online 15 May 2017
      Source:Acta Otorrinolaringológica Española
      Author(s): Carla Branco, João Paço
      Introduction Myringosclerosis is one of the most frequent late complications of the insertion of ventilation tubes, and its aetiopathogenesis remains unknown. The calcification that occurs in the formation of myringosclerosis plaque raises the hypothesis of the presence of a calcium metabolism disorder. The objective is to determine whether calcemia contributes to the development of myringoscelerosis after insertion of ventilation tubes. Material and methods A longitudinal, prospective, analytical cohort study was conducted in patients undergoing myringotomy with the insertion of ventilation tubes due to otitis media with effusion. Calcemia was evaluated pre-operatively and in the follow-up the appearance of myringosclerosis and the percentage of the tympanum involved were evaluated. Results The study included 156 patients (297 ears), with calcemia values ranging from 7.6 to 10.2mg/dl. Myringosclerosis was identified in 35.4% of the operated ears. No relationship was found between the appearance of myringosclerosis and calcemia (p =.596). It was found, however, that the greater the percentage of the tympanum affected by myringosclerosis, the lower the calcemia values (p =.014). Conclusion The population studied had calcemia values within the normal range, which allows us to infer that no changes in calcium metabolism are required for the development of myringosclerosis. Moreover, unlike in previous studies, higher calcium levels are not associated with more myringosclerosis. Calcemia did not influence the appearance of myringosclerosis after myringotomy with the insertion of ventilation tubes.

      PubDate: 2017-05-19T11:34:12Z
      DOI: 10.1016/j.otorri.2017.02.003
  • Metástasis de adenocarcinoma de vesícula biliar a piel de conducto
           auditivo externo, a propósito de un caso
    • Authors: Valery Nuñez Carrasco; Jose Luis Serdio Arias; Juan Jose Artazkoz del Toro; Leticia Melgar Vilaplana
      Abstract: Publication date: Available online 15 May 2017
      Source:Acta Otorrinolaringológica Española
      Author(s): Valery Nuñez Carrasco, Jose Luis Serdio Arias, Juan Jose Artazkoz del Toro, Leticia Melgar Vilaplana

      PubDate: 2017-05-19T11:34:12Z
      DOI: 10.1016/j.otorri.2017.01.004
  • Comments on “Alveolar sarcoma of the parapharyngeal space: A case
    • Authors: Ana María Cano-Valdez; Diana Brisa Sevilla-Lizcano; Abelardo Meneses-García
      Abstract: Publication date: Available online 15 May 2017
      Source:Acta Otorrinolaringológica Española
      Author(s): Ana María Cano-Valdez, Diana Brisa Sevilla-Lizcano, Abelardo Meneses-García

      PubDate: 2017-05-19T11:34:12Z
      DOI: 10.1016/j.otorri.2017.03.002
  • Vértigo posicional paroxístico benigno, ese gran desconocido
    • Authors: Virginia Franco-Gutiérrez; Paz Pérez
      Abstract: Publication date: Available online 15 May 2017
      Source:Acta Otorrinolaringológica Española
      Author(s): Virginia Franco-Gutiérrez, Paz Pérez

      PubDate: 2017-05-19T11:34:12Z
      DOI: 10.1016/j.otorri.2017.02.004
  • Test de pepsina en saliva: prueba útil y sencilla para el diagnóstico
           del reflujo faringo-laríngeo
    • Authors: Luz Barona-Lleó; Claudia Duval; Rafael Barona-de Guzmán
      Abstract: Publication date: Available online 15 May 2017
      Source:Acta Otorrinolaringológica Española
      Author(s): Luz Barona-Lleó, Claudia Duval, Rafael Barona-de Guzmán
      Introducción y objetivos El reflujo faringo-laríngeo (RFL) es una enfermedad caracterizada por la presencia de síntomas, signos y alteraciones tisulares, consecuencia del movimiento retrógrado del contenido gastrointestinal hacia el tracto aerodigestivo superior. Representa hasta el 10% de las consultas en otorrinolaringología. El objetivo de nuestro trabajo es describir los hallazgos obtenidos al aplicar el test de determinación de pepsina en saliva (PEP-test) en una muestra de pacientes con signos clínicos sugestivos de RFL. Material y métodos En nuestro estudio clínico descriptivo se han incluido 142 sujetos con síntomas sugestivos de RFL que obtuvieron puntuaciones por encima de 13 en la escala RSI. A todos ellos se les realizó una endoscopia laríngea para descartar otras enfermedades que pudieran justificar los síntomas y el PEP-test. Ésta se realizó en ayunas a todos los sujetos, y en aquellos con resultados negativos se realizó una segunda determinación una hora después de comer. Resultados Los resultados obtenidos en las pruebas realizadas en los 142 sujetos incluidos fueron los siguientes: 105 pacientes (73,94%) presentaron resultados positivos en alguna de las determinaciones de pepsina en saliva y en 37 sujetos (26,06%) los resultados de ambas determinaciones fueron negativos. Conclusión El PEP-test es un método sencillo, económico, no invasivo y fácilmente repetible que podría minimizar el uso de tratamientos empíricos y pruebas invasivas para el diagnóstico del RFL, si bien son necesarias más investigaciones para la validación del mismo. Introduction and objectives Laryngopharyngeal Reflux (LPR) is a disease characterized by the presence of symptoms, signs and tissue damage caused by retrograde flow of gastric contents to the upper aerodigestive tract. It represents up to 10% of otolaryngology consultations. The aim of the study is to describe the findings obtained by applying the salivary pepsin test (PEP-test) in a sample of patients with the clinical suspicion of LPR. Material and methods Our descriptive clinical study included 142 subjects with symptoms suggestive of LPR and a score above 13 on the RSI scale. The subjects underwent laryngeal endoscopy to rule out other pathologies that could justify the symptoms and the salivary pepsin test (PEP-test). The latter was carried out on fasting subjects and a second test one hour after eating, only on those with negative results. Results The results obtained in the tests performed on the 142 patients included in the study were: 105 (73.94%) presented positive results in some of the salivary pepsin tests and the results of both tests were negative in 37 subjects (26.06%). Conclusion The salivary pepsin test is a simple, low-cost, non-invasive and easily repeatable tool which could minimize empirical treatments and invasive tests for LPR diagnosis, although further research is needed for its validation.

      PubDate: 2017-05-19T11:34:12Z
      DOI: 10.1016/j.otorri.2017.03.001
  • Utilidad y versatilidad del colgajo en isla de la arteria supraclavicular
           en reconstrucción de cabeza y cuello
    • Authors: José A. González-García; Carlos M. Chiesa-Estomba; Jon A. Sistiaga; Ekhiñe Larruscain; Leire Álvarez; Xabier Altuna
      Abstract: Publication date: Available online 13 May 2017
      Source:Acta Otorrinolaringológica Española
      Author(s): José A. González-García, Carlos M. Chiesa-Estomba, Jon A. Sistiaga, Ekhiñe Larruscain, Leire Álvarez, Xabier Altuna
      Introducción El colgajo supraclavicular en isla es un colgajo rotacional pediculado que puede presentar ciertas ventajas en reconstrucción de cabeza y cuello en pacientes donde una reconstrucción microvascularizada no sea factible o aconsejable. Material y métodos Presentamos nuestra experiencia durante el año 2016 en 5 casos con la aplicación de este colgajo, como alternativa a una reconstrucción microvascularizada tras resección de distintos tumores de cabeza y cuello. En 2 casos se utilizó para reconstrucción del faringostoma quirúrgico tras laringectomía total con faringectomía parcial. En un caso para reconstrucción facial lateral tras resección parcial de temporal. En un caso para reconstrucción de un defecto cutáneo tras laringectomía total ampliada y en otro para cobertura cutánea tras el cierre primario de una fístula faringocutánea. No hubo complicaciones del colgajo y el resultado final fue satisfactorio en todos los casos. Resultados El colgajo supraclavicular en isla presenta una utilidad y es muy versátil en reconstrucciones de cabeza y cuello. El tiempo quirúrgico en pacientes de riesgo se reducirá respecto a colgajos libres microvascularizados. Su técnica quirúrgica es relativamente sencilla y se adapta perfectamente a reconstrucciones mucosas o cutáneas. Conclusión El colgajo supraclavicular en isla es una opción recomendable en reconstrucción de cabeza y cuello, su uso parece estar incrementándose y supone una alternativa segura y sobre todo rápida a los colgajos libres microvascularizados en pacientes seleccionados. Introduction The supraclavicular island flap is a rotational pedicled flap and may have some advantages in head and neck reconstruction compared with free-tissue transfer when this kind of reconstruction is not affordable or recommended. Material and methods We present our experience during the year 2016 in the application of the supraclavicular island flap in five cases as an alternative to microvascular reconstruction in several defects after resection of head and neck tumours. In two patients, the flap was used to close the surgical pharyngostoma after total laryngectomy with partial pharyngectomy. In one patient, it was used in lateral facial reconstruction after partial resection of the temporal bone. In one case, it was used to close a skin defect after total laryngectomy with prelaryngeal tissue extension. And in the last case to close a neck skin defect after primary closure of a pharyngo-cutaneous fistula. There were no flap complications, and the result was satisfactory in all cases. Results The supraclavicular artery island flap is useful and versatile in head and neck reconstruction. Operating room time in aged patients or those with comorbidities will be reduced compared to free flaps. The surgical technique is relatively easy and can be used for skin and mucosal coverage. Conclusion The supraclavicular island flap could be a recommended option in head and neck reconstruction, its use seems to be increasing and provides a safe and time-saving option to free flaps in selected patients.

      PubDate: 2017-05-15T11:03:49Z
      DOI: 10.1016/j.otorri.2017.03.004
  • Discrepancy between clinical and pathological neck staging in oral cavity
    • Authors: Vânia Henriques; Eduardo Breda; Eurico Monteiro
      Abstract: Publication date: Available online 12 May 2017
      Source:Acta Otorrinolaringológica Española
      Author(s): Vânia Henriques, Eduardo Breda, Eurico Monteiro
      Introduction The presence of cervical lymph node metastases in patients with oral cavity squamous cell carcinoma reduces survival by up to 50%. Objective The aims of this study are to assess the accuracy of clinical N staging versus pathological N staging and its impact on survival in order to identify predictive factors associated with the presence of occult neck metastases. Methods Outcomes of 105 patients with oral cavity squamous cell carcinoma who underwent surgical treatment of the primary tumor and neck were retrospectively evaluated. Results For pN0 and pN+ patients 5-year overall survival was respectively 53% and 27%; disease specific survival was 66% for pN0 and 33% for pN+. Patients with clinical negative lymph nodes were pathologically upstaged in 62% of cases. Disease specific survival according to staging discrepancy had statistically significant impact on survival (p =0.009). Conclusion Clinical staging usually underestimates the presence of nodal disease. Neck dissection should be performed in cN0 oral cavity squamous cell carcinoma.

      PubDate: 2017-05-15T11:03:49Z
      DOI: 10.1016/j.otorri.2017.02.008
  • Clasificación de las resecciones transorales en la orofaringe: propuesta
           del grupo de trabajo de la Sociedad Catalana de Otorrinolaringología
    • Authors: David Virós Porcuna; Francisco Avilés Jurado; Carlos Pollán Guisasola; Rosa Delia Ramírez Ruiz; Jacinto García Lorenzo; Marc Tobed Secall; Isabel Vilaseca González; José Miguel Costa González; Josep Soteras Olle; Francesc Casamitjana Claramunt; Anna Sumarroca Trouboul; Rafael Hijano Esqué; Guillem Viscasillas Pallàs; Manel Mañós Pujol; Miquel Quer Agustí
      Abstract: Publication date: Available online 12 May 2017
      Source:Acta Otorrinolaringológica Española
      Author(s): David Virós Porcuna, Francisco Avilés Jurado, Carlos Pollán Guisasola, Rosa Delia Ramírez Ruiz, Jacinto García Lorenzo, Marc Tobed Secall, Isabel Vilaseca González, José Miguel Costa González, Josep Soteras Olle, Francesc Casamitjana Claramunt, Anna Sumarroca Trouboul, Rafael Hijano Esqué, Guillem Viscasillas Pallàs, Manel Mañós Pujol, Miquel Quer Agustí
      Introducción y objetivos La cirugía mínimamente invasiva ha presentado una expansión muy importante en la última década. Con el objetivo de aportar un lenguaje común tras cirugía transoral de la orofaringe, se ha creado un sistema de clasificación de las resecciones en esta zona, independientemente de la instrumentalización utilizada. Métodos Desde el Grupo de Trabajo en Oncología de la Sociedad Catalana de Otorrinolaringología, se presenta una propuesta de clasificación basada en una división topográfica de las diferentes zonas de la orofaringe, así como en la afectación de las estructuras anexas según las vías anatómicas de extensión de estos tumores. Resultados La clasificación se inicia utilizando la letra D o I según la lateralidad sea derecha (D) o izquierda (I). A continuación se coloca el número del área resecada. Esta numeración define las zonas iniciando a nivel craneal donde el área I sería el paladar blando, el área II lateral en la zona amigdalina, el área III en la base de lengua, el área IV en los repliegues glosoepiglóticos, la epiglotis y repliegues faringoepiglóticos, el área V pared orofaríngea posterior y VI el trígono retromolar. Se añade el sufijo p si la resección afecta profundamente al plano submucoso de la zona comprometida. Las diferentes áreas propuestas tendrían, de una forma teórica, diferentes implicaciones funcionales. Conclusiones Propuesta de sistema de clasificación por áreas que permite definir diferentes tipos de cirugía transoral de la orofaringe así como compartir los resultados y ayudar en la docencia de este tipo de técnicas. Introduction and goals There has been a very significant increase in the use of minimally invasive surgery has in the last decade. In order to provide a common language after transoral surgery of the oropharynx, a system for classifying resections has been created in this area, regardless of the instrumentation used. Methods From the Oncology Working Group of the Catalan Society of Otorhinolaryngology, a proposal for classification based on a topographical division of the different areas of the oropharynx is presented, as also based on the invasion of the related structures according to the anatomical routes of extension of these tumours. Results The classification starts using the letter D or I according to laterality either right (D) or left (I). The number of the resected area is then placed. This numbering defines the zones beginning at the cranial level where area I would be the soft palate, lateral area II in the tonsillar area, area III in the tongue base, area IV in the glossoepiglottic folds, epiglottis and pharyngoepiglottic folds, area V posterior oropharyngeal wall and VI the retromolar trigone. The suffix p is added if the resection deeply a...
      PubDate: 2017-05-15T11:03:49Z
      DOI: 10.1016/j.otorri.2017.03.006
  • Aprendiendo de la demanda asistencial en el síndrome de apnea del
           sueño infantil
    • Authors: Paz Martinez-Beneyto; Cristina E. Soria Checa; Paloma Botella-Rocamora; Inés Rincon-Piedrahita; Francisco J. Garcia Callejo; Jaime Marco Algarra
      Abstract: Publication date: Available online 12 May 2017
      Source:Acta Otorrinolaringológica Española
      Author(s): Paz Martinez-Beneyto, Cristina E. Soria Checa, Paloma Botella-Rocamora, Inés Rincon-Piedrahita, Francisco J. Garcia Callejo, Jaime Marco Algarra
      Introducción y objetivos El síndrome de apnea-hipopnea del sueño (SAHS) pediátrico engloba alteraciones multisistémicas que afectan al estado general de salud, valorado indirectamente mediante el estudio de la demanda asistencial. Objetivo: cuantificar la frecuentación de consultas médicas en niños con SAHS durante 5 años y compararla con una población sana. Métodos Estudio casos-control longitudinal ambispectivo en un hospital del sistema nacional de salud. Reclutamos a 69 niños remitidos por SAHS sin otras patologías para que la demanda asistencial fuera predominantemente atribuida al SAHS. Se seleccionó a otros 69 niños sanos como grupo control. Obtuvimos datos de frecuentación durante 5 años: el año en el que se realizó el tratamiento del SAHS («año 0»), 1 y 2 años antes («año –1» y «año –2»), y 1 y 2 años tras el tratamiento («año+1» y «año+2»). Resultados El índice de frecuentación (IF), descrito como cociente entre demanda asistencial por los niños con SAHS y niños sanos, fue 1,89 durante el año –2 y 2,15 durante el año –1 (p<0,05). El tratamiento disminuyó la utilización, con IF de 1,59 durante el año+1 y 1,72 en el año+2 (p<0,05). Las principales causas de sobrefrecuentación fueron otorrinolaringológicas y neumológicas. Conclusiones Los niños con SAHS muestran mayor demanda asistencial, al menos 2 años antes del tratamiento, lo que implica un deterioro de la salud global que pudiera estar presente años antes de que la abordemos. El tratamiento repercute en una mejora, aunque permanece alta tras el tratamiento, sugiriendo enfermedad residual o secuelas. Introduction and objectives Paediatric Obstructive Sleep Apnoea-Hypopnoea Syndrome (OSAS) is a multisystemic condition affecting child's health status that may be investigated analyzing demand for healthcare. Objective: to quantify the frequency of medical consultations in children with OSAS over a 5-year period, compared to a healthy population. Methods A longitudinal, case-control, ambispective study was conducted at a hospital pertaining to the national public health system. 69 consecutive children referred for OSAS were recruited with no diseases other than OSAS so that healthcare demand was purely attributed to this condition. Matched healthy control children were selected to compare these data. Data regarding frequency of the medical consultations were obtained over 5 years: the year of the treatment (“Year0”), 1 and 2 years before (“Year -1” and “Year -2” respectively), and 1 and 2 years after treatment (“Year+1” and “Year+2”) Results Frequentation Index (FI), as ratio between the use of health services by OSAS children and healthy controls was 1.89 during Year-2, and 2.15 during Year-1 (P<.05). Treatment diminishes utilization, with FI of 159 during year+1 and 1.72 during year+2 (P<.05). The main causes of attendance were otolaryngological and pneumological diseases, improving after treatment.
      PubDate: 2017-05-15T11:03:49Z
      DOI: 10.1016/j.otorri.2017.02.002
  • Comentarios sobre el hallazgo de nervio laríngeo derecho no recurrente
           durante la tiroidectomía
    • Authors: José Luis Pardal-Refoyo
      Abstract: Publication date: Available online 12 May 2017
      Source:Acta Otorrinolaringológica Española
      Author(s): José Luis Pardal-Refoyo

      PubDate: 2017-05-15T11:03:49Z
      DOI: 10.1016/j.otorri.2017.02.010
  • Síndrome de Alagille: hipoplasia de canales semicirculares
    • Authors: Alexandre Perez-Girbes; Miguel Mazón; Elena Pont
      Abstract: Publication date: Available online 12 May 2017
      Source:Acta Otorrinolaringológica Española
      Author(s): Alexandre Perez-Girbes, Miguel Mazón, Elena Pont

      PubDate: 2017-05-15T11:03:49Z
      DOI: 10.1016/j.otorri.2017.02.009
  • Cochleotoxicity monitoring protocol
    • Authors: José Ferreira Penêda; Nuno Barros Lima; Leandro Ribeiro; Diamantino Helena; Bruno Domingues; Artur Condé
      Abstract: Publication date: Available online 10 May 2017
      Source:Acta Otorrinolaringológica Española
      Author(s): José Ferreira Penêda, Nuno Barros Lima, Leandro Ribeiro, Diamantino Helena, Bruno Domingues, Artur Condé
      Introduction Cochlear damage is frequent in long-term aminoglycosides therapy or chemotherapeutic treatments with platinum-based agents. Despite its prevalence, it is currently underestimated and underdiagnosed. A monitoring protocol is vital to the early detection of cochleotoxicity and its implementation is widely encouraged in every hospital unit. Our aim was to elaborate a cochleotoxicity monitoring protocol for patients treated with platinum compounds or aminoglycosides antibiotics. Methods PubMed® database was searched using terms relevant to drug cochleotoxicity in order to identify the most adequate protocol. Several articles and guidelines influenced our decision. Results There is no consensus on a universal monitoring protocol. Its formulation and application rely heavily on available resources and personnel. High-frequency audiometry and otoacoustic emissions play an important role on early detection of cochleotoxicity caused by aminoglycoside antibiotics and platinum compounds. Conclusion A cochleotoxicity monitoring protocol consisting on an initial evaluation, treatment follow-up and post-treatment evaluation is proposed.

      PubDate: 2017-05-15T11:03:49Z
      DOI: 10.1016/j.otorri.2017.03.005
  • Tratamiento del cáncer de laringe avanzado y calidad de vida.
           Revisión sistemática
    • Authors: Francisco Javier García-León; Raúl García-Estepa; Antonio Romero-Tabares; Jaime Gómez-Millán Borrachina
      Abstract: Publication date: Available online 25 March 2017
      Source:Acta Otorrinolaringológica Española
      Author(s): Francisco Javier García-León, Raúl García-Estepa, Antonio Romero-Tabares, Jaime Gómez-Millán Borrachina
      Introducción y objetivos El objetivo fue comparar la calidad de vida de los pacientes con cáncer de laringe en estadio avanzado tratados con preservación de órgano respecto a aquellos tratados quirúrgicamente. Métodos Se realizó una revisión sistemática consultando MedLine, EMBASE, y PubMed (1991-2014) y Web of Science (2012-2014). Los términos de búsqueda fueron: cáncer de laringe, preservación de órgano, quimioterapia, laringectomía, resultados de tratamiento y calidad de vida. Se incluyeron revisiones sistemáticas, metaanálisis, informes de evaluación de tecnologías sanitarias y estudios comparativos con grupo control, publicados en idioma español, francés o inglés. La selección y evaluación de la calidad fue realizada por dos investigadores. Se usaron los criterios de la Colaboración Cochrane para evaluar el riesgo de sesgo y los del Scottish Intercollegiate Guidelines Network (SIGN) para el nivel de evidencia. Resultados De los 208 estudios identificados en la búsqueda se incluyeron tres: un ensayo clínico y dos estudios observacionales, con un total de 211 pacientes. Su calidad y nivel de evidencia fueron bajos. Los resultados fueron contradictorios, en algunas ocasiones favorables a la cirugía y en otras, a la combinación de radioterapia y quimioterapia, pero en general, sin diferencias significativas entre los tratamientos. Se trataba de estudios heterogéneos, con metodología diferente, tamaño insuficiente, limitaciones en su calidad, con importante riesgo de sesgo y utilización de escalas de medida distintas. Conclusiones Carecemos de estudios de calidad suficiente para establecer si la calidad de vida en los pacientes con cáncer de laringe en estadio avanzado es diferente en función del tratamiento recibido. Introduction and objectives The objective was the comparison of the quality of life in patients with advanced laryngeal cancer treated with organ preservation versus surgical treatment. Methods We performed a systematic review in the databases MedLine, EMBASE, and PubMed (2014 1991) and Web of Science (2012 - 2014). The search terms were: Laryngeal cancer, organ preservation, chemotherapy, laryngectomy, treatment outcomes and quality of life. Systematic reviews, meta-analysis, reports of health technology assessment and comparative studies with control group, published in Spanish, French or English were included. The selection and quality assessment was made by two researchers. The criteria of the Cochrane Collaboration were used to assess the risk of bias and Scottish Intercollegiate Guidelines Network (SIGN) for the level of evidence. Results Of the 208 studies identified in the search, three were included a clinical trial and two observational studies, with a total of 211 patients. Quality and level of evidence was low. The results were contradictory, on occasion they favoured surgery, and on other occasions chemotherapy, but in general there were no statistical differences between the treatments. The studies were heterogeneous, with different methodology, undersized, limitations in quality with high risk of bias and use of different measurement scales. Conclusions There are not ...
      PubDate: 2017-04-07T01:57:47Z
      DOI: 10.1016/j.otorri.2016.11.005
  • Aplicación del índice acústico de calidad vocal para la cuantificación
           objetiva de la severidad de la disfonía
    • Authors: Faustino Núñez-Batalla; Estefanía Díaz-Fresno; Andrea Álvarez-Fernández; Gabriela Muñoz Cordero; José Luis Llorente Pendás
      Abstract: Publication date: Available online 15 February 2017
      Source:Acta Otorrinolaringológica Española
      Author(s): Faustino Núñez-Batalla, Estefanía Díaz-Fresno, Andrea Álvarez-Fernández, Gabriela Muñoz Cordero, José Luis Llorente Pendás
      Introducción En las últimas décadas se han estudiado muchos parámetros acústicos con el fin de cuantificar la disfonía, sin embargo las medidas actuales podrían no ser sensibles a la calidad vocal percibida. En un metaanálisis donde se evaluó la relación entre la calidad global percibida de la voz se identificaron numerosas medidas acústicas que no dependen de la extracción del periodo fundamental tales como las derivadas del cepstrum y que pueden ser usadas tanto en vocales sostenidas como en habla conectada. Un método específico recientemente diseñado para cuantificar la severidad global de la disfonía es el índice acústico de calidad vocal (AVQI) que es un constructo multivariante que combina múltiples marcadores acústicos para generar un único número que se correlaciona razonablemente con la calidad global vocal. Métodos Esta investigación se basó en un archivo de voces grabadas procedentes de dos grupos de individuos: 60 personas sanas vocalmente y 58 participantes con trastornos vocales. Se grabaron vocales sostenidas y una muestral de habla conectada para su análisis y así obtener los seis parámetros incluidos en el AVQI utilizando el programa Praat. El análisis estadístico de los resultados se llevó a cabo con el programa SPSS para Windows versión 12.0. Resultados Correspondencia entre el valor del AVQI y el grado de severidad global de la disfonía: correlación r = 0,68 (p<0,000), y entre el AVQI y el parámetro B del GRABS: r = 0,68 (p<0,000). Conclusiones Los resultados obtenidos muestran una buena correlación con la calidad vocal percibida. En conclusión, el AVQI es una medida multivariante, accesible, factible y razonablemente válida para medir clínicamente la severidad global de la severidad de la disfonía. Introduction Over the past several decades, many acoustic parameters have been studied as sensitive to and to measure dysphonia. However, current acoustic measures might not be sensitive measures of perceived voice quality. A meta-analysis which evaluated the relationship between perceived overall voice quality and several acoustic-phonetic correlates, identified measures that do not rely on the extraction of the fundamental period, such the measures derived from the cepstrum, and that can be used in sustained vowel as well as continuous speech samples. A specific and recently developed method to quantify the severity of overall dysphonia is the acoustic voice quality index (AVQI) that is a multivariate construct that combines multiple acoustic markers to yield a single number that correlates reasonably with overall vocal quality. Methods This research is based on one pool of voice recordings collected in two sets of subjects: 60 vocally normal and 58 voice disordered participants. A sustained vowel and a sample of connected speech were recorded and analyzed to obtain the six parameters included in the AVQI using the program Praat. Statistical analysis was completed using SPSS for Windows, version 12.0. Results Correlation between perception of overall voice quality and AVQI: A significant difference exists (t(95) = 9.5; p<.000) between normal and dysphonic voices. ...
      PubDate: 2017-02-20T22:57:57Z
      DOI: 10.1016/j.otorri.2016.11.010
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