A Blasco Huelva

Complejo Hospitalario Universitario de Badajoz, Ara Pacis Augustalis, Extremadura, Spain

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Publications (166)0 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: We present a prospective study with the aim of assessing the differences found between position-triggered vertiginous syndromes, those diagnosed as benign paroxysmal positional vertigos (BPPV) in primary care and non-specific clinics, and those classified as BPPV at an otoneurology unit. Over a 17 month period, 432 consecutive patients were included after evaluation at a otoneurology unit receiving all referrals for vestibular pathologies. The existence of trigger factors was investigated, as was the distribution of the diagnoses associated with a positional trigger. The characteristics of the patients with a final diagnosis of BPPV were also studied. Of this population, 217 patients (50.23%) reported a positional change as the trigger for their symptoms, 106 (24.53%) were referred from their initial care centres with a diagnosis of BPPV, and 128 (29.62%) were classified as truly BPPV. The coincidence between the preliminary diagnosis and the definitive one was 52.8%. A history of positional paroxysmal vertigo during seconds was linked to BPPV in 78% of cases. Only in 4.7% of the BPPV cases diagnosed at the otoneurology unit had provoking manoeuvres been performed. We have found that an adequate anamnesis is capable of providing accurate guidance for diagnostic purposes in most cases of BPPV, but the performance of provoking manoeuvres and the correct specific treatment for this pathology is of paramount importance when classifying a patient with suspected BPPV.
    Acta Otorrinolaringológica Española 02/2008; 59(1):21-9.
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    ABSTRACT: Introduction We present a prospective study with the aim of assessing the differences found between position-triggered vertiginous syndromes, those diagnosed as benign paroxysmal positional vertigos (BPPV) in primary care and non-specific clinics, and those classified as BPPV at an otoneurology unit. Patients and method Over a 17 month period, 432 consecutive patients were included after evaluation at a otoneurology unit receiving all referrals for vestibular pathologies. The existence of trigger factors was investigated, as was the distribution of the diagnoses associated with a positional trigger. The characteristics of the patients with a final diagnosis of BPPV were also studied. Results Of this population, 217 patients (50.23 %) reported a positional change as the trigger for their symptoms, 106 (24.53 %) were referred from their initial care centres with a diagnosis of BPPV, and 128 (29.62 %) were classified as truly BPPV. The coincidence between the preliminary diagnosis and the definitive one was 52.8 %. A history of positional paroxysmal vertigo during seconds was linked to BPPV in 78 % of cases. Only in 4.7 % of the BPPV cases diagnosed at the otoneurology unit had provoking manoeuvres been performed. Conclusions We have found that an adequate anamnesis is capable of providing accurate guidance for diagnostic purposes in most cases of BPPV, but the performance of provoking manoeuvres and the correct specific treatment for this pathology is of paramount importance when classifying a patient with suspected BPPV.
    Acta Otorrinolaringológica Española. 01/2008; 59(1).
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    ABSTRACT: We present a prospective study assessing the real incidence, aetiology, and evolution of vocal impairment following total thyroidectomy. Sixty-six patients who underwent total thyroidectomy between 2003 and 2006 were included, recording demographic and analytic variables, with emphasis on subjective vocal changes observed after surgery, measured by means of the GRABS scale. A control group of 25 patients operated under general anaesthesia and oro-tracheal intubation was chosen using random sampling. In 30 patients (45.5 %), post-operative dysphonia was observed. Among these, only 2 (3 %) were permanent, and 11 were due to nerve damage (10 inferior and 1 superior laryngeal nerves). In 8 patients (12.2 %), GRABS score was above 5. In the rest of these 30 patients, the complaint was a single decreased tone (10 cases), lack of intensity (9 cases) and vocal fatigue (3 cases), always with a GRABS score equal to or less than 2 points. The most significantly related factor with the onset of dysphonia was the section of strap muscles (OR=12.5). Dysphonia is a common complication of total thyroidectomy, but its incidence is not always related to nerve injury. Some technical (and sometimes avoidable) factors, such as the section of prelaryngeal muscles, could have an important relationship with this adverse event.
    Acta Otorrinolaringológica Española 11/2007; 58(8):352-7.
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    ABSTRACT: Objetives We present a prospective study assessing the real incidence, aetiology, and evolution of vocal impairment following total thyroidectomy. Patients and method Sixty-six patients who underwent total thyroidectomy between 2003 and 2006 were included, recording demographic and analytic variables, with emphasis on subjective vocal changes observed after surgery, measured by means of the GRABS scale. Acontrol group of 25 patients operated under general anaesthesia and oro-tracheal intubation was chosen using random sampling. Results In 30 patients (45.5 %), post-operative dysphonia was observed. Among these, only 2 (3%) were permanent, and 11 were due to nerve damage (10 inferior and 1 superior laryngeal nerves). In 8 patients (12.2 %), GRABS score was above 5. In the rest of these 30 patients, the complaint was a single decreased tone (10 cases), lack of intensity (9 cases) and vocal fatigue (3 cases), always with a GRABS score equal to or less than 2 points. The most significantly related factor with the onset of dysphonia was the section of strap muscles (OR=12.5). Conclusions Dysphonia is a common complication of total thyroidectomy, but its incidence is not always related to nerve injury. Some technical (and sometimes avoidable) factors, such as the section of prelaryngeal muscles, could have an important relationship with this adverse event.
    Acta Otorrinolaringológica Española 10/2007; 58(8).
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    ABSTRACT: We report the clinical case of a hematoma after surgery of cervical spondylosis which required an urgent tracheotomy due to failure in the orotracheal intubation. This illness in advanced degree, so called cervical spondylotic myelopathy, is the most serious consequence of cervical intervertebral disc degeneration.
    Anales otorrinolaringológicos ibero-americanos 02/2007; 34(2):105-10.
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    ABSTRACT: Choanal atresia is an infrequent congenital malformation. Classically, 4 surgical approaches have been described for its treatment: transnasal, transpalatal, trans-septal, and transantral. Of these, transpalatal was preferred. In recent years, the progress in nasal endoscopy has led to reconsideration of the transnasal route as being less invasive and providing excellent results. The use of stents to prevent re-stenosis is a controversial issue. However, the application of substances such as mitomycin may offer decreased need for stenting by reducing the development of cicatrix tissue. We report the case of a patient with bilateral choanal atresia and its surgical treatment using nasal endoscopy with topical mitomycin. We report the case of a patient with bilateral choanal atresia and the surgical treatment with topical mitomycin.
    Acta Otorrinolaringológica Española 02/2007; 58(1):34-6.
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    ABSTRACT: Althouh lymphomas are an illness that characteristically affects the lymph nodes they can present in other locations (extranodes). The lymphoid tissue of the salivary glands can be considered part of the called mucosa-associated lymphoid tissue (MALT). We report the case of a diffuse large B-cells parotid lymphoma. The location on the parotid gland, within its rareness, is the most common for salivary gland lymphomas whose diagnosis is always histological by examination of the removed piece since the biopsy can be nonsufficient and take to a wrong diagnosis besides the greater risk of injury on the facial nerve.
    Anales otorrinolaringológicos ibero-americanos 02/2007; 34(2):195-200.
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    ABSTRACT: Parathyroid hyperfunction condition has a very diverse and unspecific symptoms and signs. We have performed an anatomopathologic study of 146 parathyroid gland from patients diagnosed from hyperparathyroidism. About a 72.6% of the patients presented a parathyroid adenoma while in the rest 27.4% it was observed principal cells hyperplasia. Up to now we have not registered any cases of parathyroid carcinoma after anatomopathological exam of the removed gland. The mayority of the adenomas (85%) were found on the lower parathyroids and its size varied between 6 mm and 5 cm. In one case an double adenoma was diagnosed and in another two cases the adenoma was located in the superior mediastine.
    Anales otorrinolaringológicos ibero-americanos 02/2007; 34(2):135-42.
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    ABSTRACT: We report two adult cases of sudden cardiorespiratory arrest because an acute epiglottitis that ocurred in our hospital. Although it is an uncommon pathology nowdays with good prognosis generally, we try to call the attention about this complication which can happen of unforseeable way even in previous absence of respiratory obstruction. One of the patients required coniotomy in ICU due to impossibility of orotracheal intubation (OI) and the other died in spite of an urgent performance.
    Anales otorrinolaringológicos ibero-americanos 01/2007; 34(1):1-8.
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    ABSTRACT: We report the case of a 86 years old male who, in the course of a coughing attack, refers spontaneous cervical and pharyngeal pain in addition to hoarness, dysphagia and some dyspnea. His exploration revealed a small right neck hematoma but with infiltration of the orohypopharynx and right hemilarynx for spreading later to posterior pharyngeal wall and left aryepiglottic fold. The patient was sent to ICU although he did not required a control of airway by intubation or tracheotomy finally.
    Anales otorrinolaringológicos ibero-americanos 01/2007; 34(1):9-15.
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    ABSTRACT: Benign paroxysmal positional vertigo (BPPV) is the most common of the peripheral vertigo. We report the case of a 45 years old female with that pathology suspected by the symptoms which the patient related to head changes of positions and movements. Her diagnosis was confirmed by the maneuver of Dix-Hallpike, that was positive, and the treatment consisted in a maneuver of canalicular reposition according to Epley's technique. Such maneuver was successful and actually the patient is without symptoms after more than 2 years since the first episode. Finally we have performed a bibliographic review to verify the effectiveness of that treatment.
    Anales otorrinolaringológicos ibero-americanos 01/2007; 34(1):67-73.
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    ABSTRACT: We report the results of a microbiological clinic study that was performed by our ENT Department between years 2000 and 2001 whose main objective was to determine, in Badajoz Area of Health, which bacteria were involved in the acute diffuse external otitis of patients without previous antibiotic treatment (two weeks before obtaining the samples). Of 79 isolated microorganisms in 62 patients that fulfilled the requirements established Pseudomonas, mainly P. Aeruginosa, represented a 46.83% altogether followed by Staphylococcus (18.98%). In almost one fourth part of the cases strains of associated fungi were identified.
    Anales otorrinolaringológicos ibero-americanos 01/2007; 34(1):45-51.
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    ABSTRACT: Choanal atresia is an infrequent congenital malformation. Classically, 4 surgical approaches have been described for its treatment: transnasal, transpalatal, trans-septal, and transantral. Of these, transpalatal was preferred. In recent years, the progress in nasal endoscopy has led to reconsideration of the transnasal route as being less invasive and providing excellent results. The use of stents to prevent re-stenosis is a controversial issue. However, the application of substances such as mitomycin may offer decreased need for stenting by reducing the development of cicatrix tissue. We report the case of a patient with bilateral choanal atresia and its surgical treatment using nasal endoscopy with topical mitomycin. We report the case of a patient with bilateral choanas atresia and the surgical treatment with topical mitomycin.
    Acta Otorrinolaringológica Española 01/2007; 58(1).
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    ABSTRACT: Recurrent thyroid abscesses in children are an uncommon clinical disorder that use to be due to 3rd or 4th branchial anomalies and pyriform sinus fistula. We are reporting the clinical case ofa 6 year-girl who was diagnosed as left thyroid lobe and istmic abscess of 3 cm, drained by general anesthesia with positive culture for St. Viridans. Four months later she was re-admitted by the same cause and we performed a new drainage, by punction, and endovenous antimicrobial therapy for aerobic and anaerobic pathogens with good evolution. The imaging tests showed no anatomical alterations.
    Anales otorrinolaringológicos ibero-americanos 01/2007; 34(1):81-6.
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    ABSTRACT: A prospective study is presented to evaluate some practical and financial aspects regarding surgical endoscopic ligation or cauterization of sphenopalatine (SP) and anterior ethmoidal (AE) arteries performed to control posterior nasal bleeding. 35 patients admitted at the ENT ward between 2004 and 2006 were included in the study, and distributed into two groups depending on the protocol applied in each case. Until March 2005 the surgery was performed if there was failure or insecurity of the posterior packing, and since that date a substitutive surgical protocol (not including posterior packing) was applied. 82.9% of the patients were male, with a mean age of 55.74 years and a left bleeding in a 60% of the cases. Ligature/cauterization was performed on SP in 28 (80%) patients, on AE in 4 (11.4%), and on both arteries in 3 cases (8.6%). 38.7% of the SP approach only one sphenopalatine foramen was observed, through which an only branch of the artery passed; 42% of the cases two branches passed through an only foramen, and in 19.3% two or more branches were present, breaking into the nose through two or more independent clefts. AE was intradural in 3 cases, intranasal attached to the cranial base in other 3 and intranasal detached to the cranial base in 1 patient. Besides, highly significant differences were found between the two protocols, observing a mean reduction of hospital stay of 3.1 days, which throws up savings of 939.3 euros per patient. Surgical treatment for epistaxis has proved to be effective (91.2% in our experience) and safe, determining an important reduction in hospital stay and avoiding the morbility of posterior packing. Accurate knowledge of the anatomy of the arteries implied and specific actuation upon the correct bleeding territory are essential to perform this surgery.
    Acta Otorrinolaringológica Española 12/2006; 57(9):394-400.
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    ABSTRACT: To evaluate the efficacy and cost-effectiveness of the treatments used for controlling epistaxis, particularly compared with the surgical endoscopic ligation or cauterization of sphenopalatine (SP) and anterior ethmoid (AE) arteries, a intervention prospective-retrospective study is presented with the aim of assessing the feasibility of these surgical techniques as an alternative to conventional treatments. 184 consecutive patients admitted in the ENT ward between the years 1997 and 2005 were included in the study, and distributed into three groups depending on the last treatment applied to control their bleeding: AP group.- anterior packing (n=98); PP group.- posterior packing (n=66), and ES group.- endoscopic ligation and/or cauterization of SP or AE (n=20). Highly significant differences were found between the groups, not only regarding the efficacy (90% for surgical treatment compared with 41.3% for AP and 63.1% for PP), but also the length of postreatment hospital stay (AP.- 4.92 days; PP.- 6.3 days; ES.- 2.15 days). The lack of efficacy of conventional treatment and the increasing risk factors that condition nasal bleeding, together with the advance of endoscopic and anesthesic procedures have brought along the possibility of a surgical solution for these patients. Our results demonstrate the feasibility of these techniques as alternative for nasal packing in the treatment of posterior epistaxis, and even its ethical and economical convenience as a substitutive to posterior packing.
    Acta Otorrinolaringológica Española 06/2006; 57(5):228-34.
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    ABSTRACT: We report the case ofa 61 years old woman with multiple pathologies: HTA, diabetes, relapsing polychondritis, hypercholesterolemia, iatrogenic Cushing, cardiopathy, cystic fibrosis, etc. She began, an increment of TA (220/130 mm Hg) or hypertensive crisis, with a sudden left cervical hematoma located on the carotid bifurcation according to CT imaging. We oractice an arteriography that was informed as normal and the patient was admitted and controlled of an ORL as Vascular Surgeon. The bleeding stop spontaneously we treat the patient conservativity.
    Anales otorrinolaringológicos ibero-americanos 02/2006; 33(5):443-8.
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    ABSTRACT: We report the clinical case of an adenoid cystic carcinoma on the base of the tongue, a rare malignant tumor of slow-growing but aggressive with a propepnsity for perineural invasion. Treatment modalities more common include surgery and radiotherapy but locorregional recurrences are frequent and relatively early in the first years. A review of the literature of this pathology is performed.
    Anales otorrinolaringológicos ibero-americanos 02/2006; 33(5):449-54.
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    ABSTRACT: We report the case of a female patient who consulted to the Room Emergencies due to abundant watery otorrea of 3 months without another symptom or apparent cause. The studys confirmed the presence of cerebrospinal fluid (CSF) and the imaging tests (CT and MRI) demonstrated the existence of a communication between the right ear and middle cerebral fossa through tegmen timpani. The woman was operated by ORL (closing the fistula) and neurosurgery (placing an external lumbar drainage) with good postsurgical evolution.
    Anales otorrinolaringológicos ibero-americanos 02/2006; 33(5):461-6.
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    ABSTRACT: We report the clinical case of a 39 years old female diagnosed as a chronic lymphocytic tiroiditis by F.N.A.B. with multinodular goiter of long evolution. The patient was operated by total thyroidectomy and her final anatomopathologic result was papillary carcinoma diffuse sclerosing variant. During the surgical act several cervical nodes were detected and removed being informed the most of them as metastasic. A review of the literature at respect of this malignant neoplasm is performed.
    Anales otorrinolaringológicos ibero-americanos 02/2006; 33(4):347-53.

Publication Stats

107 Citations

Institutions

  • 1999–2008
    • Complejo Hospitalario Universitario de Badajoz
      Ara Pacis Augustalis, Extremadura, Spain
  • 2005
    • Hospital Universitario Infanta Cristina de Parla
      Parla, Madrid, Spain
  • 1999–2005
    • Hospital Universitario Infanta Cristina de Badajoz
      Ara Pacis Augustalis, Extremadura, Spain