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OBJECTIVE: To know the variability in the depth of the sigmoid sinus within the mastoid cavity in temporal bones according to the classifications of Sun et al, Ichigo et al and Melo et al. MATERIALS AND METHODS: Descriptive, non experimental, retrospective, quantitative study was done, assessing computed tomographies of Mexican patients older than 18 years of Regional Hospital General Ignacio Zaragoza (ISSSTE), Mexico City, who attended to external consultation of Otorhinolaryngology from June 2022 to March 2023. Prevalence of each classification and the distribution of demographic variables were calculated, the degree of relationship among the data sets of each sigmoid sinus classification was measured by correlation coefficient analysis. RESULTS: A total of 105 cases of patients ranging in age from 18 to 84 years were analyzed; the study showed variability in the depth of the sigmoid sinus within the mastoid cavity in the temporal bones among patients in position and shape according to sex and side of the ear, it was observed that the most frequent classification of sigmoid sinus in the right ear was lateral position, type 3 and protrusive shape, in the left ear it was lateral position, type 2 and saucer shape. The degree of relationship of the right ear was statistically significant between the proposal of Sun et al and Ichigo et al. CONCLUSIONS: The right ear showed the most protrusive sigmoid sinus and it is more frequent that in women the position of the sigmoid sinus is deeper than in men. [ABSTRACT FROM AUTHOR]

RESUMO Introdução: Os recursos tecnológicos digitais, a exemplo dos jogos, podem ser usados de forma eficiente e colaborativa no processo de ensino-aprendizagem, principalmente pela facilidade de serem inseridos no contexto acadêmico, uma vez que significativa parte dos estudantes tem acesso à internet e faz uso desses mecanismos em seu cotidiano. Tais recursos podem ser utilizados para aprimorar o conhecimento acerca de uma área específica, como a otorrinolaringologia, que envolve habilidades clínicas essenciais na formação do médico generalista, sendo destaque entre os agravos frequentes na atenção primária. Objetivo: Nesta pesquisa, objetiva-se o desenvolvimento de uma ferramenta didática que possa auxiliar na aquisição de conhecimentos específicos pertinentes à prática clínica de médicos egressos. Método: Trata-se de um estudo descritivo, de caráter experimental de um aplicativo denominado ORLearning, baseado em competências previamente definidas em um consenso Delphi, a ser usado em estudantes de Medicina a respeito da otorrinolaringologia. Resultado: Construiu-se o protótipo com interfaces próprias destinado a discentes de Medicina. Conclusão: Frisamos a importância do uso dessas ferramentas tecnológicas no processo de ensino-aprendizagem da especialidade para graduandos e recém-formados em Medicina, de modo a tornar esse processo lúdico e inovador.

Se reporta el caso de paciente masculino de 25 años de edad sin antecedentes patológicos conocidos, presentando sintomatología de un mes de evolución dado por aumento de volumen en dorso nasal con signos de flogosis sin salida de secreción acompañado de dolor local de moderada a fuerte intensidad que alivia a la ingesta de antiinflamatorios no esteroideos (AINES) motivo por el cual se valora y se decide su ingreso. Durante su estancia hospitalaria se realiza estudio anatomopatológico que reporta infección por leishmaniasis por lo que se indica terapia antimonial pentavalente a través de vía endovenosa y tópica con posterior remisión completa y cicatrización de herida por la que consulta inicialmente dicho paciente. Discusión: la Ulamida tópica a una concentración del 10% alcanza una efectividad en la resolución de la infección, compatible con los hallazgos del estudio Bullón et al. (2021) afirmando que el estudio por Granado et al. (2021) expone el uso de Glucantime en inyección intradérmica o IV 0,2-0,5 ml cada 3-7 días (hasta 5 sesiones) generando 91% de eficacia. Conclusión: el uso de Ulamina y Glucantime como tratamiento para la Leishmaniasis resulta efectivo (100%) dado su potencial antimonial pentavalente (SbV) en forma de antimoniato de meglumina la cual posee como principio activo. De la misma manera, su eficacia radica en su capacidad transdérmica o IV lo que resulta factible como tratamiento prolongado en pacientes con lesiones causadas por este microorganismo.

Viruses represent one of the main causes of human morbidity and mortality worldwide. Plants have been used since time immemorial to treat, cure or alleviate diseases. We present some of them that make compounds with antiviral action and are used in traditional medicine. The objective of this work was to contribute to the knowledge of plants popularly used for the treatment of respiratory diseases of viral origin. The parts or organs mainly used are: the stem, leaves and flowers, while the method of use is mainly in decoction or infusion and its administration route is orally. The chemical compounds contained in plants used with antiviral properties are very diverse in nature, and belong to the groups of: essential oils, phenolic acids, alkaloids, flavonoids, glycosides, gums and mucilages, oleoresins; pectins, lignans, saponins and tannins. [ABSTRACT FROM AUTHOR]

La patología vestibular presenta diferencias entre inicio y curso de cada paciente, por ello, es importante evaluar la autopercepción del paciente ante su enfermedad. Con este fin, Jacobson y Newman (1990) elaboraron el Dizzines Handicap Inventory (DHI), el cual valora las alteraciones del sistema vestibular a nivel físico, emocional y funcional, convirtiéndose en el instrumento más aceptado, razón por la cual ha sido traducido a idiomas como el alemán, ruso, portugués, español o italiano entre otros, teniendo mayor relevancia para nuestra realidad las traducciones realizadas al español en España, México o Colombia, a partir de las cuales se han hecho adaptaciones culturales y validaciones en países como México, Colombia, Argentina y Chile. Conocedores de la importancia de esta prueba para la evaluación de los pacientes, se realizó la adaptación cultural y la validación del DHI a la realidad lingüística peruana, tomando como base la traducción y adaptación de Pérez et al. (2000), debido a que esta versión presentó una consistencia interna de α=0,92 para el DHI total, el componente emocional de α=0,8, físico de α=0,85 y funcional de α=0,66, siendo estos resultados próximos al resultado obtenido por Jacobson y Newman en 1990. Esta validación se hizo a través del criterio de jueces expertos, por medio del V de Aiken con un índice de confianza del 95%, obteniendo 0,93 de índice de confiabilidad total, 0,93 nivel físico, 0,91 nivel emocional y 0,93 nivel funcional, quedando el instrumento adaptado a la realidad lingüística peruana y validado.

Introduction and objectives: VEXAS syndrome (VS) is a recently described clinical entity that mainly affects males, and is due to a somatic mutation in the UBA1 gene. It can present with multiple systemic manifestations, especially hematological and dermatological, being the affectation of the head and neck very frequent, especially, auricular chondritis (AC). The objective of this study was to describe the otorhinolaryngological manifestations of VS, knowledge of which by the otolaryngologist could contribute to early diagnosis and treatment of the disease. Methods: A review of the medical literature was carried out, using the PRISMA criteria adapted to the type of study, of the otorhinolaryngological manifestations of VS, from its description in the year 2020 to December 2022, using the Pubmed database. Results: 81 articles that met the inclusion criteria were included in our work, which described 133 cases in detail. The results showed that VS occurs mainly in men over 50 years of age, presenting in more than half of the cases head and neck manifestations, among which AC, nasal chondritis and periorbital edema stand out. Conclusions: Since VS can affect any part of the body, mimicking the clinical pictures of other diseases, it has often been confused, in patients with otorhinolaryngological manifestations, especially with recurrent polychondritis. Knowledge by the otolaryngologist of the head and neck manifestations associated with it can contribute to early diagnosis and treatment, improving the prognosis of the disease. [ABSTRACT FROM AUTHOR]

Introduction and objective: Trisomy 21 is the most frequent chromosomal alteration and, because of the increase in life expectancy, requires more specialized care. Ear, nose, and throat (ENT) manifestations are a dominant focus of morbidity. Hearing problems are more common when compared to the rest of the population and can impact educational and social development, affecting their quality of life. The aim of this study was to analyze the results of the otological and auditory follow-up of children with Down syndrome (DS), evaluated in the ENT Department of the Hospital Clínico Universitario de Valladolid (HCUV). Method: Prospective/retrospective longitudinal study of 83 children with DS who attended consultation for childhood hearing loss between 1993 and 2021. Results: We detected 66% of external ear malformations. Middle ear pathology was present in 93%. Hearing loss was found in 61%, being bilateral in 78%. Of those diagnosed, 87% were mild/moderate and 6% were profound. Mixed hearing loss was the most frequent type, followed by sensorineural hearing loss. ENT surgery was performed in 62%, with adenoidectomy being the most frequent. Discussion: ENT follow-up recommended for children with DS is a difficult task to organize, as it is necessary to develop specific planning to make it possible in our public health system. Conclusions: Given the frequency and important repercussions of hearing impairment in children with DS, early identification and indefinite follow-up is essential to try to promote their correct development. [ABSTRACT FROM AUTHOR]

Introduction: Foreign bodies (FB) are frequent reasons for consultation in otolaryngology, especially in the pediatric age group. They present highly symptomatic cases with a favorable outcome if diagnosed and treated promptly. Result: The reported case is of an oligosymptomatic patient with a challenging diagnosis who underwent surgical treatment. Discussion: FBs are common reasons for consultations in otolaryngology, accounting for 11% of emergency cases. They can progress to complications in 22% of cases. The most frequent age group affected was 1-4 years old, with no gender prevalence. The most commonly affected sites are the ear, followed by the nasal cavity and oropharynx. FBs in the oropharynx are highly symptomatic, with odynophagia being the main symptom. When oligosymptomatic, they become one of the most silent, making diagnosis difficult, as in the reported case. Generally, complications are uncommon, and surgical treatment is rarely required. Conclusions: Early diagnosis, combined with management by a qualified professional, can prevent major complications during FB removal. Therefore, this becomes extremely necessary when dealing with patients with FBs located in unusual locations with atypical symptoms. The significance of this article lies in its uncommon clinical presentation, which complements the existing literature on the subject. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To describe the role of the Otolaryngologist (ENT) in the treatment of patients with COVID-19. MATERIALS AND METHODS: A retrospective study performed from January 1st to May 31st, 2021 at the Temporary COVID-19 Unit at the Centro Banamex (UTC-19 CB), Mexico City. RESULTS: There were received 210 ENT consultations. Most of the patients were male and aged between 51 and 60 years. CONCLUSIONS: COVID-19 patients may require ENT care for multiple reasons that may or may not be related to COVID-19. The ENT plays a major role in the evaluation and management of patients with tracheostomy and epistaxis. ENT has a significant risk of infection; however, with proper use of personal protective equipment timely and quality care can be provided. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To inquire the diagnostic and management procedures among the members of the Mexican College of Otology, NeuroOtology and Skull Base Surgery (CMONCBC) by means of an anonymous survey. MATERIALS AND METHODS: A prospective, observational, descriptive, cross-sectional survey study, with 11 questions, prepared for this purpose by a panel of experts from the Regional Hospital General Ignacio Zaragoza, Mexico City, to describe the diagnostic protocol and treatment of surgeons from the Mexican College of Otology, NeuroOtology and Skull Base Surgery (CMONCBC). Survey was applied in May-June, 2021. RESULTS: An 11-items questionnaire was applied to the 54 members of the CMONCBC with 34 responses received; mean age of those who answered was of 41 a 49 years (± 1.07). For diagnosis the majority used the determination of glucose (19/34) and CT scan (23/34). Conservative treatment was used by the majority (27/34), as well as the use of 3 layers of grafting material in the reconstructions of skull base defects (22/34). Most of the surgeons did not indicate prophylactic vaccination (22/34). CONCLUSIONS: There is agreement among experts in the use of diagnostic tools for the cerebrospinal fluid leaks, although there is need to establish evidence-based Mexican guidelines of treatment and random controlled trials for skull base reconstruction strategies. [ABSTRACT FROM AUTHOR]

A saúde auditiva abrange, em um dos aspectos, a prática da higienização correta do canal auricular, a fim de prevenir doenças inflamatórias e infecciosas, como a Otite Externa. Este trabalho trata-se de um relato de experiência, realizado com base nas percepções dos autores, acerca da preparação e da aplicação da atividade educativa em saúde proposta pela disciplina de PROINTER II, do curso de Enfermagem da Universidade Federal de Uberlândia (UFU). Diante da importância da audição e da qualidade de vida dos cidadãos, este trabalho tem como propósito difundir o conhecimento acerca da temática, bem como preparar os autores para troca de saberes com a comunidade. Para a análise subjetiva dos efeitos advindos da ação, todos os participantes demonstraram as perspectivas positivas e negativas a partir de uma nuvem de palavras. O companheirismo, o orgulho, a dispersão do saber, o trabalho em grupo e o conhecimento são apresentados pelos membros como descritores positivos para a ação. Entretanto, a ansiedade, o pouco tempo de desenvolvimento, a vergonha, a timidez e os gastos surgiram como dificuldades para o estabelecimento da ação, mas não impediram o sucesso do trabalho no ambulatório. Portanto, essa ação educativa possibilitou uma experiência proveitosa tanto para o público quanto para os estudantes, responsáveis pela execução da atividade. Os discentes atuaram na promoção em saúde, esclarecendo dúvidas e instruindo os participantes acerca da correta higienização auricular a partir do uso de um molde de orelha, de um banner e de perguntas ao público, bem como utilizando dados retirados de artigos científicos, a fim de difundir informações seguras e confiáveis aos pacientes da otorrinolaringologia.

The correct and healthy use of the artistic voice requires a deep knowledge of the vocal instrument. Medicine and singing find a nexus of union in the scientific discipline of vocal hygiene. The aim of this article, based on a methodology of historical documentation analysis, is to show the relevance of medicine in the development of singing and its diffusion through the publication of treatises on voice hygiene in the 19th century. In addition, the figure of Dr. Faustino Barberá, promoter of scientific dissemination in the context of the official education of singing, is studied. [ABSTRACT FROM AUTHOR]

Introduction: Targeted needs assessment which includes identifying the needs of learners is a key step of program development. However, this step is commonly underestimated in postgraduate medical education programs, including otolaryngology residency training. Determining the needs of otolaryngologists may help educators to design more purposeful continuing medical education training programs. Furthermore, needs of specialists may provide a clearer insight about effectiveness of the residency programs in that specialty. Objective: To determine training needs of otolaryngology specialists and to identify deficiencies in otolaryngology residency training programs. Methods: Seventy-eight otolaryngology specialists, who completed all data gathering forms properly, were included in this descriptive, cross-sectional study. Demographic data of the participants were collected. Training needs of the participants were determined in seven basic areas of otolaryngology via two-round Delphi method. The basic areas were otology–neurotology, rhinology, laryngology, head and neck surgery, pediatric otolaryngology, sleep disorders and facial plastic surgery. Additionally, we asked an open-ended question to investigate the reasons why the participants perceived themselves incompetent and undereducated, or why they needed further training in some of the basic otolaryngology areas. Results: Facial plastic surgery, otology-neurotology and head and neck surgery were the most cited training areas in the needs assessment. Training needs differed according to experience and place of work. Financial expectations, deficiencies in residency training, regression in knowledge and skills, and special interest were effective determinants on decisions of the participants while determining their training needs. Conclusion: Otolaryngologists need further training in some areas of their field due to different reasons. Determining these areas and reasons will help in designing more effective continuous medical education activities and residency training programs in otolaryngology. Resumo: Introdução: A avaliação de necessidades específicas, que inclui a identificação das necessidades dos alunos, é um passo fundamental no desenvolvimento de programas educacionais. No entanto, essa etapa costuma ser subestimada em programas de pós-graduação em educação médica, inclusive na residência em otorrinolaringologia. Determinar as necessidades dos otorrinolaringologistas pode ajudar os educadores a projetar programas mais direcionados de treinamento em educação médica continuada. Além disso, a análise das necessidades dos especialistas pode oferecer uma visão clara sobre a eficácia dos programas de residência nessa especialidade. Objetivo: Determinar as necessidades de treinamento de especialistas em otorrinolaringologia e identificar deficiências nos programas de residência em otorrinolaringologia. Método: Este estudo descritivo e transversal incluiu 78 especialistas em otorrinolaringologia que preencheram todos os formulários de coleta de dados adequadamente. Os dados demográficos dos participantes foram coletados. As necessidades de treinamento dos participantes foram determinadas em sete áreas básicas da otorrinolaringologia com o método Delphi em duas rodadas. As áreas básicas foram otologia/neurotologia, rinologia, laringologia, cirurgia de cabeça e pescoço, otorrinolaringologia pediátrica, distúrbios do sono e cirurgia plástica facial. Além disso, uma pergunta aberta foi usada para investigar os motivos pelos quais os participantes consideravam ter pouco conhecimento ou ser incapazes de atuar nessa área, ou por que precisavam de mais treinamento em algumas dessas áreas básicas. Resultados: Na avaliação das necessidades, cirurgia plástica facial, otologia-neurotologia e cirurgia de cabeça e pescoço foram as áreas de treinamento mais relatadas. As necessidades de treinamento variaram de acordo com a experiência e o local de trabalho. Expectativas financeiras, deficiências no treinamento durante a residência, regressão do conhecimento e habilidades, além de interesse especial, foram determinantes efetivos nas decisões dos participantes ao identificar suas necessidades de treinamento. Conclusão: Por diferentes motivos, os otorrinolaringologistas precisam de mais treinamento em algumas áreas. A determinação dessas áreas e motivos ajudará a planejar atividades de educação médica continuada e programas de treinamento em residência em otorrinolaringologia mais eficazes.

Presentado en sesión de 11 de abril de 1951

Presentado en sesión de 22 de noviembre de 1944

To analyze and correlate auditory signs and symptoms, emphasising tinnitus, audiological findings, and their incidence in individuals with vascular loop (AV) of VII/VIII pair demonstrated by MRI images of the cerebellopontine angle, classifying them according to Chavda. A retrospective and cross-sectional study by analyzing clinical data from the medical records of 15 patients, correlating hearing and otological complaints with results found in the complementary tests of Audiometry and MRI. Patients who presented alterations in the path of the vessels that penetrate the IAC, forming a vascular loop of the VII and/or VIII cranial nerve, were classified according to Chavda. All patients had an MRI with a vascular loop of the VIII pair diagnosed. Eleven of them (73.33%) were bilateral. In 5 patients, there was an agreement between the complaint and the MRI findings: bilateral symptoms and bilateral vascular loop. Tinnitus generated by vascular para-auditory structures is also called pulsatile tinnitus. These conditions lead to turbulent flow that causes tinnitus, synchronous with the patient's pulse. There are studies demonstrating there is no correlation between tinnitus and vascular contact with the VIII pair. We found the presence of tinnitus in approximately 80% of patients with vascular loop, but the complaint did not always coincide with the pathology, making it hard to correlate complaints and pathology. The presence of a vascular loop on MRI is not pathological but an examination finding. The neurovascular conflict of the VII/VIII cranial nerve present in the MRI images did not alone justify the otoneurological signs and symptoms and the audiovestibular alterations found in the individuals evaluated in this study. [ABSTRACT FROM AUTHOR]

The occurrence of foreign bodies involving the nasal cavities, ears and oropharynx is a reason for frequent consultations in emergency department of otolaryngology. Objective: To describe the cases of foreign bodies in the emergency department in a private and specialized clinic in otorhinolaryngology in Belo- Horizonte city. Method: A retrospective, analytical and quantitative study of medical records of patients with foreign bodies of the ear, nose, pharynx and larynx was carried out from January 2019 to January 2020. Results: 531 cases identified due to foreign bodies were identified. Foreign bodies were more frequently located in the ears (68.17%), in the nasal cavities (25.80%) and in the oropharynx (6.03%). The mean age of the patients was 10 years old. The rate of cases that required general anesthesia to remove foreign bodies was 2.2%. Conclusion: The importance of an experienced otorhinolaryngologist to act in these cases and avoid complications is highlighted. In addition, the availability of specific instruments and operation room is essential in the necessary cases. [ABSTRACT FROM AUTHOR]

Resumo: Introdução: Afecções otorrinolaringológicas são destaques entre as enfermidades mais frequentes na atenção primária. Acredita-se que a sobrecarga na atenção secundária seja consequência da baixa resolução dos problemas na atenção primária. Uma possível explicação para esse fato seria a deficiência na capacitação médica durante a graduação. Estima-se que a carga horária média de otorrinolaringologia seja 0,6% da carga horaria média total, após análise de 141 matrizes curriculares, correspondendo a aproximadamente 70,5% do total das escolas médicas em funcionamento em 2013. Nessa área, poucos estudos têm sido realizados em relação ao ensino e à necessidade de reavaliação curricular. Objetivo: O presente estudo tem o intuito de buscar um consenso sobre as competências necessárias ao generalista na especialidade de otorrinolaringologia. Métodos: Criou-se um questionário inicial que abordava as competências otorrinolaringológicas pertinentes à prática clínica dos médicos da atenção primária. Por meio da metodologia Delphi, no formato eletrônico, o questionário foi enviado para 20 especialistas com formações distintas: médicos generalistas, otorrinolaringologistas e médicos de família e comunidade. Essa heterogeneidade entre os especialistas contribuiu para garantir a confiabilidade dos resultados. Os resultados obtidos após cada rodada eram analisados pelos pesquisadores, que observavam as tendências e as opiniões dissonantes, bem como suas justificativas. Ao final da sistematização e compilação dos resultados, um novo questionário era elaborado e reenviado, iniciando uma nova rodada até que o consenso fosse estabelecido em todas competências. Resultados: Realizaram-se cinco rodadas para o estabelecimento do consenso em todas as 17 competências otorrinolaringológicas avaliadas pelas proposições, o possibilitou a definição do nível de competência dos conteúdos e procedimentos otorrinolaringológicos preconizados ao egresso de Medicina. Conclusão: Os dados obtidos neste trabalho podem servir para o embasamento, direcionamento e desenvolvimento do currículo otorrinolaringológico nos cursos de graduação de Medicina, visto que não se encontrou na literatura consenso estabelecendo as competências mínimas otorrinolaringológicas na formação curricular da graduação.

BACKGROUND: Mumps has modified its clinic and epidemiologic characteristics in last decades, and because of this the diagnostic strategy changed too. OBJECTIVE: To update the peculiarities of mumps with a strong rooting with Otorhinolaryngology. PATIENTS AND METHODS: A retrospective study was carried out in Otolaryngolgy Service of General Hospital of Requena, Valencia, Spain, from January 2017 to June 2020 on patients assisted under mumps suspicion, as well as their direct contacts. Symptomatology and laboratory were registered (blood amylase, serology by enzimoimmunoassay and real time-PCR for virus detection in saliva). RESULTS: We diagnosed 47 cases in 42 months, with a mean age of 26.29 ± 6.13 years old and a decreased incidence from 19.6/105 inhabitants in 2017 to 6 in 2020. Parotid swelling (mostly unilateral) and fever were the most regular clinic findings (33/47 cases). Thirteen of them were non-symptomatic and detected by mean of tracing infected patients. Diagnostic sensitivity was 54.8% for a first physical exploration but increased to 70.5.% if associated to higher levels of blood amylase, 36% for serology tests and 100% for PCR. CONCLUSIONS: The disease shows cyclic outbreaks affecting young adults above all, with parotid damage mainly unilateral. Antibodies detection only must be employed for seroprevalence studies. Physical exam with blood amylase measurement showed more usefulness, and real time-PCR results in saliva samples were excellent for the diagnosis. [ABSTRACT FROM AUTHOR]

Hoy en día el conocimiento avanza a pasos agigantados. Cada vez hay más fonoaudiólogos en diversas áreas de la profesión. Llama la atención de muchos el área artística, pues es un área poco explorada y amplia. Este artículo tiene el objetivo de reflexionar sobre la intervención vocal en artistas (cantantes, actores y otros). Su implementación debe comprender una mirada completa de la persona: voz, fisiología, fisiopatología, emociones, rol, aspectos médicos, farmacológicos y características individuales. Esto promueve la adherencia de un profesional de la voz a su área de conocimiento y genera un espacio de sanidad, exploración y libertad artística en términos actuales, incluso en medio de una pandemia.

Background and Objective: There is great heterogeneity in the methodology and evaluation in specialized health training (SHT) in otorhinolaryngology in our country. The figure of the resident tutor is the cornerstone on which the ESF system is based and the regulation and recognition of this figure varies. This article aims to take a snapshot of the current situation of the ESF in Spain and to describe the activity of tutors., Materials and Methods: During the month of September 2023, a survey was sent in a Google Forms® format through the Spanish Society of Otolaryngology and Head and Neck Surgery. The survey consisted of 8 multiple-choice questions and 4 questions in which they were asked to rank a series of 5 weaknesses, threats, opportunities and strengths selected by the authors, in order to perform a SWOT analysis., Results: A total of 103 responses were obtained, of which 81 corresponded to accredited tutors. 63% of the tutors indicated that they did not have enough time to carry out their teaching work and 48% did not carry out a regular assessment of their residents. 64% of the tutors believe that the quality of otorhinolaryngology training in Spain is good and 61% are satisfied with their job as tutors. The main weakness was the short duration of the training programme, and the pressure of care was found to be the main threat. An experienced training system was considered the main strength and the creation of a national network of tutors was seen as an opportunity for improvement., Conclusions: The creation of a common and transversal otorhinolaryngology training pathway for all accredited centres and the creation of a network of mentors and residents are necessary to address the problems of SHT. The role of the tutor must be recognised and reinforced to improve specialist training., (Copyright © 2024. Published by Elsevier España, S.L.U.)

La granulomatosis con poliangeitis es una enfermedad poco común, cuya incidencia anual es de 8-10 casos por millón de personas, causada por una reacción autoinmune inusual asociada a la elevación de los anticuerpos anticitoplasma de neutrófilos (ANCA) que ocasionan vasculitis de pequeños vasos e inflamación granulomatosa. Estas reacciones ocasionan síntomas que usualmente comienzan de manera localizada, afectando la cabeza y el cuello, que progresan a una afectación sistémica con pobre pronóstico, sin embargo en ocasiones estos pueden ser pasados por altos y atrasar su diagnóstico. El artículo se centra en mencionar las manifestaciones clínicas más importantes en la cabeza y el cuello. El diagnóstico es difícil y se basa en las manifestaciones clínicas, asociadas a un análisis histopatológico y positividad de los ANCA. El tratamiento temprano ayuda a mejorar el pronóstico de esta, y se necesita de un equipo multidisciplinario para el diagnóstico y tratamiento de esta enfermedad, para así lograr una remisión y prevenir la mayor cantidad de efectos adversos de los tratamientos. Granulomatosis with polyangiitis is a rare disease, with an anual incidence of 8-10 cases per million people, it´s caused by an unusual autoimmune reaction associated with antineutrophil cytoplasmic antibodies (ANCA), producing small-vessel vasculitis and granulomatous inflammation. These reactions result in symptoms, usually localized starting in the head and neck region, progressing to a systemic form with a poor prognosis, however, some of these symptoms can be overlooked and delay the diagnosis. This article centers in mentioning the most important clinical manifestations in the head and neck. Diagnosis is difficult, and it’s based on clinical manifestations associated with histopathological analysis and ANCA positivity. Early treatment helps improving the prognosis, and a multi-disciplinary cooperation is needed for the diagnosis and treatment of this disease, to adequately achieve the remission and to prevent most of the adverse effects of the treatments.

BACKGROUND: Otorhinolaryngology is the specialty which generates the biggest proportion of external consultation, nevertheless, it doesn't count with many epidemiological studies. OBJECTIVES: To describe and to analyze the epidemiology of otorhinolaryngological causes of hospitalization in Mexico during 2015, emphasizing on the impact of early diagnosis on the rest of the variables. MATERIAL AND METHOD: An observational, analytical and cross-sectional study of hospital discharge causes with an otorhinolaryngological ICD-10 reported by Mexican Health Secretary during 2015. Descriptive statistics, classic hypothesis tests and analytical statistics with linear and multinomial regression models were held by the means of STATA program (p < 0.05). RESULTS: A sample of 10,153 patients was obtained that represented 0.95% of the universe. The mean age was 19.5 years, 55.5% were men. Pediatric patients (55.4%), upper airway, pharynx and tonsils (69.2%) were the most affected. During hospitalization: an early diagnosis was made in 90.4% of the cases; the mean length of stay was of 2.1 days; in-hospital infection and death occurred both in < 1% of the cases. Early diagnosis was related to a shorter length of stay and a greater proportion of discharges by improvement. CONCLUSIONS: It is infrequent that otorhinolaryngological diseases are a motive of hospitalization or death. An important positive factor in a patient's evolution is the early diagnosis. [ABSTRACT FROM AUTHOR]

Objective: Laryngeal microsurgery is a procedure indicated in benign laryngeal lesions; it is also a diagnostic tool in patients with dysphonia or in cases where malignancy is suspected. Methodology: Retrospective study in which clinical records, surgical protocols, videoestroboscopies, and pathology documents of patients under laryngeal microsurgery between 2011 and 2016 were reviewed. Univariate analysis was performed using Chi squared test (p <0.05). Results: Mean age was 51.2 ± 6.6 years, males were the most frequently intervened. Smoking was the most common comorbidity. The main macroscopic lesions observed were premalignant and malignant, polyps and cysts; in the pathology, polyps, carcinomas, and cysts were found. Polyps were the most frequent lesions found in both genders (33% vs 45%, p = 0.03). In patients with a smoking comorbidity, polyps were the most common lesion in both women and men (46% vs. 30%, p = 0.02). A greater presence of carcinomas was described in males over 60 with a history of smoking (33% vs 15%, p = 0.0001). Conclusions: Polyps, cysts, and carcinomas were mainly found in males over 60. A greater presence of carcinomas was described in male patients with a history of smoking. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVES: Predictive value of preoperative tests in estimating difficult intubation may differ in the laryngeal pathologies. Patients who had undergone direct laryngoscopy (DL) were reviewed, and predictive value of preoperative tests in estimating difficult intubation was investigated. METHODS: Preoperative, and intraoperative anesthesia record forms, and computerized system of the hospital were screened. RESULTS: A total of 2611 patients were assessed. In 7.4% of the patients, difficult intubations were detected. Difficult intubations were encountered in some of the patients with Mallampati scoring (MS) system Class 4 (50%), Cormack-Lehane classification (CLS) Grade 4 (95.7%), previous knowledge of difficult airway (86.2%), restricted neck movements (cervical ROM) (75.8%), short thyromental distance (TMD) (81.6%), vocal cord mass (49.5%) as indicated in parentheses (p < 0.0001). MS had a low sensitivity, while restricted cervical ROM, presence of a vocal cord mass, short thyromental distance, and MS each had a relatively higher positive predictive value. Incidence of difficult intubations increased 6.159 and 1.736-fold with each level of increase in CLS grade and MS class, respectively. When all tests were considered in combination difficult intubation could be classified accurately in 96.3% of the cases. CONCLUSION: Test results predicting difficult intubations in cases with DL had observedly overlapped with the results provided in the literature for the patient populations in general. Differences in some test results when compared with those of the general population might stem from the concomitant underlying laryngeal pathological conditions in patient populations with difficult intubation.

Introduction: There are currently several medical specialties; this creates confusion about the fi eld of action of each of them. The work of an otolaryngologist and head and neck surgeon is wrongly limited to diseases of the ears, nose, and throat. Objective: To examine the perception that general practitioners, medical specialists and the general population have of the diseases that a certain specialist solves. Materials and methods: This is a descriptive study in which a survey was applied to general practitioners, residents and to the general population of the Hospital Español de México. Results: A total of 146 surveys was obtained. All the respondents-except general surgery residents-, 106 (72.6%), consider otolaryngologists and head and neck surgeons experts only in functional nasal and aesthetic surgery. Conclusions: The opinions obtained from the surveyed population differ greatly from each other and evidently show that, in general, there is no clear knowledge of the fi eld of action of our specialty, which results in a delay in effective medical care and patient protection. [ABSTRACT FROM AUTHOR]