[Malignant oncocytic papilloma. An infrequent type of sinonasal papilloma]

Oncocytic scheneiderian papilloma (OSP), or cylindrical cell papilloma, is the less frequent of the three morphologically distinct papillomas occurring in the nose and paranasal sinuses. We report a case of a patient with an OSP and review on the diagnostic and prognostic implications of this type of tumor.

[Multi-dimensional study of the voice in the teaching professionals of La Rioja]

The vocal pathology is very frequent among the teaching professionals. We have selected 140 teachers, 70 normals, and 70 with dysphonia. To all of them we have realised a complete voice exploration: aerodyinamic tests, tone and extension of the voice, perceptual evaluation of the voice with the GRBAS scale and also a videolaringostroboscopy to diagnose the teachers. Among the dysphonic teachers there is a poor neumophonologic coordination, a major use or an inadequate use of the respiratory and/or laryngeal musculature. The dysphonic teachers present a more pathological voice in the GRBAS scale than the normal teachers.

[Vocal fold nodules. Risk factors in teachers. A case control study design]

Vocal nodules are structural lesions very common amongst professional voice users such as teachers. We have studied the risk factors that predispose the development of vocal nodules in teachers. Two hundred and forty-two teachers were selected: 120 with vocal nodules and 120 with normal vocal folds. Professional and personal factors as well as classroom environment were studied. A complete evaluation of the voice was performed, aerodynamic measures, tone and extension of the voice, acoustic analysis, perceptual evaluation of the voice as well as a videolaryngostroboscopy which was definitive in the diagnosis. Younger teachers with less years of teaching experience a greater have tendency to develop vocal nodules than the rest. Class-room's dryness, loudness and echo are correlated with the pathological group. The most relevant personal factors in the pathological group were previous vocal pathology, laryngeal surgery, nasal surgery and gastroesophageal reflux. Vocal intensity and vocal frequency ranks were shorter in the pathological group. We could also see that, fonatory flow was less effective in the pathological group.

[Our experience with extranodal lymphomas of the ORL region]

Head and neck extranodal lymphomas are rare. Waldeyer lymphatic ring is the most common localisation of these lymphomas, followed by oral cavity and parothoid glands. We have done a retrospective study of patients with extranodal lymphomas diagnosed in our hospital between 1991 and 1999. We have included in this study 23 patients, 15 males and 9 females. We have used the REAL classification. All of them have been non-Hodgkin lymphomas. The rhinopharynx has been the most affected region, followed by the palatine tonsils and oral cavity. Most of them were of medium degree and they were in the initial stages. The presentation symptoms varied depending on the localisation. The age, stage and histologic degree were important for the treatment election.

[An exceptional form of cranio-facial fibrous dysplasia: fibrous dysplasia of middle turbinate]

Fibrous dysplasia is a rare bone disease that can be misdiagnosed because of the slowness of its symptoms. Although it is a benign disease its clinical behaviour can be severe, with possibility of local growth and malignant degeneration into osteosarcoma. An uncommon case of fibrous dysplasia is reported, affecting only the middle turbinate. Diagnostic and therapeutic problems are discussed.

[Benign sinusal mucor colonization in association with septal deviation]

Mucormycosis is a well recognised opportunistic infection caused by saprophytic fungi of the Mucoraceae family. Usually, the upper aerodigestive tract is the portal of entry. Patients who are debilitated or inmunosuppressed might present with these infections, although sometimes can happen in patients with good health. We present a case of benign mucor colonitation at the sinus maxillary associated a deviated nasal septum.

[Tuberculous chronic otitis media. A clinical case]

Tuberculous otitis media is a rare cause of chronic suppurative infection of the middle ear and mastoid. Patients typically have chronic tympanic membrane perforation and ear discharge associated with progressive, profound hearing loss, and resistance to antibiotic treatment. Diagnosis is often delayed by a low clinical suspicion, thus leading to complications such as irreversible hearing loss and facial nerve paralysis. Histological examination of a biopsy specimen reveals tuberculous changes. The disease is treated with antituberculosis agents.