Papers by Liz Katherine Ojito Castillo
EMC - Otorinolaringoiatria, 2015
Le riniti e le rinosinusiti acute sono delle patologie frequenti e benigne nella maggior parte de... more Le riniti e le rinosinusiti acute sono delle patologie frequenti e benigne nella maggior parte dei casi. La loro diagnosi è, prima di tutto, clinica. La difficoltà del loro trattamento è la differenziazione delle forme virali, più frequenti e banali, e delle forme batteriche, rare ma potenzialmente gravi. Le recenti raccomandazioni sono riassunte in questa esposizione. Analizzando le prove scientifiche del momento, esse insistono sui criteri diagnostici clinici, sulle indicazioni degli esami complementari, sull'efficacia dei vari trattamenti e sull'importanza dell'informazione e dell'educazione dei pazienti. I futuri lavori in questo settore dovranno permettere di selezionare in modo più preciso i pazienti che richiedono realmente una terapia antibiotica e di evitare, così, importanti spese sanitarie nonché la comparsa di ceppi batterici resistenti.
EMC - Otorrinolaringología, 2015
Las rinitis y rinosinusitis agudas son afecciones frecuentes y benignas en la mayoría de los caso... more Las rinitis y rinosinusitis agudas son afecciones frecuentes y benignas en la mayoría de los casos. Su diagnóstico es esencialmente clínico. La dificultad de su tratamiento consiste en diferenciar las formas víricas, más frecuentes y banales, de las formas bacterianas, que son infrecuentes pero potencialmente graves. En este artículo se resumen las recomendaciones recientes, que se basan en la evidencia actual e insisten en los criterios diagnósticos clínicos, las indicaciones de las pruebas complementarias, la eficacia de los distintos tratamientos, así como la importancia de la información y de la educación de los pacientes. Los futuros trabajos en este ámbito deberán permitir seleccionar con más precisión a los pacientes que requieren realmente una antibioticoterapia y evitar de ese modo unos gastos sanitarios considerables, así como la aparición de cepas bacterianas resistentes.
Revue de laryngologie - otologie - rhinologie
ABSTRACT
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2012
EMC - Otorrinolaringología, 2015
Existen numerosas patologias adquiridas del oido externo, que ademas son muy diversas, debido a s... more Existen numerosas patologias adquiridas del oido externo, que ademas son muy diversas, debido a sus particularidades anatomicas. El medico otorrinolaringologo, que suele ser el primero en atenderlas, no debe pasarlas por alto. En este articulo se presenta una resena anatomica y fisiologica, seguida por los principios basicos de la exploracion fisica del conducto auditivo externo, asi como de las principales pruebas complementarias utiles. A continuacion, se describen todas las patologias, haciendo hincapie tanto en los procesos frecuentes como en las otitis externas, pero tambien en una patologia potencialmente grave: la otitis externa necrosante, con la que siempre hay que ser muy cauteloso. Ademas de las patologias infecciosas, tambien se expondran las patologias dermatologicas, tumorales y traumaticas. Se dedica un apartado especifico a las complicaciones de la radioterapia externa y a las estenosis del conducto.
Revue de laryngologie - otologie - rhinologie, 2004
The aim of this retrospective study was to analyse the data of patients with rhino-orbital-cerebr... more The aim of this retrospective study was to analyse the data of patients with rhino-orbital-cerebral mucormycosis for predisposing factors, diagnosis, treatment and survival rate. The role of frozen section in early diagnosis and use of nasal endoscopy in diagnosis, treatment and follow-up of patients has also been examined. Retrospective case series. University Teaching Hospital. The case notes of 9 patients with diagnosis of mucormycosis who presented from 1973 to 2001 were examined. The data for predisposing factors, signs/symptoms, histological diagnosis, radiological intervention, medical and surgical treatment and final outcome was analysed. There were 9 patients with mucormycoses. Early diagnosis was made by endoscopic examination and frozen section in 5 patients, which was later confirmed by histology. Treatment included parental and/or local amphotericin, hyperbaric oxygen and debridement either by endoscopic or external approach, with or without orbital exenteration. This r...
Revue de laryngologie - otologie - rhinologie, 2006
Hypocalcemia is the most common complication of total thyroidectomy. During surgery the blood sup... more Hypocalcemia is the most common complication of total thyroidectomy. During surgery the blood supply to preserved parathyroid glands may be compromised, monitoring for post operative hypocalcemia is often the primary reason patients remain in hospital. The aim of this prospective study was to evaluate the role of early parathyroid hormone (PTH) assay for predicting thyroidectomy-related hypocalcemia. 62 patients underwent total thyroidectomy between November 2004 and April 2005 in our institution. Quick PTH assay was performed 1 hour post thyroidectomy. Based on the result (PTH > or <16 pg/mL) the patients were separated into two groups. Serum calcium levels and ionised fractions were determined 24, 48 and 72 hours after surgery. Post operative hypocalcemia was defined as calcium levels <2.00 mmol/L and/or ionised calcium levels <1.00 mmol/L. In 16 cases hypocalcemia occurred in the first 72 hours (25.8 %). In all of these cases, PTH measured 1 hour after thyroidectomy w...
Annales d'oto-laryngologie et de chirurgie cervico faciale : bulletin de la Société d'oto-laryngologie des hôpitaux de Paris, 2005
To study the contribution of computed tomography (CT) to evaluate the intensity of the sinus muco... more To study the contribution of computed tomography (CT) to evaluate the intensity of the sinus mucosa's response to an inflammatory stimulus. Eight New-Zealand white rabbits where used. Rabbit n degrees 1 was the control. CT, macroscopic examination with analysis of secretion volumes, and histological examination were used to study the response of the sinuses to inflammation. There was perfect match between the CT scan aspect and the quantity of secretions (kappa and Cohen's coefficient=1). The CT scan aspect well correlated with inflammatory cell infiltration (kappa and Cohen's coefficients=0.8). The CT scan contributes usefully to the analysis of sinus contents and can be used to assess the intensity of the sinus mucosal inflammatory reaction. Consequently, the CT scan can be used not only to validate an animal model of acute or chronic sinusitis, but can also be used to evaluate medical or surgical treatments in such an animal model.
Revue de laryngologie - otologie - rhinologie, 2003
The purpose of this study is to show the place of MIBI scintigraphy in the preoperative investiga... more The purpose of this study is to show the place of MIBI scintigraphy in the preoperative investigation of primary hyperthyroidism, and then to demonstrate the extent to which this test allows us to formulate new surgical strategies, thus reducing the need for neck exploration in favour of minimally invasive techniques. We have carried out a retrospective study related to 118 cases of primary hyperthyroidism. A MIBI scintigraphy has been applied on all the patients, so that we have been able to compare its results with the surgical and histological findings. Our study shows a great accuracy of MIBI scintigraphy, with respect to the localization of parathyroid adenoma, which represents the major cause of primary hyperparathyroidism. Furthermore, these results prove the reliability of the new surgical strategies: unilateral neck exploration and minimally invasive surgery, when facing a single scintigraphic site. As of now, MIBI scintigraphy must be part of preoperative investigation in ...
Revue de laryngologie - otologie - rhinologie, 2001
Surgical management of cerebrospinal fluid leaks (CSFL) has improved these few past years with th... more Surgical management of cerebrospinal fluid leaks (CSFL) has improved these few past years with the development of paranasal sinus surgery under optical guidance. CSFL localized in the sphenoid sinus represent only 5 to 15% of all CSFL. The authors have analyzed a serie of 15 patients having undergone surgery from 1992 to 1999 for CSFL: 10 cases followed pituitary gland surgery realized through sublabial-transsphenoidal approach, 2 cases followed head trauma, 1 case followed a secondary neurosurgical procedure following recurrence of a rathke's cleft cyst, 1 case followed medical treatment of a bulky pituitary gland adenoma and 1 case was associated to an empty sella syndrome. The surgical procedure has relied on sphenoid sinus approach through the sphenoethmoidal recess (SER) (n = 8), transethmoidal approach (TE) (n = 2) or transseptal approach (TS) (n = 7) followed by a filling of the defect by a graft of fat with biological glue (n = 17). Sometimes it was associated to a carti...
Annales d'oto-laryngologie et de chirurgie cervico faciale : bulletin de la Société d'oto-laryngologie des hôpitaux de Paris, 2000
Nodular thyroid pathology is frequent and remains a controversial issue when it comes to establis... more Nodular thyroid pathology is frequent and remains a controversial issue when it comes to establishing an ideal endocrine surgical strategy. We studied clinical and complementary data predictive of malignancy using a large retrospective analysis of 366 cases operated for nodular pathology of the thyroid gland between January 1995 and December 1997 in our Head and Neck Surgery Unit of the Pasteur Hospital in Nice, France. The incidence of malignancy was 12.8% with the usual histologic findings (83% of well-differentiated tumors: 70% papillary, 13% vesicular, 9% medullar, 6% oncocytic and 2% anaplastic). Statistical analysis did not conclude on the predictive value of several items in terms of their relationship to high risk of malignancy (p > 0.05): size of nodules, signs of local compression, biological findings, presence of calcifications, mixed ultrasound aspect, no hypoechogenic halo, scintigraphic aspect. This retrospective work did however identify items predictive of maligna...
Annales d'oto-laryngologie et de chirurgie cervico faciale : bulletin de la Société d'oto-laryngologie des hôpitaux de Paris, 1999
Chronic sinus pathology is a frequently encountered disease in HIV infected patients. The respons... more Chronic sinus pathology is a frequently encountered disease in HIV infected patients. The responsible bacterial agents and management are yet to be settled. The authors report the results of a retrospective study led in the unit of Head and Neck Surgery of the University Hospital of Nice. 25 patients where HIV holders and had a sinus pathology which had lasted more than 6 weeks, despite one or several antimicrobial drug administrations. Clinical and CT scan data are detailed as well as pathology results of the samples harvested during sinus surgery (bacteria free 32%, Pseudomonas aeruginosa 32%, Streptococcus pneumoniae 16%, Staphylococcus aureus 16%, Hemophilus influenzae 16%, anaerobic agents 16% and Toxoplasma gondii 4%). All patients underwent surgery (antral puncture with maxillary sinus drainage 17, functional endoscopic sinus surgery 8). Results where gathered at 4 months with 76% of relapse (100% in patients with less than 200/mm3 CD4 cells). In conclusion empiric antimicrob...
Rhinology, 1999
The surgical management of Cerebro-spinal Fluid (CSF) rhinorrhea has been modified these last yea... more The surgical management of Cerebro-spinal Fluid (CSF) rhinorrhea has been modified these last years due to the improvement of endoscopic sinus surgery techniques allowing the treatment of selective dural tears by the endonasal route. Over a period of 6 years, 27 patients with CSF rhinorrhea were operated on by the endonasal approach under optical guidance. CSF rhinorrhea was due, in 20 cases, to surgical iatrogenic trauma, in 4 cases to head injury, and in 1 case it was secondary to a conservative medical treatment of a pituitary adenoma. In 2 cases the cause was unknown. The average follow-up in this series was 24.7 months. The technique used was successful in 22 patients (81.5%). Considering these results and others reported in the literature, we think the use of the endonasal approach with optical guidance should always be considered as a valuable alternative to open surgery and should be discussed in all cases of CSF rhinorrhea with neurosurgeons.
Neuro-Chirurgie, 1998
Schwannomas of trigeminal nerve account for 0.07% to 0.36% of all intra-cranial tumors. We report... more Schwannomas of trigeminal nerve account for 0.07% to 0.36% of all intra-cranial tumors. We report three observations about Jefferson's type D tumors, mainly extra-cranial with only small intra-cranial extension, concerning two men and one woman, who were respectively 36, 60 and 63 years old. Two of them presented with facial pain and hypoesthesia in the same territory. The third one developed a diplopia. In all cases, CT scanner analysis evidenced a large hypodense tumor extending in the infratemporal fossa. Temporal lobe and cavernous sinus were pushed aside by the intra-cranial extension. Tumors were hypo intense in T1-weighted image with significant enhancement after gadolinium injection. One of the tumors was a cystic form and in that case, an hyper signal in T2-weighted image was detected in the middle of the lesion. A combined subtemporal and transmaxillary approach was performed in 2 cases. In the third case, the removal of the tumor was only performed by a transmaxillary...
Revue de laryngologie - otologie - rhinologie, 1997
Malignant melanoma with primary onset in the nasal cavity and paranasal sinuses remains a scarcel... more Malignant melanoma with primary onset in the nasal cavity and paranasal sinuses remains a scarcely encountered malignancy and we report 12 cases of our own experience from 1991. These mucosal melanomas occur mainly in the elderly and present most commonly as a one sided airway obstructive syndrome with often bleeding in the nasal cavity. No sex or race ratio is found. Histological examination of the surgical specimen has been made easier since the use of immunohistochemical studies. The original site of onset is commonly located at the inferior part of the nasal cavity but in many cases, it is noted several sites of tumor localization. Despite well conducted treatment the prognosis remains quite deceiving and significantly poor. In our study, the 4-year actuarial survival was 26%. The 5-year survival rate ranges in the literature from 10% to 40%. Short and long term follow-up show an important rate of recurrence (local and lymph node metastases as well as distant metastases). The in...
Annales d'Otolaryngologie et de Chirurgie Cervico-faciale, 2004
ABSTRACT
EMC - Cirugía Otorrinolaringológica y Cervicofacial, 2007
La casi totalidad de las intervenciones de las glándulas paratiroideas se realiza en el marco del... more La casi totalidad de las intervenciones de las glándulas paratiroideas se realiza en el marco del tratamiento de los hiperparatiroidismos. En este artículo se recordarán los conocimientos básicos embriológicos, anatómicos e histopatológicos necesarios para su realización. La estrategia quirúrgica de referencia era la exploración bilateral de la celda tiroidea con el control sistemático de las cuatro glándulas. No obstante, el tratamiento del hiperparatiroidismo primario ha evolucionado de forma evidente en los últimos años, gracias a las mejoras del diagnóstico de localización preoperatoria. Esto ha permitido realizar cada vez más intervenciones unilaterales y una cirugía dirigida denominada mínimamente invasiva, para disminuir de este modo el coste y la morbilidad. Las distintas fases de la técnica quirúrgica de referencia se describirán y se ilustrarán con precisión. Se describirán las indicaciones y técnicas quirúrgicas de acceso unilateral y de cirugía dirigida, la utilización de la anestesia local y los aportes de la determinación intraoperatoria de hormona paratiroidea (PTH). También se planteará el tratamiento de los casos especiales (recidiva, cáncer, ectopia).
Annales d'Otolaryngologie et de Chirurgie Cervico-faciale, 2004
ABSTRACT
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Papers by Liz Katherine Ojito Castillo