Ithzel Villarreal - Academia.edu (original) (raw)

Papers by Ithzel Villarreal

European Archives of Oto-Rhino-Laryngology

Purpose Although metabolic tumor volume (MTV) and total lesion glycolysis (TLG) have shown good p... more Purpose Although metabolic tumor volume (MTV) and total lesion glycolysis (TLG) have shown good prognostic value in head and neck cancer (HNC), there are still many issues to resolve before their potential application in standard clinical practice. The purpose of this study was to compare the discrimination ability of two relevant segmentation methods in HNC and to evaluate the potential benefit of adding lymph nodes’ metabolism (LNM) to the measurements. Methods We retrospectively analyzed a recently published database of 62 patients with HNC treated with chemoradiotherapy. MTV and TLG were measured using an absolute threshold of SUV2.5. Comparison analysis with previously published background-level threshold (BLT) results was done through Concordance index (C-index) in eight prognostic models. Results BLT obtained better C-index values in five out of the eight models. The addition of LNM improved C-index values in six of the prognostic models. Conclusion We found a potential benef...

Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2015

Lettres à l'éditeur L'hamartome épithélial respiratoire adénomatoïde : une entité rarissime ayant... more Lettres à l'éditeur L'hamartome épithélial respiratoire adénomatoïde : une entité rarissime ayant son origine dans la paroi nasale latérale ଝ * Auteur correspondant.

Revista Española de Medicina Nuclear e Imagen Molecular, 2018

The Journal of Laryngology & Otology, 2018

ObjectiveTo evaluate the presence of endolymphatic hydrops in patients with immune-mediated inner... more ObjectiveTo evaluate the presence of endolymphatic hydrops in patients with immune-mediated inner-ear disease.MethodsThe presence of endolymphatic hydrops was prospectively evaluated in 17 patients clinically diagnosed with secondary (n = 5) or primary (n = 12) immune-mediated inner-ear disease, who attended the ENT department of a tertiary care centre for evaluation or treatment over the previous year. All patients underwent magnetic resonance imaging of the temporal bone.ResultsIntratympanic gadolinium three-dimensional magnetic resonance imaging diagnosed hydrops in 11 of 12 patients with primary immune-mediated inner-ear disease (92 per cent). Of these, seven patients (64 per cent) presented only cochlear (n = 5) or predominantly cochlear (n = 2) hydrops. A positive magnetic resonance imaging result was observed in only one of five patients with secondary immune-mediated inner-ear disease (20 per cent).ConclusionThis study confirms the presence of endolymphatic hydrops in immune...

Srpski arhiv za celokupno lekarstvo, 2020

Introduction/Objective. Tonsillitis is a very common condition found in the pediatric population ... more Introduction/Objective. Tonsillitis is a very common condition found in the pediatric population but also in adult patients. One of the consequences of such conditions is poor voice quality. Hoarseness, poor voice impostation, interruption, and hypernazalization are just some of the differences in patient voice quality. The objective of this paper was to examine the effects of tonsillectomy on the voice quality. Methods. The sample included 37 patients, 17 female and 20 male, ranging in age 3?39 years. The method involved recording patients one month before and one month after tonsillectomy with a digital sound recorder, with recordings analyzed in the Praat program. The variables monitored in the basic voice were as follows: voice pitch, standard deviation of voice, degree of voice interruption, jitter, shimmer, and signal-to-noise ratio. In the statistical analysis, in addition to standard descriptive analyzes, t-test and ACNOVA were also used. Results. The results showed that the...

Journal of Investigational Allergology and Clinical Immunology, 2020

Background: Since the initial anecdotal reports of coronavirus disease 2019 (COVID-19) from China... more Background: Since the initial anecdotal reports of coronavirus disease 2019 (COVID-19) from China, a growing number of studies have reported on smell and/or taste dysfunction (STD). Objective: The aim of our study was to investigate the frequency and severity of STD in COVID-19 patients and to evaluate the association with demographic characteristics, hospital admission, symptoms, comorbidities, and blood biomarkers. Methods: We performed a multicenter cross-sectional study on patients who were positive for SARS-CoV-2 (n=846) and controls (n=143) from 15 Spanish hospitals. Data on STD were collected prospectively using an in-person survey. The severity of STD was categorized using a visual analog scale. We analyzed time to onset, recovery rate, time to recovery, hospital admission, pneumonia, comorbidities, smoking, and symptoms. Results: STD was at least 2-fold more common in COVID-19-positive patients than in controls. COVID-19-positive hospitalized patients were older, with a lower frequency of STD, and recovered earlier than outpatients. Analysis stratified by severity of STD showed that more than half of COVID-19 patients presented severe loss of smell (53.7%) or taste (52.2%); both senses were impaired in >90%. In the multivariate analysis, older age (>60 years), being hospitalized, and increased C-reactive protein were associated with a better sense of smell and/or taste. COVID-19-positive patients reported improvement in smell (45.6%) and taste (46.1%) at the time of the survey; in 90.6% this was within 2 weeks of infection. Conclusion: STD is a common symptom in COVID-19 and presents mainly in young and nonhospitalized patients. More studies are needed to evaluate follow-up of chemosensory impairment.

International Journal of Otolaryngology and Head & Neck Surgery, 2014

Objectives: The aim of this paper is to establish a correct approach to the diagnosis of a primar... more Objectives: The aim of this paper is to establish a correct approach to the diagnosis of a primary malignant melanoma of the parotid gland. Methods: We present a case of a patient with a painless mass situated in the left parotid region after an initial cytological and radiological study suggesting a Warthin tumor whose treatment involved a total parotidectomy with a facial nerve reconstruction. Results: The histopathological result showed a malignant melanoma that after various studies and evaluations showed no other primary origin different from the parotid gland itself. Conclusions: Salivary gland melanomas are relatively rare entities that when being of a primary origin and localized in the parotid gland become even more uncommon. Upon a melanoma found in the parotid gland, the first suspicion should be a metastatic origin, being the most common sites the oral cavity and the skin from the head and neck region.

1 Malignant tumors of the parotid gland account scarcely for 5 % of all head and neck tumors. Mos... more 1 Malignant tumors of the parotid gland account scarcely for 5 % of all head and neck tumors. Most of these neoplasms have a high tendency for recurrence, local infiltration, perineural extension, and metastasis. Although uncommon, these malignant tumors require complex surgical treatment sometimes involving a total parotidectomy including a complete facial

Copyright © 2015 Rafael Ramı́rez-Camacho et al. This is an open access article distributed under ... more Copyright © 2015 Rafael Ramı́rez-Camacho et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Introduction. The presence of a serous cyst in the tympanic membrane implies the description of a new or unpublished entity based on our knowledge whose origin may be very unlikely explained on actual embryologic and anatomic background. Clinical Case. We present a case of a 45-year-old woman with progressing right hearing loss. Physical examination revealed a whitish, round-shaped malformation in the posterior-inferior quadrant of the right tympanic membrane. The cyst was removed with a transcanal tympanoplasty. Discussion. A thorough PubMed search that involved the terms tympanic membrane gland, epithelial inclusion

Revista Espanola De Medicina Nuclear, 2018

Introduction To evaluate the utility of positron emission tomography-computed tomography (PET/CT)... more Introduction To evaluate the utility of positron emission tomography-computed tomography (PET/CT) as an imaging tool for the characterization of immune-mediated inner ear disease (IMIED), providing measurements of the inner ear region activity as well as detecting possible involvement of other organs. Material and methods The study included 28 patients with IMIED and 4 sex-matched and age-matched control subjects with no history of ear disease. Eighteen patients were considered to be suffering from primary IMIED and 10 patients from secondary. PET/CT scans with 18F-FDG were performed to assess systemic involvement as well as inner ear region activity. Interpretation of PET/CT scans was performed independently by two nuclear medicine physicians blinded to clinical history. In order to assess inter-rater agreement before performing the analysis of the inner ear, different Bland & Altman plots and the intraclass correlation coefficients were estimated. Results Different metabolically a...

Acquired nasopharingeal stenosis (NSP) is a rare cause, but to be considered, of nasal breathing ... more Acquired nasopharingeal stenosis (NSP) is a rare cause, but to be considered, of nasal breathing insufficiency. Its diagnosis is made initially by nasofibroendoscopy with consequent radiological confirmation. The most common cause is iatrogenia, followed by inflammatory diseases. In extremely rare cases the cause is uncertain. The main treatment involves surgery followed by classical postoperative stenting during a variable time. We present a case of an adult patient with stenotic choanas without an apparent cause who underwent an endoscopic surgical procedure with microdebrider and bilateral nasal packing with Merocel® for seven days. After five years of follow-up, the functional results are good. In addition, we perform a review of possible surgical techniques which we can be used in this type of pathology, and their postoperative care according to different authors.

Early detection and appropriate treatment of hearing loss are essential to min-imise the conseque... more Early detection and appropriate treatment of hearing loss are essential to min-imise the consequences of hearing loss. In addition to conventional audiometry (125---8000 Hz), extended high-frequency audiometry (9000---20 000 Hz) is available. This type of audiometry may be useful in early diagnosis of hearing loss in certain conditions, such as the ototoxic effect of cisplatin-based treatment, noise exposure or oral misunderstanding, especially in noisy environments. Eleven examples are shown in which extended high-frequency audiometry has been useful in early detection of hearing loss, despite the subject having a normal conventional audiometry. The goal of the present paper was to highlight the importance of the extended high-frequency audiometry examination for it to become a standard tool in routine audiological examinations.

European Archives of Oto-Rhino-Laryngology

Objective COVID-19 patients may present mild symptoms. The identification of paucisymptomatic pat... more Objective COVID-19 patients may present mild symptoms. The identification of paucisymptomatic patients is paramount in order to interrupt the transmission chain of the virus. Olfactory loss could be one of those early symptoms which might help in the diagnosis of COVID-19 patients. In this study, we aim to develop and validate a fast, inexpensive, reliable and easy-to-perform olfactory test for the screening of suspected COVID-19 patients. Study design Phase I was a case-control study and Phase II a transversal descriptive study. Subjects and methods Olfaction was assessed with the ethyl alcohol threshold test and symptoms with visual analogue scales. The study was designed in two phases: In Phase I, we compared confirmed COVID-19 patients and healthy controls. In Phase II, patients with suspected COVID-19 infection referred for testing were studied. Results 275 participants were included in Phase I, 135 in Phase II. The ROC curve showed an AUC of 0.749 in Phase I, 0.737 in Phase II. The cutoff value which offered the highest amount of correctly classified patients was ≥ 2 (10% alcohol) for all age intervals. The odds ratio was 8.19 in Phase I, 6.56 in Phase II with a 75% sensitivity. When cases report normal sense of smell (VAS < 4), it misdiagnoses 57.89% of patients detected by the alcohol threshold test. Conclusion The olfactory loss assessed with the alcohol threshold test has shown high sensitivity and odds ratio in both patients with confirmed COVID-19 illness and participants with suspected SARS-CoV-2 infection.

European Archives of Oto-Rhino-Laryngology

Background Since the outbreak in China due to coronavirus disease 2019 (COVID-19) various studies... more Background Since the outbreak in China due to coronavirus disease 2019 (COVID-19) various studies have been published describing olfactory and gustatory dysfunction (OGD). Objective The aim was to investigate the frequency and severity of OGD in SARS-CoV-2 (+) outpatients compared to controls with common cold/flu like symptoms and two negative RT-PCR. Methods A multicenter cross-sectional study on SARS-CoV-2-positive outpatients (n = 197) and controls (n = 107) from five Spanish Hospitals. Severity of OGD was categorized by visual analogue scale (VAS). Frequency and severity of the chemosensory impairment were analyzed. Results The frequencies of smell (70.1%) and taste loss (65%) were significantly higher among COVID-19 subjects than in the controls (20.6% and 19.6%, respectively). Simultaneous OGD was more frequent in the COVID-19 group (61.9% vs 10.3%) and they scored higher in VAS for severity of OGD than controls. In the COVID-19 group, OGD was predominant in young subjects 46.5 ± 14.5 and females (63.5%). Subjects with severe loss of smell were younger (42.7 years old vs 45.5 years old), and recovered later (median = 7, IQR = 5.5 vs median = 4, IQR = 3) than those with mild loss of smell. Subjects with severe loss of taste, recovered later in days (median = 7, IQR = 6 vs median = 2, IQR = 2), compared to those with mild loss. Conclusion OGD is a prevalent symptom in COVID-19 subjects with significant differences compared to controls. It was predominant in young and females subjects. Stratified analysis by the severity of OGD showed that more than 60% of COVID-19 subjects presented a severe OGD who took a longer time to recover compared to those with mild symptoms.

European Archives of Oto-Rhino-Laryngology

Purpose Severe acute respiratory syndrome caused by COVID-19 has spread globally for the last few... more Purpose Severe acute respiratory syndrome caused by COVID-19 has spread globally for the last few months. Healthcare workers (HCW) are overexposed and infection rates are higher than in the rest of the population. Strict clinical assessment is paramount to detect suspicious cases. In this context, olfactory or taste dysfunction (OTD) appears as an early and frequent symptom. Evaluating its presence in early stages plays an important role nowadays. Methods We performed a descriptive observational single-center study among 256 HCW at Hospital Universitario de Fuenlabrada affected by COVID-19 and confirmed using RT-PCR. A telephonic interview was performed, after obtaining oral informed consent. Results OTD was present in up to 70% of the cases as an early symptom, including mild-to-severe cases. The extent of these sensory deficits lasted an average of 11 days. In 26% of the patients, these sensory alterations persisted for over a month. Conclusion OTD is reported as an early symptom among HCW with SARS-CoV-2 infection. Its strong association with test positivity is useful in the management of the infection and should be enough to indicate preventive isolation. We consider that OTD needs to be included in clinical screening questionnaires in HCW.

SSRN Electronic Journal

calcium phosphate product in the serum, leading to soft tissue calcification. Radiologic imaging ... more calcium phosphate product in the serum, leading to soft tissue calcification. Radiologic imaging help confirm this condition. Adequate control of serum calcium-phosphate levels will diminish the risk of formation or recurrent deposits in these patients.

Acta Oto-Laryngologica Case Reports, 2016

Acta Oto-Laryngologica, 2016

Scientifica, 2016

Objective. The aim of this study is to analyze the high-frequency hearing levels in patients with... more Objective. The aim of this study is to analyze the high-frequency hearing levels in patients with rheumatoid arthritis and to determine the relationship between hearing loss, disease duration, and immunological parameters.Materials and Methods.A descriptive cross-sectional study including fifty-three patients with rheumatoid arthritis was performed. The control group consisted of 71 age- and sex-matched patients from the study population (consecutively recruited in Madrid “Area 9,” from January 2010 to February 2011). Both a pure tone audiometry and an extended-high-frequency audiometry were performed.Results. Extended-high-frequency audiometry diagnosed sensorineural hearing loss in 69.8% of the patients which exceeded the results obtained with pure tone audiometry (43% of the patients). This study found significant correlations in patients with sensorineural hearing loss related to age, sex, and serum anti-cardiolipin (aCL) antibody levels.Conclusion.Sensorineural hearing loss mus...

Iranian journal of otorhinolaryngology, 2015

Malignant tumors of the parotid gland account scarcely for 5% of all head and neck tumors. Most o... more Malignant tumors of the parotid gland account scarcely for 5% of all head and neck tumors. Most of these neoplasms have a high tendency for recurrence, local infiltration, perineural extension, and metastasis. Although uncommon, these malignant tumors require complex surgical treatment sometimes involving a total parotidectomy including a complete facial nerve resection. Severe functional and aesthetic facial defects are the result of a complete sacrifice or injury to isolated branches becoming an uncomfortable distress for patients and a major challenge for reconstructive surgeons. A case of a 54-year-old, systemically healthy male patient with a 4 month complaint of pain and swelling on the right side of the face is presented. The patient reported a rapid increase in the size of the lesion over the past 2 months. Imaging tests and histopathological analysis reported an adenoid cystic carcinoma. A complete parotidectomy was carried out with an intraoperative notice of facial nerve ...

European Archives of Oto-Rhino-Laryngology

Purpose Although metabolic tumor volume (MTV) and total lesion glycolysis (TLG) have shown good p... more Purpose Although metabolic tumor volume (MTV) and total lesion glycolysis (TLG) have shown good prognostic value in head and neck cancer (HNC), there are still many issues to resolve before their potential application in standard clinical practice. The purpose of this study was to compare the discrimination ability of two relevant segmentation methods in HNC and to evaluate the potential benefit of adding lymph nodes’ metabolism (LNM) to the measurements. Methods We retrospectively analyzed a recently published database of 62 patients with HNC treated with chemoradiotherapy. MTV and TLG were measured using an absolute threshold of SUV2.5. Comparison analysis with previously published background-level threshold (BLT) results was done through Concordance index (C-index) in eight prognostic models. Results BLT obtained better C-index values in five out of the eight models. The addition of LNM improved C-index values in six of the prognostic models. Conclusion We found a potential benef...

Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2015

Lettres à l'éditeur L'hamartome épithélial respiratoire adénomatoïde : une entité rarissime ayant... more Lettres à l'éditeur L'hamartome épithélial respiratoire adénomatoïde : une entité rarissime ayant son origine dans la paroi nasale latérale ଝ * Auteur correspondant.

Revista Española de Medicina Nuclear e Imagen Molecular, 2018

The Journal of Laryngology & Otology, 2018

ObjectiveTo evaluate the presence of endolymphatic hydrops in patients with immune-mediated inner... more ObjectiveTo evaluate the presence of endolymphatic hydrops in patients with immune-mediated inner-ear disease.MethodsThe presence of endolymphatic hydrops was prospectively evaluated in 17 patients clinically diagnosed with secondary (n = 5) or primary (n = 12) immune-mediated inner-ear disease, who attended the ENT department of a tertiary care centre for evaluation or treatment over the previous year. All patients underwent magnetic resonance imaging of the temporal bone.ResultsIntratympanic gadolinium three-dimensional magnetic resonance imaging diagnosed hydrops in 11 of 12 patients with primary immune-mediated inner-ear disease (92 per cent). Of these, seven patients (64 per cent) presented only cochlear (n = 5) or predominantly cochlear (n = 2) hydrops. A positive magnetic resonance imaging result was observed in only one of five patients with secondary immune-mediated inner-ear disease (20 per cent).ConclusionThis study confirms the presence of endolymphatic hydrops in immune...

Srpski arhiv za celokupno lekarstvo, 2020

Introduction/Objective. Tonsillitis is a very common condition found in the pediatric population ... more Introduction/Objective. Tonsillitis is a very common condition found in the pediatric population but also in adult patients. One of the consequences of such conditions is poor voice quality. Hoarseness, poor voice impostation, interruption, and hypernazalization are just some of the differences in patient voice quality. The objective of this paper was to examine the effects of tonsillectomy on the voice quality. Methods. The sample included 37 patients, 17 female and 20 male, ranging in age 3?39 years. The method involved recording patients one month before and one month after tonsillectomy with a digital sound recorder, with recordings analyzed in the Praat program. The variables monitored in the basic voice were as follows: voice pitch, standard deviation of voice, degree of voice interruption, jitter, shimmer, and signal-to-noise ratio. In the statistical analysis, in addition to standard descriptive analyzes, t-test and ACNOVA were also used. Results. The results showed that the...

Journal of Investigational Allergology and Clinical Immunology, 2020

Background: Since the initial anecdotal reports of coronavirus disease 2019 (COVID-19) from China... more Background: Since the initial anecdotal reports of coronavirus disease 2019 (COVID-19) from China, a growing number of studies have reported on smell and/or taste dysfunction (STD). Objective: The aim of our study was to investigate the frequency and severity of STD in COVID-19 patients and to evaluate the association with demographic characteristics, hospital admission, symptoms, comorbidities, and blood biomarkers. Methods: We performed a multicenter cross-sectional study on patients who were positive for SARS-CoV-2 (n=846) and controls (n=143) from 15 Spanish hospitals. Data on STD were collected prospectively using an in-person survey. The severity of STD was categorized using a visual analog scale. We analyzed time to onset, recovery rate, time to recovery, hospital admission, pneumonia, comorbidities, smoking, and symptoms. Results: STD was at least 2-fold more common in COVID-19-positive patients than in controls. COVID-19-positive hospitalized patients were older, with a lower frequency of STD, and recovered earlier than outpatients. Analysis stratified by severity of STD showed that more than half of COVID-19 patients presented severe loss of smell (53.7%) or taste (52.2%); both senses were impaired in >90%. In the multivariate analysis, older age (>60 years), being hospitalized, and increased C-reactive protein were associated with a better sense of smell and/or taste. COVID-19-positive patients reported improvement in smell (45.6%) and taste (46.1%) at the time of the survey; in 90.6% this was within 2 weeks of infection. Conclusion: STD is a common symptom in COVID-19 and presents mainly in young and nonhospitalized patients. More studies are needed to evaluate follow-up of chemosensory impairment.

International Journal of Otolaryngology and Head & Neck Surgery, 2014

Objectives: The aim of this paper is to establish a correct approach to the diagnosis of a primar... more Objectives: The aim of this paper is to establish a correct approach to the diagnosis of a primary malignant melanoma of the parotid gland. Methods: We present a case of a patient with a painless mass situated in the left parotid region after an initial cytological and radiological study suggesting a Warthin tumor whose treatment involved a total parotidectomy with a facial nerve reconstruction. Results: The histopathological result showed a malignant melanoma that after various studies and evaluations showed no other primary origin different from the parotid gland itself. Conclusions: Salivary gland melanomas are relatively rare entities that when being of a primary origin and localized in the parotid gland become even more uncommon. Upon a melanoma found in the parotid gland, the first suspicion should be a metastatic origin, being the most common sites the oral cavity and the skin from the head and neck region.

1 Malignant tumors of the parotid gland account scarcely for 5 % of all head and neck tumors. Mos... more 1 Malignant tumors of the parotid gland account scarcely for 5 % of all head and neck tumors. Most of these neoplasms have a high tendency for recurrence, local infiltration, perineural extension, and metastasis. Although uncommon, these malignant tumors require complex surgical treatment sometimes involving a total parotidectomy including a complete facial

Copyright © 2015 Rafael Ramı́rez-Camacho et al. This is an open access article distributed under ... more Copyright © 2015 Rafael Ramı́rez-Camacho et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Introduction. The presence of a serous cyst in the tympanic membrane implies the description of a new or unpublished entity based on our knowledge whose origin may be very unlikely explained on actual embryologic and anatomic background. Clinical Case. We present a case of a 45-year-old woman with progressing right hearing loss. Physical examination revealed a whitish, round-shaped malformation in the posterior-inferior quadrant of the right tympanic membrane. The cyst was removed with a transcanal tympanoplasty. Discussion. A thorough PubMed search that involved the terms tympanic membrane gland, epithelial inclusion

Revista Espanola De Medicina Nuclear, 2018

Introduction To evaluate the utility of positron emission tomography-computed tomography (PET/CT)... more Introduction To evaluate the utility of positron emission tomography-computed tomography (PET/CT) as an imaging tool for the characterization of immune-mediated inner ear disease (IMIED), providing measurements of the inner ear region activity as well as detecting possible involvement of other organs. Material and methods The study included 28 patients with IMIED and 4 sex-matched and age-matched control subjects with no history of ear disease. Eighteen patients were considered to be suffering from primary IMIED and 10 patients from secondary. PET/CT scans with 18F-FDG were performed to assess systemic involvement as well as inner ear region activity. Interpretation of PET/CT scans was performed independently by two nuclear medicine physicians blinded to clinical history. In order to assess inter-rater agreement before performing the analysis of the inner ear, different Bland & Altman plots and the intraclass correlation coefficients were estimated. Results Different metabolically a...

Acquired nasopharingeal stenosis (NSP) is a rare cause, but to be considered, of nasal breathing ... more Acquired nasopharingeal stenosis (NSP) is a rare cause, but to be considered, of nasal breathing insufficiency. Its diagnosis is made initially by nasofibroendoscopy with consequent radiological confirmation. The most common cause is iatrogenia, followed by inflammatory diseases. In extremely rare cases the cause is uncertain. The main treatment involves surgery followed by classical postoperative stenting during a variable time. We present a case of an adult patient with stenotic choanas without an apparent cause who underwent an endoscopic surgical procedure with microdebrider and bilateral nasal packing with Merocel® for seven days. After five years of follow-up, the functional results are good. In addition, we perform a review of possible surgical techniques which we can be used in this type of pathology, and their postoperative care according to different authors.

Early detection and appropriate treatment of hearing loss are essential to min-imise the conseque... more Early detection and appropriate treatment of hearing loss are essential to min-imise the consequences of hearing loss. In addition to conventional audiometry (125---8000 Hz), extended high-frequency audiometry (9000---20 000 Hz) is available. This type of audiometry may be useful in early diagnosis of hearing loss in certain conditions, such as the ototoxic effect of cisplatin-based treatment, noise exposure or oral misunderstanding, especially in noisy environments. Eleven examples are shown in which extended high-frequency audiometry has been useful in early detection of hearing loss, despite the subject having a normal conventional audiometry. The goal of the present paper was to highlight the importance of the extended high-frequency audiometry examination for it to become a standard tool in routine audiological examinations.

European Archives of Oto-Rhino-Laryngology

Objective COVID-19 patients may present mild symptoms. The identification of paucisymptomatic pat... more Objective COVID-19 patients may present mild symptoms. The identification of paucisymptomatic patients is paramount in order to interrupt the transmission chain of the virus. Olfactory loss could be one of those early symptoms which might help in the diagnosis of COVID-19 patients. In this study, we aim to develop and validate a fast, inexpensive, reliable and easy-to-perform olfactory test for the screening of suspected COVID-19 patients. Study design Phase I was a case-control study and Phase II a transversal descriptive study. Subjects and methods Olfaction was assessed with the ethyl alcohol threshold test and symptoms with visual analogue scales. The study was designed in two phases: In Phase I, we compared confirmed COVID-19 patients and healthy controls. In Phase II, patients with suspected COVID-19 infection referred for testing were studied. Results 275 participants were included in Phase I, 135 in Phase II. The ROC curve showed an AUC of 0.749 in Phase I, 0.737 in Phase II. The cutoff value which offered the highest amount of correctly classified patients was ≥ 2 (10% alcohol) for all age intervals. The odds ratio was 8.19 in Phase I, 6.56 in Phase II with a 75% sensitivity. When cases report normal sense of smell (VAS < 4), it misdiagnoses 57.89% of patients detected by the alcohol threshold test. Conclusion The olfactory loss assessed with the alcohol threshold test has shown high sensitivity and odds ratio in both patients with confirmed COVID-19 illness and participants with suspected SARS-CoV-2 infection.

European Archives of Oto-Rhino-Laryngology

Background Since the outbreak in China due to coronavirus disease 2019 (COVID-19) various studies... more Background Since the outbreak in China due to coronavirus disease 2019 (COVID-19) various studies have been published describing olfactory and gustatory dysfunction (OGD). Objective The aim was to investigate the frequency and severity of OGD in SARS-CoV-2 (+) outpatients compared to controls with common cold/flu like symptoms and two negative RT-PCR. Methods A multicenter cross-sectional study on SARS-CoV-2-positive outpatients (n = 197) and controls (n = 107) from five Spanish Hospitals. Severity of OGD was categorized by visual analogue scale (VAS). Frequency and severity of the chemosensory impairment were analyzed. Results The frequencies of smell (70.1%) and taste loss (65%) were significantly higher among COVID-19 subjects than in the controls (20.6% and 19.6%, respectively). Simultaneous OGD was more frequent in the COVID-19 group (61.9% vs 10.3%) and they scored higher in VAS for severity of OGD than controls. In the COVID-19 group, OGD was predominant in young subjects 46.5 ± 14.5 and females (63.5%). Subjects with severe loss of smell were younger (42.7 years old vs 45.5 years old), and recovered later (median = 7, IQR = 5.5 vs median = 4, IQR = 3) than those with mild loss of smell. Subjects with severe loss of taste, recovered later in days (median = 7, IQR = 6 vs median = 2, IQR = 2), compared to those with mild loss. Conclusion OGD is a prevalent symptom in COVID-19 subjects with significant differences compared to controls. It was predominant in young and females subjects. Stratified analysis by the severity of OGD showed that more than 60% of COVID-19 subjects presented a severe OGD who took a longer time to recover compared to those with mild symptoms.

European Archives of Oto-Rhino-Laryngology

Purpose Severe acute respiratory syndrome caused by COVID-19 has spread globally for the last few... more Purpose Severe acute respiratory syndrome caused by COVID-19 has spread globally for the last few months. Healthcare workers (HCW) are overexposed and infection rates are higher than in the rest of the population. Strict clinical assessment is paramount to detect suspicious cases. In this context, olfactory or taste dysfunction (OTD) appears as an early and frequent symptom. Evaluating its presence in early stages plays an important role nowadays. Methods We performed a descriptive observational single-center study among 256 HCW at Hospital Universitario de Fuenlabrada affected by COVID-19 and confirmed using RT-PCR. A telephonic interview was performed, after obtaining oral informed consent. Results OTD was present in up to 70% of the cases as an early symptom, including mild-to-severe cases. The extent of these sensory deficits lasted an average of 11 days. In 26% of the patients, these sensory alterations persisted for over a month. Conclusion OTD is reported as an early symptom among HCW with SARS-CoV-2 infection. Its strong association with test positivity is useful in the management of the infection and should be enough to indicate preventive isolation. We consider that OTD needs to be included in clinical screening questionnaires in HCW.

SSRN Electronic Journal

calcium phosphate product in the serum, leading to soft tissue calcification. Radiologic imaging ... more calcium phosphate product in the serum, leading to soft tissue calcification. Radiologic imaging help confirm this condition. Adequate control of serum calcium-phosphate levels will diminish the risk of formation or recurrent deposits in these patients.

Acta Oto-Laryngologica Case Reports, 2016

Acta Oto-Laryngologica, 2016

Scientifica, 2016

Objective. The aim of this study is to analyze the high-frequency hearing levels in patients with... more Objective. The aim of this study is to analyze the high-frequency hearing levels in patients with rheumatoid arthritis and to determine the relationship between hearing loss, disease duration, and immunological parameters.Materials and Methods.A descriptive cross-sectional study including fifty-three patients with rheumatoid arthritis was performed. The control group consisted of 71 age- and sex-matched patients from the study population (consecutively recruited in Madrid “Area 9,” from January 2010 to February 2011). Both a pure tone audiometry and an extended-high-frequency audiometry were performed.Results. Extended-high-frequency audiometry diagnosed sensorineural hearing loss in 69.8% of the patients which exceeded the results obtained with pure tone audiometry (43% of the patients). This study found significant correlations in patients with sensorineural hearing loss related to age, sex, and serum anti-cardiolipin (aCL) antibody levels.Conclusion.Sensorineural hearing loss mus...

Iranian journal of otorhinolaryngology, 2015

Malignant tumors of the parotid gland account scarcely for 5% of all head and neck tumors. Most o... more Malignant tumors of the parotid gland account scarcely for 5% of all head and neck tumors. Most of these neoplasms have a high tendency for recurrence, local infiltration, perineural extension, and metastasis. Although uncommon, these malignant tumors require complex surgical treatment sometimes involving a total parotidectomy including a complete facial nerve resection. Severe functional and aesthetic facial defects are the result of a complete sacrifice or injury to isolated branches becoming an uncomfortable distress for patients and a major challenge for reconstructive surgeons. A case of a 54-year-old, systemically healthy male patient with a 4 month complaint of pain and swelling on the right side of the face is presented. The patient reported a rapid increase in the size of the lesion over the past 2 months. Imaging tests and histopathological analysis reported an adenoid cystic carcinoma. A complete parotidectomy was carried out with an intraoperative notice of facial nerve ...