Acta otorrinolaringológica española
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Cough lasting more than 8 weeks is considered chronic. If the classic causes of chronic cough have been discarded, vagus nerve sensory disturbances are currently considered the most important etiological cause. Patients with chronic cough of laryngeal origin have associated symptoms such as globus, dysphagia, dysphonia, dyspnoea and/or stridor. ⋯ The cough associated with reflux has 2 mechanisms: Exposure to acid in the distal oesophagus (gastroesophageal reflux) and microaspiration of oesophageal contents into the larynx and tracheo-bronchial tree (pharyngo-laryngeal reflux). Laryngeal neuropathy hypersensitivity responds well to speech therapy as a treatment for refractory chronic cough. Because chronic cough is a sign of laryngeal sensory, neuropathy can improve with neuroleptic drugs such as amitriptyline and gabapentin.
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Acta Otorrinolaringol Esp · Jul 2011
Review Case Reports[Merkel cell carcinoma: a presentation of 5 cases and a review of the literature].
Merkel cell carcinoma is an unusual, aggressive skin tumour, with a tendency to recurrence after its surgical extirpation. Five cases of tumours in the cervicofacial region seen at our Centre in the last five years are presented, along with a review of the literature, focusing on its etiopathogeneis, approach and treatment.
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Myasthenia gravis is an illness of insidious onset whose first manifestation often is dysphagia. We report the case of a 25 year-old woman who consulted for nosebleed. On her first visit she referred progressive dysphagia, but the results of endoscopic digestive examination and indirect laryngoscopy were normal. ⋯ Myasthenia gravis was diagnosed by means of electromyography and determinations of antibodies against acetylcholine receptors. We reviewed the literature on the clinical manifestations, diagnostic procedures, and treatment of this condition. This case highlights the importance of suspecting myasthenia gravis in young women with dysphagia and a family or personal history of autoimmune disease in order to reach an early diagnosis and treatment.
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Acta Otorrinolaringol Esp · Jan 1998
Review Case Reports[Dysphagia in Forestier's disease (vertebral ankylosing hyperostosis)].
Forestier's disease is characterized by the formation of vertebral bridges which joint the ventral aspect of the vertebral bodies by ossification of the anterior vertebral longitudinal ligament. A 58-year-old man with idiopathic ankylotic hyperostosis had pronounced osteophytosis of the neck that produced the unusual symptom of dysphagia. The literature is reviewed and the pathogenic criteria, diagnosis, and therapy are discussed.
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Acta Otorrinolaringol Esp · Jul 1992
Review Case Reports[Pneumocephalus as a complication of mastoid surgery].
Non-traumatic otologic diseases are a rare cause of pneumocephalus. Among them, few reports have been described whereas it occurred following oto-surgery. ⋯ The definite diagnosis was done by CT scan imaging. We realize a review of the literature about this subject, we describe the clinical and diagnostic features, its possible physiopathology, and its surgical management.