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In order to evaluate possible trend changes in the epidemiological factors of adenotonsillar surgery, a total of 1,958 operations performed between 1992 and 2002 were reviewed.One third of the operations were to remove tonsils in comparison with the two thirds that were to remove adenoids. Three procedures were used: 59% adenoidectomies, 28% adenotonsillectomies and 13% tonsillectomies. During the study period, the percentage of adenotonsillectomies decreased, whereas the number of adenoidectomies increased. In general, this kind of surgery is mainly performed on males.Although we have not discovered variations regarding gender and average age for the operations, adenotonsillar surgery has increased over recent years and the percentage ratio of the various procedures has altered as a result of new indications.

The osteomas of the mastoids are slow growing benign tumors, made predominantly of mature bone. Clinically these tumors are asymptomatic, except for cosmetic deformities, and they are usually casual radiological findings. Surgical treatment is indicated for symptomatic osteomas. In Spain only sixteen cases of extracanalicular osteoma have been described in the literature. Two new cases are reported and a review of the literature is presented.

In a previous report, we showed the efficacy of the submucous sclerosant therapy with Etoxiesclerol (Polidocanol) in two patients with Rendu-Osler-Weber disease. We confirm, in this present study, the advantages of Etoxiesclerol in the treatment of the epistaxis in the Rendu-Osler disease, in six patients, 3 males and 3 females and likewise in two patients with non-specific granuloma of nasal septum and another patient with cavernous hemangioma of soft palate.

Leiomyoma is a benign tumor of smooth muscle origin that is rarely found in oral cavity. We report a case of leiomyoblastoma of the tongue. The interest of this lesion is supported by its location and by the difficulty to determine its biological behavior. About 25% of the oral smooth muscle tumors are malignant, and have been reported "leiomyoma" locally invasive.

The unilateral abscess of the anterior portion of the tongue is an extremely rare occurrence. We report a case in which we have used the ultrasonography in the diagnosis, and discuss, as etiologic hypothesis the participation of Blandin-Nühn glands in the genesis of these abscess.

Cementifying fibroma is a benign fibro-osseous lesion with dental origin. We describe a case of cementifying fibroma of the maxillary sinus, an unusual location for this tumor.

The adenoid cystic carcinoma represents less than 1% of all the malignant tumours located in the larynx. Only about 80 cases have been described so far in world literature. In contrast with the epidermoid carcinoma of the larynx, the adenoid cystic carcinoma is not apparently related to common risk factors such as smoking. However the prognosis is much worse, with survival rates of less than 20% after 15-20 years. Treatment is surgical, although radiotherapy may be of help. In this paper a new case of adenoid cystic carcinoma located in the supraglottis of a 26-years-old woman is reported and the world literature is reviewed.

Two cases of pleomorphic adenoma of the parotid deep lobe are presented. Both of them were removed through back-submandibular approach. We favor this procedure as the best for tumors of the parapharyngeal space, whereas the mandibulotomies are indicated when dealing with strong adhesions, reoperations or malignancies.

Various tonsillar diseases caused by Actinomyces are described, including acute and chronic tonsillitis and neoplasm-like forms. These forms are illustrated by a clinical case because of the importance of considering this cause in the differential diagnosis.

After a study of a family with 9 members who had one or more episodes of idiopathic facial palsy at some point in life, we reviewed the literature for the role of heredity as an etiopathogenetic factor in peripheral facial palsy. Differential criteria for the most controversial aspects were considered, such as incidence and the type or mechanism of transmission which conditions the appearance of peripheral facial palsy in patients with possible genetic factors.

Cholesterol granuloma is a histological term used to describe a non-specific inflammatory reaction produced by the presence of cholesterol crystals, which may originate a foreign-body reaction. Cholesterol granuloma of the temporal bone is silent for years and not preceded by a history of otitis media. The diagnosis is made by CT and MRI, which reveal an expansive, isodense lesion brain tissue and increased signal intensity on both T1 and T2-weighted images respectively. A case of cholesterol granuloma of the petrous apex is presented. The granuloma was excised completely using an infra-retrolabyrinthine approach.

A descriptive study was made of medical and surgical activity over a six-month period in an outpatient ENT clinic of Valladolid, Spain, serving a health district of 142,779 persons. Age, sex, type of consultation, symptoms, complementary studies, diagnosis, check-up, and surgical treatment were analyzed and correlated in 1170 patients.

Cervical emphysema may have its origin in multiple causes. The continuity of the fascial planes connecting the soft tissues of the neck to the mediatinum and retroperitoneum enables the "aberrant air" localized in one of these three areas to spread to the other ones. The otolaryngologist must know the differential diagnosis of the presence of air in the neck, since the ultimate treatment to be given will depend on the etiology involved. We present two clinical cases of cervical emphysema secondary to spontaneous pneumomediastinum. One of the cases is idiopathic while the other one is associated with diabetic ketoacidosis. We analyze this and other causes that can give rise to cervical emphysema.

Objective tinnitus usually has a vascular origin, but dural arteriovenous fistulas are rarely the cause of this sign. We report a case of arteriovenous meningeal fistula (AVMF) of the lateral sinus, origin of pulsatile objective tinnitus. Etiology, pathophysiology, symptoms, diagnosis, differential diagnosis and treatment of these fistulas are reviewed.

170 external otitis have been diagnosed and treated for one year (1989) in our ENT department. The etiology of the otitis was both bacterial and mycotic. The purpose of this paper is to study the clinical, therapeutic, epidemiologic and microbiologic aspects of this type of otitis.

The form of the anterior mandible in 45 patients was assessed before, immediately after, and 1 year after genioplasty. A specific, consistent pattern of bone apposition and resorption was observed after advancement genioplasty. A consistent but inverse apposition-resorption pattern was observed after reduction genioplasty. In view of the observed pattern of bony change, it is recommended that fixation devices for genioplasty be placed in areas of future bone deposition.

Osteoma of the mastoid is a osseous, benign and infrequent tumour. To date approximately 50 such cases in the world, and 7 cases in Spain have been described. Clinically this tumours are asymptomatic, except by cosmetic deformities, and are usually unsuspected roentgenographic findings. Treatment is surgical through a postauricular approach. A case of osteoma of the mastoid and a review of the literature is presented.

The syndrome of crocodile tears, or Bogorad's syndrome is a rare complication of the facial paralysis. It's characterized by lachrymation on the same side of the palsy in connection with stimulation of salivation (e.g. when eating). We present a case of Melkersson's syndrome who developed a syndrome of crocodile tears.

The purpose of this paper is to study the incidence of external ear pathology in our ENT Service in the period between November 1987 and November 1988. During this period 238 cases of this pathology were diagnosed.

We present two cases of granular myringitis. A clinical study, diagnosis and therapy of this rare condition are undertaken.