Nuestros investigadores

Juan Manuel Alcalde Navarrete

Publicaciones científicas más recientes (desde 2010)

Autores: Baptista, Peter Michael, (Autor de correspondencia); Álvarez, Laura; et al.
ISSN 0001-6519  Vol. 69  Nº 1  2018  págs. 42 - 47
The objective of this communication is to describe our preliminary results in upper airway stimulation surgery via hypoglossal nerve stimulation implantation for obstructive sleep apnoea. We describe 4 cases and the outcomes of the surgery were analysed using the Epworth scale, apnoea-hypopnoea index, minimal 02 Sat, average 02 Sat and snoring intensity. In all cases a significant reduction in Epworth scale values and apnoea-hypopnoea index were obtained (P<.05). The minimum and average oxygen saturation had better values after the surgery, however, there was no statistically significant difference. The snoring severity measured subjectively changed from "intense" to "absent", in all cases. The preliminary results obtained with the upper airway stimulation surgery via hypoglossal nerve stimulation showed objective and subjective improvement after the implant activation. (C) 2017 Elsevier Espana, S.L.U. and Sociedad Espanola de Otorrinolaringologia y Cirugia de Cabeza y Cuello. All rights reserved.
Autores: Alcalde, Juan Manuel; Cambeiro, Felix Mauricio; et al.
ISSN 0167-8140  Vol. 122  Nº 2  2017  págs. 255 - 259
Surgical resection and PHDRB is a successful treatment strategy in selected patients with previously irradiated head and neck cancer. Long-term locoregional control can be achieved in a substantial number of cases despite a high rate of inadequate surgical resections although at the expense of substantial toxicity.
Autores: de Torres, Juan Pablo; Bastarrika, Gorka; et al.
ISSN 0903-1936  Vol. 49  Nº 1  2017  págs. 1601521
Autores: Garriz, Maite; Irimia, Pablo; Alcalde, Juan Manuel; et al.
ISSN 0174-304X  Vol. 48  Nº 1  2016  págs. 53-56
There are only four previous pediatric reports of the glossopharyngeal neuralgic form of the stylohyoid complex syndrome. Stylohyoid complex has merely been described as cases of glossopharyngeal neuralgia in children. Case Report¿A 12-year-old boy came to our hospital because of recurrent episodes of severe cranial pain (9/10) lasting for 5 to 15 minutes. Pain affected the right tonsillar fossa, ear, and mastoid region. Since the start at the age of 9 years, the frequency of painful episodes has progressively increased: when admitted to our clinics 3 years later, the child was having up to five episodes daily in spite of analgesic, antiepileptic, and antidepressant drugs; he had abandoned school and leisure. Between episodes, neurological examination detected only discomfort to pressure on the right tonsillar fossa. Three-dimensional computed tomography images of the skull base showed an elongated right styloid process and bilateral calcification of the stylohyoid ligament. After surgical excision of the right styloid process and of part of the stylohyoid ligament, the glossopharyngeal painful episodes ceased. The patient remains asymptomatic seven years later. Conclusion¿In spite of its rarity in childhood, this debilitating but treatable syndrome should be kept in mind for the differential diagnosis of recurrent cranial pain in the pediatric population.
Autores: Fernández, Secundino; Alcalde, Juan Manuel; Baptista, Peter Michael; et al.
ISSN 0194-5998  Vol. 151  Nº 1 Suppl  2014  págs. P185-186
Autores: Cambeiro, Felix Mauricio; et al.
ISSN 1043-3074  Vol. 34  Nº 8  2012  págs. 1081-1088
Background This study aimed to test the safety of using perioperative high-dose-rate brachytherapy (PHDRB) in resected head and neck cancer. Methods From 2000 to 2008, 97 patients received PHDRB after complete macroscopic resection. Group 1 (previously irradiated patients) received 32 to 40 Gray (Gy) of PHDRB in 8 to 10 twice-daily (bid) treatments (R0R1 resections). Group 2 (unirradiated patients) received 16 to 24 Gy of PHDRB in 4 to 6 bid treatments (R0R1 resections) followed by external beam irradiation (EBRT) of 45 Gy/25 daily fractions +/- concomitant chemotherapy. Results The median follow-up was 4.3 years. The cumulative hazard of 2-year grade = 3 complications in group 1 was 45.9%, and the rate of grade = 3 complications in group 2 was 24.6%. Actuarial locoregional control at 2 and 5 years for group 1 was 60.9% and for group 2, 84.1% and 79.4%. Conclusions Complications and locoregional failure rates were similar to those reported in the reference standards despite a much smaller treatment volume. (c) 2012 Wiley Periodicals, Inc. Head Neck, 2012
Autores: Martínez-Monge, Rafael; Cambeiro, Felix Mauricio; Moreno, Marta; et al.
ISSN 0360-3016  Vol. 79  Nº 4  2011  págs. 1158 - 1163
Purpose To determine patient, tumor, and treatment factors predictive of local control (LC) in a series of patients treated with either perioperative high-dose-rate brachytherapy (PHDRB) alone (Group 1) or with PHDRB combined with external-beam radiotherapy (EBRT) (Group 2). Patient and Methods Patients (n = 312) enrolled in several PHDRB prospective Phase I¿II studies conducted at the Clínica Universidad de Navarra were analyzed. Treatment with PHDRB alone, mainly because of prior irradiation, was used in 126 patients to total doses of 32 Gy/8 b.i.d. or 40 Gy/10 b.i.d. treatments after R0 or R1 resections. Treatment with PHDRB plus EBRT was used in 186 patients to total doses of 16 Gy/4 b.i.d. or 24 Gy/6 b.i.d. treatments after R0 or R1 resections along with 45 Gy of EBRT with or without concomitant chemotherapy. Results No dose-margin interaction was observed in Group 1 patients. In Group 2 patients there was a significant interaction between margin status and 2-Gy equivalent (Eq2Gy) dose (p = 0.002): (1) patients with negative margins had 9-year LC of 95.7% at Eq2Gy = 62.9Gy; (2) patients with close margins of >1 mm had 9-year LC of 92.4% at Eq2Gy = 72.2Gy, and (3) patients with positive/close <1-mm margins had 9-year LC of 68.0% at Eq2Gy = 72.2Gy. Conclusions Two-gray equivalent doses ¿70 Gy may compensate the effect of close margins ¿1 mm but do not counterbalance the detrimental effect of unfavorable (positive/close <1 mm) resection margins. No dose¿margin interaction is observed in patients treated at lower Eq2Gy doses ¿50 Gy with PHDRB alone.
Autores: Rodríguez Fraile, Macarena; Alcalde, Juan Manuel; et al.
ISSN 0212-6982  Vol. 30  Nº 5  2011  págs. 325-326