viernes, 30 de agosto de 2013

Acúfenos, Efectos colaterales de un fármaco antimalaria: Mefloquine

FDA Slaps ‘Black Box’ Warning on Malaria Drug Linked to Killings

Jul 30, 2013 1:07pm
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The FDA has strengthened the warning on the malaria drug, mefloquine hydrochloride. 
(Image credit:
A common malaria drug that has been linked to the case of Staff Sgt. Robert Bales, who has pleaded guilty to killing 16 Afghan civilians last year, will carry a “black box” warning, the Food and Drug Administration said Monday.

The FDA says the drug, mefloquine hydrochloride, which was once marketed in the United States as Lariam, could cause serious neurological and psychiatric side effects that might become permanent.

Such a warning on the revised patient Medication Guide dispensed with each prescription and wallet card is the most serious kind of warning about these potential problems, the FDA says.

Bales, who is facing a possible life sentence by a military court for the rampage in Afghanistan, might have used the antimalarial drug given routinely to soldiers in that part of the world.

His lawyer, John Henry Browne, has said that he has documents indicating that Bales took mefloquine while in Iraq, but medical records in Afghanistan were incomplete.

Mefloquine was developed by the U.S. military and has been used for more than three decades by the government to prevent and to treat malaria among soldiers and Peace Corps workers.

Its temporary side effects are well-known: vivid dreams or hallucinations, ringing in the ears, depression and hallucinations.

But the FDA now says symptoms like dizziness and loss of balance could become permanent. Psychiatric symptoms could continue for months or years.

The drug can cause varying neurological side effects 5 to 10 percent of the time, according to Dr. David Sullivan, an infectious disease specialist at the  Johns Hopkins Malaria Research Institute in Baltimore.

The manufacturer also warns against prescribing it to anyone who has suffered a seizure or brain injury, according to the drug label.

An adverse-event report from the FDA recently emerged from March of 2012, written by an unidentified pharmacist, that cites a soldier-patient in the U.S. Army who “developed homicidal behavior and led to homicide killing 17 Afghanis.”

Bales is not named in that anonymous report, which, if it refers to the same man, erroneously lists 17 dead, rather than 16.
A study of FDA adverse-event reports from 2004 to 2009 published in the journal PLOS One lists mefloquine as a drug that has been associated with violent behavior.

Mefloquine was first developed in the 1970s at the U.S. Department of Defense’s Walter Reed Army Institute of Research as a synthetic analogue of quinine, the first effective treatment for malaria. It was licensed in 1989 by the FDA for use against chloroquine-resistant malaria.

The brand-name drug, Lariam, is manufactured by the Swiss company <a href=”” target=”external”>Hoffmann-La Roche.</a>

The company has not manufactured the drug in the United States since 1998 when generic forms of  mefloquine became available. But, according to Sullivan, Lariam is still available and “lingers on the market.”

Company senior spokesman Chris Vancheri told earlier this month that generic mefloquine “distributed by other companies continues to be approved by the FDA as safe and effective medicines.”

Infectious disease expert Sullivan said mefloquine is largely safe and that he, too, takes a weekly dose of it when traveling and has “never had any side effects.”

Sullivan said the military widely uses antimalarial drugs in Afghanistan, but mefloquine is not the first choice.
The military has several drugs in its arsenal for prophylactic (preventive) treatment of malaria, a mosquito-borne disease that causes fever, chills and flu-like illness that, if left untreated, can cause death.

An estimated 219 million cases of malaria occurred worldwide and 660,000 people died in 2010, most in Africa, according to the U.S. Centers for Disease Control and Prevention.

Acúfenos en las artes, música, Juicio por hipoacusia y acufenos a Justin Bieber

Justin Bieber Sued for $9M By Deafened Mom

By Suzan Clarke
Jul 13, 2012 10:02am
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Victor Chavez/WireImage/Getty Images

Stacey Wilson Betts is no Belieber. In fact, she claims she had such a bad experience at a Justin Bieber concert that she’s suing the teen heartthrob for $9.2 million.
In the suit filed in U.S. District Court in Oregon on Tuesday, Betts, of Wilsonville, Ore., claims she suffered severe hearing damage at a Bieber concert two years ago when sounds there exceeded safe decibel levels.

According to the suit – which was posted on TMZ – Betts said she took her daughter to a July 14, 2010 show at the Rose Quarter in Portland, Ore.
The courts papers claim the injury occurred when Bieber climbed into a heart-shaped gondola that pulled him over the crowd.

The complaint states: “Mr. Bieber created a wave like effect of screaming by pointing into various sections of the arena. Then enticed the crowd into a frenzy of screams by continuously waving his arms in a quick and upward motion, whereas I was struck with a sound blast.”

Betts, who is representing herself in the case, claims she suffered severe hearing loss, tinnitus and hyperacusis – which is abnormally acute hearing — in both ears.

The suit names Bieber, along with his record company, Island Def Jam Records;  the concert promoter, AEG Worldwide; and the venue owner, Vulcan Sports Entertainment.

Bieber and the co-defendants were “negligent” in failing to provide safe decibel levels, Betts’ complaint says.
“Due to their negligance (sic) and my subsequent inability to protect myself, my quality of life has been permanently reduced in addition to the injury,” the court papers also claim.

Bieber’s reps didn’t respond to a request for comment.


Acúfenos en las artes, música, "The Ramones Play Aberdeen, WA (Nirvana’s hometown)"

Fuente de la imagen

The Ramones Play Aberdeen, WA (Nirvana’s hometown)

On March 5, 1977, the Ramones played the Rocker Tavern in Aberdeen, Washington.  The bar, like Aberdeen itself, was populated by hard working and hard drinking loggers.

Stephen Rabow, then a student at Olympia’s Evergreen State College, attended along with several friends.
A cover band opened, playing the popular songs of the day.  

Bands playing Rocker’s had a very specific between-song procedure: they were expected to stop for a minute or two after each number.  

During this time, couples would leave the dance floor to refresh their drinks and/or look for a different partner.  This ritual was repeated after each song.

The cover band finished its set and the Ramones began setting up their equipment.  Rabow and his friends braced themselves.  “Just the hiss of the amplifiers…[we are] like looking at each other in fear,” Rabow remembers.

The Ramones took the stage, leather-clad punk rockers fresh from New York City.  

Joey announced, “Wuh the Ramones!  Glad yah heeah!” in his thick Queens accent.  

Then the band did their standard ‘one-two-three-four’ and launched into a two-minute blast of deafening noise.  

As was the Ramones’ style, they finished up the first song and Dee Dee immediately counted off ‘one-two-three-four’ and the band lurched into the next tune.  

The Ramones continued at their frenetic pace, not allowing patrons off the dance floor.

For the audience, the scene became surreal.  “They’re stuck,” says Rabow.  “These people are stuck on the dance floor.  
They don’t know what’s going on. 

It’s louder than hell.  It was like an alien invasion.  They didn’t know what had happened to them.”

The entire show made it onto a 1979 bootleg recording called At Your Birthday Party.
Neil Hubbard says:
The first time I saw the Ramones was the night before they played in Aberdeen, Washington. It was Friday March 4, 1977. My friend Robert Bennett and I, with about one week’s notice, had contacted their booking agent and gotten them to let us book an all ages show in Seattle, instead of having them play at a tavern where none of their under 21 fans could’ve seen them.
So we went to a place in Bremerton called Natasha’s on that Friday night, to get a preview. I’ve never been to such a weird place. Bremerton is a Navy town across Puget Sound from Seattle. This place was a hang out for the Navy guys. We arrived long before the show started and helped the band load their gear in for sound check. Pop Rocks were a new thing then, and the guys in the band were fascinated by them.
The doors to the venue opened and the Navy guys started coming in. Somehow it was legal for them not only to bring their own beer, but it was also legal for them to bring girlfriends who were under 21. So in they came, a half rack of beer in one arm and a 16 year old girl on the other. Definitely weird.
I wish I could remember the name of the opening act, but they did Kansas covers. A perfectly matched billing, if you ask me. Once the Ramones took the stage me and my small gaggle of friends were the only people left on the dance floor. The others had retreated to the far dark corners of the club. But there was no escape from the immense intensity of sound those four boys from Queens put out. Like a New York subway train lurching between stations, they did their standard 2 minute blast, stopped, 1,2,3,4, two minutes more of blistering, blissful noise, on a repeat cycle for maybe 30 minutes. They only had one album of material at that point, so it was a rather short show.
The most memorable moment, the effects of which remain with me today, was between songs. I was walking in front of the stage left speaker stack, when an enormous burst of feedback from Johnny’s guitar ripped out from the speakers and into my left ear. I wasn’t wearing any hearing protection. As the sound entered my ear, I felt a “twang” and my left eye suddenly began watering uncontrollably. My hearing had been permanently damaged. Ever since that moment I’ve had tinnitus–ringing in my left ear. I hear it right now as I type. At some point after that I started wearing earplugs, and as a professional bagpiper I’ve worn custom fitted musicians plugs since Bill Rieflin turned me on to them in about 1992.
But the damage was done that night at Natasha’s–to my hearing and to my musical sensibilities. 

The Ramones have remained one of my favorite bands ever since. We didn’t make the trek to Aberdeen the next night, but two nights later on Sunday March 6, 1977, we promoted the Ramones and Meyce show in the Georgian Ballroom of Seattle’s Olympic Hotel, today the Fairmont Olympic. 500 leather-clad punks invaded Seattle’s fanciest hotel in what is probably the oddest punk venue booking in Seattle history.
And today, I feel sad that three of those four original Ramones are no longer with us, and we have only the memories of their great shows, and their records, to remind us what an incredible band they were.

Fuente:  Posted: August 30, 2011 in Offbeat Seattle-Related Music Stories

sábado, 24 de agosto de 2013

Estrogen and hearing: a summary of recent investigations.


Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden.


Is the female sex steroid estrogen the key to preserved hearing in the aging human?
This question remains unanswered, but hearing loss is more profound in elderly males than females.

 There are also well-known sex differences in the auditory brainstem response (ABR), i.e. women have shorter latencies than men.

Moreover, menopausal women who are administered hormone replacement therapy have slightly better hearing than those who are not, and women with Turner's syndrome (45,X), who are biologically estrogen-deficient, show longer ABR latencies and early presbyacusis.

These findings are also supported by animal experiments.

When boosted with estrogen or testosterone the non-reproductive female midshipman fish alters its inner ear auditory mechanism so that it can hear the male's hum-like call.

If estrogen receptor beta is knocked out in mice, severe progressive hearing loss occurs, leading to early deafness. In apparent contradiction to these findings, there have been case reports suggesting that hormone replacement therapy and oral contraceptive use can lead to hearing loss, but of another type, namely acute sudden deafness.

Such contradictory aspects of the action of estrogen are commonly found and may spring from the fact that there are two estrogen receptors, alpha and beta, both of which are present in the inner ear of mice, rats and humans.

Knowing how sex steroids can alter hearing ability may give important clues as to how estrogen can preserve hearing in humans. In this review we present a summary of current knowledge about hearing and estrogen.

Fuente:  Acta Otolaryngol. 2006 Jan;126(1):10-4.

Estrogenic modulation of auditory processing: A vertebrate comparison

  • Neurobiology and Behavior Graduate Program, University of Washington, 1959 NE Pacific St., Seattle, WA 98195, USA
  • Virginia Merrill Bloedel Hearing Research Center, University of Washington, 1959 NE Pacific St., Seattle, WA 98195, USA


Estrogens influence mammalian auditory development.
Estrogens protect the mammalian auditory system from damage.
Estrogens enhance auditory function during breeding periods.
Brain-derived estrogens can enhance local response properties in the avian forebrain.


Sex-steroid hormones are well-known regulators of vocal motor behavior in several organisms. 

A large body of evidence now indicates that these same hormones modulate processing at multiple levels of the ascending auditory pathway. 

The goal of this review is to provide a comparative analysis of the role of estrogens in vertebrate auditory function. 

Four major conclusions can be drawn from the literature: 

First, estrogens may influence the development of the mammalian auditory system. 
Second, estrogenic signaling protects the mammalian auditory system from noise- and age-related damage. Third, estrogens optimize auditory processing during periods of reproductive readiness in multiple vertebrate lineages. 

Finally, brain-derived estrogens can act locally to enhance auditory response properties in at least one avian species. 

This comparative examination may lead to a better appreciation of the role of estrogens in the processing of natural vocalizations and mayprovide useful insights toward alleviating auditory dysfunctions emanating from hormonal imbalances.

Available online 31 July 2013

Complex level alterations of the 2f1–f2 distortion product due to hypoxia


  • a Department of Otorhinolaryngology, Head and Neck Surgery, University of Munich, Germany
  • b Department of Neurology, University of Munich, Germany
  • c Department of Medicine, Division of Pneumology, Medizinische Klinik Innenstadt, University of Munich, Germany
  • d Department of Neuroradiology, University of Munich, Germany
  • e Department of Anaesthesiology, University of Munich, Germany



For diagnostic purposes and a better understanding of the pathophysiology of inner ear hearing disorders it would be of great interest to have parameters available that indicate inner ear hypoxia. 

In animal studies typical hypoxia-related alterations of the 2f1f2 distortion product otoacoustic emissions (DPOAE) such as a reversible level decrease and destabilization could be demonstrated. 

The goal of this study was to investigate whether these hypoxia-associated alterations can also be observed in humans because this might help develop a new diagnostic tool for patients with inner ear disorders.


In 16 volunteers DPOAE levels were continuously measured at first under normal room air conditions, during and after 8.5 h of oxygen deprivation (13% O2) and during re-oxygenation. Saturation of oxygen of arterial blood (SaO2) was monitored.


The mean SaO2 during the hypoxic interval was 78%. 
A significant decrease in DPOAE level under hypoxia occurred in five different test persons at one or more frequencies (f2 = 1, 1.5, 2, 3, and 4 kHz). 
A destabilization of the DPOAE level with considerable fluctuations during hypoxia was observed in nine subjects at one or more frequencies. 

Furthermore, the so called ‘post hypoxia effect’ could be observed in five participants.


The observations made here have been described similarly in animal studies and seem to be characteristic of metabolic disorders of the cochlea caused by hypoxia. 

To our knowledge, this is the first study to examine DPOAE level alterations over time in humans under conditions of normobaric hypoxia. 

If DPOAE destabilization is observed in a clinical setting in patients with certain inner ear hearing disorders hypoxia can be suspected as one underlying pathophysiological cause which might influence treatment decisions.

Fuente: Auris Nasus Larynx, Available online 3 August 2013

Tone burst stimulus for auditory brainstem responses: Prediction of hearing threshold at 1 kHz


  • ENT Division, University of Turin, Italy



To assess differences in hearing threshold estimation of four different ABR tone-bursts at 1 kHz.


Twenty-one (21) ears from 11 subjects were tested with pure-tone audiometry (PTA): 
5 ears (24%) were normal hearing, 
5 (24%) affected by mild hearing loss, 
7 (33%) showed moderate hearing loss and 
4 (19%) severe hearing loss. 

After PTA each subject underwent tone-burst ABR test at 1 kHz using 
  • a linear gated (L_ABR) 
  • or Blackman windowed (B_ABR) stimuli with (nn_ABR) and without ipsilateral notched noise. 
Stimulation rate and filters settings were unchanged.


Overall correlation between PTA and all ABRs thresholds was high, ranging from 0.84 to 0.94.

In normal hearing ears none of the differences was significant, except for those measured with B_nn_ABR, which showed a mean 16 dB overestimation of the pure-tone threshold (p < 0.05). 

In mild hearing loss group none of the differences between thresholds were significant. 

In moderate and severe hearing loss groups significant differences were measured with L_nn_ABR (p < 0.05) with a mean 7.5 dB underestimation of PTA.


Although very similar, some significant differences were found when considering specific group of patients with different degrees of hearing loss.

Acúfenos en las noticias: Ruido en Caracas, Venezuela.


Proponen medidas para controlar bullas callejeras


 Los niveles de ruido que se generan a diario en la ciudad tienen mucha incidencia en los problemas de salud que sufren los caraqueños: el estrés, la irritabilidad, la ansiedad, los trastornos de sueño, las afecciones cardiovasculares y problemas auditivos como el tinnitus, especie de silbido o sonido interno que una persona escucha persistentemente aunque no haya fuente sonora externa.

"Vivimos en una ciudad con niveles tóxicos de contaminación sónica y aun así ningún gobierno le ha prestado la atención que merece. 
De aquí a diez años va a haber graves problemas de audición porque ocurre como con el humo de los fumadores: el que genera el ruido se daña, pero inevitablemente el que está a su alrededor también sale afectado", señala Javier Bracho, médico foniatra y otorrino.

Orden. La falta de control de los ruidos molestos, además de afectar la salud, genera problemas de otra índole: "venta ilegal de alcohol, consumo de drogas, peleas, y si uno reclama, te ganas un enemigo porque sigues viviendo en el mismo sitio", expresa Margarita Yépez, vecina de Catia.

Yépez considera que a los bulleros "tiene que controlarlos el Gobierno porque lamentablemente no puedes dejar el respeto según la conciencia de cada quien. La gente no sabe convivir, así que las autoridades tienen que regular". 

Carros escandalosos. En el caso de los carros bulleros, la aplicación de las ordenanzas podría acompañarse de otras medidas legales, "los institutos de tránsito no deberían permitir que los carros circulen con cornetas o aparatos con una potencia mayor a 80 decibeles", dice el foniatra y agrega que el conductor de un vehículo con estas características sufre alteración de los sentidos, pérdida de atención e incluso podría tener taquicardia. 

Otra medida que apuntan los mismos organismos de seguridad es hacer mayor patrullaje en calles o áreas cercanas a instituciones universitarias. 

"Los muchachos se quedan en estos sitios consumiendo alcohol, oyendo música, pero esto suele traer problemas. En nuestro municipio, la mayoría de las llamadas que recibimos de carros con música en la vía pública son en las zonas de la Universidad Santa María, Los Cortijos y Montecristo (hay dos instituciones de educación superior)", especifica Pedro Ure, comisario de Polisucre. 

Ure aclara que por esta falta no hay orden de aprehensión, "a menos que haya alteración del orden público con peleas o algún tipo de delito, pero sí podemos decomisar los equipos, remolcar el carro y luego lo dejamos a la orden de la Fiscalía Municipal".
Fuente de la imagen:

Acúfenos en las noticias: "El lenguado Menier"

La comida de los sábados

Es la última vez que entran lenguados en mi casa y que yo entro en Internet para buscar una receta


Estaba buscando en Internet la receta del lenguado menier, cuando caí en un foro de afectados por el síndrome de ménière.

Pinché un caso y otro y otro y a las 12 del mediodía aún estaba leyendo historias increíbles de gente que escuchaba acúfenos y tinnitus, que así se llaman esos ruidos, y que sentían vértigos y náuseas desde la mañana hasta la noche. Los acúfenos y los tinnitus, nombres que suenan a insectos de la era precámbrica, vienen del interior de la bóveda craneal, de lo más profundo de la calavera, de modo que no te sirve de nada cagarte en el vecino de arriba ni llamar al 112.

El síndrome aparece de repente y desaparece de súbito al cabo de tres o cuatro años, a veces cinco o seis, como si se hubieran largado a otra cabeza.

Los médicos no tienen ni idea del origen ni del desorigen de este conjunto atroz de síntomas. Aconsejan vasodilatadores, yoga, ejercicio físico, sodio, pero da la impresión de que lo aconsejan por aconsejar, como para hacer tiempo mientras el puto síndrome encuentra un cerebro más atractivo al que okupar tras dar una patada en el encéfalo.

A mí, dice uno de los participantes en el foro, me desapareció un día, debajo de la ducha.

Acababa de enjabonarme el pelo, cuando noté que me faltaba algo y lo que me faltaba era el tinnitus. Salí de la bañera a ciegas, me detuve frente al espejo, con la cabeza sin aclarar en todos los sentidos, pues ni me había quitado el champú ni se me había ido la confusión, y esperé ansioso el regreso de los zumbidos, pero no regresaron.

A mí, cuenta un tal Pedro Solipsista, de Soria, me desapareció el vértigo mientras me masturbaba, cuando estaba a punto de eyacular, y se me cortó el rollo, me corrí hacia dentro, como los budistas.

Había historias para todos los gustos, para todos los disgustos más bien, pero a mí me esperaban los lenguados en la cocina y a las dos, como todos los sábados, venían a comer mis suegros.
Me lo recordó mi mujer:
—¿Pero qué haces todavía en el ordenador? A los lenguados se los van a comer las moscas.
—Estoy repasando la receta del menier, que hace siglos que no lo hago —dije yo.
La verdad es que el lenguado menier está tirado, su secreto es la salsa, a base de cilantro (mejor que el perejil), zumo de limón, mantequilla, y un poco de sal, todo ello mezclado en el aceite donde previamente se han freído o frito los lenguados debidamente sazonados.

A lo que íbamos es que había en el foro de los afectados una murciana a la que habían atacado los vértigos y los acúfenos por primera vez mientras preparaba un lenguado a la menier para sus suegros.

—No sé —añadía la pobre mujer— si fue por la asociación entre una palabra y otra, que son tan parecidas, si fue porque odio a mis suegros, o porque soy un poco aprensiva, no sé, no sé, el caso es que estaba enharinando los peces cuando la cocina comenzó a dar vueltas y como aquello no me había ocurrido nunca creí que se acababa el mundo, o que se acababa Murcia al menos. Pero ni el mundo ni Murcia se acabaron, me acabé yo, porque esto es una mierda de vida.

Yo me había puesto un poco en guardia leyendo las historias de los unos y de los otros mientras los lenguados, con este calor, se pudrían sobre la encimera de la cocina.

En esto, me pareció escuchar dentro de mi cabeza un ruido pequeño, como de alguien que intentara forzar un candado con una horquilla.

Me levanté pálido, como un actor del teatro chino (o japonés, ahora no caigo), y le dije a mi mujer que los lenguados que los hiciera ella.
—¿Y eso?— preguntó extrañada, porque los sábados siempre cocino yo.
—Porque estoy hasta los huevos de cocinar para tus padres— le dije.
Sorprendida por aquel cambio de carácter, pues soy de natural pacífico, dijo que bueno que los haría ella, pero que le diera yo las instrucciones porque jamás los había hecho al síndrome ménière.

—No son al síndrome ménière, idiota, son a la menier, sencillamente. Lo del síndrome es otra cosa.
Así que me senté a la mesa de la cocina con un vaso de vino blanco y le fui diciendo haz esto, haz lo otro, y cuando la salsa comenzó a emulsionar, ¡zas!, el candado de dentro de la cabeza se abrió y cesaron los ruidos.
—¡Qué bien!— dije.
—¡Qué bien qué!— dijo ella.
—Nada, esto de que cocinen para uno.
Total, que le salieron mejor que a mí y nos los comimos muy a gusto, en compañía de los padres de ella, que son gente muy civilizada. Hasta el momento estamos todos sanos, todos bien, a gusto con nuestros trabajos y nuestras vidas, pero es la última vez que entran lenguados en mi casa y que yo entro en Internet para buscar una receta.

Fuente: Diario El País, España

Acúfenos en las noticias: Policiales de Pocitos Uruguay.


Policía herido en tiroteo en Pocitos se encuentra "estable y se alimenta"

Anímicamente se encuentra bien y esta semana será operado de la rotura de tendón, se informó en un comunicado. 
lun ago 19 2013 17:03
La Dirección Nacional de Sanidad Policial informó que Carlos Dollenart, el policía herido en el tiroteo en Pocitos, se encuentra “estable, anímicamente bien, sin fiebre y se alimenta”.
El agente “fue valorado por otorrinolaringólogo controlando fistula salival por lesión de parótida izquierda (glándula salival situada a ambos lados de la cara) y acúfenos (percepción de sonidos en el oído); en tratamiento con antinflamatorios y antibióticos”.

Fue tratado por un cirujano plástico y traumatólogo por rotura una rotura en el pulgar izquierdo. El cirujano plástico lo operará el 21 de agosto de la rotura de tendón.

Dollenart, de 39 años, fue el policía herido de gravedad durante la rapiña a la sucursal del Correo de Benito Blanco y Martí. Ingresó junto a Carlos Rodríguez (fallecido) al local y los delincuentes dispararon siete veces sobre su cuerpo.

De tres impactos lo protegió el chaleco antibalas, pero los restantes le provocaron heridas varias en miembros superiores e inferiores, mejilla izquierda con fractura de maxilar inferior y una pequeña contusión en la cara anterior del tórax.


Conferencia sobre el tratamiento Farmacológico de los acúfenos

El Dr. Darío Roitman brindó una conferencia sobre "Tratamiento Farmacologico de los acúfenos", el dia 09 de agosto de 2013, en el Congreso 1° Encuentro Argentino Brasilero de Otorrinolaringologia, organizado por la FASO y la Asociacion Brasileira de otorrinolaringolía e Cirugía cérvico-facial. que se desarrolló en el Salón Palais Rouge, Ciudad de Buenos Aires entre el 07 y el 09 de Agosto de 2013.