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Arch Argent Pediatr 2011;109(5):417-422 / 417 RESUMEN Las malformaciones linfáticas son anomalías del desarrollo del sistema linfático que tienden a sufrir complicaciones en su evolución. En la última década, la terapia con agentes esclerosantes ha ido ganando popularidad sobre la cirugía, por su eficacia, sus menores complicaciones y sus excelentes resultados estéticos. Presentamos una serie de 24 pacientes tratados mediante esclerosis percutánea con bleomicina. Los resultados fueron excelentes (reducción de volumen ≥ 95% y asintomáticos) en 12 pacientes, buenos (reducción de volumen entre 50% y 95% y asintomáticos) en 5 pacientes, regulares (reducción de volumen < 50% y asintomáticos) en 4 pacientes, y malos (sin cambios de volumen respecto al inicio o sin desaparición de síntomas iniciales) en 3 pacientes. Estos resultados estuvieron directamente relacionados con el tipo de malformación. Las complicaciones observadas fueron de escasa relevancia clínica. La escleroterapia con bleomicina es un método eficaz y seguro en el tratamiento de pacientes con malformación linfática uniquística o macroquís-tica. Su indicación también podría extenderse a pacientes con malformación linfática microquís-tica o cavernosa que serán sometidos a cirugía, para obtener una reducción de su tamaño y menor linforragia postoperatoria, y a pacientes postquirúrgicos sintomáticos, en quienes no fue posible la resección total de la malformación. Palabras clave: malformación linfática, escleroterapia percutánea, linfangioma, malformación vascular. SUMMARYLymphatic malformations are developmental abnormalities of the lymphatic system, which tend to complicate during their evolution. In the last decade, therapy with sclerosing agents has gained popularity over surgery due to its effectiveness, fewer complications, and excellent cosmetic results. We present a series of 24 patients treated with percutaneous bleomycin injection. Results were excellent (volume reduction ≥ 95%, without symptoms) in 12 patients, good (volume reduction between 50% and 95%, without symptoms) in 5 patients, fair (volume reduction <50%, without symptoms) in 4 patients, and poor (no change in volume from baseline and persistence of symptoms) in 3 patients. These results were directly related to the type of lymphatic malformation. The complications found had little clinical relevance. Sclerotherapy with bleomycin is an effective and safe treatment for patients with unicystic or macrocystic lymphatic malformations. It could also be used in patients with microcystic or cavernous lymphatic malformation undergoing surgery to reduce both the malformation size and postoperative lymphorrhea, and in postoperative symptomatic patients whose malformation could not be totally resected. INTRODUCCIÓNLas malformaciones linfáticas (ML) son anomalías del desarrollo normal del sistema linfático y representan una de las formas más frecuentes de malformación vascular. 1Existen publicaciones que sugieren una conducta expectante para las ML asintomáticas, 2 pero la mayoría de los autores c...

There is little literature on the semiological aspects of the clinical Vestibulo-Occulomotor Reflex (VOR) cancellation technique. This study aims to determine which would be the best head movement frequency cutoff to perform the VOR cancellation clinical test. Materials and methods: 98 horizontal semicircular canals with normal gains from normal individuals were included. The VOR was cancelled by placing a headband with a fixed target over the individual's head, and the patient was told to keep their eyes on the target while the examiner recorded the presence and number of saccades that were evident with the naked eye by performing sinusoidal cephalic rotations at different frequencies. The head rotation frequency was compared with the following variables: 1-Saccades that are evident with the naked eye -SHIMP (+) clinical-, 2-The presence of saccades performed for a period of 2 seconds, 3- The presence of saccades performed in every cycle, 4- Amplitude in º/sec. of the performed saccades, 5-Percentage of VOR cancellation and 6-Age. Conclusion: To avoid a false positive caused by SHIMP saccades during the clinical evaluation of the VOR cancellation at the patient's bedside, we recommend performing cephalic rotations with frequencies lower than 0.5Hz - 0.6Hz for the age group under 67 years old. In patients older than and equal to 67 years old, the interpretation of the VOR cancellation using this method should be cautious, and it should be performed with glasses if worn. Keywords: vestibulo-cular reflex cancellation, SHIMP saccades, SHIMP headband

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