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Objective: To evaluate the clinical and pathologic parameters associated with level IIb metastasis in transglottic laryngeal carcinoma.Methods: A total of 238 laryngeal squamous cell carcinoma patients admitted to our tertiary center and surgically treated between January 2006 and January 2014. Of these 238 patients, 134 patients with transglottic laryngeal SCC were enrolled in the study. The type of neck dissection, the location of histopathologically proven metastatic lymph nodes, clinical N and T stages were reviewed. Palpable lymph nodes were accepted clinically cN(+) and the opposite as cN(-).Results: Of the 134 patients, 116 were diagnosed as cN(-), and 18 were as cN(+). Level IIb metastasis was diagnosed in 12 patients in the cN(+) group, and in two patients in the cN(-) group. Histopathological level IIb metastasis was shown in 14 of 134 patients, representing 16 of 268 neck dissection specimens. Level IIb metastasis was shown in the ipsilateral specimens in 12 patients and contralateral specimens in two patients. Forty-one of 134 patients presented cartilage invasion, and nine of them were diagnosed with level IIb metastasis.Conclusion: Thyroid cartilage invasion, the presence of level IIa invasion and advanced stage disease are the risk factors for level IIb metastasis. Therefore, level IIb should not be neglected during neck dissection in transglotticlaryngeal carcinoma.

To compare nondiagnostic fine needle aspiration biopsy cytology results between pathologists and clinicians. Fine needle aspiration biopsy has proven to be a safe, economical, accurate, and rapid diagnostic technique. A successful aspiration biopsy requires a specimen with adequate cellularity, high-quality preparation, an experienced physician, and a cytopathologist. Up to 32% of fine needle aspiration biopsies of various organs (thyroid, breast, etc.) may ultimately be nondiagnostic due to scant cellularity and poor preparation. Materials and methods: A total of 2247 reports of fine needle aspiration biopsies were reviewed, all obtained from files in the Pathology Laboratory of the İzmir Atatürk Training and Research Hospital. The reports included specimens from thyroids, breasts, lymph nodes, and salivary glands. Data from the fine needle aspiration biopsies were reviewed by physicians; for each case, both clinicians and cytopathologists were consulted in order to determine the clinical utility and the cost-effectiveness of the evaluation of aspiration biopsies. Results: Our database showed that nondiagnostic cytology results obtained by clinicians alone were higher (34.1%) than those of cytopathologists (2.8%). Conclusion: We conclude that the evaluation of fine needle aspiration biopsies involving cytopathologists not only substantially increases the adequacy of cytology specimens and decreases the number of nondiagnostic specimens, but it also increases the cost-effectiveness of the procedure.

Malign karotis cismi tümörleri, karotis bifurkasyonun- daki kemoreseptörlerden kaynaklanan nadir görülen neoplazmlardır. Boyunda kitle şikayeti ile başvuran 61 yaşında erkek hasta malign karotis cismi tümörü tanı- sı aldı. Eşlik eden lenf nodları ile birlikte kitle çıkarıldı. Ameliyat sonrası izlemde tümör nüksü ya da uzak metastaz gözlenmedi, Malignant carotid body tumors are rare neoplasms which originate from the chemoreceptor cells at the carotid bifurcation. A 61-year old man presented with a neck mass which was diagnosed as malignant carotid body tumor. Surgical resection of the mass with accompanying lymph nodes was performed. No evidence of local recurrence or distant metastasis were detected during the follow-up period.

Amaç : Bu çalışmanın amacı, antioksidan enzimler olan SOD ve GPX ile NP dokusunda artmış olduğunu düşündüğümüz serbest oksijen radikallerinin oluşumundan sorumlu MPO enzim seviyelerinin polip dokusu ile sağlıklı nazal mukoza örneklerinde spektrofotometrik yöntemle karşılatırılmasıdır.Materyal ve metod : Çalışmaya toplam 76 olgu dahil edilmiştir.Hasta grubunu NP sebebiyle ESC yapılan ve yakın zamanda steroid tedavisi almayan 38 hasta oluşturmuştur. Kontrol grubunu ise rinosinüziti olmayan, alt konka ya da nazal valv cerrahisi yapılan 38 hasta oluşturmuştur.Nazal polip ve nazal mukoza dokularında MPO, SOD ve GPx enzim düzeyleri karşılaştırılmıştır. Nazal polipozisli grubun kontrol grubuna kıyasla ortalama doku MPO düzeyleri anlamlı yüksek bulunmuştur. Bunun yanında Nazal polipozisli grubun kontrol grubuna kıyasla ortalama doku SOD ve GPx düzeyleri anlamlı olarak düşük bulunmuştur.Sonuç :Sonuç olarak polip dokusunda MPO enzim düzeyinin normale göre yüksek olup, SODve GPx enzim düzeylerinin düşük olması oksidatif stresin nazal polip gelişiminde rol oynadığını göstermektedir.Anahtar kelimeler : Nazal polip , Myeloproksidaz, Glutatyon Peroksidaz, Süperoksit dismutaz, Oksidatif Stress Objective : The aim of this study is to compare the MPO enzyme levels responsible for the formation of free oxygen radicals, which are thought to be increased in NP tissue with SOD and GPX, which are antioxidant enzymes, to the polyp tissue in healthy nasal mucosa samples by spectrophotometric method.Materials and methods : A total of 76 cases were included in the study. The patient group consisted of 38 patients who underwent ESC due to NP and did not receive steroid treatment in the near future. The control group consisted of 38 patients without rhinosinusitis who underwent inferior concha or nasal valve surgery. MPO, SOD and GPx enzyme levels were compared in nasal polyps and nasal mucosa tissues. Mean tissue MPO levels were significantly higher in the nasal polyposis group than in the control group. Besides, the average tissue SOD and GPx levels compared to nasal polyposis group was significantly lower in the control group.Results:As a result of this study, higher MPO enzyme levels in polyp tissue and lower SOD and GPx enzymes levels in polyp tissue compared to healthy nasal mucosa shows us that oxidative stress plays an important role in nasal polyp development.Key words : Nasal polyp, Myeloperoxidase, Glutathion Peroxidase, Superoxide dismutase, Oxidative Stress 80

Amaç: Bu çalışmada inkus uzun kolu defekti nedeniyle hidroksiapatit kemik çimento ve parsiyel ossiküloplasti replasman protezi (PORP) kullanılarak kemikçik zincir rekonstrüksiyonu yapılan hastalarda işitme sonuçlarını karşılaştırmayı amaçladık .Hastalar ve Yöntemler:Çalışmada İzmir Katip Çelebi Üniversitesi Atatürk Eğitim ve Araştırma Hastanesi Kulak Burun Boğaz Bölümü'nde Ocak 2007- Aralık 2014 tarihleri arasında inkus uzun kolu defekti nedeniyle kemikçik zincir rekonstrüksiyonu yapılan 47 hasta dahil edildi. Hastalar kemikçik zincir onarım tekniğine göre, PORP kullanılan 25 hasta (Grup 1) ve hidroksiapatit kemik çimento kullanılan 22 hasta (Grup 2) olarak iki gruba ayrıldı. Çalışmaya dahil edilen hastaların yaş, cinsiyet parametreleri, preoperatif dönemdeki muayene bulguları, operasyon öncesi odyolojik tetkikleri, ameliyat notları ve postoperatif dönemdeki muayene bulguları, operasyon sonrası yapılmış olan odyolojik tetkikleri incelendi.Bulgular: Hastaların tümünde greft intakttı. PORP grubunda hava-kemik yolu aralığı (HKA) preoperatif 31 dB, postoperatif 19.2 dB; kemik çimento grubunda preoperatif ve postoperatif sırasıyla HKA 34.1 dB ve 20.2 dB idi. Gruplar karşılaştırıldığında HKA kazançlarında istatiksel olarak anlamlı bir fark yoktu (P = 0.654). Postoperatif dönemde, PORP grubunda % 60, kemik çimento grubunda %59,1 hastada HKA'nın 20 dB ve altında olduğu saptandı.Sonuç: İnkus uzun kolu defekti olan hastalarda kemikçik zincir onarımı amacıyla kullanılan PORP ve hidroksiapatit kemik çimento etkili yöntemlerdir ve iki yöntemin başarısı arasında bir anlamlı fark yoktur. Objective: The objective of this study was to compare the success rates of hydroxyapatite bone cement (HBC) with partial ossicular replacement prosthesis (PORP) for incus long process defects. Patients and Methods: This study was conducted with on 47 patients who had ossiculoplasty for incus long process defects in the Department of Otorhinolaryngology İzmir Katip Çelebi University Atatürk Training and Research Hospital, between January 2007 and December 2014 . Ossicular reconstruction was done with PORPs in 25 patients (group 1), while hydroxyapatite bone cement was used in 22 patients (group 2). Age and gender parameters, examination findings and audiological examinations in the pre and postoperative period were evoluatedResults: In 47 (100%) of the 47 patients the graft was intact. The mean preoperative ABG was 31 dB and mean postoperative ABG was 19.2 dB in the PORP group. The preoperative and postoperative ABG in the bone cement group was 34.1 dB and 20.2 dB, respectively. When the groups were compared for mean closure in the ABG, the difference was not statistically significant (P =0.654). The postoperative ABG ≤ 20 dB was achieved by 60% in the PORP group and 59.1% in the bone cement group.Conclusion: Both hydroxyapatite bone cement application and PORP are effective methods in reconstructing incus long process defects and there is no significant difference between the two methods 70