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Objectives: The aim of this study was to review the demographic and clinicopathological findings of the patients who underwent prophylactic or therapeutic parotidectomy due to the secondary neoplasm of the parotid gland (SNP), the outcomes of the patients with SNP and to provide a perspective to the parotid and neck approach in head and neck skin cancer cases. Methods: The clinical data of 178 patients who underwent parotidectomydue to neoplasm in the Department of Otorhinolaryngology, Head and Neck Surgery of a tertiary referral center from 2012 to 2017 were reviewed. Results: Among 178 patients, twenty-two (12.4%) patients were found to underwentprophylactic or therapeutic parotidectomy due to SNP. Six of these patients had pathologically positive parotid metastases (therapeutic parotidectomy). The median age of six patients was 67 years (ranging from 2 to 83 years). Five patients were male and one was female. The most common indication of parotidectomy (prophylactic and therapeutic) and pathology of parotid mass due to SNP and Cutaneous Squamous Cell Carcinoma (SCC) (36.3% and 50%, respectively). Conclusions: Owing to rapidly progressive feature and high morbidity, close observation of parotid in case of metastasis is crucial for recurrent SCC of the face and scalp.

Introduction: Surgical treatment options are limited for nasopharyngeal cancer for many reasons including epidemiological and histological properties, proximity to important structures, heavy lymphatic drainage, and the difficulty in ensuring a safe surgical margin; therefore primary treatment is generally radiotherapy and chemotherapy. With current radiotherapy technology, oncological success has been increased and the quality of life of patients during the postradiotherapy period is improved. Objective: The role of magnetic resonance imaging and positron emission-computed tomography in the follow-up of recurrent nasopharyngeal cancer patients who were initially treated with radiotherapy was evaluated with respect to histopathological findings. Methods: A total of 110 patients with nasopharyngeal cancer who had received radiotherapy were included in the study. Patients who were suspected to have recurrence according to endoscopic nasopharyngeal examination and magnetic resonance imaging findings were requested to undergo positron emission-computed tomography. Biopsies were taken from 40 patients who had suspicious lesions in positron emission-computed tomography images. These patients’ age, gender, presence/absence of contrast enhancement on magnetic resonance imaging, the SuvMax values of nasopharyngeal and neck lesions, T/N phases at initial diagnosis, histopathological recurrence, and history of neck dissection were assessed. Results: Recurrence was observed in 8 patients (20.0%). Among these, 4 (10.0%) had recurrence at the nasopharynx and 4 (10.0%) at the neck. Patients with recurrence were found to be of older age, male gender, advanced T/N phase, contrast enhancement on magnetic resonance imaging, and higher nasopharyngeal and neck SuvMax values in positron emission-computed tomography. However, these differences were not statistically significant. Only the history of neck dissection was significantly more common among those with recurrence (p < 0.001). However, in multivariate analysis, those with a nasopharyngeal SuvMax value higher than 4.58 were found to have 7.667-fold higher risk for recurrence (p = 0.036). Conclusions: Magnetic resonance imaging and positron emission-computed tomography should be evaluated together in the follow-up of nasopharyngeal cancer. Patients with minimal SuvMax 4.58 on positron emission-computed tomography after contrast enhancement in the T2 sequence on magnetic resonance imaging may considered appropriate for biopsy. Biopsies in patients with a SuvMax value lower than 4.58 can be avoided. Thus, patients avoid surgical stress and unnecessary costs. Resumo Introdução: As opções de tratamento cirúrgico são limitadas para o carcinoma nasofaríngeo por várias razões, inclusive aspectos epidemiológicos e histológicos, proximidade de estruturas importantes, drenagem linfática carregada e dificuldade de garantir uma margem cirúrgica segura; portanto, o tratamento primário é geralmente radioterapia e quimioterapia. Com a tecnologia atual de radioterapia, o sucesso oncológico aumentou e a qualidade de vida dos pacientes durante o período pós-radioterapia é garantida. Objetivo: O papel da ressonância magnética e da tomografia computadorizada por emissão de pósitrons no seguimento de pacientes com carcinoma nasofaríngeo recorrente, inicialmente tratados com radioterapia, foi avaliado em relação aos achados histopatológicos. Método: Foram incluídos no estudo 110 pacientes com carcinoma nasofaríngeo que receberam radioterapia. Pacientes com suspeita de recorrência de acordo com o exame endoscópico nasofaríngeo e com achados de ressonância magnética foram solicitados a fazer tomografia computadorizada por emissão de pósitrons. Foram feitas biópsias de 40 pacientes com lesões suspeitas nas imagens de tomografia computadorizada por emissão de pósitrons. Os pacientes foram avaliados segundo idade, sexo, presença/ausência de realce por contraste na ressonância magnética, valores SUVmax de lesões nasofaríngeas e cervicais, estágios T/N no diagnóstico inicial, recorrência histopatológica e histórico de esvaziamento cervical. Resultados: A recorrência foi observada em 8 pacientes (20,0%). Entre esses, 4 (10,0%) apresentaram recorrência na nasofaringe e 4 (10,0%) no pescoço. Pacientes com recorrência eram do sexo masculino, apresentavam idade mais avançada, estágio avançado T/N, realce por contraste na ressonância magnética e maiores valores de SuvMax nasofaríngeo e cervical na tomografia computadorizada por emissão de pósitrons. Entretanto, essas diferenças não foram estatisticamente significantes. Apenas o histórico de esvaziamento cervical foi significantemente mais comum entre aqueles com recorrência (p < 0,001). No entanto, na análise multivariada, aqueles com um valor de SUVmax nasofaríngeo superior a 4,58 apresentaram um risco 7,667 vezes maior de recorrência (p = 0,036). Conclusão A ressonância magnética e a tomografia computadorizada por emissão de pósitrons devem ser avaliadas em conjunto no seguimento da doença. Pacientes com valor de SUVmax mínimo de 4,58 na tomografia computadorizada por emissão de pósitrons após realce com contraste na sequência T2 na ressonância magnética podem ser considerados mais adequados para biópsia. Biópsias em pacientes com um valor de SUVmax menor do que 4,58 podem ser evitadas. Dessa forma, podemos evitar o estresse cirúrgico para o paciente e custos desnecessários.

Objectives:Platelet-rich plasma (PRP) was administered into the temporomandibular joint (TMJ) space, which had been exposed to radiotherapy (RT), in an attempt to prevent and/or treat the late-term complications associated with RT when used for the treatment of head and neck cancers (nasopharyngeal cancer in particular) on the musculoskeletal system.Methods:A total of 13 adult male New Zealand ( Oryctolagus cuniculus) rabbits were used in the study. The animals were classified into 3 groups: 6 in the RT group, 6 in the RT+PRP group, and 1 in the control group (exposed to neither). The TMJ space of each rabbit was exposed to 2240 cGy external RT in total, and PRP was administered into the TMJ space 1 month later. The joints were surgically removed 1 month later and examined histopathologically.Results:In the group given RT+PRP, the level of inflammation, amount of muscle fibrosis, vascular wall fibrosis, synovial membrane and condyle cartilage thickness, temporal extrabone fibrous cell layer count, and intramuscular changes were similar to those recorded in the control group, although the positive effects of PRP were not found to be statistically significant.Conclusions:The findings of the present study demonstrate that injections of PRP may increase joint inflammation and therefore enhance blood supply, resulting in the onset of regeneration. These favorable effects of PRP may be helpful in the fight against late-term musculoskeletal complications of RT and may minimize such side effects as sore jaw, malnutrition, and weight loss.

OBJECTIVES This study was aimed to overview the treatment protocols of lip cancer and find out a cutoff point of tumor diameter and depth of invasion (DOI) for the survival parameters. MATERIALS AND METHODS One hundred and ninety-one patients with lip SCC were studied. RESULTS The average age of the patients was 62 years. Among 191 patients, 82.7% of the patients were men, 96.4% of them had lower lip cancer, and 84% were staged as early (pT1, pT2 ). Primary tumor excision with neck dissection was applied to 62.3% of the patients. Lymph node metastases rate was found to be 11%, and recurrence rate was 6.3%. There was statistically significant difference in between the tumor diameters and DOI values of patients with and without metastasis, and recurrence (p

Objectives The aim of this study was to compare the effect of the presence of one or two arytenoids on early/late period swallowing-aspiration functions. Methods Supracricoid partial laryngectomy (SCPL) with the diagnosis of laryngeal cancer between 2012 and 2014 were retrospectively evaluated. The patients were categorized into two groups as follows: group I, patients who underwent SCPL with one arytenoid cartilage and group II, patients who underwent SCPL with two arytenoid cartilages. The time of decannulation and oral feeding onset, and swallowing-aspiration functions were evaluated and compared in the early nutritional period, first, and third months. Results There was no significant correlation between decannulation time and swallowing-aspiration. The aspiration rates in group I and group II were similar and there was no significant difference in oral feeding onset and aspiration grades in the first and third months between both groups. Conclusion We found similar oncological and functional outcomes in SCPL which protected one or two arytenoid cartilages. Therefore we suggest to be performed one arytenoid cartilage SCPL in selected patients who was advance stage and tumor volume over with larynx cancer.

WOS: 000529182700008 PubMed: 31012346 The aim of this prospective study was to analyze the voice and quality-of-life outcomes of microscopic diode laser surgery (MDLS). The study was conducted on a series of 46 patients with Tis-T1a glottic carcinoma treated with microscopic endolaryngeal diode laser surgery. Patients were asked to complete the Voice Handicap Index and quality-of-life questionnaires of the European Organization for Research and Treatment of Cancer. When comparing the pre- and postoperative scores, there were significant difference on the physical scores (P = .014) of the patients who underwent type III cordectomy and functional (P = .022), emotional (P = .002), and overall scores (P = .005) of the patients who underwent type IV cordectomy, in the direction of better quality of voice after MDLS. The postoperative functional, physical, emotional, and overall scores of groups were significantly increased with the extension of resection.

Aim: Salivary gland tumors (SGTs) are rare neoplasms thus, the local records are valuable to obtain the epidemiological overview. This study aimed to determine the demographic and clinicopathological features of SGTs in our clinic and compare the findings with the studies from Turkey and all over the world.Material and methods: The data of 185 patients who underwent surgery for SGT in The Department of Otorhinolaryngology-Head and Neck Surgery of a tertiary referral center between 2012 and 2017 were studied retrospectively. The demographic and clinicopathological features of the patients were recorded.Results: Among all patients with primary and secondary SGTs, the median age was 53 years, 54.6% of the patients were men. Patients with primary tumor constituted 96.8% of all cases. Malignancy rate was 14. Parotid gland was the most common location (90%). Nearly half of all primary tumors were diagnosed as pleomorphic adenoma (n=84, 46.9%). Mucoepidermoid carcinoma was the most common malign neoplasm of the parotid gland. There were only six patients (3.2%) that had secondary SGT.Conclusion: Pleomorphic adenoma and mucoepidermoid carcinoma were the most common benign and malign pathologies, respectively. The lowest malignancy rate and the highest rate of warthin tumor of the existing literature were the most conspicuous findings of our study. Although the frequency of the secondary SGTs is low, the possibility of metastasis should be considered especially for the patients above 65 years of age., Amaç: Tükürük bezi tümörleri (TBT’ler) nadir görülen neoplazmlardır, bu nedenle lokal kayıtlar epidemiyolojik bir bakış açısı elde etmek için değerlidir. Bu çalışma, kliniğimizde opere edilen TBT’lerin demografik ve klinikopatolojik özelliklerini belirlemeyi ve bu bulgular ile Türkiye ve tüm dünyadaki çalışmaları karşılaştırmayı amaçlamıştır.Gereç ve yöntemler: 2012 ve 2017 yılları arasında bir üçüncü basamak sağlık merkezinin Kulak Burun Boğaz ve Baş Boyun Cerrahisi Kliniği’nde TBT nedeniyle opere edilen 185 hastanın verileri geriye dönük olarak incelendi. Hastaların demografik ve klinikopatolojik özellikleri kaydedildi.Bulgular: Primer ve sekonder TBT’li tüm hastalar arasında median yaş 53, hastaların %54,6’sı erkekti. Primer tümörlü hastalar tüm vakaların %96,8’ini oluşturmaktaydı. Malignite oranı 14 idi. Parotis bezi en sık lokalizasyondu (%90). Tüm primer tümörlerin yaklaşık yarısına pleomorfik adenom tanısı kondu (n = 84, %46,9). Mukoepidermoid karsinom, parotis bezinin en sık görülen malign neoplazmı idi. Sekonder TBT’si olan sadece altı hasta (%3,2) vardı.Sonuç: Pleomorfik adenom ve mukopidermoid karsinom sırasıyla en sık görülen benign ve malign patolojilerdir. Literatürdeki en düşük malignite oranı ve en yüksek warthin tümörü oranı çalışmamızın en çarpıcı bulgularıdır. İkincil TBT’lerin sıklığının düşük olmasına rağmen, özellikle 65 yaşın üzerindeki hastalarda metastaz olasılığı düşünülmelidir.

Comert, Ayhan/0000-0002-9309-838X WOS: 000452441400111 PubMed: 29944552 Background: This study was designed to define the detailed anatomical relations of the jugular bulb with the facial nerve, sigmoid sinus, otic capsule, and internal acoustic canal allowing the safe management of the jugular bulb. Methods: Thirty-five formalin-perfused cadaveric temporal bones that had well mastoid and petrous pneumatization without any neurovascular variations on computed tomography scan were selected for the study. The bones were dissected via translabyrinthine approach. Results: The dome of the jugular bulb was located under the facial nerve in 21 of the cases (60%), in the mastoid cavity in 8 of the cases (22.9%), and in the tympanic cavity in 6 of the cases (17.1%). Significant difference was observed only between the temporal bones in which the dome of the jugular bulb was located in the mastoid cavity and under the facial nerve with regard to the mastoid cortex-lateral semicircular canal measurement (P = 0.04). Conclusion: Because of the high variability of the position of the dome of the jugular bulb, the precise knowledge of the relations of the jugular bulb and the preoperative radiologic verification of possible variations are essential to avoid the problems associated with its position and to decide the approach individually.

AIM The present study aimed to compare edema and ecchymosis in the early and late postoperative periods following the application of different surgical techniques (open and endonasal) and different types of lateral osteotomy (internal and external). METHODS The files and photographs of a total of 120 patients whose records were regularly maintained/updated and who underwent septorhinoplasty operation with the same surgeon were retrospectively evaluated. Sixty-nine (57.5%) patients were women and 51 (43.5%) were men. The patients were divided into 4 different groups according to the operations they underwent as follows--Group I: open technique septorhinoplasty + internal/continuous lateral osteotomy; Group II: endonasal rhinoplasty + internal/continuous lateral osteotomy; Group III: open technique septorhinoplasty + external/perforating lateral osteotomy; and Group IV: endonasal rhinoplasty + external/perforating lateral osteotomy. Postoperative edema and ecchymosis, and lateral nasal wall mucosal damage because of osteotomy were evaluated. RESULTS Postoperative second day edema and ecchymosis scores were statistically significantly better in patients in Group II compared with the patients in Group I (P = 0.010 and P = 0.004, respectively). Postoperative first day edema and postoperative seventh day ecchymosis scores were statistically significantly better in the patients in Group IV compared with the patients in Group III (P = 0.025 and P = 0.011, respectively). Intraoperative bleeding was similar in all groups. The nasal tip was more flexible in patients who underwent closed technique rhinoplasty. Unilateral mucosal damage occurred in 3 patients (4%) with internal lateral osteotomy, whereas no mucosal damage was present in patients with external osteotomy. CONCLUSIONS The difference in the rate of edema and ecchymosis in the early postoperative period between the closed technique rhinoplasty and the open surgical approach was statistically significant, whereas osteotomy did not cause a significant difference. According to these results, the authors suggest endonasal surgery to prevent the development of edema and ecchymosis, whereas the choice of lateral osteotomy should be dependent on the experience of the surgeon.

INTRODUCTION: The authors aimed to evaluate the outcomes of free flap reconstructions performed for intraoral region in a single center.METHODS: Eleven free flaps have been performed for defects of the head and neck over a 4-year period. The patients were evaluated in terms of defects, flaps performed, complications and hospital stays.RESULTS: Seven patients were reconstructed with radial forearm free flap, one patient was reconstructed with free transverse rectus abdominis musculocutaneous flap, two patients were reconstructed with free vertical rectus abdominis musculocutaneous flap and the remaining one was reconstructed with free fibula osteomusculocutaneos flap. None of the flaps required reexploration for anastomotic thrombosis or hematoma. No flap failure occurred. We did not encounter any mortality or major morbidity. The average hospital stay was 21.1 days with a range from 11 to 25 days. DISCUSSION AND CONCLUSION: Multidisciplinary approach should be encouraged for the reconstruction of intraoral defects. The versatility of free tissue transfers allows reconstruction of most complex defects; although it carries significant risks, including longer operative times, donor site morbidity, recipient site complications and microsurgical failure, and longer hospital stays.

OBJECTIVES This study aims to determine the problems of patients applied provox 2 voice prosthesis for speech rehabilitation with their prosthesis and our treatment modalities to increase the quality of life of these patients. PATIENTS AND METHODS A total of 210 patients (180 males, 30 females; mean age 58±11.9 years; range 37 to 83 years) who underwent total laryngectomy, applied and changed provox 2 voice prosthesis for voice restoration were included in the study. For speech restoration of the patients with a primary (intraoperative) and secondary (postoperative) tracheoesophageal fistula was opened. In the 15th postoperative day, provox 2 voice prosthesis was placed to approximately 0.5 cm inferior and midline fistula line of the tracheostoma. The patients underwent speech exercises. RESULTS The mean change time of prosthesis was 7.5 months (range 1 to 48 months). Fungal colonization was detected in 141 patients (66%) who had voice prostheses. Granulation tissue developed around the voice prosthesis in 30 patients (14%), three patients (1%) swallowed their voice prosthesis, tracheoesophageal fistula width remained permanently in two patients (1%), and these patients were abandoned to use their voice prosthesis. Mediastinitis occurred in one patient (1%). CONCLUSION Due to several reasons such as success of high speech despite of complications and being easy to fight with these complications, provox voice prosthesis is an effective method to use for voice restoration.

Objective. In this study, we present the results of endolaryngeal diode laser surgery in patients with an early stage laryngeal carcinoma involving the anterior commissure (AC). Methods. A total of 108 patients (103 males, five females; mean age: 52.4 years; range; 31 to 75 years) who were treated between January 2010 and January 2015 were included in this study. All patients with glottic cancer had anterior commissure lesions . Complications, recurrence rates, and overall survival associated with diode laser surgery were recorded. Results. Based on the AC classification, the initial local control rate was 89.4% for the AC0 tumors, 81.3% for the AC1 tumors, and 90% for the AC2 tumors. Five-year disease-free and overall survival rates were 93.1% and 98.3, respectively. Conclusion. This study provides evidence that microscopic endolaryngeal diode laser surgery is a safe and effective option for the treatment of early glottic cancer involving the AC.

WOS: 000424969000002 BACKGROUND/AIMS The aim of this study was to evaluate the effects of alveolar mucosa, bone, cheek skin, and lip invasion of buccal carcinoma on locoregional recurrence and survival rates. MATERIALS and METHODS The study included 36 patients with T3-T4a buccal carcinoma. Both T3 and T4a tumors were divided into two subgroups: T3 tumors limited to buccal mucosa, T3 tumors with the involvement of alveolar mucosa, T4a tumors with bone invasion, and T4a tumors with skin and/or lip invasion. RESULTS In T3-T4a tumors, the rates of tumors limited to the buccal mucosa, tumors involving alveolar mucosa, bone of either the maxilla or mandible, and skin and/or lips were 25%, 22.2%, 33.3%, and 19.4%, respectively. The 3-year disease-free survival rate of patients with T3 and T4a tumors was 70.6% and 52.6%, respectively. The 5-year disease-free survival rate of patients with T3 and T4a tumors was 58.8% and 42.1%, respectively. Regarding the 3- and 5-year survival rates, no statistically significant difference was observed between T3 and T4a tumors and between their subgroups. CONCLUSION Despite the lack of statistical significance, there seemed to be a trend toward worse survival among the patients with bone invasion.

AIM The objective was to present in this study the administered treatment, reconstruction, and outcomes for lesions excised according to a prediagnosis of facial tumor, whose pathological finding was reported as nonmelanoma skin tumor. METHODS A total of 178 patients with full medical histories who were operated on for skin tumors in the Ear, Nose, and Throat Clinic of Ankara Oncology Education and Research Hospital between February 2010 and March 2012 were evaluated retrospectively. The test group was made up of 125 men (70%) and 53 women (30%), with a median age of 56 years (range, 29-89 years). RESULTS Basal cell carcinoma was diagnosed in 112 patients (63%), 45 (40%) of whom underwent flap reconstruction procedures; squamous cell carcinoma (SCC) was diagnosed in 55 patients (31%), 25 (45%) of whom underwent flap reconstruction procedures; 5 patients (3%) were diagnosed with basosquamous carcinoma, 3 (60%) of whom underwent flap reconstruction, and metatypical carcinoma was found in 6 patients (3%), and 5 (80%) underwent flap reconstruction treatment. Recurrence occurred in 10 (18%) of the 55 SCC patients. Invasion depths in the patients with recurrence were between 7 and 30 mm. In 21 (46%) of the 45 patients without recurrence, invasion depths were between 4 and 30 mm, whereas the invasion depths in the other 24 patients (53.3%) were less than 4 mm. CONCLUSIONS Metastatic lymph node involvement localized to the auricular, infra-auricular, and postauricular was present in the pathological specimens of all patients with lesions who had selective neck dissection I to IV included into their treatment. The depth of invasion of SCCs was found to be statistically significant in terms of recurrences.

AIM This study was to present long-term oncological results, as well as the variables, that can increase nodal metastasis and reduce survival in patients diagnosed in the early and late stages of laryngeal cancer. METHODS A total of 85 patients were included in the study. These patients were grouped as supracricoid partial laryngectomy (PL), supraglottic horizontal PL, and vertical frontolateral PL. Furthermore, at least 3 years of the long-term outcomes of the patients in these 3 groups were compared. RESULTS Twenty-two of the patients (26%) had nodal metastasis, 16 (72%) of these patients were in Group I (P = 0.017); 14 patients (51%) had preepiglottic space (P = 0.075); 12 patients (50%) had paraglottic space involvement (P = 0.002); 9 (45%) patients with nodal metastasis had a depth of invasion more than 20 mm (P

The present study investigated the long-term complications of parotidectomy, the differences in these complications in regard to the pathological diagnosis and type of surgery. The patients were questioned regarding the presence of facial paresis–paralysis, pain, loss of sensation, scarring, collapse, and mouth dryness in the area of operation. Complaints of pain (p = 0.287), scarring (p = 0.456), and mouth dryness (p = 0.136) did not show statistically significant differences between the cases with benign or malignant pathological outcomes. However, complaints of loss of sensation (p

Castleman disease (CD) is a lymphoproliferative disorder that is most frequently seen as an asymptomatic mass in the mediastinum. Among the head and neck region, the neck is the most frequent localization. It is seldom localized in the oral cavity. Surgical excision is the primary choice of treatment. The current study presents a patient with previous non-Hodgkin Lymphoma (NHL) history, who was complaining of a mass gradually increasing in size beneath the right and left buccal mucosa and a histopathological diagnosis of Castleman disease – plasma cell type. The related literature is also reviewed., Castleman hastalığı (CH), en sık mediastende asemptomatik kitle olarak görülen lenfoproliferatif bir hastalıktır. Baş boyun bölgesinde ise en sık boyun da görülür. Oral kavite de yerleşimi nadirdir. Tedavisinde cerrahi eksizyon uygulanır. Bu makalede sağ ve sol yanak mukoza altında, giderek büyüyen şişlik şikayeti ile tarafımıza başvuran ve histopatolojik tanısı castleman hastalığı- plazma hücreli tip olarak raporlanan, non hodgkin lenfoma (NHL) öyküsü olan hasta, literatür eşliğinde sunulmuştur.

Anatomical knowledge regarding the long thoracic nerve (LTN) is important during surgical procedures considering that dysfunction of this nerve results in clinical problems. The purpose of this study was to explore the anatomy of the LTN, its origin, configuration, branching pattern, and relationship to the middle scalene muscle (MSM). The course of the LTN was investigated in 12 embalmed cadavers (21 sides). We defined four different types for this nerve according to the origins of its roots. The most common formation of the LTN was the contribution of three branches that originated from the fifth, sixth, and seventh cervical ventral roots. C5 and C6 components or upper portion of the LTN roots lay primarily between the middle and posterior scalene muscles, sometimes passed through the MSM, and less frequently coursed over the MSM. C7 contributions to the LTN were always located anterior to the MSM. Contributions from C8 were also found over the MSM. The median number of branches arising directly from the cervical roots and branches arising from the main trunk of the nerve were 3 and 7, respectively. Along its course, the median number of branches to the serratus anterior was 10.

Background. Cysts in the larynx are rare and generally asymptomatic. However, large cysts in adults can be symptomatic. If they are symptomatic, they typically present with respiratory and feeding difficulties. They are usually benign in terms of pathology. Several surgical techniques may be used for treatment.Case Report. A 56-year-old man presented to our clinic with hoarseness. Routine laryngeal examination revealed a giant mass and the larynx could not be visualized. At magnetic resonance imaging (MRI), a cystic mass originating from the vallecula was detected. There was no pathology at the glottic level. We planned tracheotomy for the airway and endoscopic surgery for excision. The mass was excised using CO2laser and was reported as benign.Conclusion. An asymptomatic vallecular cyst may cause difficult intubation in any operation. It may also cause respiratory or other complications. Airway management should be led by an ear, nose, and throat surgeon, since tracheotomy may be required. Endoscopic excision with CO2laser is a good choice for treatment in elective cases. In this report, we discuss the diagnosis and treatment of a patient with an asymptomatic giant vallecular cyst.

Amac: Total larenjektomi sonrasi hastalarda en sik kullanilan konușma rehabilitasyonu yontemi trakeoozefagial fistul (TOF) acilarak konușma protezi uygulamasidir. Bu calișmanin amaci primer TOF acilan hastalarda preoperatif radyoterapinin (RT) komplikasyon ve konușma oranina etkisi olup olmadiginin incelenmesidir. Gerec Yontem: Calișmaya larenks karsinomu nedeniyle total larenjektomi yapilan ve primer TOF acilan 124 hasta dahil edildi. Hastalar primer cerrahi uygulanan (Grup 1) ve preoperatif RT alan (Grup 2) olmak uzere iki grupta incelendi. Bulgular: Protez cevresinden tukuruk kacagi primer cerrahi uygulanan (Grup 1) hastalarin 20’sinde (%19,4), preoperatif RT goren (Grup 2) hastalarin 12’sinde (%57,1) gozlendi (p=0,01). Bu fark istatistiksel olarak anlamli bulundu. Grup 1’deki hastalarin % 76,6’sinda, Grup 2’deki hastalarin % 76,1’inde konușma saglanabildi. Konușmaya bașlama zamanlari kiyaslandiginda iki grup arasinda istatistiksel olarak anlamli fark saptanmadi (p=0,142). Sonuc: Primer TOF’un en buyuk avantaji operasyon lojunda geniș goruș alani saglamasi nedeniyle ozefagus perforasyonu ve mediastinit gibi major komplikasyon oraninin az olmasidir. Trakea arka duvarinda nekroz ve protez cevresi tukruk kacagi gelișimi preoperatif RT goren hastalarda primer TOF uygulanimi sonrasi erken ve gec donemde gozlenen komplikasyonlardir.

Amac: Calișmanin amaci cerrahi ile beraber radyoterapi ve kemoterapi veya primer radyoterapi ile beraber kemoterapi goren T4 tonsil karsinomlu olgularda tedavi sonuclarinin karșilaștirilmasidir. Gerec ve Yontem: T4a evreli, tonsil karsinomu nedeniyle kuratif tedavi goren 21 hasta calișmaya dahil edildi. Bu hastalarin 9’una cerrahi ve adjuvan radyoterapi ve kemoterapi uygulandi, 12’si primer radyoterapi ile kombine kemoterapi gordu. Bulgular: Cerrahi sonrasinda postoperatif radyoterapi ve kemoterapi goren ve primer radyoterapi ile kombine kemoterapi goren hastalarin lokoregional rekurrens oranlari sirasi ile %77 ve %75 olarak saptandi. Kaplan-Meier sagkalim analizi kullanilarak cerrahi uygulanan hastalarin hastalik spesifik 2 ve 3 yillik sagkalim oranlari sirasi ile %73 ve %45 olarak hesaplandi. Primer radyoterapi ve kemoterapi goren hastalarin 2 ve 3 yillik hastalik spesifik sagkalim oranlari ise %67 ve %42 olarak saptandi. Sonuc: Ileri evre orofarenks tumorlerinde radikal cerrahi ve cerrahi sonrasi radyoterapi ve kemoterapi tedavisinin yerini yavaș yavaș primer radyoterapi ile kombine kemoterapi tedavisi almaktadir. Bulgularimiz T4 evreli tonsil tumorlerinde klinigimizin mevcut yaklașimi olan radikal cerrahi tedavinin yerini primer radyoterapi ile kombine kemoterapinin alabilecegi fikrini ortaya koymuștur.

The present study aimed to demonstrate how the nasal mucociliary transport times are affected in the patients receiving radiotherapy for head-neck tumor in two different anatomic localizations. The study included 44 patients receiving radiotherapy under the diagnoses of the nasopharyngeal and laryngeal cancer. The mucociliary transport times of both groups were measured via saccharine tablets before radiotherapy, and at months 3 and 6 after radiotherapy. The difference between the groups was statistically evaluated. The pre-irradiation (pre-RT) mean transport times of NPC and LC patients were 9.7 and 9.1 min, respectively. The difference in the mucociliary transport times between these two groups was not statistically significant (p = 0.49). The mean transport time was 26.1 min at post-RT month 3, 23.9 min, at month 6; the change from pre-RT to month 3 was significant (p < 0.05) and the change from month 3 to 6 was not statistically significant (p = 0.182). The mean transport time of the LC patients was 16.8 min. At post-RT month 3, 12.4 min. at month 6; the change from pre-RT to month 3 (p < 0.05) and the change from month 3 to 6 were statistically significant (p = 0.007). It was found that radiotherapy affected the physiological conditions of the patients with nasopharyngeal cancer in a more severe and sustained way compared to the LC patients, which negatively affects the patient's response to the treatment by the resulting organic and psychological effects.