RESUMO
PURPOSE: To determine the minimum lymph node yield (LNY) in patients with laryngeal squamous cell carcinoma (LSCCs). METHODS: This retrospective study was performed in a tertiary care hospital setting and included 42 LSCC patients aged 39-81 years (females, n = 2; males, n = 40) who underwent a total or partial laryngectomy and elective bilateral level II-IV neck dissections (unilateral neck dissections: n = 84). RESULTS: The average LNY in the unilateral level II-IV lymph node dissections was 25.9 ± 10, and the average metastatic LNY was 0.9 ± 1.9. The unilateral neck dissections were grouped according to the number of lymph nodes. There was no significant difference between the groups in terms of the metastatic LNY (p = 0.5). The metastatic lymph node density (LND) (metastatic lymph node yield/LNY) was 0.043 for unilateral neck level II-IV neck dissections. A Cox regression analysis revealed no significant relationship between survival and the LNY and LND in bilateral neck dissections (p = 0.4 and p = 0.8, respectively). CONCLUSIONS: The results revealed no minimum number of lymph nodes that could reliably detect metastatic lymph nodes in LSCC patients.
Assuntos
Carcinoma de Células Escamosas , Neoplasias Laríngeas , Laringectomia/métodos , Linfonodos/patologia , Metástase Linfática/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Procedimentos Cirúrgicos Eletivos , Feminino , Humanos , Neoplasias Laríngeas/mortalidade , Neoplasias Laríngeas/patologia , Neoplasias Laríngeas/cirurgia , Masculino , Pessoa de Meia-Idade , Pescoço , Esvaziamento Cervical/métodos , Estadiamento de Neoplasias , Estudos Retrospectivos , Análise de Sobrevida , Turquia/epidemiologiaRESUMO
OBJECTIVE: The authors aimed to determine the changes in the odor threshold and sinonasal outcome test-22 scores of the patients after septoplasty surgery in terms of nasal septum deviation classifications. METHODS: Forty-nine patients with nasal septum deviation, aged between 17 and 65, were included in our study. The sinonasal outcome test-22 scores questionnaire and the N-Butanol Threshold test were administered to the patients, 2 days before and 2 months after the septoplasty. RESULTS: The authors' study had 4 major findings: Odor threshold scores improved after septoplasty operation both for the narrower and the wider side of the nasal airway passage. The Vidigal classification for nasal septum deviation was best for predicting the changes for odor threshold scores after septoplasty operation. The nasal septum deviation in which the nasal septum was pushing the inferior turbinate to lateral nasal wall caused the most smell dysfunction according to the Vidigal classification. Unilateral vertical crest affecting the nasal valv area or the posterior part of the septum had the most negative effect on olfactory functions according to the Mladina classification. CONCLUSION: Septoplasty operation leads to improvement in odor threshold scores, and the Vidigal nasal septum deviation classification was best in predicting postoperative odor threshold changes.
Assuntos
Septo Nasal/cirurgia , Deformidades Adquiridas Nasais/cirurgia , Odorantes/análise , Rinoplastia , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cavidade Nasal/cirurgia , Deformidades Adquiridas Nasais/fisiopatologia , Período Pós-Operatório , Rinoplastia/efeitos adversos , Olfato , Inquéritos e Questionários , Adulto JovemRESUMO
BACKGROUND Nasal septal perforation (NSP) may alter nasal airflow patterns and physiology. To the best of our knowledge, no studies in the English literature have investigated the effect of NSP and its treatment on polysomnographic parameters. In this study, we aimed to investigate polysomnographic parameters in patients with NSP as well as changes in those parameters after treatment of NSP. MATERIAL AND METHODS Nineteen patients diagnosed with NSP were included in the study. All patients had baseline and post-procedure polysomnographies (PSG) after insertion of silicone septal button for closure of NSP. RESULTS Both median AHI [5.30 (14.40) vs. 2.40 (14.50)] and median supine AHI [10.00 (42.10) vs. 6.60 (37.00)] decreased after correction of the perforation. There was a large reduction in median supine AHI in patients with a perforation size >66 mm2 [10.10 (34.15) vs. 1.60 (28.30)]. CONCLUSIONS We conclude that NSP did not cause any deterioration in objective sleep parameters as determined by PSG, other than a decrease in REM sleep duration and an increase in supine AHI. Correction of NSP did not affect REM duration and supine AHI decreased after treatment.
Assuntos
Perfuração do Septo Nasal/fisiopatologia , Perfuração do Septo Nasal/terapia , Apneia Obstrutiva do Sono/terapia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polissonografia/métodos , Respiração , Sono/fisiologia , Apneia Obstrutiva do Sono/etiologia , Transtornos do Sono-Vigília/terapiaAssuntos
Displasia Ectodérmica/genética , Integrina beta4/genética , Mutagênese Insercional , Diagnóstico Pré-Implantação/métodos , Adulto , Blastômeros , Displasia Ectodérmica/diagnóstico , Transferência Embrionária , Feminino , Fertilização in vitro/métodos , Hormônio Foliculoestimulante Humano/administração & dosagem , Triagem de Portadores Genéticos , Heterozigoto , Humanos , Gravidez , Análise de Sequência de DNARESUMO
Peritonsillar abscess is the most common deep infection of the head and neck that occurs in adults; the treatment of the disease remains controversial. A prospective study using a single high dose steroid treatment for peritonsillar abscess, was undertaken in 62 patients to determine the treatment's effectiveness in relieving symptoms such as fever, throat pain, dysphagia and trismus. All patients were randomly assigned to two groups: 28 patients received intravenous antibiotic therapy and a single dose placebo and 34 patients were treated with single use of high dose steroid in addition to intravenous antibiotic. Patients were hospitalized after needle aspiration and therefore their clinical courses and responses to therapy could be rigorously assessed. Comparison of clinical outcomes with respect to hours hospitalized, throat pain, fever, trismus were assessed between the two groups. Clinical outcomes revealed a statistically significant difference between the two groups (p < 0.01), indicating that single use of high dose steroid prior to antibiotic therapy is more effective than the use of an antibiotic alone. These results suggest that single intravenous use of steroid in addition to antibiotic therapy is an excellent choice for the management of peritonsillar abscess.
Assuntos
Anti-Inflamatórios/administração & dosagem , Metilprednisolona/administração & dosagem , Abscesso Peritonsilar/tratamento farmacológico , Adolescente , Adulto , Idoso , Anti-Infecciosos/administração & dosagem , Deglutição/fisiologia , Quimioterapia Combinada , Feminino , Humanos , Injeções Intravenosas , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Abscesso Peritonsilar/microbiologia , Estudos Prospectivos , Resultado do TratamentoRESUMO
OBJECTIVES: The exact preoperative diagnosis of parotid gland masses requires highly specific and sensitive diagnostic techniques. The specificity, sensitivity and accuracy of ultrasonography guided fine needle aspiration biopsy of parotid gland masses were assessed. PATIENTS AND METHODS: There were 46 female and 36 male patients. The mean age was 39 years (range 18 to 74 years). Ultrasonography guided fine needle aspiration biopsies were performed and cytologic diagnoses were compared with postoperative histopathologic findings of specimens. RESULTS: In our series, 65 of the lesions (79%) were found to be benign and 17 (21%) were malignant. There were one false negative and one false positive results. The sensitivity, specificity and accuracy rates were found to be 94.1%, 98.4% and 97.6% for parotid tumors, respectively. CONCLUSION: Ultrasonography guided fine needle aspiration biopsy of parotid gland masses have been proven to be a highly specific, sensitive, and a safe preoperative diagnostic technique when performed by an experienced clinician and cytopathologist.
Assuntos
Neoplasias Parotídeas/diagnóstico por imagem , Ultrassonografia de Intervenção/métodos , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/epidemiologia , Adenocarcinoma/patologia , Adolescente , Adulto , Idoso , Biópsia por Agulha Fina/métodos , Carcinoma de Células Acinares/diagnóstico por imagem , Carcinoma de Células Acinares/epidemiologia , Carcinoma de Células Acinares/patologia , Carcinoma Mucoepidermoide/diagnóstico por imagem , Carcinoma Mucoepidermoide/epidemiologia , Carcinoma Mucoepidermoide/patologia , Feminino , Humanos , Linfoma/diagnóstico por imagem , Linfoma/epidemiologia , Linfoma/patologia , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Neoplasias Parotídeas/epidemiologia , Neoplasias Parotídeas/patologia , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Turquia/epidemiologiaAssuntos
Displasia Fibrosa Óssea/diagnóstico , Osso Temporal , Criança , Diagnóstico Diferencial , Feminino , HumanosRESUMO
OBJECTIVE: To assess the anatomic and functional results of primary Type1 cartilage tympanoplasty performed with the palisade technique and to compare them with the results of primary Type 1 tympanoplasty performed with temporalis fascia in children. STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS: The records of 45 children with intact ossicular chain and no history of mastoidectomy or tympanic perforations occupying more than 50% of the membrane area were evaluated. Patients with similar age and middle ear pathologic findings were selected in an effort to make the groups as homogeneous as possible. Of those, 21 children were included in the cartilage study group, and 24 patients were included in the fascia group. INTERVENTIONS: An over-under tympanoplasty technique using either a palisaded tragal cartilage or temporalis muscle fascia. MAIN OUTCOME MEASURES: Successful outcome was defined as full, intact healing of the graft without perforation, retraction, or lateralization for at least 12 months after the operation and with improvement of hearing. Postoperative speech reception thresholds and postoperative air-bone gap were compared with preoperative levels within and between the groups. RESULTS: Tympanoplasty with the palisade cartilage technique resulted in a significantly higher graft acceptance rate (100%) than with the fascia technique (70.2%; p = 0.008). Speech reception threshold levels, pure-tone average, and air-bone gaps improved significantly with surgery in both the palisade and fascia groups (p < 0.001). Comparison of audiologic results between the groups did not reveal any statistically significant difference (p > 0.05). CONCLUSION: Palisade tympanoplasty in children yielded good anatomic and functional results. The anatomic results obtained using this technique were superior to those obtained using temporalis muscle fascia. Children who underwent Type 1 tympanoplasty with palisaded cartilage had equivalent postoperative audiometric results compared with children who underwent Type 1 tympanoplasty with temporalis fascia. Thus, palisade cartilage tympanoplasty is an effective technique for both tympanic membrane closure and hearing improvement in children.