A study on the efficacy of combined surgery in advanced-stage congenital cholesteatoma with canal-wall-up surgery.

PURPOSE: This study aimed to compare the outcomes of patients with advanced congenital cholesteatoma who underwent microscopic or endoscope-combined Canal Wall Up Tympanomastoidectomy (CWUT) in our clinic and to determine the contribution of endoscope use in reducing recurrence/residual rates. METHODS: In this retrospective study, the data of individuals who underwent microscopic or combined endoscopic surgery between 2008 and 2022 in our clinic were scanned from the database. Demographic data, preoperative computed tomography (CT) findings, preoperative and postoperative hearing results, operation and intraoperative status of the ossicles, duration of surgery, postoperative follow-up period, recurrence and residual disease status during follow-up were investigated. RESULTS: The data of 37 pediatric cases operated in our clinic were included in the study. All of the included cases were Potsic Stage 4 patients who underwent CWUT. The mean age of the operated individuals was 8.7 years (5-12 years) and the mean follow-up period was 47.3 months (12-112 months). 19 cases were performed microscopically only, 2 recurrences and 5 residuals were detected. 18 cases were performed combined and 1 recurrence and 1 residual was found. CONCLUSION: In this study, it was determined that using an endoscope together with a microscope in congenital cholesteatoma cases, decreased the rate of recurrence and residual disease by protecting the external auditory canal in patients with advanced mastoid invasion.

Uncommon Childhood Unilateral Cervical Giant Thymic Cyst.

Cervical thymic cysts are rare and present in the first decade of life. They constitute 0.3% to 1% of congenital neck masses. Thymic tissue foci, which exist between the mandible and the mediastinum, can be found at the descent of the thymic primordium. Thymic cysts should be considered in pediatric patients who present with cervical neck masses. The diagnosis of thymic cysts can only be made by histopathologic examinations. In recent years, the number of reports of thymic cyst cases have increased, one possible cause being the heightened awareness of thymic cysts among pathologists.

Is Transnasal Endoscopic Marsupialization Sufficient in Thornwaldt Cysts?

OBJECTIVE: Thornwaldt cyst is a rare nasopharyngeal lesion that develops from primitive notochord residues. The aim of this study is to evaluate the long-term results of transnasal endoscopic marsupialization surgery in the treatment of Thornwaldt's cyst, its success and its qualification in the treatment. METHOD: The data of 21 patients who underwent transnasal endoscopic marsupialization surgery for symptomatic Thornwaldt cyst in our hospital between 2009 and 2015 and followed up regularly after the operation were reviewed retrospectively. RESULTS: Eleven patients were female and 10 were male. The mean age of the patients was 35.5 years (15-60). All patients underwent transnasal endoscopic marsupialization as a surgical technique. No intraoperative and postoperative complications were observed. In all cases, the complaints regressed postoperatively. There was no recurrence at 4-year follow-up. CONCLUSION: Transnasal endocopic marsupialization as a surgical method can be performed safely in Thornwaldt cyst cases because of its easy applicability, short surgical time, low recurrence rates and efficacy in treatment.

Experimental Investigation of the Effect of Polydioxanone Plate and Platelet-Rich Plasma on Cartilage Regeneration.

Objectives: This study aimed to investigate the effectiveness of polydioxanone (PDS) plate and platelet-rich plasma (PRP) on the regeneration of cartilage grafts, which are frequently used in nasal and septal surgery. Methods: Fifteen white New Zealand Albino-type female rabbits were used in the study. Our study was carried out on 4 different applications on each animal: cartilage only, cartilage+PRP, cartilage+PDS plate, and cartilage+PRP+PDS plate, and in 3 different periods: the first month, the second month, and the third month. Results: A significant difference was obtained between the groups using cartilage+PRP and cartilage+PRP+PDS only in the first month. When both application types were compared, a statistically significant decrease was found in the histopathological cartilage viability score after PDS use. In examining peripheral chondrocyte proliferation, a statistically significant difference was found only in the third-month comparison. When the group using only cartilage was compared with the group using cartilage+PDS, it was determined that peripheral chondrocyte proliferation was significantly reduced at the end of the third month with PDS. In evaluating fibrosis and foreign body reaction, a statistically significant increase was detected using a PDS plate. In histopathological cartilage viability score statistical analysis, a significant difference was obtained between the groups using cartilage+PRP and cartilage+PRP+PDS only in the first month. Degeneration in the cartilage structure was observed macroscopically in the specimens where the PDS plate was used. Shape change and cartilage deformation were observed in the PDS plate specimens. Conclusions: When the results were examined, this observation coincided with the statistically significant increase in foreign body reaction and fibrosis in the PDS plate groups. However, these results contradicted our hypothesis before the study and the information in the literature. Our results will help provide preliminary information and guidance for future studies and offer a different perspective.

Evaluation of nasal airway alterations associated with septorhinoplasty by both objective and subjective methods.

The aim of functional septorhinoplasty is to create an esthetically elegant nose and harmony in the face by preserving nasal function as well as maintaining or restoring adequate airway. Since nasal complaints are usually subjective, it may be difficult to evaluate the functions objectively. In the present study, we aimed to investigate the alterations in nasal function associated with septorhinoplasty by using both objective and subjective methods. The study population consisted of 40 patients who underwent septorhinoplasty and 40 healthy controls. Before and after the operation, visual analog scale, acoustic rhinometry, rhinomanometry, and Odiosoft-Rhino test were applied to all patients and controls. There were significant differences in all parameters both before and after the operation. While a significant difference was obtained between the patient and control groups in terms of preoperative values, no significant difference was found between postoperative values of these groups. Both objective and subjective methods are important in evaluations.

Patient-reported outcomes after endonasal rhinoplasty for the long nose.

BACKGROUND: The long nose with an inferiorly rotated tip commonly results from a discrepancy between tip support and the downward forces of long septum, long upper lateral cartilage, and elongated lower lateral cartilage. Although many techniques have been described for surgical correction, very few studies were designed to include patient-reported outcomes. OBJECTIVE: The purpose of this study was to introduce our current management of long nose with drooping tips as well as to present the patient-reported outcomes of our case series of endonasal rhinoplasties. METHODS: This study prospectively analyzed 121 patients who underwent rhinoplasty for the correction of long nose with drooping tips. Study participants completed both a baseline questionnaire before the rhinoplasty operation and a postsurgical patient questionnaire 12 months following the operation, including the European QOL Questionnaire and Rhinoplasty Outcomes Evaluation Questionnaire. RESULTS: Mean values corresponding to the European QOL Questionnaire visual analog scale score significantly increased after surgery compared with baseline (P < 0.01). Mean values corresponding to self-care (P < 0.01), usual activities (P < 0.05), discomfort (P < 0.01), and anxiety (P < 0.01) showed significant decrease after surgery. A general and significant improvement of the mean Rhinoplasty Outcomes Evaluation Questionnaire scores by rhinoplasty increased from 20.14 ± 7.38 to 82.05 ± 12.8 (P < 0.01). CONCLUSIONS: Resection of the caudal portion of upper lateral cartilage may correct aesthetic problems in patients with long nose with a drooping tip in which a reduction in the width and the length of middle third of the nose is required. This study suggested an efficient method for aesthetic correction of long nose with the improved patient-reported outcomes.

Comparative analysis of primary and secondary rhinoplasties according to surgeon's perspective, patient satisfaction, and quality of life.

OBJECTIVES: We sought to analyze and compare the problems and technical difficulties related to surgical intervention, patient satisfaction, and quality of life after primary and secondary rhinoplasties. METHODS: A total of 168 cases of rhinoplasty were grouped as primary or secondary according to the patient's history of rhinoplasty. The type of nasal deformity, the surgical approach, and the difficulty of the surgery were recorded. The levels of patient satisfaction and the quality of life were assessed before and after the operation with the Rhinoplasty Outcomes Evaluation (ROE) and European Quality of Life-5 Dimension (EQ-5D) questionnaires. A quantitative and statistical analysis was performed. RESULTS: Thirty-three patients had secondary rhinoplasty, and 135 patients had primary rhinoplasty. Relatively high rates of saddle nose deformity, crooked nose, and tip asymmetry were observed in the secondary rhinoplasty group. The preoperative and postoperative scores on the ROE and EQ-5D questionnaires demonstrated statistically significant differences in both the primary and secondary rhinoplasty groups. The comparison of postoperative change between the primary and secondary rhinoplasty groups did not demonstrate a statistically significant difference. CONCLUSIONS: The surgical difficulty of secondary rhinoplasty is approximately twice that of primary rhinoplasty because of the high rate of major deformities. However, the levels of patient satisfaction and improvements in quality of life are similar after primary and secondary rhinoplasties.

Diode laser treatment of hypertrophic inferior turbinates and evaluation of the results with acoustic rhinometry.

Inferior turbinate hypertrophy is the most common cause of chronic nasal obstruction. When conservative medical treatment options fail in patients with inferior turbinate hypertrophy, reduction of the inferior turbinate can be performed using surgical techniques. Laser-assisted turbinate surgery has the advantages of limited tissue trauma and reduced bleeding. We evaluated the effectiveness and outcomes of using a diode laser (λ = 980 nm) in turbinate reduction. Our study included 62 patients with symptoms of nasal obstruction due to hypertrophic inferior turbinates, who did not respond to medical treatment (≥ 1 year). Patients were treated with diode laser between January 2009 and December 2010 in our ENT (ear, nose, and throat) department. Subjective outcome of severity of nasal obstruction was assessed on a standard 10-cm visual analog scale (VAS). Acoustic rhinometry was used to measure nasal patency. The cross-sectional areas 1, 2, and 3 and the volumes between 2.5 and 5.5 cm were measured. VAS scores and acoustic rhinometry measurements were performed preoperatively and 1, 6, and 12 months after surgery. The mean follow-up was 13.1 ± 1 months. The mean operation time was 3 min per turbinate; no nasal packing was necessary. We did not observe any major complications. Both subjective and objective evaluations showed significant improvement. VAS scores improved, the mean MCA2, MCA3, and V2-5 measurements increased significantly 1 year after surgery. In the first year after surgery, 53 of 62 (85.4%) patients reported marked improvements in nasal breathing. Our results showed that, objectively and subjectively, the success rates in diode laser-assisted turbinate reduction were satisfactory. The diode laser, being one of the most portable and least expensive of the lasers available for turbinate surgery, makes it possible for turbinate reduction to be performed under topical anesthesia within a short period of time with excellent patient acceptance.

Use of cone beam computed tomography in otolaryngologic treatments.

Cone beam computed tomography (CBCT) allows us to evaluate 3-dimensional (3D) morphology of the maxillofacial skeleton and also used in dentomaxillofacial imaging to solve complex diagnostic and treatment planning problems such as craniofacial fractures, temporamandibular dysfunctions or sinus imaging. CBCT uses a rectangular or round 2D detector, which allows a single rotation of the gantry to generate a scan of the entire region of interest. Technological and application-specific factors such as development of compact, relatively low-cost, high-quality, large, flat-panel detector arrays; the availability of low-cost computers with processing power sufficient for cone beam image reconstruction; the fabrication of highly efficient radiograph tubes capable of multiple exposures necessary for cone beam scanning at prices lower than those currently used for fan beam CT; and limited volume scanning (e.g., head and neck) eliminating the need for subsecond gantry rotation speeds make this possible. The objective of this study is to review published evidence for CBCT having an important role in ORL treatments. We aimed to review all the available literature about the CBCT imagination in ORL treatments. Systematic literature search was performed using PubMed and Ovid. Additional literature was retrieved from reference lists in the articles. Systematic analysis of the literature from 1998 to 2010 was performed. A total of 40 abstracts were evaluated independently by two members of the project group, and 38 articles were included in the review.

Audio-vestibular and radiological analysis in Meniere's disease.

OBJECTIVE: Intravenous gadolinium-enhanced inner ear magnetic resonance imaging (IV Gd-enhanced inner ear MRI) is a new technique for diagnosing Meniere's disease (MD). Vestibular tests have also long been used for MD, but which tests should be included in the oto-neurological test battery remains controversial. The evaluation method to be used to confirm the clinical diagnosis in MD is not clear. This study aimed to examine the results of vestibular tests and IV Gd-enhanced inner ear MRI in individuals diagnosed with unilateral definite Meniere's disease. METHODS: IV Gd-enhanced inner ear MRI (Endolymphatic Hydrops [EH] and Perilymphatic Enhancement [PE]), conventional audiometry (0.25-8 kHz), video Head Impulse Test (vHIT), cervical Vestibular Evoked Myogenic Potential (cVEMP), air caloric test, and dizziness handicap inventory were applied to 16 adult patients diagnosed with unilateral definite MD. RESULTS: Among the patients with definite MD, EH (cochlear and/or vestibular) was identified in 93.7% and 68.7% of the symptomatic and the asymptomatic ears, respectively. There was a positive correlation between the hearing thresholds at 2, 4, 6 and 8 kHz and the degree of cochlear EH (p < 0.05). PE (cochlear and/or vestibular) was observed in 37.5% of the asymptomatic and symptomatic ears. The sensitivity of the vestibular test battery (vHIT, cVEMP, and caloric test) was 100% and its specificity was 50%, while the sensitivity of the IV Gd-enhanced inner ear MRI (EH and PE together) was 93.8% and the specificity was 81.3%. CONCLUSION: MRI had higher sensitivity and specificity than the vestibular test battery. PE or vHIT alone was not considered to be reliable in the diagnosis of MD. In suspected MD, the clinical history, hearing tests, and IV Gd-enhanced inner ear MRI are sufficient for diagnosis. If MRI technique is not possible, vestibular tests (caloric test and cVEMP, not vHIT) can provide reliable results when evaluated together.

Comparison of endocanalicular laser dacryocystorhinostomy with and without endonasal procedures.

AIM: To evaluate the role of concomitant endonasal procedures in endocanalicular diode laser dacryocystorhinostomy (DCR). MATERIALS AND METHODS: This was a retrospective study, conducted on adult patients with primary acquired nasolacrimal duct obstruction. Thirty-one (seven bilateral) patients formed group 1 and 37 (five bilateral) patients group 2. Group 1 underwent endocanalicular laser DCR. In group 2, concomitant endonasal procedures, namely middle turbinectomy and endonasal mechanical enlargement of the neo-ostium were additionally performed. Mean follow-up period was 14.6 months for group 1, and 11.0 for group 2. RESULTS: Functional success was defined as the absence of epiphora, and anatomical success as the ability to irrigate the lacrimal system. Anatomic and functional success at each visit were compared using chi-square tests (p < 0.05). Total laser energies used for each case were compared using the Mann-Whitney U test (p < 0.05). Anatomical success rates were increased at the third month, sixth month and final visits. The increase was statistically significant. P value was 0.04 for the third and sixth month results comparison. Final anatomical success rates were 27/38 for group 1 and 39/42 for group 2 (p = 0.02). Final functional success rates were 25/38 patients in group 1 and 36/42 in group 2 (p = 0.07). Mean total laser energy used decreased from 300.0 to 165.0 joules (p < 0.001). CONCLUSIONS: Based on our increased anatomical success rates, concomitant endonasal procedures may help increase success rate in endocanalicular diode laser DCR cases.

In vitro study on immune response modifiers as novel medical treatment options for cholesteatoma.

OBJECTIVES: To investigate cytokine profile of cholesteatoma and to collect information about important intercellular signaling pathways by establishing two different cell culture models, to block important intercellular signaling pathways in cholesteatoma by applying immune system modifier drugs to develop alternative medical therapy options for cholesteatoma. METHODS: To observe the pathogenesis of cholesteatoma and to apply the immunomodulatory drugs, cholesteatoma tissue culture models were constituted with HEKa cells and cholesteatoma keratinocytes, which were obtained from 3 patients who underwent operations for cholesteatoma. Medicines including 5-fluorourasil, imiquimod, cyclosporine, and tacrolimus were applied on both cholesteatoma keratinocytes and HEKa cells. After 48 h of incubation, IL-1, IL-6, IL-8, IL-10, TNF-α, and Ki67 levels were measured to determine cell viability rates. RESULTS: In the cholesteatoma control group, IL-6 and TNF-α levels were found higher than in the HEKa control group. All repurposed drugs in the study demonstrated anti-inflammatory, anti-proliferative, and cytotoxic effects on cholesteatoma. Imiquimod and tacrolimus in particular are potential treatment prospects for cholesteatoma due to their strong anti-inflammatory and cytotoxic effects. CONCLUSION: Medical therapy options for cholesteatoma are still missing and surgery is not the ultimate solution. We have focused on intercellular inflammatory processes, which play significant roles in the pathogenesis of cholesteatoma in our paper. Inflammation and proliferation of cholesteatoma decreased after all repurposed drug applications in our study. Anti-inflammatory and anti-proliferative effects of tacrolimus and imiquimod was more significant than other drugs in the study. For this reason, tacrolimus and imiquimod should be examined in depth with in vivo studies in terms of efficacy and safety for medical treatment of cholesteatoma.

[Quality of life before and after surgery in patients with nasal polyposis]. / Nazal polipli hastalarda ameliyat öncesi ve sonrasi yasam kalitesi.

OBJECTIVES: The postoperative symptoms, paranasal computed tomography (CT) findings and quality of life of the patients who had undergone surgical treatment for nasal polyposis were evaluated. PATIENTS AND METHODS: This study included 32 patients (18 females, 14 males; mean age 43 years; range 14 to 64 years) who applied to our clinic between January 2008 and January 2009 and were operated on with diagnosis of pure nasal polyps. In addition, 36 healthy volunteers were randomized to the control group. The patients were evaluated before and after surgery, on the 3rd week and 3rd month with routine ear nose and throat physical examination and through the Short Form-36 (SF-36) questionnaire as the nasal symptom scores and quality of life. The SF-36 questionnaire was used in the control group as well. In this SF-36 questionnaire the patients were evaluated for eight domains. Control paranasal CT findings at 6th months after surgery were compared with the CT findings before surgery. RESULTS: We determined improvement of nasal symptoms in patients (nasal obstruction, headache, loss of sense of smell, rhinorrhea and posterior rhinorrhea) at the 3rd week and 3rd month after surgery compared to before surgery (p<0.05). We also determined improvement in the domains of SF-36 questionnaire (general healthy, physical functioning, problems of emotional role, social functioning, pain, vitality and mental health) at the 3rd week and 3rd month after surgery compared to before surgery (p<0.05). Control paranasal CT findings of patients at 6th months after surgery was also improved significantly compared to before (p<0.001). CONCLUSION: We determined improvement in all symptoms and quality of life for a short period of time after the surgical treatment performed on patients with nasal polyposis. The paranasal CT has an important place for diagnosis and treatment.

The effects of phototherapy on quality of life in allergic rhinitis cases.

Phototherapy, using a combination of UV-A (25%), UV-B (5%) and visible light (70%), is known to be affective in suppressing the clinical symptoms of allergic rhinitis significantly. It has also been shown that phototherapy locally reduces the number of inflammatory cells and the level of mediators. We aimed to investigate the efficacy of phototherapy in improving the quality of life of patients with allergic rhinitis using Rhinoconjunctivitis Quality of Life Questionnaire, besides checking the total symptom scores of 100 consecutive cases. When the previous and after treatment data were compared, statistically significant differences were found in all quality of life variables (P < 0.001). These results suggest that phototherapy is an effective method to relieve symptoms of allergic rhinitis and has a positive effect on the quality of life of allergic patients. Further studies are needed to plan an ongoing treatment of phototherapy at certain intervals for continuous relief of symptoms and a better and longstanding quality of life.

Efficacy of Platelet-Rich Plasma on Fat Grafts in the Repair of Tympanic Membrane Perforations: An Experimental Study.

OBJECTIVE: We investigated the use of autologous platelet-rich plasma (PRP) to improve the success rate of fat graft myringoplasty in perforated tympanic membranes of rats. MATERIALS AND METHODS: A total of 20 healthy Wistar albino female rats were divided into two groups. In Group 1, the left tympanic membranes were perforated and grafted with a fat graft that was harvested from the inguinal region. In Group 2, the left tympanic membranes were perforated, and a fat graft was also harvested from the inguinal region. Then, the fat was soaked in 0.5 mL PRP and grafted at the perforation. After the procedure, the rats were examined, and the graft situation was assessed at 3, 5, 7, 10, and 14 days. All of the rats were sacrificed 21 days after perforation, and a histopathological examination was made. RESULTS: We compared fat graft histopathological and otomicroscopic findings between the groups. While we did not observe graft rejections in Group 2, we saw 1 case of graft rejection in Group 1. In the histopathological examination, PRP prevents fat graft resorption by the terms of the adipocyte area, granulation tissue area, and vacuolization area. CONCLUSION: This study demonstrated the efficacy of fat grafts prepared with PRP on rat tympanic membranes. The fat graft with PRP did not statistically improve the success rate compared to the graft without PRP. Histopatologic findings of the study showed that PRP prevents fat graft resorption. Further studies are needed to further examine the advantages of the graft with PRP.

[A case of maxillary sinus mucocele with orbital involvement]. / Orbital yayilimli maksiller sinüs mukoseli: Olgu sunumu.

Maxillary sinus mucoceles account for less than 10% of all paranasal sinus mucoceles. They are reported mostly as long-term sequelae of Caldwell-Luc operations. Orbital involvement is an extremely rare condition that might result in orbital complications. A 43-year-old woman presented to the ophthalmology department with progressive ophthalmologic complaints. She was referred to our department for suspicion of a mass in the left maxillary sinus. The patient had undergone a left Caldwell-Luc sinus procedure two years before followed by two maxillary sinus lavages. Findings of computed tomography and magnetic resonance imaging of the paranasal sinuses were suggestive of a maxillary mucocele. Endoscopic sinus surgery and Caldwell-Luc procedure were performed to remove the mucocele that filled the maxillary sinus. Because the eyeball prolapsed through the defect in the inferior orbital wall to the maxillary antrum, a Silastic sheath was placed between the orbital base and the eyeball. No postoperative complication was observed.

Evaluation of the Vestibular System and Etiology in Children with Unilateral Sensorineural Hearing Loss.

OBJECTIVE: The aim of this study was to evaluate the vestibular system of children with unilateral sensorineural hearing loss (USNHL), investigate the etiological factors of USNHL and analyze whether a genetic predisposition exists. MATERIALS AND METHODS: Thirty-three children aged less than 18 years with USNHL, who visited the ear, nose, and throat (ENT) department between January 2004 and December 2012, were included in this study. Cases with conductive hearing loss were excluded from the study. The patients were subjected to etiologic, genetic, and ophthalmologic evaluation; radiologic imaging; electronystagmography (ENG); and vestibular evoked myogenic potential (VEMP) tests. The control group, which included 25 healthy children (13 males and 12 females), had undergone audiological assessment and were subjected to ENG and VEMP tests. RESULTS: All of the patients had severe-to-profound hearing loss. Mumps immunoglobulin G was positive in 22 (66.7%) of 33 patients. The 35delG mutation was not found in any of the patients. All of the patients underwent temporal computed tomography (CT) and magnetic resonance imaging (MRI). Inner ear anomaly was present in 51.5% of the patients. Overall, 21 of 31 ENG patients had canal paresis in the affected ear. The VEMP response was absent on the affected side in three patients. The n23 latency average of the patient group was longer than that of the control group. CONCLUSION: Because USNHL causes irreversible problems in children, early diagnosis and auditory rehabilitation are very important. As USNHL is accompanied by inner ear anomaly, children with USNHL should undergo temporal bone CT and MRI. To evaluate the vestibular system, ENG and VEMP are non-invasive and diagnostic tests.

Scintigraphic evaluation of nasal mucociliary activity in unilateral chronic otitis media.

Mucociliary clearance is a key defence mechanism in human upper and lower airways. Although mucociliary activity is present in both ears of the patients, most cases of chronic otitis media are unilateral. In this study, we aim to evaluate the difference between nasal mucociliary activity of the affected and non-affected sides in patients with unilateral chronic otitis media. Both nasal transport times of 36 patients with unilateral chronic otitis media were compared statistically with each other and with the control group by independent samples t-test. The nasal mucociliary transport times of the nasal cavity at the same side as the affected ear and as the non-affected ear are significantly different, in the same patients. Our study shows that impaired or decreased nasal mucociliary activity may result in dysfunction of the eustachian tube and middle-ear ciliary activity, which plays an important role in the aetiopathogenesis of chronic otitis media.

Plasmacytoid myoepithelioma of the soft palate: a review of the literature and report of a case with immunohistochemical findings.

Myoepitheliomas of salivary glands are rare neoplasms, accounting for less than 1% of all salivary gland tumors. They are classified into four cell types: epithelioid, spindle, clear, and plasmacytoid. Among them, the plasmacytoid cell type appears to have a predilection for the oral cavity, especially the palate. We presented a 32-year-old man with plasmacytoid myoepithelioma arising in the soft palate, together with a brief discussion of the clinicopathologic features and differential diagnosis in the light of the literature.

[Detection of primary carcinoma by positron emission tomography in an unknown primary tumor with cervical metastasis: a case report]. / Primeri bilinmeyen boyun metastazinda pozitron emisyon tomografisi ile primer kanserin saptanmasi: olgu sunumu.

Unknown primary tumors with cervical metastasis account for about 1-3% of patients with neck masses. In many cases, the primary site cannot be detected by diagnostic procedures such as endoscopy, computed tomography, or magnetic resonance imaging, affecting the treatment and prognosis of these patients unfavorably. A 43-year-old male patient presented with a painless mass in the neck. He had previously undergone a neck biopsy, the result of which had been reported as metastatic carcinoma. The primary site could not be determined by extensive diagnostic procedures. Investigation with positron emission tomography with 18F-2-fluoro-2-deoxy-D-glucose suggested the base of the tongue as the primary site, which was then confirmed by an endoscopic biopsy from the tongue. It should be borne in mind that positron emission tomography may be helpful in the diagnosis of unknown primary tumors with cervical metastasis.