The validity and reliability of the Turkish version of the University of Washington Quality of Life Questionnaire for patients with head and neck cancer.

PURPOSE: The University of Washington Quality of Life Questionnaire (UW-QOL) is an English-language survey used to assess the quality of life of patients with head and neck cancer. The present study aimed to translate this widely used questionnaire into Turkish according to international guidelines and to statistically determine its validity and reliability by administering it to native Turkish-speaking patients. MATERIALS AND METHODS: This prospective study was performed at Hacettepe University, Faculty of Medicine, Turkey. The study included patients newly diagnosed as having head and neck cancer. Translation and cultural adaptation of the questionnaire were performed first. Then, the translated version was tested on a consecutive series of patients seen in the department of otorhinolaryngology head and neck surgery and the department of radiation oncology between September 2006 and February 2008. The patients were asked to complete 3 sets of questionnaires. The first set was completed 1 day before the beginning of treatment, the second 3 months after the completion of treatment, and the third 10 days after the second questionnaire was completed. The first and second sets included the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire-Turkish version and UW-QOL-Turkish version. The third set included the Turkish UW-QOL only. Performance status was assessed and rated by a physician using the Karnofsky and ZEW (Zubrod/The Eastern Cooperative Oncology Group (ECOG)/World Health Organization) performance scales, synchronous with the first and second sets of questionnaires. RESULTS: The original English version of UW-QOL was carefully translated into Turkish, and a final Turkish version of UW-QOL was developed in an iterative fashion. To determine its validity and reliability, 67 patients were included in the study. Internal consistency (Cronbach α = .757) was adequate, and test-retest reliability (interclass correlation coefficient, 0.941) was excellent. The composite scores of the translated UW-QOL were compared statistically with the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire scores, Karnofsky and ZEW performance scales, T stage of the disease, and UW-QOL global questions scores to support the scale's construct validity, and statistically significant associations were observed. CONCLUSIONS: The Turkish UW-QOL appears to be a valid and reliable tool for use with Turkish patients with head and neck cancer; it can also be used in clinical investigations and routine clinical practice in Turkey.

Metastatic choriocarcinoma: a rare presentation as a neck mass.

Testicular carcinoma metastatic to the neck is rare. Even more rare is a finding of choriocarcinoma as a neck mass without any sign of a primary testicular tumor, as only a few cases have been reported in the literature. We describe a new case that occurred in a 29-year-old man who presented with a neck mass. Fine-needle aspiration biopsy identified the tumor as a malignant epithelial neoplasm. Radiologic findings indicated the presence of a systemic metastasis of a tumor to the chest and abdomen, as well as the neck. Findings on an incisional biopsy of the neck mass were consistent with a choriocarcinoma. The testicles were normal on palpation and ultrasonography. The patient was diagnosed with metastatic choriocarcinoma with an unknown primary, and he was started on chemotherapy. On the second day of treatment, which was 25 days after his referral to our clinic, he died of respiratory insufficiency.

Type I thyroplasty revision 1 year after a window was mistakenly created on the cricoid cartilage.

Unilateral vocal fold paralysis causes glottic incompetence and can result in significant morbidity. To prevent such morbidity, surgeons treat affected patients with vocal fold medialization techniques; type I thyroplasty medialization surgery is widely used for this purpose. In this procedure, a window is opened on the thyroid cartilage to allow for placement of a silicon prosthesis to medialize the vocal fold. A 38-year-old woman presented to our clinic for evaluation of hoarseness and a low-pitched voice, which we diagnosed as being caused by left vocal fold paralysis. Two years earlier, she had undergone a thyroidectomy for the treatment of benign thyroid disease. One year after that, she underwent type I thyroplasty medialization surgery at another center. During that operation, the surgeon had mistakenly created the window on the cricoid cartilage rather than the thyroid cartilage. When he inserted the silicon prosthesis into the cricoid window, the patient developed acute respiratory obstruction. At that point, the prosthesis was removed and the operation was terminated. One year later, she presented to us, and we performed a revision type I thyroplasty. Intraoperatively, we discovered that the original window had been opened on the cricoid cartilage instead of the thyroid cartilage, which was intact. We left the cricoid window untouched, opened a new window on the thyroid cartilage, and completed the type I thyroplasty in the usual fashion. The patient's postoperative recovery was uneventful, and she was doing well at 5 years of follow-up. To the best of our knowledge, no case of a thyroplasty window being opened on a cricoid cartilage has been reported in the literature.

Ceruminous adenoma mimicking furunculosis in the external auditory canal.

Tumors arising from the ceruminous glands are very rare. Herein, we report a case of ceruminous adenoma mimicking furunculosis in the external auditory canal (EAC), along with a discussion of the various pathological types and a review of their management.

Bilateral external auditory canal squamous cell carcinoma: a case report.

Squamous cell carcinoma (SCC) of the external auditory canal (EAC) is an extremely rare malignant tumor with a prevalance between 1 and 6 cases per 1 million population. The incidence is higher in patients presenting with otological diseases (1 in 5,000 to 15,000). Certain associating factors have been described in the literature. This malignancy frequently presents with symptoms similar to a case of otitis externa or a chronic suppurative otitis media. In this paper, we present a patient who had bilateral SCC of EAC caused by radiotherapy for nasopharyngeal carcinoma. To our knowledge, our case is the fifth bilateral SCC of the EAC and the first bilateral radiotherapy related SCC of the EAC reported in the literature so far.