[The relationship between operation type, adjuvant radiation therapy, spinal accessory nerve and quality of life in patients with laryngeal cancer]. / Larenks kanserli hastalarda ameliyat tipi, adjuvan radyoterapi ve spinal aksesuvar sinir ile yasam kalitesi arasindaki iliski.

OBJECTIVES: In this study, we aimed to investigate the effect of operation type, adjuvant radiation therapy (RT), and preserved spinal accessory nerve on the quality of life in patients with laryngeal cancer. PATIENTS AND METHODS: A total of 191 consecutive patients (185 males, 6 females; mean age 59±10 years; range 42 to 79 years) who were operated due to laryngeal cancer were included. The quality of life scores were estimated using the Washington University Quality of Life Questionnaire, version IV. The patients were divided into six groups according to the operation type, the need for postoperative RT and preserved or operated spinal accessory nerve during the neck dissection. Group 1 consisted of patients with total or near total laryngectomy; group 2 consisted of those with partial laryngeal surgery; group 3 consisted of those with postoperative RT; group 4 consisted of those without postoperative RT; group 5 consisted of those with preserved 11th cranial nerve during the neck dissection, and group 6 consisted of those with non-preserved 11th cranial nerve during the neck dissection. The questionnaire scores were compared among the groups. RESULTS: The compact quality of life scores were 77.4±11.3 in group 1, 86.2±7.2 in group 2, 79.1±9.5 in group 3, 83.4±10.6 in group 4, 87.3±9.4 in group 5, and 79.4±10.8 in group 6. There was a statistically significant difference in the compact quality of life scores among the surgery groups, neck dissection groups and RT groups (p=0.018, p<0.001, p<0.001, respectively). There was no effect of preserved 11th cranial nerve on daily activity, swallowing, chewing, appearance, recreation, salivation, taste, speech, mood, and anxiety parameters. This nerve was not preserved in 71.9% of the patients who were urged to change their job due to shoulder problems. The difference was statistically significant (p<0.001). CONCLUSION: According to our study results, we concluded that partial laryngectomy improved the quality of life, rather than total or near-total laryngectomy, while postoperative RT had an adverse effect on the quality of life and preserved spinal accessory nerve during the neck dissection had a positive impact on the quality of life in patients with laryngeal cancer.

An indolent course of multiple myeloma mimicking a solitary thyroid cartilage plasmacytoma.

Multiple myeloma, solitary plasmacytoma, and extramedullary plasmacytoma constitute a continuum of a disease spectrum, which is called plasma cell neoplasms. These three entities can not be differentiated from each other on a histological basis and, for this reason, clinical evaluation is important in their differential diagnoses. Differential diagnosis guides the proper planning of treatment and helps in estimation of survival. Multiple myeloma located within the larynx is very rare. Because of its rarity, any established diagnostic and treatment criteria do not exist. In this report, a case of laryngeal multiple myeloma is presented for its extraordinary presentation and also for educational purposes.