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This study assessed arterial stiffness in head and neck cancer patients using speckle tracking carotid strain ultrasonography (STCS-US). It investigated the impacts of neck irradiation and neck dissection on the arterial stiffness of these patients by comparing their stiffness parameters with those of healthy controls. A total of 101 participants (67 patients and 34 healthy controls) were enrolled in this study. Fifty-two patients received definitive radiation therapy (TD: 60-72 Gy in 30 days) at least two years ago. Participants were grouped into four according to their states of neck irradiation (IR) and neck dissection (ND): Group (IR+/ND-) had 28 patients, Group (IR+/ND+) had 24 patients, Group (IR-/ND+) had 15 patients, and Group (IR-/ND-) had 34 healthy controls. All the participants underwent STCS-US. Arterial stiffness parameters relating to arterial compliance (AC) and elastic modulus (EM) were significantly changed in Group (IR+/ND-) and Group (IR+/ND+) in the transverse plane (p < 0.001, p < 0.001) and in the longitudinal plane (p < 0.001, p < 0.001); the change in ß-stiffness index (ß-SI) was more significant in the transverse plane (p = 0.002). Group (IR+/ND+) had significant transverse circumferential (p = 0.001) and radial strain parameters (p = 0.001). The carotid intimal medial thickness (CIMT) significantly changed in Group (IR+/ND+) compared to controls (p = 0.001). Our findings indicate that neck irradiation and neck dissection increase arterial stiffness as single treatments; however, double treatment is associated with a higher increase. Neck irradiation affects strain parameters more than neck dissection alone. The study demonstrated the feasibility and clinical value of the STCS method in assessing arterial stiffness and its potential use in cardiovascular risk assessment for patients with head and neck cancer.
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OBJECT: To prepare a national guideline for Otorhinolaryngologist who treat allergic rhinitis patients. METHODS: The study was conducted by three authors, namely the writing support team. The support team made the study plan, determined the writing instructions, chose the subgroups including the advisory committee, the advisors for authors and the authors. A workshop was organized at the very beginning to explain the details of the study to the team. Advisors took the chance to meet their coworkers in their subgroups and determined the main headings and subheadings of the guideline, together with the authors. After key words were determined by the authors, literature search was done in various databases. The authors keep in touch with the advisors and the advisors with the advisory committee and the support group at every stage of the study. National and International published articles as well as the abstracts of unpublished studies, imperatively presented in National Congresses, were included in this guideline. Only Guideline and meta-analyses published in last seven years (2013-2017) and randomized controlled studies published in last two years (2015-2017) were included. After all work was completed by the subgroups, support team brought all work together and edited the article. RESULTS: A detailed guideline about all aspects of allergic rhinitis was created. CONCLUSION: The authors believe that this guideline will enable a compact and up-to-date information on allergic rhinitis to healthcare professionals. This guideline is the first in the field of Otolaryngology in Turkey. It should be updated at regular intervals.
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OBJECTIVES: To investigate the correlation between tumor stage, Ki-67, Bcl-2, hypoxia inducible factor-1α (HIF-1α), cyclin D1 and metabolic tumor volume (MTV), total lesion glycolysis (TLG), maximum standardized uptake value (SUVmax) measured by 18F fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in patients diagnosed with laryngeal cancer. PATIENTS AND METHODS: In this study, included 25 consecutive laryngeal cancer patients (2 women, 23 men) diagnosed and treated in the Otorhinolaryngology Department of our tertiary care center. All cases underwent 18F FDG PET/CT and SUVmax, mean standardized uptake value, MTV, and TLG values were calculated. Tumor staging was made and immunohistochemical staining was carried out for Ki-67, Bcl-2, HIF-1α and cyclin D1. RESULTS: Eight (32%) patients had glottic laryngeal cancer, 6 (24%) had supraglottic laryngeal cancer and 11 (44%) had transglottic laryngeal cancer. Cyclin D1 was significantly correlated with MTV (r = 0.45, P = 0.03), TLG (r = 0.492, P = 0.01) and T-stage (r = 0.483, P = 0.02). Bcl-2 was significantly correlated with SUVmax (r = -0.41, P = 0.05) and tumor stage (r = -0.442, P = 0.03). MTV and TLG are significantly correlated with nodal stage (r = 0.422, P = 0.04, r = 0.419, P = 0.04), while TLG (r = 0.403, P = 0.05) and SUVmax (r = 0.440, P = 0.03) were correlated with tumor stage. CONCLUSION: Our results indicated that biomarkers such as cyclin D1 and Bcl-2 were correlated with measures such as MTV, TLG, and SUV in 18F-FDG PET/CT. Integrative and combined evaluation of biomarkers and imaging data derived from 18F-FDG PET/CT are important for staging and appropriate management of patients with laryngeal cancer.
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Biomarcadores Tumorais/metabolismo , Neoplasias Laríngeas/metabolismo , Prognóstico , Carga Tumoral , Adulto , Idoso , Idoso de 80 Anos ou mais , Ciclina D1/metabolismo , Feminino , Fluordesoxiglucose F18 , Humanos , Subunidade alfa do Fator 1 Induzível por Hipóxia/metabolismo , Antígeno Ki-67/metabolismo , Neoplasias Laríngeas/diagnóstico por imagem , Neoplasias Laríngeas/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Proteínas Proto-Oncogênicas c-bcl-2/metabolismoRESUMO
BACKGROUND: The supplement Pycnogenol® (PYC) has been used for the treatment of several chronic diseases including allergic rhinitis (AR). However, the in vivo effects on allergic inflammation have not been identified to date. AIMS: To investigate the treatment results of PYC on allergic inflammation in a rat model of allergic rhinitis. STUDY DESIGN: Animal experimentation. METHODS: Allergic rhinitis was stimulated in 42 rats by intraperitoneal sensitization and intranasal challenge with Ovalbumin. The animals were divided into six subgroups: healthy controls, AR group, AR group treated with corticosteroid (dexamethasone 1 mg/kg; CS+AR), healthy rats group that were given only PYC of 10 mg/kg (PYC10), AR group treated with PYC of 3mg/kg (PYC3+AR), and AR group treated with PYC of 10 mg/kg (PYC10+AR). Interferon-γ (IFN-γ), interleukin-4 (IL-4), interleukin-10 (IL-10), and OVA-specific immunoglobulin E (Ig-E) levels of serum were measured. Histopathological changes in nasal mucosa and expression of tumor necrosis factor-α (TNF-α) and IL-1ß were evaluated. RESULTS: The levels of the IL-4 were significantly decreased in the PYC3+AR, PYC10+AR and CS+AR groups compared with the AR group (p=0.002, p<0.001, p=0.006). The production of the IFN-γ was significantly decreased in the PYC3+AR and PYC10+AR groups compared with the AR group (p=0.013, p=0.001). The administration of PYC to allergic rats suppressed the elevated IL-10 production, especially in the PYC3+AR group (p=0.006). Mucosal edema was significantly decreased respectively after treatment at dose 3 mg/kg and 10 mg/kg PYC (both, p<0.001). The mucosal expression of TNF-α has significantly decreased in the PYC3+AR and PYC10+AR groups (p=0.005, p<0.001), while the IL-1ß expression significantly decreased in the CS+AR, PYC3+AR, and PYC10+AR groups (p<0.001, p=0.003, p=0.001). CONCLUSION: PYC has multiple suppressive effects on allergic response. Thus, PYC may be used as a supplementary agent in allergic response.
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Vasoconstrictors agents is used in septal surgery, in attempt to improve haemostasis and thereby improve the surgical field. We aimed to compare the effect of lignocaine with adrenaline injection and alone lignocaine injection with topical adrenalin on perioperative hemodynamic effect, hemorrhage and postoperative pain. Patients undergoing surgery were randomised into two groups: group I in whom infiltration was performed with lignocaine (2 %) with adrenaline (1:100,000), group II in whom infiltration was performed with lignocaine (2 %) injection with topical adrenalin application (1:10,000). The two groups were matched by age, sex, body weight, pre-anesthesia blood pressure, heart rate, oxygen pressure and hemorrhage. The hemostatic effects postoperative pain in each group were analyzed. No statistically significant differences in operation time, hemodynamic effect, and intraoperative blood loss were reached between the two groups of patients (p > 0.05). But also group I had significantly better pain scores versus control group in the 2nd, 4th, 6th postoperative hours (p < 0.05). We suggest that the use of adrenaline infiltration during septal surgery is unnecessary and may subject the patient to the risk of cardiogenic side-effects of systemic absorption.
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Laryngopharyngeal reflux (LPR) is a type of reflux, seen with complaints of hoarseness, chronic cough, and globus sensation, different from gastroesophageal reflux disease (GERD). The aim of this study was to evaluate the awareness, knowledge, and practices of family physicians and trainees who were being trained in medical branches other than ENT and to determine the effective factors on decision making for diagnosis of this disorder. The study was designed as a two-stage study. At the first stage, a data collection tool, involving 29 questions by which the knowledge, awareness, and applications of the physicians about LPR would be determined, was developed with 12 specialists, using Delphi method. At the second stage, 101 family physicians replied the questionnaire online. For 45 trainees other than ENT, the questionnaire was filled face-to-face by one of the investigators. In patients admitted with complaints of hoarseness, lasting longer than 2 weeks, cough, lasting longer than 3 weeks, and globus sensation, the physicians considered LPR as the preliminary diagnosis with rates of 88.4, 82.2, and 62.8 %, respectively. 87.0 % of physicians, participating in the study, started treatment for reflux empirically in patients having complaints of hoarseness, chronic cough, and globus sensation; however, only 29.0 % of physicians prescribed this treatment for periods of 3 or 6 months. 69.9 % of physicians, participating in the study, made a diagnosis of reflux in general during their daily practices; only 6.9 % made the discrimination between LPR and GERD. Of all physicians, 27.9 % prescribed double-dose PPI or H2.
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Competência Clínica , Conhecimentos, Atitudes e Prática em Saúde , Refluxo Laringofaríngeo/diagnóstico , Médicos de Família/normas , Adulto , Doença Crônica , Tosse/etiologia , Transtornos de Deglutição/etiologia , Técnica Delphi , Diagnóstico Diferencial , Feminino , Refluxo Gastroesofágico/diagnóstico , Rouquidão/etiologia , Humanos , Refluxo Laringofaríngeo/complicações , Refluxo Laringofaríngeo/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Médicos de Família/educação , Médicos de Família/estatística & dados numéricos , Inibidores da Bomba de Prótons/uso terapêutico , Estatísticas não Paramétricas , Inquéritos e Questionários , Avaliação de Sintomas/estatística & dados numéricos , Fatores de TempoRESUMO
Medial sural artery perforator (MSAP) flap is a relatively new flap which is a modification of medial gastrocnemius myocutaneous flap. Both radial forearm flap and MSAP has common benefits, such as thinness, long pedicle and pliability; however, MSAP has lower donor site morbidity when compared with radial forearm flap. Because of this reason, the MSAP flap has gained popularity during the last decade. The objective of this study was to determine clinical application results of this flap in reconstruction of post-oncologic defects in the head and neck region. 11 patients operated for head and neck post oncologic defects and reconstructed with MSAP between June 2014 and Dec 2015 were included in the study. Age, gender, histopathology, area of reconstruction, flap size, number of perforators were reviewed. Postoperatively recipient and donor site complications, hospital stay and additional surgical procedures were also analyzed. We had seven uncomplicated cases; one total flap failure due to arterial problem, in three cases due fistula formation and local wound healing problems additional surgeries were performed. All venous anastomosis were performed with 9/0 sutures, nine arterial anastomosis were performed with 9/0 and two arterial anastomosis were performed with 10/0 nylon sutures. Medial sural artery perforator flap is a good alternative in head and neck reconstruction, with the advantages of thin and pliable skin, a reliable vascular pedicle, straightforward intramuscular dissection. But there are certain drawbacks like tedious pedicle and perforator dissection, small arterial pedicle size which complicates anastomosis and obscurities of anatomy. Surgical team must always be ready for a difficult micro anastomosis and an alternative flap choice must be prepared and counseled with the patient in case of inadequate perforators.
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Procedimentos Cirúrgicos Dermatológicos/métodos , Neoplasias de Cabeça e Pescoço/cirurgia , Retalho Perfurante/irrigação sanguínea , Adulto , Idoso , Idoso de 80 Anos ou mais , Anastomose Cirúrgica , Procedimentos Cirúrgicos Dermatológicos/efeitos adversos , Feminino , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do TratamentoRESUMO
CONTEXT: Pycnogenol®, which is French maritime pine bark extract, is a potent antioxidant. It is used in medical conditions caused by oxidative stress. Cisplatin (cis-diamminedichloroplatinum II) is an antineoplastic agent. However, its serious side effects such as ototoxicity limit its usage. OBJECTIVE: Antioxidants can be used to prevent ototoxicity. We investigated the effect of Pycnogenol® on cisplatin-induced ototoxicity. MATERIALS AND METHODS: Rats were randomly assigned to four groups of five. Distortion product-evoked otoacoustic emissions (DPOAE) test was performed for each rat. The experimental groups were as follows: Control Group, Pycnogenol® Group: 10 mg/kg Pycnogenol® intraperitoneally for 7 days, Cisplatin Group: intraperitoneally 15 mg/kg single injection of cisplatin on the fifth day, Cisplatin + Pycnogenol® Group: intraperitoneally 10 mg/kg Pycnogenol® treatment for 7 days, additionally on the fifth day, 15 mg/kg single injection of cisplatin was given. On the eighth day, DPOAE was re-performed and rats were sacrificed. Apoptosis was evaluated histopathologically. RESULTS: Mean percentage of apoptotic cells was 1.5, 3, 30 and 11% in organ of Corti and 2, 2, 40, 15% in spiral ganglion neurons in Control Group, Pycnogenol® Group, Cisplatin Group and Cisplatin + Pycnogenol® Group, respectively. Cisplatin Group and Cisplatin + Pycnogenol® Group were significantly different when compared to Control Group histopathologically both in organ of Corti and spiral ganglion neuron (p <0.001, p = 0.019, p = 0.001, p = 0.015). DPOAE results showed that Cisplatin + Pycnogenol® Group was significantly different when compared to Cisplatin Group at 3, 6 and 8 kHz (p < 0.05). CONCLUSION: Pycnogenol protected against cisplatin ototoxicity. Also, pycnogenol is not ototoxic.
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Antineoplásicos/toxicidade , Cisplatino/toxicidade , Cóclea/efeitos dos fármacos , Flavonoides/farmacologia , Animais , Cóclea/fisiologia , Masculino , Órgão Espiral/efeitos dos fármacos , Emissões Otoacústicas Espontâneas/efeitos dos fármacos , Extratos Vegetais , Ratos , Gânglio Espiral da Cóclea/efeitos dos fármacosRESUMO
Epistaxis is one of the most frequently encountered emergency problems in our country, as it is throughout the world. In epistaxis, the benefits of implementing clinical guidelines are evident in both daily practice and medical education. In this article, the authors aimed to present their approach to adult patients with epistaxis and to share their experience, which considered the life quality of the patients to be at the forefront, based on some of their patients. In management of epistaxis, the implementation of the simplest method, minimally affecting the life quality of the patient, may be easier with a stepped approach. The authors consider that the stepped approach that they have implemented and presented in their study may lead to using less invasive methods and may accordingly improve the life quality of the patient.
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Epistaxe/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Cauterização , Celulose Oxidada , Terapia Combinada , Estudos Transversais , Endoscopia , Epistaxe/epidemiologia , Epistaxe/etiologia , Epistaxe/psicologia , Feminino , Humanos , Comunicação Interdisciplinar , Colaboração Intersetorial , Masculino , Pessoa de Meia-Idade , Qualidade de Vida/psicologia , Recidiva , Retratamento , Tampões Cirúrgicos , Turquia , Adulto JovemRESUMO
OBJECTIVES: In this study, we aimed to investigate the laryngeal histopathological alterations and thyroid hormone receptors in rats with experimentally-induced postnatal hypothyroidism. MATERIALS AND METHODS: In this prospective, randomized study, pregnant Wistar albino rats were followed and newborn 20 Wistar albino rat pups were included in the study. The pups were randomly divided into two groups: In group 1 (methimazole (MMI)-induced hypothyroidism group), the mothers and pups were given MMI added water up to 90th day, as the pups were fed with breast milk for 19 to 22 days. In group 2 (control group), the mothers and pups were fed with MMI-free water up to 90th days. When the pups were 90 days of age, they were decapitated and their larynx was removed. Their larynx was evaluated for edema, inflammation, goblet cells, and thyroid hormone receptors (TR-α, TR-ß). RESULTS: Nine larynx samples for group 1 and eight for group 2 were studied. There was a significant difference in inflammation between the groups with slightly lower in the hypothyroidism group (p=0.009). The TR-α, TR-ß, and edema were significantly higher in the hypothyroidism group (p=0.002, p=0.029, p=0.029). There was no significant difference in the Goblet cells between the groups (p=0.637). CONCLUSION: Histopathologically increased laryngeal edema and increased thyroid hormone receptors were found, shedding light on the mechanism of voice changes in hypothyroidism.
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Hipotireoidismo/metabolismo , Receptores dos Hormônios Tireóideos/metabolismo , Animais , Modelos Animais de Doenças , Edema , Feminino , Humanos , Hipotireoidismo/complicações , Laringe/patologia , Metimazol , Gravidez , Estudos Prospectivos , Distribuição Aleatória , Ratos , Ratos Wistar , Distúrbios da Voz/etiologiaRESUMO
Since newborns are obligatory nasal breathers, upper respiratory tract problems may sometimes be life threatening. The most common pathology causing dyspnea and stridor in newborns is laryngomalacia. Nasal cavity pathologies that risk the neonatal airway are more rarely met. These anomalies may be seen either as solitary anomalies or as a part of a syndrome. While choanal atresia is one of the best-known nasal cavity anomalies, choanal stenosis, congenital nasal mid-line masses, congenital nasal pyriform aperture stenosis, and nasal tip anomalies are more rarely seen structural pathologies. Choanal atresia may be present either as an isolated congenital anomaly or as a part of CHARGE syndrome. Some rare chromosome anomalies may also cause significant problems during nasal respiration in newborns. With this study, we presented a case series of newborns with pathologies that affected nasal respiration. Although the diagnosis and treatment of choanal atresia and congenital dacryocystocele are well known, the information on the diagnosis and treatment of the other two uncommon cases are limited. With this study, we aimed to contribute to the literature by presenting our approach in six cases having congenital pathologies that cause nasal respiratory obstruction.
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OBJECTIVE: One of the frequently encountered disorders of wound healing following laryngectomy is pharyngocutaneous fistula. However, although studies have been performed with the aim of prevention of pharyngocutaneous fistulae, there are very few studies with tissue adhesives and platelet-rich plasma. In this study, our aim was to investigate the histopathologic changes in wound healing caused by various tissue adhesives and platelet-rich plasma, together with their effects on prevention of pharyngocutaneous fistula. METHODS: 40 male rats were randomly divided into five groups: control, platelet-rich plasma, fibrin tissue adhesive, protein-based albumin glutaraldehyde and synthetic tissue adhesive groups. The pharyngotomy procedure was performed and was sutured. Except the control group, tissue adhesives and platelet-rich plasma were applied. Then, the skin was sutured. On the seventh day, the rats were sacrificed. The skin was opened and pharyngotomy site was assessed in terms of fistulae. The pharyngeal suture line was evaluated histopathologically by using Ehrlich Hunt scale. RESULTS: Inflammatory infiltration was found to be higher in "platelet-rich plasma" group than "fibrin tissue adhesive" and "synthetic tissue adhesive" groups. The fibroblastic activity of "platelet-rich plasma", "fibrin tissue adhesive" and "protein-based albumin glutaraldehyde" groups was higher than the control group. The positive changes created by platelet-rich plasma and fibrin tissue adhesive at the histopathologic level were found together with no detected fistula. Among the study groups, there was no statistical difference for pharyngeal fistula development. This result may be obtained by the small number of animal experiments. CONCLUSION: These results shed light on the suggestion that platelet-rich plasma and fibrin tissue adhesive can be used in clinical studies to prevent pharyngocutaneous fistula.
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Fístula Cutânea/prevenção & controle , Adesivo Tecidual de Fibrina/farmacologia , Glutaral/farmacologia , Laringectomia/métodos , Doenças Faríngeas/prevenção & controle , Faringe/efeitos dos fármacos , Plasma Rico em Plaquetas , Adesivos Teciduais/farmacologia , Cicatrização/efeitos dos fármacos , Animais , Feminino , Adesivo Tecidual de Fibrina/uso terapêutico , Glutaral/uso terapêutico , Inflamação , Masculino , Faringe/patologia , Faringe/cirurgia , Complicações Pós-Operatórias , Ratos , Adesivos Teciduais/uso terapêuticoRESUMO
Objective Essential Palatal Tremor (PT) is a disorder in which radiological brain images appear normal but the clicking noise caused by peritubal, palatal muscle contractions remains the main complaint of patients. The condition occurs rarely in childhood. This paper demonstrates such a rare case with bilateral presentation of essential PT in a 12-yr-old girl could successfully be treated with botulinum toxin therapy at Otorhinolaryngology Department in 2013, as she was still asymptomatic after 16 months. Besides, being minimally invasive with negligible side effects, this choice of treatment with botulinum toxin A (BTA) leads to a long-term symptom free outcome from essential PT.
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BACKGROUND: Neutrophil to Lymphocyte Ratio (NLR) is considered to be a reliable indicator in etiological investigation and identification of the disease severity in inflammatory disorders. There are numerous observations or evidences suggesting that Bell's palsy is an inflammatory disorder. OBJECTIVES: Our aim was to investigate the presence of any clue which might suggest inflammatory etiology and also the presence of compliance between NLR elevation and inflammation severity in children. METHODS: Patients younger than 18 years with Bell's palsy and who had not another inflammatory disorder in addition to Bell's palsy were included. A total of 25 patients and 25 healthy individuals were taken. The patient group and the control group were compared in terms of NLR, neutrophil and lymphocytes. The relationship of NLR with pre-treatment House-Brackmann classification was evaluated. RESULTS: The mean age was 9.86±5.07 in the patient group and 9.14±5.94 in the control group. In all members of the patient group, oral prednisolone (1 mg/kg/d) was administered for 7 days. The post-treatment House-Brackmann classification of all patients was determined as grade 1. The average neutrophil values were significantly higher in the patient group. In terms of average lymphocyte values, no statistically significant difference was found. The average NLR value was 1.78 (0.93-4.58) in the pediatric patient group and 1.1 (0.6-2.05) in the control group. NLR was significantly higher in the patient group. NLR and pre-treatment House-Brackmann classification showed no statistically significant correlation (r=0.173, p>0.05). When cut-off value was taken as 3 for NLR, no statistically significant difference was found between groups. CONCLUSIONS: High NLR values determined in pediatric patients with Bell's palsy support the inflammatory feature of this disease. NLR is recommended as a supportive parameter in the diagnosis of pediatric patients with Bell's palsy.
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Paralisia de Bell/sangue , Linfócitos , Neutrófilos , Adolescente , Paralisia de Bell/tratamento farmacológico , Paralisia de Bell/etiologia , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Humanos , Inflamação , Contagem de Linfócitos , Masculino , Prednisolona/uso terapêuticoRESUMO
Positive airway pressure (PAP) devices are used in the treatment of obstructive sleep apnoea syndrome (OSAS). In cases of PAP failure, many different surgical methods can be used for the treatment. The authors present an unusual case of a patient with Bi-level PAP (BiPAP)-intolerant severe OSAS who was treated with combined surgical methods. A 55-year-old man was treated with BiPAP due to OSAS; he was admitted to the clinic with nose stuffiness, respiratory distress and BiPAP adherence with tolerance and compliance problems. Septal deviation, concha hypertrophy, lateral pharyngeal band hypertrophy and Thornwaldt cyst were determined in the examination. Combined surgical methods were administered. The patient's apnoea hypopnoea index (AHI) was 72.8 in diagnostic polysomnography. Preoperative AHI was 7.3 and postoperative AHI was 2.3 while using BiPAP and, after the surgery, the BiPAP intolerance was eliminated. The authors suggest that a combination of different surgical methods would be an adjuvant treatment to increase BiPAP compliance.
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Pressão Positiva Contínua nas Vias Aéreas , Obstrução Nasal/cirurgia , Apneia Obstrutiva do Sono/terapia , Terapia Combinada , Cistos/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Obstrução Nasal/etiologia , Septo Nasal/anormalidades , Septo Nasal/cirurgia , Doenças Nasofaríngeas/cirurgia , Cooperação do Paciente , Índice de Gravidade de Doença , Tonsilectomia , Conchas Nasais/cirurgiaRESUMO
A 22-year-old man presented to our department with a mass on the base of his tongue. He had a cavernous voice causing a moderate speech disorder, and he had some difficulty in swallowing. He had severe problems with sleep, associated with apnoea. In a fibreoptic laryngoscopic examination, a large 4×5 cm vascular mass was detected extending from the base of the patient's tongue to his epiglottis. It covered the epiglottis. Thyroid scintigraphy showed only thyroid tissue on the base of the tongue. Surgery was initiated transorally under the guidance of a rigid endoscope, but as the mass continued extended to the epiglottis, a transhyoid approach was taken. At a 3-month follow-up, the patient was symptom free. Electrocautery-assisted resection under the guidance of a rigid endoscope can reliably be used in surgery of a lingual thyroid. However, a transhyoid approach provides a better view and also helps in achieving haemostasis.
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Epiglote/patologia , Laringoscopia , Tireoide Lingual/diagnóstico , Procedimentos Cirúrgicos Bucais/métodos , Apneia Obstrutiva do Sono/etiologia , Distúrbios da Fala/etiologia , Língua/cirurgia , Adulto , Epiglote/cirurgia , Seguimentos , Humanos , Tireoide Lingual/complicações , Tireoide Lingual/cirurgia , Masculino , Apneia Obstrutiva do Sono/patologia , Apneia Obstrutiva do Sono/cirurgia , Distúrbios da Fala/patologia , Língua/anormalidades , Língua/patologiaRESUMO
BACKGROUND: Mean platelet volume (MPV) is a marker which has been investigated in many cancers but data for head and neck lesions are limited. We aimed to study the MPV levels in head and neck cancers as a diagnostic marker. MATERIALS AND METHODS: A total of 96 head and neck cancer patients and 31 control patients who did not meet exclusion criteria were enrolled in the study. The cancer locations, the platelet and MPV levels at the first diagnosis time were collected. RESULTS: The head and neck cancer location distribution between these patients was 2 (2.1%) buccal, 9 (9.4%) tongue, 6 (6.3) lip, 1 (1%) gingiva, 1 (1%) hypopharynx, 1 (1%) ear, 58 (60.4%) larynx, 2 (2.1%) maxilla, 2 (2.1%) nasal, 1 (1%) nasopharynx, 2 (2.1%) palatal, 3 (3.1%) primary unknown, 1 (1%) retromolar, 1 (1%) thyroid, 2 (2.1%) tonsil, and 4 (4.2%) salivary gland. MPV levels were significantly different between cancer and control group (p=0.002). The cut-off point for MPV predicting head and neck cancer is >10 fL (sensitivity=55.21, specificity=87.10). CONCLUSIONS: MPV level increase, a readily assessable parameter which does not bring extra costs can warn us regarding head and neck cancer risk.
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Neoplasias de Cabeça e Pescoço/sangue , Neoplasias de Cabeça e Pescoço/diagnóstico , Volume Plaquetário Médio , Idoso , Biomarcadores Tumorais/sangue , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Curva ROCRESUMO
Tuberculosis is an infectious disease, which is the leading cause of mortality and morbidity and is still a serious health concern. The fact that extra pulmonary tuberculosis does not have specific examination and radiographic findings and that clinical findings vary depending on the organ in which it is detected cause diagnostic difficulties. The head and neck region is an uncommon site for tuberculosis and tuberculosis can localise in many different places of the head and neck region. In this article, the authors present a case of nasopharyngeal tuberculosis, which clinically mimics nasopharyngeal carcinoma and rare cutaneous tuberculosis of the pinna. A wide knowledge of head and neck tuberculosis, including the disease in the differential diagnosis and carrying out microbiological examinations are necessary for accurate diagnosis.
Assuntos
Orelha Externa , Doenças Nasofaríngeas/diagnóstico , Tuberculose Cutânea/diagnóstico , Tuberculose dos Linfonodos/diagnóstico , Idoso , Antituberculosos/uso terapêutico , Biópsia , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Doenças Nasofaríngeas/tratamento farmacológico , Doenças Nasofaríngeas/microbiologia , Tuberculose Cutânea/tratamento farmacológico , Tuberculose dos Linfonodos/tratamento farmacológicoRESUMO
OBJECTIVE: Trastuzumab and lapatinib are widely used chemotherapeutic agents. Our aim in this study was to assess the possible ototoxicity of these chemotherapeutic agents. MATERIALS AND METHODS: Forty-eight rats were divided into six groups: Group 1 (control, n=8) received intraperitoneal saline for 7 days. Group 2 (n=8) and Group 3 (n=8) received 10 mg/kg and 30 mg/kg single doses of intraperitoneal trastuzumab, respectively. Lapatinib was administered by oral gavage to Group 4 (n=8) at 100 mg/kg/day and to group 5 (n=8) at 300 mg/kg/day for 7 days. Group 6 (n=8) received only one dose of 10 mg/kg intraperitoneal trastuzumab; subsequently, Group 6 received one dose of lapatinib at 100 mg/kg/day by oral gavage for 7 days. Before any medication was administered, distortion product emissions (DPOAE) were obtained. DPOAE tests were performed again on the rats on day 7, after which the mastoid bullas were harvested. The apoptosis degree was evaluated by the terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) procedure. RESULTS: The lapatinib 300 and lapatinib+trastuzumab groups (p=0.008 and p=0.001, respectively) were significantly different from the control group according to the spiral ganglion TUNEL. Apoptosis in the organ of corti was statistically different compared with the control group in the lapatinib 100, lapatinib 300, and lapatinib+trastuzumab groups (p=0.035, p=0.001, and p<0.001, respectively). Trastuzumab induced damage in only the organ of corti; however, lapatinib induced damage in both the organ of corti and spiral ganglion. The degree of the damage in the organ of corti was high when trastuzumab and lapatinib were concomitantly used. Supporting this data, a reduction in DPOAE amplitudes was observed during the combined usage of the drugs. CONCLUSION: Administering trastuzumab and lapatinib causes ototoxic effects.