Nodule and cancer assessment following thyroid surgery: a cohort of 460 patients.

OBJECTIVE: Thyroid nodule formation and the cancer risk of these nodules have recently become widely researched topics. Developments in diagnosis and treatment options have correlated with an increased number of diagnosed patients. However, such a high number of malignant patients in a single center is rare, and this advantage is able to assess the patients in reverse by reviewing nodularity in the malignant patient population. In this study, we retrospectively reviewed nodularity and malignancy following thyroid surgery in a high-risk population with high thyroid cancer rates. PATIENTS AND METHODS: Out of 1,007 thyroid patients either referred to or operated on at Ankara Oncology Training and Research Hospital between January 1995 and December 2003, 460 patients with readily available data were included in the study. RESULTS: Of the 460 patients, 74.9% were female and 25.1% were male. The mean age of female patients operated on due to thyroid nodules was 43.7 years (SD: 14.7; range: 12-81) and 47.1 years for males (SD: 14.6; range: 14-80) (p = 0.02). The mean age of patients with a solitary thyroid nodule (STN) was 40.57 years (SD: 13.65) and 45 years (SD: 14.49) for multinodular cases, with the number of nodules increasing with age (p = 0.0008). Malignancy was seen in 78% of STN cases and 73% of multinodular goiter (MNG) cases (p = 0.554). Comparing genders, 74.2% of female patients and 79.6% of male patients with an STN showed malignancy (p = 0.556). Similarly, 73.4% of females and 75.7% of males with MNG showed malignancy (p = 0.694). Multicentric malignancy was detected in 65.2% of MNG cases and 26.6% of STN cases (p < 0.001). This was especially prominent in papillary carcinomas, which had multicentric malignancy rates of 66.6% for MNG and 22.4% for STN (p < 0.001). CONCLUSIONS: The females tended to develop nodules at an earlier age than the males, the MNG risk increased with age, and multicentric malignancy was prominent in MNG in papillary carcinomas.

A custom-made silicon mold for pressure therapy to ear keloids.

Keloids are raised reddish nodules that develop at the site of an injury. They are characterized histologically by an abundance of fibroblasts, thick collagen bundles, and ground substance. Auricular keloid formation is a known complication of ear piercing. Many types of treatments have been described for auricular keloids.Pressure therapy in combination with surgery, corticosteroid injection, or both is widely used to manage and prevent hypertrophic scarring. Many pressure devices and procedures have been developed. However, all of them are designed for the earlobe region. If a keloid grows in the posterior auricular region, none of the devices described in the literature will be effective. The authors developed a custom-made silicon ear mold that covers whole ear. With this mold, pressure can be applied homogeneously to the lobule and cartilaginous region, which the other devices described in the literature cannot affect. The preparation technique includes making the negative cast mold of the patient's ear, creating the positive cast mold from the negative cast mold, and forming the negative silicon mold from the positive cast. After all the processes, a silicon sheet has been designed according to the region needing to be pressurized. The designed silicon sheet is applied to the region, followed by placement of the silicon mold. A simple tennis head band can be used to stabilize the silicon cast. If the keloid extends to the posterior auricular region, pressurizing with clips or other devices described previously will be difficult. Application of pressure to the cartilaginous auricle needs custom-made devices. At this point, a pressure sore caused by a device applied to the ear is the most important problem. To prevent the ear from developing a pressure sore, the device should press to whole area homogeneously. For this reason, the device applied for pressure therapy to the ear must be custom made.