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ABSTRACT: 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.
Kulak burun bogaz ihtisas dergisi: KBB = Journal of ear, nose, and throat 02/2005; 14(1-2):39-43.
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ABSTRACT: It was intended to compare various characteristics of phonation obtained in cases who underwent near-total laryngectomy (NTL) and frontolateral laryngectomy (FLL).
The study included 29 male cases, 9 of whom underwent NTL, 10 of whom underwent FLL and 10 who had normal laryngeal speech. All cases were evaluated and compared statistically according to the fundamental frequency (Fo), intensity and voiceless time measurements, maximal phonation time (MPT), speech rate and speech intelligibility.
Fo and Fo range were found significantly high in both patient groups, but MPT and speech rate was meaningfully decreased in these groups relative to the control group. There were not any significant differences between the two patient groups. The speech intelligibilities of the NTL group patients were significantly low relative to other two groups. The voiceless time measurements during phonation were significantly high in two patients groups, but we also found that it was not effective on speech rate and intelligibility.
The phonation gained after NTL is similar to that of FLL in respect of various features. But owing to differences of the speech intelligibility measurements, we concluded that patients who underwent NTL could be exposed to more problems during communication with their social surroundings.
Kulak burun bogaz ihtisas dergisi: KBB = Journal of ear, nose, and throat 02/2004; 12(3-4):71-7.
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ABSTRACT: We reviewed preoperative, perioperative, and postoperative findings and the survival data to determine which patients may be appropriate for near-total laryngectomy.
We reviewed hospital records of 20 patients (all males; mean age 56.6 years; range 35 to 73 years) who underwent near-total laryngectomy. Indications for patient selection for near-total laryngectomy and survival data were evaluated in comparison with literature reports.
The site of the tumor was the sinus pyriformis in two, and the larynx in 18 patients. Thirteen patients had T3, seven patients had T2 tumors. The lesions were localized in the sinus pyriformis in two patients with T2 tumors. The locoregional control rate at the end of two years was 75%; two- and three-year survival rates were 81.2% and 64.2%, respectively.
Following a detailed and meticulous investigation in the preoperative period, near-total laryngectomy seems to be appropriate in selected patients with advanced laryngeal and hypopharyngeal tumors in which partial laryngectomy procedures are not considered. It may both provide cure and preserve phonation. It may also be considered for functional purposes in patients whose pulmonary functions are insufficient for partial laryngectomy, in those in whom food aspiration is inevitable after partial laryngectomy, and in those suffering from lifelong food aspiration due to neurologic causes, and for oncologic reasons in patients who develop local recurrences after partial laryngectomy.
Kulak burun bogaz ihtisas dergisi: KBB = Journal of ear, nose, and throat 9(2):121-5.
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ABSTRACT: 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.
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.
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).
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.
Kulak burun bogaz ihtisas dergisi: KBB = Journal of ear, nose, and throat 20(6):277-84.
