[Show abstract][Hide abstract] ABSTRACT: Lateral cervical cystic mass in a young adult very rarely could be a first sign of an occult thyroid papillary microcarcinoma metastasis. In this paper, we presented a 37-year-old male patient whose preoperative 6 cm left lateral cervical cystic mass was initially diagnosed as branchial cleft cyst, but then the postoperative histopathological examination of the mass was revealed as papillary thyroid carcinoma metastasis. Preoperative fine needle aspiration biopsy was relevant with a branchial cleft cyst. In the left thyroid lobe there were 3 solid nodules with 4, 6, and 12 mm dimensions, respectively. One of the nodules had malignant well-differentiated cells diagnosed after fine needle aspiration biopsy. After total thyroidectomy, histopathologic evaluation of biopsy material's showed papillary thyroid microcarcinomas. This case indicates that especially in a young adult lateral cervical cystic mass should be carefully considered preoperatively for the possibility of metastatic occult thyroid carcinoma, especially for papillary carcinoma in differential diagnosis, and evaluation of the thyroid gland should be taken into account.
[Show abstract][Hide abstract] ABSTRACT: Background
To study the diagnostic accuracy of physical examination (PE), ultrasonography (US), contrastenhanced computed tomography (CT) and in preoperative detection of macroscopic nodal metastasis in primary/recurrent papillary thyroid carcinoma (PTC) patients to determine if the routine addition of CT would be beneficial in accurate preoperative lymph-node surgery planning. Methods
In a tertiary center prospective study, 162 PTC patients underwent preoperative lymph-node evaluation by PE, US, and CT. Sensitivity, specificity, positive/negative predictive value (PPV/NPV) of each nodal detection technique were calculated in central/lateral cervical compartments. The gold standard for diagnostic-accuracy was surgical pathology. ResultsIn patients undergoing primary (Group I)/revision (Group II) surgical treatment for PTC, combined US/CT yielded significantly higher sensitivity for macroscopic lymph-node detection in both lateral and central neck, most marked in Group I-central compartment. Conclusions
Combined preoperative US/CT provides reliable, objective, preoperative macroscopic nodal metastasis map to design rational nodal surgery in primary/revision PTC patients. (c) 2013 Wiley Periodicals, Inc. Head Neck 36: 191-202, 2014
[Show abstract][Hide abstract] ABSTRACT: Even endotracheal intubation could be considered safe in operations under general anesthesia; rarely, it could cause recurrent laryngeal nerve paralysis as a complication. As mentioned in the literature, as a possible reason for this, anterior branches of the recurrent laryngeal nerve in the larynx could suffer from compression between the posteromedial part of the thyroid cartilage and the cuff of the tube. In the literature, unilateral vocal cord paralysis due to endotracheal intubation occurs more frequently in comparison to bilateral vocal cord paralysis. These types of palsies usually totally improve in approximately 6 months. A patient who experienced bilateral vocal cord paralysis in the early postoperative period after undergoing an endotracheal intubation process for general anesthesia and primary partial lip resection and supraomohyoid neck dissection due to lower lip carcinoma is presented in our article. Although vocal cord paralysis occurring after head and neck surgery is first thought as a complication of the surgery, endotracheal intubation should be considered as a possible cause of this paralysis. In relation with this patient, causes, clinical symptoms, and treatment procedures of vocal cord paralysis due to endotracheal intubation are discussed under guidance of the literature.
No preview · Article · Jan 2012 · The Journal of craniofacial surgery
[Show abstract][Hide abstract] ABSTRACT: Titanium mesh may be an alternative material to be used in laryngotracheal reconstruction. Twenty New Zealand rabbits were divided into two groups. Group A underwent laryngotracheoplasty with titanium mesh-buccal mucosa-muscle complex, and Group B received auricular cartilage grafts. All animals survived without complications. The animals were killed at 60 days, and laryngotracheal regions were evaluated. There was no subglottic collapse at physiologic and supraphysiologic negative airway pressures in Group A and mild-moderate collapse in Group B. Macroscopically the average antero-posterior and lateral diameters were not statistically different among two groups. Light microscopic examination revealed no fibrosis, necrosis or new cartilage formation in both groups. Inflammation and granulation were more pronounced in Group A. The lumens in both groups were moderately obstructed. Reconstruction of the upper airway with titanium mesh may be used in very selected cases where autologous grafting materials are inadequate and unsatisfactory.
No preview · Article · Aug 2010 · Archives of Oto-Rhino-Laryngology
[Show abstract][Hide abstract] ABSTRACT: Pilomatrixoma is an uncommon benign tumor that arises from hair cortex cells. Generally; that this tumor is hard, slow growing, located dermal or sub dermal is also known as the name of calcifying epithelioma of Malherbe's. This lesion may occur at any age from infancy to elder and is the most common under age 20. Female to male ratio is 3/2 with female predominance. Approximately half of the cases are in the head and neck area. Although the head and neck region is the most frequent area where pilomatrixoma evolves, otolaryngologists do not have sufficient information and experience about the disease. Generally, this leads to misdiagnose of the lesion preope-ratively. Therefore, clinical diagnostic features must be well known by the physician. This provides accurate diagnosis of almost all cases preoperatively. In this paper, we present a 22 year-old female patient with diagnosis of pilomatrixoma in the neck region. Despite close excision to the lesion, the recurrence rate is very low. The purpose of this our case presentation is awareness of the disease and its clinical diagnostic features by the physicians, especially otolaryngologists.
Preview · Article · Jun 2010 · Goztepe Tip Dergisi
[Show abstract][Hide abstract] ABSTRACT: Inflammatory pseudotumor is a tumor-like lesion with histopathologic characteristics of inflammation. A 63-year-old woman, who presented with complaints of 2 neck masses on the right side of the neck with waxing and waning course in whom excisional biopsy was performed revealing inflammatory pseudotumor of the lymph node in the neck, is presented, and this rare clinical entity is discussed together with relevant literature.
Full-text · Article · May 2010 · The Journal of craniofacial surgery
[Show abstract][Hide abstract] ABSTRACT: The objective of the prospective study is to examine the laryngeal changes by laryngeal videostroboscopy and electromyography (EMG) regarding new-onset dysphonia in asthmatic patients taking inhaled corticosteroids (ICS). Laryngeal changes and electrophysiological status of the laryngeal muscles were evaluated by these methods in 12 patients both at the time of presentation of dysphonia and after cessation of therapy. Laryngeal changes of our patients were mucosal edema, erythema, thickening, adduction deficit, nodule and irregularity in videostroboscopy. Significant correlations were found between laryngeal pathology and dosage and duration of ICS therapy. We detected myopathy by EMG in most of the patients. Also, EMG revealed that cricothyroid muscle was much more affected than thyroarytenoid muscle. In conclusion, we consider that steroid myopathy or mucosal inflammatory theory alone is not sufficient to explain the etiopathogenesis of dysphonia in asthmatic patients taking ICS. The laryngeal mucosal changes were detected by laryngeal videostroboscopic examination in some asthmatic patients, with dysphonia using ICS, and/or laryngeal myopathy was found by laryngeal EMG in some of them in this study. Thus, various factors may have role simultaneously in the occurrence of dysphonia.
No preview · Article · Nov 2009 · Archives of Oto-Rhino-Laryngology
[Show abstract][Hide abstract] ABSTRACT: No diagnostic test had been specifically developed to diagnose nonallergic rhinitis (NAR). Also a negative nasal smear for eosinophils does not rule out the diagnosis. There is a significant diagnostic problem in patients with NAR. How can we solve this problem?
Assessment of other cells than eosinophils present in the cytogram such as basophils, neutrophils, and goblet cells may help us to classify and management of diagnostic problem of rhinitis. We sought to characterize the cellular pattern of patients with allergic rhinitis (AR) and compare them with those of NAR.
According to the skin prick test positivity or negativity, individuals were divided into AR and NAR groups, respectively. Allergic rhinitis group was further divided into seasonal, perennial, and mixed subgroups. Nonallergic rhinitis group was also divided into the following 5 subgroups according to the nasal smear cytologic result: basophilic, neutrophilic, eosinophilic, mixed, and nonallergic noninfectious type. So the frequency rates of the subgroups were calculated and also smear cytologic results were compared.
Frequency of AR was approximately equal to NAR in subjects with chronic rhinitis. Neutrophilic, eosinophilic, mixed, and nonallergic noninfectious types were the common types of NAR. An evident nasal eosinophilia was found in AR and eosinophilic NAR, whereas a higher percentage of goblet cells were determined in nonallergic noninfectious rhinitis. There is no significant difference between cytologic results from NAR and AR patients.
In the patient with positive skin test result, the presence of nasal eosinophilia strongly supports the diagnosis of AR. No diagnostic test had been specifically developed to diagnose chronic NAR. Also, a negative nasal smear for eosinophils does not rule out the diagnosis. Assessment of other cells present in the cytogram such as basophils, neutrophils, and goblet cells may also provide valuable information for differential diagnosis and management of these conditions.
Full-text · Article · Sep 2009 · American journal of otolaryngology
[Show abstract][Hide abstract] ABSTRACT: To investigate the possible thermal effects of microwaves from mobile phones on facial nerves (FN) and surrounding soft tissue.
A prospective study.
We studied FN conduction rate and compound muscle action potentials (CMAP) on 12 rabbits before exposure to radiofrequency radiation (RFR) emitted from a mobile phone. Also, the temperature change in the soft tissues around the FN was investigated by a four channel Luxtron fiber optic system. A mobile phone with 1900 MHz frequency was placed over the ipsilateral ear of the rabbit for 25 minutes, and FN and surrounding tissues were exposed to a 1.5 watts pulse modulated (217 packets/s) electromagnetic field. During exposure to RFR, immediately after turning off the mobile phone, and 25 minutes after the exposure temperature change in the surrounding tissue of the FN was recorded and compared to preexposure values. Additionally, another recording regarding the FN functions was done and the data were compared to preexposure values.
The average temperature of the surrounding soft tissues was 0.39 K higher than the preexposure values during the exposure and immediately after turning off the mobile phone, and decreased to normal levels 25 minutes after the exposure, which was statistically significant. The amplitudes of FN CMAP after radiofrequency radiation exposure were significantly smaller than the preexposure amplitudes and the amplitudes were normal in the 25 minute measurement.
The RFR emitted from a mobile phone can cause temporary FN dysfunction that can be due to temporary temperature increase in the soft tissue around the FN.
No preview · Article · Mar 2009 · The Laryngoscope