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|4.||Extracranial head and neck schwannomas: A series of 14 patients|
Aslı Çakır, Taner Kemal Erdağ, Mustafa Cenk Ecevit, Enis Alpin Güneri, Semih Sütay, Ahmet Ömer İkiz
doi: 10.5606/kbbihtisas.2017.92480 Pages 257 - 263
INTRODUCTION: This study aims to evaluate patients operated due to extracranial head and neck schwannomas.
METHODS: A total of 14 patients (6 males, 8 females; mean age 42.6 years; range 7 to 73 years) who were treated for extracranial head and neck schwannomas between January 1995 and December 2015 were retrospectively reviewed. Demographic data, tumor location, surgery, and clinical characteristics of the patients were discussed in light of the literature.
RESULTS: All patients were evaluated radiologically and with fine needle aspiration biopsy preoperatively. Total removal of the tumor was achieved in all patients. All tumors had benign character. Mean follow-up period was 14 months. Recurrence or malignancy was not detected in any patient.
DISCUSSION AND CONCLUSION: Schwannomas may present in a variety of sites in the head and neck region, and cause usually non-specific symptoms. Therefore, the preoperative diagnosis requires a clinical suspicion. Preoperative magnetic resonance imaging is a useful and simple method for diagnosis.
|5.||Evaluation of phonophobia with audiological tests in vestibular migraine patients|
Sercan Göde, Göksel Turhal, Isa Kaya, Nur Seda Saban, Cenk Arslanbuğa, Esra Tıklar, Şengül Arslan, Pınar Baba, Berna Deniz Kuntman, Tevfik Anıl Düzgülşen, Ceyda Tarhan, Mehmet Fatih Öğüt
doi: 10.5606/kbbihtisas.2017.59458 Pages 264 - 268
AMAÇ: Bu çalışmanın amacı vestibüler migren hastalarında rahatsız edici ses düzeyi (loudness discomfort level - LDL) ve short increment sensitivity index (SISI) ölçümlerinin tanısal değerinin incelenmesidir.
YÖNTEMLER: Çalışmaya yirmi vestibüler migren hastası (grup 1) ve 20 sağlıklı kontrol (grup 2) alındı. Saf ses odyometrisi, SISI, timpanometri ve LDL uygulandı.
BULGULAR: Grup 1 ve 2nin median LDL skorları sırasıyla 99.50 dB (IQR: 19.5) and 105 dB (IQR: 6) olarak bulundu. LDL skorları grup 1de anlamlı olarak daha düşük izlendi (p<0.05). Vestibüler migren seçim kriteri olduğunda LDL ölçümlerinin Reciever Operating Characteristic (ROC) analizine göre eğri altında kalan alan 0.76 (p<0.05) olarak saptandı. 103.5 dB cut-off noktası olarak belirlendiğinde LDL testinin sensitivitesi %75, spesifisitesi ise %82 olarak bulundu. SISI skorları ve fonofobi arasında anlamlı ilişki saptanmadı (p>0.05).
SONUÇ: Bu çalışma LDL değerlerinin vestibüler migrende bir odyolojik test olarak potansiyel tanısal değerini gösteren ilk çalışmadır. LDL değerlerinin epizodik vertigonun ayırıcı tanısındaki tanısal değerinin aydınlatılması için yeni çalışmalara ihtiyaç vardır.
OBJECTIVE: The aim of this study was to assess loudness discomfort level (LDL) and short increment sensitivity index (SISI) in patients with vestibular migarine and evaluate the diagnostic role of these tests.
METHODS: Twenty vestibular migraine patients (group 1) and twently healthy control subjects (group 2) were included. Pure tone audiomtery, SISI, tympanometry and LDL were performed.
RESULTS: Median LDL scores of group 1 and 2 were 99.50 dB (IQR: 19.5) and 105 dB (IQR: 6) respectively. LDL scores were significantly lower in group 1 (p<0.05). Reciever Operating Characteristic (ROC) analysis of LDL revealed that the area under curve (AUC) was 0.76 (p<0.05) when vestibular migraine was chosen as the selection criterion. When 103.5 dB was taken as the cut-off point, the sensitivity of LDL test was 75% and specificity was 82%. SISI scores were not significantly related with phonophobia (p>0.05).
CONCLUSION: This is the first study to show the potential diagnostic role of LDL levels as a audiologic tool in vestibular migraine. Further studies with are warranted to elucidate the diagnostic value of LDL in the differential diagnosis of episodic vertigo.
|6.||Post-radiotherapy hypothyroidism in head and neck cancers: When should we be concerned?|
Mehmet Çelik, Rasim Meral, Deniz Kanlıada, Levent Aydemir, Bora Başaran, Erkan Kıyak
doi: 10.5606/kbbihtisas.2017.93902 Pages 269 - 275
INTRODUCTION: This study aims to analyze the incidence of hypothyroidism (HT) in patients who underwent radiotherapy (RT) for head and neck cancers (HNC), and to determine risk factors.
METHODS: This study was a retrospective analysis of patients who were treated with RT alone or in combination with surgery and/or chemotherapy between January 2005 and May 2012. Patients were grouped according to the primary tumor site, TNM staging system, age, gender, total radiation dose (TRD), mean radiation dose of thyroid gland (MRT), neck dissection, and chemotherapy.
RESULTS: A total of 90 patients who were treated with RT were analyzed. The median age was 52±13 (range, 12-87) years. The histopathologic finding of 88 patients was squamous cell carcinoma, others were adenocystic carcinoma and undifferentiated carcinoma. The median follow-up of all patients after RT was 15 (range, 6-72) months. Post-radiotherapy HT was found in 31 patients (34.4%). In this group, clinical and subclinical HT was present in eight (26%) and 23 (74%) patients, respectively. Age younger than 60 years and increased MRT (especially mean thyroid dose 20 Gy<) were significant risk factors for post-radiotherapy HT (p<0.05).
DISCUSSION AND CONCLUSION: Physicians should pay more attention to HT in patients who were treated with RT for HNC during follow-up.
|7.||Closure of oroantral fistula with nasal septal cartilage, bone and bone cement: An alternative technique|
Burak Kersin, Erkan Soylu
doi: 10.5606/kbbihtisas.2017.88709 Pages 276 - 279
Oroantral fistula is an epithelialized communication between the oral cavity and the maxillary sinus, which occurs most commonly as a complication of molar or premolar tooth extraction. There are many techniques to repair oroantral fistula. In this article, we described an alternative technique for the closure of oroantral fistula with the use of nasal septal bone, cartilage, buccal flap, and bone cement.
|8.||Tracheal stenosis and reconstructive surgery: Our experience on anesthesia and airway management|
Demet Altun, Nükhet Sivrikoz, Achmet Ali, Bora Başaran, Bayram Şahin, Emre Çamcı
doi: 10.5606/kbbihtisas.2017.78379 Pages 280 - 284
Tracheal stenosis is an important clinical problem. Several treatment modalities are being used such as tracheal dilatation, laser surgery, surgical resection, and reconstruction. Surgery of the trachea is a special endeavor where the airway is shared by the surgeon and the anesthesiologist. In this article, we discussed the various methods of anesthesia and airway management in three cases who developed tracheal stenosis secondary to prolonged intubation in intensive care and were performed tracheal dilation, laser surgery, resection, and end-to-end anastomosis.