COMPARISON OF COMPUTERIZED TOMOGRAPHIC AND HISTOPATHOLOGICAL ,TUMOR (T) STAGING OF LARYNGEAL CANCERS

Amaç: Larenks kanserlerinde bilgisayarlı tomografi (BT) bulgularının ameliyat sonrası histopatolojik sonuçlarla karşılaştırılması. Gereç ve yöntem: Biopsi ile larenks kanseri tanısı almış yaş ortalaması 54,5 olan, 49'u erkek 52 hasta ameliyat öncesi BT tetkiki ile tümör lokalizasyonu (T) ve derin invazyon (preepiglottik ve paraglottik boşluk, subglottik alan ve kıkırdaklar) yönünden değerlendirildi. Sonuçlar patolojik (p) bakı sonuçları ile karşılaştırıldı. Bulgular: Doğruluk oranı glottik yerleşimli olanlarda %80, supraglottik yerleşimli olanlarda %64, transglottik olanlarda %76 olup, genel doğruluk oranı %73 olarak bulundu. Sonuç: T3 ve T4 evredeki tümörlerde BT evre doğruluk oranı, T1 ve T2 evre tümörlere göre yüksek bulundu. Bu doğruluk oranları literatürdekine paraleldir. Klinik muayeneyle birlikte BT değerlendirilmesi histopatolojik evrelemenin doğruluğunu arttırmaktadır. Objective: We compare the findings of computerized tomographic (CT) imaging with histopathologic results in larengeal cancer. Patients and method: Fifty-two patients (49 males, mean age 54,5) were evaluated preoperatively by CT with regard to localization (T) and deep involvement (preepiglottic space, laryngeal cartilages, paraglottic and subglottic areas). The results were correlated with histopathologic (p) findings. Results: The accuracy of CT were 80% for glottic; 64% for supraglottic, 76% for transglottic region tumors. Overall accuracy was 73%. Conclusion: Histopathologic and CT staging results are highly correlated in T3 and T4 stage tumors than T1 and T2 stage tumors, similar to those in the literature. The accuracy of histopathologic staging enhances by concomitant use of clinical and radiologic findings

Rapid Alleviation of Parkinson’s Disease Symptoms via Electrostimulation of Intrinsic Auricular Muscle Zones

Background: Deep brain stimulation of the subthalamic nucleus (STN-DBS) and the pedunculopontine nucleus (PPN) significantly improve cardinal motor symptoms and postural instability and gait difficulty, respectively, in Parkinson’s disease (PD).Objective and Hypothesis: Intrinsic auricular muscle zones (IAMZs) allow the potential to simultaneously stimulate the C2 spinal nerve, the trigeminal nerve, the facial nerve, and sympathetic and parasympathetic nerves in addition to providing muscle feedback and control areas including the STN, the PPN and mesencephalic locomotor regions. Our aim was to observe the clinical responses to IAMZ stimulation in PD patients.Method: Unilateral stimulation of an IAMZ, which includes muscle fibers for proprioception, the facial nerve, and C2, trigeminal and autonomic nerve fibers, at 130 Hz was performed in a placebo- and sham-controlled, double-blinded, within design, two-armed study of 24 PD patients.Results: The results of the first arm (10 patients) of the present study demonstrated a substantial improvement in Unified Parkinson’s Disease Ratings Scale (UPDRS) motor scores due to 10 min of IAMZ electrostimulation (p = 0.0003, power: 0.99) compared to the placebo control (p = 0.130). A moderate to large clinical difference in the improvement in UPDRS motor scores was observed in the IAMZ electrostimulation group. The results of the second arm (14 patients) demonstrated significant improvements with dry needling (p = 0.011) and electrostimulation of the IAMZ (p < 0.001) but not with sham electrostimulation (p = 0.748). In addition, there was a significantly greater improvement in UPDRS motor scores in the IAMZ electrostimulation group compared to the IAMZ dry needling group (p < 0.001) and the sham electrostimulation (p < 0.001) groups. The improvement in UPDRS motor scores of the IAMZ electrostimulation group (ΔUPDRS = 5.29) reached moderate to high clinical significance, which was not the case for the dry needling group (ΔUPDRS = 1.54). In addition, both arms of the study demonstrated bilateral improvements in motor symptoms in response to unilateral IAMZ electrostimulation.Conclusion: The present study is the first demonstration of a potential role of IAMZ electrical stimulation in improving the clinical motor symptoms of PD patients in the short term