Evaluation of Cases Who Underwent Reconstruction Through Pectoralis Major Myocutaneous Flap after Laryngopharyngectomy

Objective: In this retrospective study, we discussed the results of patients who underwent hypopharynx reconstruction through a pectoralis major myocutaneous flap (PMMF) after laryngopharyngectomy.Methods: Twenty-three patients who underwent total laryngectomy, subtotal pharyngectomy, and/ or esophagus upper segment resection due to advanced- stage (T3 and T4) laryngeal, hypopharyngeal, and esophagus upper segment-located squamous cell carcinoma and subsequent reconstruction with PMMF were retrospectively evaluated. While the minor complications were determined to be wound site infection, hemorrhage, and disruption of suture at the donor site, major complications were determined to be anastomotic line disruption, fistula, and dysphagia.Results: Eighteen (78.2%) patients were male and five (21.7%) were female; their ages varied between 33 and 72 years (mean: 60.1). According to lesion localization, 11 patients were evaluated as having laryngeal cancer, seven as having hypopharyngeal cancer, and five as having esophagus upper segment-located cancer. The rate of minor complications was 30.4%: fistula was observed in 11 (47.8%) patients and 13 (56.5%) patients mentioned difficulty swallowing only solid foods. The total follow-up period ranged from 4 to 60 (mean: 31.6) months.Conclusion: PMMF is continuing to be a good alternative reconstruction method for the reconstruction of partial hypopharyngeal defects because it is easily obtainable, one surgical team is sufficient when using the flap, and it is associated with low morbidity and mortality rates

Evaluation of iron and zinc levels in recurrent tonsillitis and tonsillar hypertrophy

WOS: 000372213200012PubMed ID: 26954864Objectives: The aim of this study is to look into the roles of iron and zinc metals in etiopathogenesis of recurrent tonsillitis and tonsillar hypertrophy by evaluating the levels of iron and zinc elements in the palatine tonsillar tissue. Methods: In total, 40 patients who underwent a tonsillectomy to treat recurrent tonsillitis and tonsillar hypertrophy were included in the study. Patients were classified into two groups, recurrent tonsillitis and tonsillar hypertrophy, determined by the results of clinical and histopathological examination. The levels of iron and zinc elements were determined for each tonsillar tissue sample. Results: There was a significant difference in the iron and zinc concentrations (p < 0.001) between the tonsillar hypertrophy and recurrent tonsillitis groups. The levels of iron and zinc were significantly lower in the recurrent tonsillitis group. Conclusions: This study suggests that low tissue concentrations of iron and zinc may lead to recurrent tonsillitis. (C) 2016 Elsevier Inc. All rights reserved

Hypertrophic Lingual Thyroid Causing Sleep Apnea

Ectopic lingual thyroid disorder, developing as a consequence of thyroid gland migration during early embryogenesis, is a rarely seen congenital anomaly. In this paper, we report a 39-year-old male patient with snoring and moderate-level obstructive sleep apnea who received the diagnosis of lingual thyroid at our clinic. We treated the patient with thyroxin suppression therapy. During our clinical follow-ups, the amount of lingual thyroid tissue significantly decreased, and the symptoms of obstructive sleep apnea disappeared

The South African guidelines on enuresis-2017

Introduction: Enuresis (or Nocturnal Enuresis) is defined as discreet episodes of urinary incontinence during sleep in children over 5 years of age in the absence of congenital or acquired neurological disorders. Recommendations: Suggestions and recommendations are made on the various therapeutic options available within a South African context. These therapeutic options include; behavioural modification, pharmaceutical therapy [Desmospressin (DDAVP), Anticholinergic (ACh) Agents, Mirabegron (beta 3-adrenoreceptor agonists), and Tricyclic Antidepressants (TCA)], alternative treatments, complementary therapies, urotherapy, alarm therapy, psychological therapy and biofeedback. The role of the Bladder Diary, additional investigations and Mobile Phone Applications (Apps) in enuresis is also explored. Standardised definitions are also outlined within this document. Conclusion: An independent, unbiased, national evaluation and treatment guideline based on the pathophysiological subcategory is proposed using an updated, evidence based approach. This Guideline has received endorsement from the South African Urological Association, Enuresis Academy of South Africa and further input from international experts within the field

Evaluating the Significance of Global and Local Features in Expressed Sequence Tag: A Clustering Quality Perspective

Abstract—Clustering of expressed sequence tag (EST) plays an important role in gene analysis. Alignment-based sequence comparison is commonly used to measure the similarity between sequences, and recently some of the alignment-free comparisons have been introduced. In this paper, we evaluate the role of global and local features extracted from the alignment free approaches i.e., compression-based method and generalized relative entropy method, in the quality of EST clustering perspective. Our evaluation shows that the local feature of EST yields much better clustering result compares to the global feature. Index Terms- sequence clustering, alignment-free, similarity measure, grammar-based distance, generalized relative entropy I

Radyoterapi sonrası iki taraflı dış kulak yolu kolesteatomu

Bu yazıda, nazofarenks karsinomu nedeniyle radyoterapi ile tedavi edilen ve radyoterapiden dört yıl sonra iki taraflı dış kulak yolu kolesteatomu saptanan 55 yaşında bir kadın olgu sunuldu. Hastada inatçı otore vardı ve tanı otoskopik bulguların yanı sıra, temporal kemik tomografisinde dış kulak yolu ön duvarını aşındıran yumuşak doku kitlesinin görülmesi ile konuldu. Cerrahi tedavi olarak kanaloplasti ve kolesteatom eksizyonu yapıldı.In this article, we report a 55-year-old female case was treated with radiotherapy due to nasopharynx carcinoma and diagnosed with bilateral external auditory canal cholesteatoma four years after radiotherapy. Persistent otorrhea was present in the patient and the diagnosis was established through noticing a soft tissue mass eroding external auditory canal anterior wall in temporal bone tomography as well as the otoscopic findings. Canaloplasty and cholesteatoma excision were administered as the surgical treatment

A Unique Case of Intranasal Metastasis from Occult Poorly Differentiated Thyroid Carcinoma

Background: Poorly differentiated thyroid carcinomas (PDTCs) lie, both morphologically and behaviorally, between well-differentiated and undifferentiated carcinomas. Metastasis of poorly differentiated thyroid carcinoma to the intranasal cavity has not been reported previously in the literature. Case Report: A 48-year-old male patient presented with massive epistaxis and nasal obstruction. On nasal examination, a bleeding, vascular mass was seen filling the left nasal cavity. The histopathological report of the nasal mass was well-differentiated thyroid carcinoma metastasis. Whole body scintigraphy, ultrasonography and positron emission tomography were done to rule out other possible metastases in the body and determine the origin of the tumor, which was identified as the left lobe of the thyroid gland, and there were multiple metastases involving the lung, sacroiliac area, and left humerus. Histopathological examination of a thyroidectomy specimen revealed PDTC consisting of insular, follicular, and papillary components. Postoperatively, the patient received radioactive iodine ablation therapy (iodine-131) and a course of external beam radiation therapy to the sacroiliac area and other metastatic regions. No recurrences were observed in a follow-up period of 5 years after surgery. Conclusion: The metastasis of differentiated thyroid carcinoma as a component of PDTC to the intranasal cavity has not been reported before. It is interesting that the well-differentiated component of the tumor was metastasized in our patient. Due to the aggressiveness of PDTC and the poor survival rates in patients who undergo surgery alone, a multidisciplinary treatment approach is required