Background:Cancers of the sinonasal region are rare and its survival rate remains poor because most of the patients are asymptomatic and diagnosed in advanced stages with surrounding important structures.Objectives:This study attempted to analyze the clinical and histological features in addition to survival and prognostic factors of surgical treatment of sinonasal cancers.Patients and Methods:A retrospective cohort study, involving 36 patients with sinonasal cancer who were treated with surgery in our hospital between 2000 and 2010, was performed. Patients were selected based on the convenience sampling. Patients treated with radiotherapy and/or chemotherapy were excluded from the analysis. Clinical symptoms and histologic findings of patients as well as malignant tumor staging and its prognosis were collected from archives.Results:We found that overall 3 and 5-year survival rates of subjects were 52.8%, and 41.6%, respectively. There was a negative correlation between the clinical stage and survival. There was a significant difference between infrastructural and suprastructural localization in 5-year survival rate (P = 0.018). In the present study, there was a strong relationship between the local control and overall survival (P < 0.01). Overall 5-year survival rate was similar in patients both in the exenterated orbit and preserved orbit (P > 0.05).Conclusions:The present study has demonstrated that clinical stage, suprastructural tumor, and the presence of tumor- positive resection margins are the most significant prognostic factors affecting local tumor control and survival. As a result of this study, these tumors should be treated in early stages by surgical margin of resection followed by adjuvant radiotherapy.
BACKGROUNDThe dermoscopic criteria of extrafacial melanomas are well-known.OBJECTIVETo determine the frequency of dermatoscopic findings in head and neck melanomas (HNM) and to assess the distinguishing dermoscopic criteria of facial and extrafacial melanoma.METHODSThis observational study included 108 patients with HNM (63% male, mean age 64 years). Participants underwent individual dermoscopic imaging of clinically melanoma. All lesions were excised, and histopathological examination was performed on all specimens.RESULTSDrawing on histopathological analysis, lentigo maligna melanoma or lentigo maligna was diagnosed in 60 lesions, superficial spreading melanoma in 18, nodular in 10, desmoplastic in 8, superficial spreading melanoma in situ in 12. The most frequent location for head and neck melanoma was the cheek (60 patients, 55.6%). Eight prominent dermatoscopic features were observed in facial melanoma: annular-granular pattern (18%); rhomboidal structures (29%); pseudonetwork (29%); asymmetrical, pigmented, follicular openings (51%); obliterated hair follicles (8%); red rhomboidal structures (18%); increased density of the vascular network (32%); scar-like depigmentation (59%).CONCLUSIONSHNM has specific dermoscopic features, and classical extrafacial dermoscopic rules are less useful for diagnosis of facial melanoma. In our study, further characteristic dermatoscopic findings were detected in facial melanoma such as low frequencies of irregular dots, 2 or fewer colors in lesions, the presence of pseudonetwork, increased density of the vascular network, red rhomboidal structures, in addition to dermatoscopic findings of extrafacial melanoma. Thus, it is concluded that the prediction and identification of HNM may be evident with the help of these signs.
In this study, the authors observed that septoplasty has positive effect on cardiopulmonary functions in the patients with nasal obstruction due to nasal septum deviation. The authors also claim that septoplasty may be a preventive procedure for future pathologies of cardiopulmonary functions.
Retrofarengeal hematom (RH), whiplash kafa travması ve antikoagülan kaynaklı koagülopatinin (AKK) nadir fakat potansiyel olarak ciddi bir komplikasyonudur. Literatürde, hematomun cerrahi drenajı kararı konusunda ikilem vardır ve fazla veri bulunmaktadır. Bu yazıda, acil servise farklı etyoloji ve semptomlarla başvuran iki ayrı olgu sunuldu. İlk olgu, kalp kapak hastalığı nedeniyle uzun süredir varfarin sodyum kullanan ve ilacın dozunu ayarlayamayan bir hastada gelişen spontan RH idi ve ikinci olgu, bir çocukta minör kafa travmasından sonra izole bir hematom idi. İlk hastaya acil trakeotomi gerekirken ikinci hastaya konservatif tedavi uygulandı. Retrofarengeal hematomda tedavi, etyolojiye ve semptomların şiddetine göre değişebilir. Hava yolu tıkanıklığı belirtileri ortaya çıktığında, tamamen tıkanma meydana gelmeden önce hava yolu derhal emniyete alınmalıdır. Antikoagüle bir hasta üst solunum yolu semptomları gösterdiğinde RH tanısı düşünülmelidir.
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