Browsing by Author "Kiriş, M."

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Adenocarcinoma of the Larynx: a Case Report With Histochemical and Immunohistochemical Studies
(2004) Bayram, I.; Ugraş, S.; Kiriş, M.; Reçber, D.
Adenocarcinomas constitute a histologically diverse group of rare laryngeal neoplasms accounting in aggregate for less than 1% of all laryngeal carcinomas. Adenocarcinoma of the larynx "not otherwise specified" (NOS) is a very uncommon neoplasia, but it shows a high degree of malignancy. We report a case of adenocarcinoma "NOS" arising in the larynx of a 60-year-old man. Histologically, the tumor tissue was composed of only adenocarcinoma component. Histochemically, the adenocarcinoma cells demonstrated Alcian blue pH: 2.5 and PAS reactivity, but did not include argentaffin and argyrophil granules. Immunohistochemical studies revealed negative reactivity for desmin, HMB45 and NSE. S-100 and chromogranin was focally positive, cytokeratin was diffusely positive.
Carotid Body Tumors: Challenging Complexity of Diagnosis and Surgical Treatment
(2003) Kiriş, M.; Cankaya, H.; Kutluhan, A.; Kiroglu, A.F.
OBJECTIVES: To evaluate the patients treated for carotid body tumors and the problems encountered during diagnosis and treatment. PATIENTS AND METHODS: The study included eight patients (5 females, 3 males; mean age 50 years; range 36 to 68 years) who underwent surgery for carotid body tumors. Diagnosis was confirmed by power Doppler ultrasonography and computed tomography or magnetic resonance imaging in all patients. Angiography was performed in three patients to evaluate vascularity and to perform embolization before surgery. Two patients had previously undergone biopsy elsewhere. The mean follow-up was 15 months (range 2 to 36 months). RESULTS: The size of the tumors varied from 3 cm to 11 cm. In two patients the tumors were found to extend to the skull base. Ligation of the external carotid artery and the common carotid artery was performed in five patients and in one patient, respectively. Surgery-associated injuries given to the internal carotid artery in two patients were repaired by sutures. The 10th cranial nerve was dissected in two patients who had undergone a prior biopsy. They developed cord paralysis and hoarseness postoperatively. Resection of the 11th cranial nerve in one patient resulted in shoulder pain and drop shoulder. The 12th cranial nerve was repaired end-to-end by neurorrhaphy in two patients. They exhibited significant improvement in nerve functions a year after surgery. CONCLUSION: The larger the tumor is, the more difficult the resection is, and the more injuries are caused to the surrounding nerves and vessels.
Differences in Clinical and Histopathologic Features Between Chronic Adenotonsillitis and Chronic Adenotonsillar Hypertrophy
(2003) Kutluhan, A.; Ugraş, S.; Kiriş, M.; Cankaya, H.; Kiroglu, A.F.; Yurttaş, V.
OBJECTIVES: This study sought to determine the clinical and histopathological differences between chronic adenotonsillitis and chronic adenotonsillar hypertrophy. PATIENTS AND METHODS: This prospective study included 286 patients (147 males, 139 females; mean age 16.6 years; range 3 to 45 years) with chronic adenotonsillitis and 197 patients (98 males, 99 females; mean age 9.5 years; range 2 to 18 years) with adenotonsillar hypertrophy. Clinical and histopathological findings were compared. RESULTS: The mean age was significantly higher (p<0.001) and acute attacks of fever, dysphagia, and sore throat were more frequent in chronic adenotonsillitis. Patients with adenotonsillar hypertrophy more commonly manifested snoring, mouth breathing, and dispnea. Physical examination showed hyperemia of the anterior plica in 93% and 15% in chronic adenotonsillitis and adenotonsillar hypertrophy, respectively. Histopathologically, the former was more commonly associated with severe lymphocyte infiltration to surface epithelium, surface epithelial defects, plasma cells, atrophy, and fibrosis. The sole outweighing difference in favor of chronic adenotonsillar hypertrophy was increased germinal centers. CONCLUSION: Clinical and histopathologic findings suggest that chronic adenotonsillitis and chronic adenotonsillar hypertrophy may be diverse diseases requiring different approaches in treatment.
The Effectiveness of Unilateral Tonsillectomy in Chronic Adenotonsillar Hypertrophy
(2005) Kutluhan, A.; Caksen, H.; Yurttaş, V.; Kiriş, M.; Yuca, K.
OBJECTIVES: This study sought to determine whether unilateral tonsillectomy was effective in the treatment of chronic adenotonsillar hypertrophy. PATIENTS AND METHODS: A total of 197 patients (96 girls, 101 boys) with chronic adenotonsillar hypertrophy were prospectively included. The patients were randomly assigned to either bilateral tonsillectomy (n=113; mean age 10.1 years; range 4 to 18 years) or unilateral tonsillectomy (n=84; mean age 4.5 years; range 3 to 8 years) performed with or without adenoidectomy. All the patients were followed-up for at least a year. RESULTS: The two groups did not differ significantly with respect to preoperative symptoms, the size of tonsils, and the presence of adenoid hypertrophy. At the end of the follow-up, no significant differences were found with respect to relief of snoring, mouth breathing, and upper airways obstruction between the two groups. A greater number of patients achieved complete improvement in snoring in the bilateral tonsillectomy group (p<0.05). With unilateral tonsillectomies, three patients required tonsillectomy to the other side, two had recurrent tonsillitis, and one had severe compensatory hypertrophy with persistent difficulty in inspiration and mouth breathing. CONCLUSION: Unilateral tonsillectomy seems to be as effective as bilateral tonsillectomy in the treatment of chronic adenotonsillar hypertrophy.
Larinks Tüberkülozu
(2002) Çankaya, H.; Uğraş, S.; Özbay, B.; Kutluhan, A.; Kiriş, M.
Larinks tüberkülozu giderek azalmakla birlikte halen görülmeye devam eden bir hastalıktır. Ses kısıklığı yanında ağrılı yutma güçlüğü yakınması olan olgularda da düşünülmelidir. Genellikle akciğer tüberkülozunun bir komplikasyonu olmasına karşın, bazen tek başına da görülebilmektedir. Larinks karsinomu ve diğer granülomatöz hastalıklar ile bu hastalığın ayırıcı tanısının yapılması önem arz etmektedir.
The Relationship Between Ostial Patency and Medical Treatment in Acute Maxillary Sinusitis: an Experimental Study
(2002) Kutluhan, A.; Inalkaç, E.; Kiroglu, A.F.; Akpolat, N.; Kiriş, M.
OBJECTIVES: We investigated the relationship between ostial patency and medical treatment in an experimental model of acute maxillary sinusitis. DESIGN AND METHODS: Forty healthy New Zealand white rabbits were assigned to two groups. The left maxillary sinus ostia were filled with absorbable gelatin sponge in one group (n=20). In the other group, half of the ostuim was blocked by bone particles and tissue adhesive (Histoacryl). Following induction of acute maxillary sinusitis, each group was divided into four subgroups, one of which was left untreated. The other subgroups received systemic antibiotic therapy plus topical administration of physiological saline solution, a decongestant, and a steroid, respectively, for 10 days. All rabbits were monitored for four weeks. Each week nasal smear samples were obtained for neutrophil and leucocyte counts. In the end, maxillary sinus biopsies were obtained to determine the extent of healing. RESULTS: There were no significant differences between subgroups having the same ostium patency. However, compared to the subgroups with patent ostia, corresponding subgroups with semi-patent ostia exhibited significantly increased nasal smear and nasal biopsy scores starting from the second week. CONCLUSION: The degree of ostial patency seems to have a significant role in the treatment of acute maxillary sinusitis.
Squamous Cell Carcinoma of the Lower Lip and Supra-Omohyoid Neck Dissection
(ARSMB-KVBMG, 2003) Kutluhan, A.; Kiriş, M.; Kaya, Z.; Kisli, E.; Yurttaş, V.; Içli, M.; Käsem, M.
Purpose: The aim of this study is to evaluate our approach to patients with squamous cell carcinoma of lower lip. Patients and methods: This study includes 31 lower lip squamous cell carcinomas followed up between 1994 and 2000. Primary treatment was applied to 28 patients of whom 23 were in stages I-II and five in stages III-IV. Three patients presented locoregional recurrence. Neck dissection was performed during primary lip resection in patients with palpable cervical lymph node involvement. Patients with unpalpable cervical lymph nodes were divided into two subgroups: one was submitted to elective neck dissection (n = 11) and the other had isolated lip resection (n = 8). Unilateral or bilateral selective supra-omohyoid neck dissection (SOHND) was performed according to the localisation of the disease. Radical dissection was performed in a secondary intervention, when SOHND revealed lymph node metastases. Radiotherapy and chemotherapy were applied for curative and / or adjuvant treatment in addition to surgery in patients with locoregional recurrence and metastatic lymph nodes or with perineural involvement. Results: Occult cervical metastasis within a single lymph node was found in one of the 11 No patients who underwent elective neck dissection. Delayed neck metastasis developed in one of the eight patients in whom isolated lip resection (without neck exploration) was performed. Chemoradiotherapy was administered to this patient, but he died. Neck metastasis was established histologically in four of five patients in stages III-IV. Postoperative radiotherapy was used on these patients. One of the patients in this group died due to inoperable local recurrence in the neck, another died because of distant metastasis. Local mandibular recurrence was seen in one of these patients after three years. Comment: Six patients (19%) died due to lower lip carcinoma in this series. Our findings show the importance of elective neck dissection and intact surgical resection margins.