Browsing by Author "Yurttaş, V."

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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.
The Role of Fine-Needle Aspiration Biopsy in the Evaluation of Head and Neck Masses
(2002) Kutluhan, A.; Kisli, E.; Yakut, F.; Yurttaş, V.; Kösem, M.
Purpose: The purpose of this study is to evaluate the role of diagnostic fine-needle aspiration biopsy (FNAB) of head and neck masses and to calculate the sensitivity and specificity of this method. Materials and Methods: The records of 219 patients who had undergone an FNAB of head or neck masses were reviewed. FNAB results were correlated with the histopathologic findings observed after surgery in 96 of 219 patients. Sensitivity, specificity and positive predictive value of FNAB for the detection of malignancy were calculated. Results: Four false-negative, 4 false-positive and 22 unsatisfactory results were obtained using FNAB, according to histopathologic findings. The overall sensitivity, specificity, accuracy and positive predictive value for malignancy were 87.5, 93.8, 91 and 87.5%, respectively. Conclusions: FNAB is a useful diagnostic tool for head and neck masses. However, FNAB results by themselves could be insufficient in the management of head and neck masses; therefore, they should be combined with clinical and radiologic findings. Copyright © 2005 S. Karger AG.
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.
Treatment of Mucoepidermoid Carcinoma of the Parotid Gland and Successful Repair of Iatrogenic Facial Nerve Paralysis
(2008) Kutluhan, A.; Yurttaş, V.; Yuca, K.; Kösem, M.; Yakut, F.
A 15-year-old female patient developed facial nerve paralysis following surgical excision of a right parotid mass at another center. The histopathologic diagnosis of the lesion was mucoepidermoid carcinoma. On admission to our clinic, she underwent extended total parotidectomy and functional neck dissection. For facial nerve reanimation, cervical plexus nerve grafting was performed for frontal and buccal branches, and ansa hypoglossi anastomosis for the marginal mandibular branch. Postoperative radiotherapy was administered. Facial nerve functions returned to normal in the postoperative sixth month (House-Brackmann grade II). No locoregional recurrence or distant metastasis occurred in the follow-up period.
Treatment of Olfactory Neuroblastoma Via Subfrontal and Midfacial Degloving Approaches: a Case Report
(2008) Kutluhan, A.; Yilmaz, N.; Yakut, F.; Yurttaş, V.; Uǧraş, S.
A 12-year-old girl presented with complaints of nasal obstruction and a right infraorbital swelling. A biopsy obtained from the right nasal passage revealed olfactory neuroblastoma. The tumor was completely excised via subfrontal craniofacial and midfacial degloving approaches. No recurrence was observed during a three-year follow-up.