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Öğe Baş Ve Boyun Tüberkülozları(2012) Yaman, Hüseyin; Alkan, Nihal; Erdem, Havva; Aydın, Leyla Yılmaz; Yıldırım, Ümran; Güçlü, EnderAmaç: Bu çalışmada baş boyun bölgesinde tüberküloz tanısı alan hastaların klinik ve tedavileri araştırıldı. Gereç ve Yöntem: Servikal tüberküloz lenfadenit ve baş boyunun diğer bölgelerinde tüberküloz tanısı alan 16 hastanın dosyaları retrospektif olarak incelendi. Hastaların yaş, cinsiyet, klinik, histopatolojik tanı ve tedavi protokolleri incelendi. Hastalara nodal eksizyon veya total eksizyon yapılmış olup tanıları histopatolojik inceleme sonucunda konulmuştur. Tüberküloz tanısı alan hastalar antitüberküloz tedavi protokolüne alınmıştır. Bulgular: Çalışmamız yaş aralığı 18 ile 72 yaş arasında değişen 16 hastayı [15 bayan (%93.75), 1 erkek (%6.25); ortalama yaş 43.614.7] içermektedir. Hastaların 13ünde (%81.25) tüberküloz lenfadenit, 1inde (%6.25) alt dudak tüberküloz, 1inde (%6.25) nazofarengeal tüberküloz, 1inde (%6.25) larengeal tüberküloz tespit edilmiştir. Antitüberküloz tedavi alan hastalarda tedavi sonucunda kitlelerin kaybolduğu gözlenmiştir. Sonuç: Baş boyun bölgesindeki kitlelerinin ayırıcı tanısında tüberküloz unutulmamalıdır. Baş boyunda genellikle tüberküloz lenfadenit şeklinde görülmekle birlikte nadirde olsa dudak, nazofarenks, larenks gibi bölgelerde de görülebilmektedir.Öğe Boyun yerleşimli castleman hastalığı(2010) Yaman, Hüseyin; Alkan, Nihal; Yıldırım, Ümran; Beşir, Fahri Halit; Yılmaz, SüleymanCastleman hastalığı nadir görülen etiyolojisi tam olarak bilinmeyen lenfoprolifetif bir hastalıktır. En sık mediastinal lenf nodu tutulumu görülmekle birlikte servikal, retroperitoneal, aksiller ve diğer bölgelerdeki lenf nodları da tutulabilir. Sıklıkla genç erişkinlerde görülür ve cinsiyet ayırımı göstermez. Histopatolojik olarak hiyalin vasküler ve plazma hücreli olmak üzere iki tipi bulunmaktadır. Kliniğine göre de lokalize ve sistemik (multisentrik) formları bulunmaktadır. Lokalize tip genellikle asemptomatiktir ve kitle veya şişlik ile kendini gösterir. Sistemik (multisentrik) tipte ise ateş, anemi, yaygın lenfadenopati ve hepatosplenomegali gibi nonspesifik semptomlar görülür. Lokalize tip hastalığın tedavisi kitlenin cerrahi olarak eksizyonudur. Sistemik tip hastalığın tedavisinde genellikle steroid tedavisi, kemoterapi ve radyoterapi kullanılmasına rağmen kesin tedavisi yoktur. Bu çalışmada boyunda kitle şikâyeti ile gelen ve hiyalin vasküler tip Castleman hastalığı tanısı konulan bir olgu sunuldu.Öğe Head and neck tuberculosis(Duzce University Medical School, 2012) Yaman, Hüseyin; Alkan, Nihal; Erdem, Havva; Aydın, Leyla Yılmaz; Yıldırım, Ümran; Güçlü, EnderObjective: To investigate clinical manifestations and treatment protocols of the patients with head and neck tuberculosis. Material and Method: Records of 16 patients with cervical lymphadenitis and tuberculosis in other sides of head and neck investigated, retrospectively. The age, gender, clinical, histopathological diagnosis and treatment protocols were noted. Nodal or total excisions were performed and all patients diagnosed histopathologically. Patients diagnosed as tuberculosis underwent antituberculosis treatment protocol. Results:Mean age of our patients were 43.6±14.7 (18-72 years old). Fifteen of 16 patients were women. The diagnoses were cervical lymphadenitis in 13 (81.25%) patients, lower lip tuberculosis in 1 (%6.25) patient, nasopharynx tuberculosis in 1 (%6.25) patient and larynx tuberculosis in 1 (%6.25) patient. After the treatment masses were disappeared. Conclusion: Tuberculosis should not be forgotten in the differential diagnosis on head and neck masses. Although tuberculosis usually occur as cervical lymphadenitis in head and neck, lip, nasopharynx and larynx can be involved rarely. © 2012 Düzce Medical Journal.Öğe Is routine histopathological analysis of nasal polyposis specimens necessary?(Springer, 2011) Yaman, Hüseyin; Alkan, Nihal; Yılmaz, Süleyman; Koç, Sema; Belada, AbdullahOur objective is to evaluate the incidence of unexpected pathologies in routine nasal polyposis specimens and necessity for histopathological evaluation of nasal polyps. A retrospective chart review of all patients who underwent nasal polyposis surgery between January 2004 and June 2010 were reviewed. The patients were divided into two groups. Group 1 consisted of patients with bilateral nasal polyposis. Group 2 consisted of patients with unilateral nasal polyposis. One hundred and seventeen patients (81 male, 36 female) were involved in this study. The mean age was 44.9 +/- A 17.7 years, ranging between 18 and 72 years. Group 1 consisted of bilateral nasal polyposis specimens. Eighty-five patients were identified with bilateral nasal polyposis. From these 85 patients, no specimens present any evidence of occult pathology on histopathological examination. Group 2 consisted of unilateral nasal polyposis specimens. There were two cases of allergic fungal sinusitis, two of inverting papilloma, one of mucocele, one of plasmacytoma, one of hemangioma, one of esthesioneuroblastoma, and one of schwannoma. Final histopathology of the remaining 23 patients was consistent with inflammation and/or nasal polyposis. We think that in cases of unilateral polyps histopathological examination of the entire material is mandatory. However, routine histological examination of bilateral nasal polyposis may possibly not be necessary in cases where the clinical assessment very clearly has not disclosed any unusual or suspicious signs.Öğe Otitis media with effusion: Recurrence after tympanostomy tube extrusion(Elsevier Ireland Ltd, 2010) Yaman, Hüseyin; Yılmaz, Süleyman; Güçlü, Ender; Subaşı, Buğra; Alkan, Nihal; Öztürk, ÖzcanObjective The incidence rate of recurrence of otitis media with effusion (OME) in children after tympanostomy tube extrusion and the relationship between recurrence and tube retention time was investigated. Also relationship between recurrence rate and initial age of tube insertion was analysed. Study Design A retrospective case series of patients who had tympanostomy tube insertion. Methods A total of 91 children (169 ears) were reviewed Ears of children divided into three groups according to retention time of tympanostomy tubes. Group I tympanostomy tube retention time less than 6 months. Group II tympanostomy tube retention time 6 months to 12 months. Group III: tympanostomy tube retention time 12 months or more Results OME recurrence rate after tube extrusion was 20 7% in the study The longer the tympanostomy tube retention time was the lower was the recurrence rate of OME. The comparison of the three groups indicated that recurrence rates were higher in group I (36 54%), than in group II (17 74%) and in group III (9 1%) There were statistically significant differences in recurrence rates between group I and group III, and between group I and II (p < 0 05, p < 0.05). However, the difference in recurrence rates between group II and group III was statistically not significant (p > 0 05) In the preschool age group and school age group, the recurrence rates were 5 5% and 15.4%. respectively There was no significant difference between these two groups (p > 0.05) OME recurrence was observed in 9.9% of males and in 11% of females. There was no significant difference in recurrence rates between males and females (p > 0.05) Conclusion. After extrusion of tympanostomy tube, children should be followed-up regularly for recurrence of OME The shorter the retention time of tympanostomy tubes was the higher was the recurrence rate. For the treatment of OME the ideal type of tubes should have the lowest complication and recurrence rates Further studies are needed to ascertain the relationship between the incidence of OME and optimal tympanostomy tubes duration of tube stay in tympanic membrane Therefore, new studies with larger series are necessary to investigate the correlation between the recurrence rates and different tympanostomy tubes after extrusion of tubes (C) 2009 Elsevier Ireland Ltd All rights reserved.Öğe Shepard grommet tympanostomy tube complications in children with chronic otitis media with effusion(Springer, 2010) Yaman, Hüseyin; Yılmaz, Süleyman; Alkan, Nihal; Subaşı, Buğra; Güçlü, Ender; Öztürk, ÖzcanThe objective of this study was to determine tympanostomy tube complications in children with chronic otitis media with effusion who were treated with Shepard grommet tympanostomy tube insertion. This tube type was selected as it is the most commonly used one in our clinic. The medical records of 162 ears of 87 children (52 male and 35 female) were reviewed retrospectively. The children were between 3 to 16 years old (mean age = 8.1 +/- A 3.1). The patients were followed up 6-66 months (mean 23.3 +/- A 14.9 months) after tympanostomy tube insertion. We reviewed age, sex, time to tube extrusion and complications. In all patients the indication for surgery was chronic middle ear effusion. Otorrhea occurred in nine ears (5.6%). Granulation tissue was seen in two ears (1.2%). Complications after tympanostomy tube extrusion included myringosclerosis (34.6%), persistent perforation (5.6%), atrophy (23.5%), retraction (16.7%) and medial displacement of tubes (1.2%). The average extrusion time was 8.5 +/- A 4.6 months (range 1-24) for Shepard grommet tympanostomy tubes. Complications of tympanostomy tube insertion are common. Myringosclerosis, tympanic membrane atrophy and otorrhea are the most frequently appearing complications. But they are generally insignificant and cosmetic. Consequently, in the majority of these complications there is no need for any management.Öğe Sublingual and supraglottic haemorrhage as a complication of warfarin therapy(Medcom Ltd, 2011) Yaman, Hüseyin; Güven, D.G.; Kandiş, Hayati; Subaşı, Buğra; Alkan, Nihal; Yılmaz, SüleymanAnticoagulant-induced haemorrhage in the upper airway is rare, but it can be life threatening if airway obstruction develops. Treatment is mainly conservative. Urgent control of airway and coagulopathy are the essential of management. Vitamin K1 or combination of fresh frozen plasma and vitamin K1 should be used for reversal of the coagulopathy. In this report, two elderly patients were reported to have oral anticoagulant (warfarin)-induced haemorrhage in the sublingual and supraglottic areas. (Hong Kong j.emerg.med. 2011; 18:177-181)
