Araştırma Çıktıları | WoS | Scopus | TR-Dizin | PubMed
Permanent URI for this communityhttps://hdl.handle.net/20.500.14719/1741
Browse
4 results
Search Results
Publication Metadata only Complication Risk in Secondary Thyroid Surgery(YERKURE TANITIM YAYINCILIK HIZMETLERI AS, 2018) Aygun, Nurcihan; Besler, Evren; Yetkin, Gurkan; Mihmanli, Mehmet; Isgor, Adnan; Uludag, Mehmet; University of Health Sciences Turkey; Bahcesehir UniversityPublication Metadata only A Rare Presentation of Autonomously Functioning Papillary Thyroid Cancer: Malignancy in Marine-Lenhart Syndrome Nodule(HINDAWI LTD, 2016) Uludag, Mehmet; Aygun, Nurcihan; Ozel, Alper; Ozturk, Feyza Yener; Karasu, Rabia; Ozguven, Banu Yilmaz; Citgez, Bulent; Mihmanli, Mehmet; Isgor, Adnan; Istanbul Sisli Hamidiye Etfal Training & Research Hospital; Istanbul Sisli Hamidiye Etfal Training & Research Hospital; Istanbul Sisli Hamidiye Etfal Training & Research Hospital; Istanbul Sisli Hamidiye Etfal Training & Research Hospital; Bahcesehir UniversityObjective. Marine-Lenhart Syndrome (MLS) is defined as concomitant occurrence of autonomously functioning thyroid nodule (AFTN) with Graves' disease (GD). Malignancy in a functional nodule is rare. We aimed to present an extremely rare case of papillary thyroid cancer in a MLS nodule with lateral lymph node metastases. Case. A 43-year-old male presented with hyperthyroidism and Graves' ophthalmopathy. On Tc99m pertechnetate scintigraphy, a hyperactive nodule in the left upper thyroid pole was detected and the remaining tissue showed a mildly increased uptake. The ultrasonography demonstrated 15.5 x 13.5 x 12 mm sized hypoechoic nodule in the left upper pole of the thyroid and round lymph nodes on the left side of the neck. Fine needle aspiration biopsy (FNAB) of the nodule and lymph node revealed cytological findings consistent with papillary cancer. Total thyroidectomy with central and left modified radical neck dissection was performed. On pathologic examination, two foci of micropapillary cancer were detected. The skip metastases were present in three lymph nodes on the neck. Conclusion. AFTN can be seen rarely in association with GD. It is not possible to exclude malignancy due to the clinical and imaging findings. In the presence of suspicious clinical and sonographic features, FNAB should be performed.Publication Metadata only A Closer Look at the Recurrent Laryngeal Nerve Focusing on Branches & Diameters: A Prospective Cohort Study(TAYLOR & FRANCIS INC, 2016) Uludag, Mehmet; Yazici, Pinar; Aygun, Nurcihan; Citgez, Bulent; Yetkin, Gurkan; Mihmanli, Mehmet; Isgor, Adnan; Istanbul Sisli Hamidiye Etfal Training & Research Hospital; Bahcesehir UniversityAim: We aimed to investigate the anatomical characteristics of the recurrent laryngeal nerve (RLN) highlighting on its diameter and branching pattern. Materials and Methods: We prospectively collected 215 patients (178 female, 37 male) who underwent thyroid/parathyroid surgery during over a 2-year period. Apart from demographic features and surgical data, diameter of RLNs, and their branches and as well as branching distance (distance between the point of bifurcation and the laryngeal entry of RLN) were recorded. Results: In 215 patients, 378 RLNs were assessed and 42% (n = 159) bifurcated RLNs were observed. The bifurcation rate was similar on the right and left side(s) of the neck (40% and 44%, respectively, p = 0.47). In those, who underwent bilateral exploration, in the case of bifurcation on the first side of the neck, the possibility of contralateral bifurcation was approximately 50%, whereas this rate was found to be only 30% in those with nonbranching RLNs. Mean branching distance was 18 +/- 9mm, and it was similar on the right and left sides (17 and 19mm, respectively). Approximately 80% of bifurcations were observed within 5-24mm of the RLN. Mean diameter of the anterior branches was found to be significantly larger compared to posterior branches (1.09 +/- 0.35 and 0.82 +/- 0.36mm, respectively, p < 0.01).Conclusions: There is great variability in RLN branching. We observed that approximately two out of three bifurcations were unilateral and anterior branches were thicker compared to posterior branches. These findings should be taken into consideration to avoid any damage to the RLN during thyroid and parathyroid surgery.Publication Metadata only Contribution of intraoperative neural monitoring to preservation of the external branch of the superior laryngeal nerve: a randomized prospective clinical trial(SPRINGER, 2017) Uludag, Mehmet; Aygun, Nurcihan; Kartal, Kinyas; Citgez, Bulent; Besler, Evren; Yetkin, Gurkan; Kaya, Cemal; Ozsahin, Hamdi; Mihmanli, Mehmet; Isgor, Adnan; Istanbul Sisli Hamidiye Etfal Training & Research Hospital; Bahcesehir UniversityPurpose The purpose of this study was to evaluate the effect of intraoperative neuromonitoring (IONM) on the injury rate of the external branch of the superior laryngeal nerve (EBSLN) during thyroidectomy. Methods A total of 133 consenting patients (98 female, 35 male, mean age, 45.6 +/- 11.7 years) undergoing thyroidectomy were randomly assigned to 2 groups. In group 1 (n = 65 patients, 105 nerves), superior thyroid pole dissection was performed with no attempt to identify the EBSLN, in group 2 (n = 68 patients, 106 nerves), IONM was used to identify the EBSLN during surgery. EBSLN function was evaluated by intraoperative electromyography of the cricothyroid muscle. The EBSLN Voice Impairment Index-5 (VII-5) was conducted preoperatively and at 1, 3, and 6 months postoperatively. The primary outcome was the prevalence of EBSLN injury. The secondary outcomes were the identification rate of the EBSLN using IONM and changes in postoperative voice performance. Results EBSLN injury was detected in eight (12.3%) patients and nine (8.6%) nerves in group 1 and in one (1.5%) patient and one (0.9%) nerve in group 2 (patients, p = 0.015, nerves, p = 0.010). IONM contributed significantly to visual (p < 0.001) and functional (p < 0.001) nerve identification in group 2. The VII-5 indicated more voice changes in group 1 than 2 at 1, 3, and 6 months postoperatively (p = 0.012, p = 0.015, and p = 0.02, respectively). Conclusion IONM contributes to visual and functional identification of the EBSLN and decreases the rate of EBSLN injury during superior pole dissection. Routine use of IONM to identify the EBSLN will minimize the risk of injury during thyroidectomy.