{"id":2942,"date":"2024-05-05T11:48:06","date_gmt":"2024-05-05T08:48:06","guid":{"rendered":"https:\/\/odyova.com\/haberler\/?p=2942"},"modified":"2024-05-05T11:48:06","modified_gmt":"2024-05-05T08:48:06","slug":"tukruk-bezi-hastaliklari","status":"publish","type":"post","link":"https:\/\/odyova.com\/haberler\/tukruk-bezi-hastaliklari\/","title":{"rendered":"T\u00fckr\u00fck bezi hastal\u0131klar\u0131"},"content":{"rendered":"

T\u00fckr\u00fck bezleri, major ve min\u00f6r t\u00fckr\u00fck bezleri olarak iki grupta incelenmektedir. Major t\u00fckr\u00fck bezleri \u00fc\u00e7 \u00e7ift olup, y\u00fcz\u00fcn her iki yan\u0131nda simetrik olarak yer al\u0131rlar. Min\u00f6r t\u00fckr\u00fck bezleri ise a\u011f\u0131z bo\u015flu\u011funu \u00e7evreleyen mukozalarda bol olarak bulunan (say\u0131lar\u0131 800-1000 aras\u0131ndad\u0131r) daha k\u00fc\u00e7\u00fck gland\u00fcler yap\u0131lard\u0131r. Major t\u00fckr\u00fck bezlerinin en b\u00fcy\u00fc\u011f\u00fc olan parotis bezi,<\/strong> mandibula ramusununarkas\u0131nda fossa retromandibularis isimli \u00e7ukur b\u00f6lgede yerle\u015fmi\u015ftir (\u015eekil 1). Arkada; yukar\u0131dan a\u015fa\u011f\u0131ya do\u011fru d\u0131\u015f kulak yolu, mastoid \u00e7\u0131k\u0131nt\u0131, sternokleidomastoid kas ile kom\u015fudur. \u00d6nde masseter kas\u0131 ile kom\u015fuluk g\u00f6sterir. Parotisin bo\u015falt\u0131m kanal\u0131 olan Stenon kanal\u0131<\/strong>, bezden \u00e7\u0131kt\u0131ktan sonra masseter kas\u0131 \u00fczerinde \u00f6ne do\u011fru ilerleyerek kas\u0131n \u00f6n kenar\u0131nda keskin bir k\u0131vr\u0131mla a\u011f\u0131z bo\u015flu\u011funa y\u00f6nelir. \u00dcst ikinci molar di\u015f hizalar\u0131nda a\u011f\u0131z bo\u015flu\u011funa a\u00e7\u0131l\u0131r.<\/p>\n

Submandib\u00fcler bez<\/strong>, boyunda submandib\u00fcler b\u00f6lgede hemen cildin alt\u0131nda yerle\u015fmi\u015ftir (\u015eekil 2 ve 3). Mylohyoid kas, bezi a\u011f\u0131z bo\u015flu\u011fundan ay\u0131r\u0131r. Digastrik kas\u0131n \u00f6n ve arka kar\u0131nlar\u0131 bezi \u00f6n ve arkadan s\u0131n\u0131rlar. Arkada sternokleidomastoid kas ve parotis kuyru\u011funa \u00e7ok yakla\u015f\u0131r. Bezin kanal\u0131 olan, Wharton kanal\u0131<\/strong> bezden \u00e7\u0131kt\u0131ktan sonra a\u011f\u0131z taban\u0131nda mukoza alt\u0131nda \u00f6ne-i\u00e7e ilerleyerek, a\u011f\u0131z taban\u0131 \u00f6n k\u0131sm\u0131nda \u2018caruncula sublingualis\u2019 isimli kabar\u0131kl\u0131\u011fa a\u00e7\u0131l\u0131r.<\/p>\n

Sublingual bez,<\/strong> a\u011f\u0131z taban\u0131 mukozas\u0131nda plika sublingualis adl\u0131 mukoza kabar\u0131kl\u0131\u011f\u0131n\u0131n hemen alt\u0131nda yer al\u0131r (\u015eekil 3). Bo\u015falt\u0131m sistemi di\u011ferlerinden farkl\u0131 olup, say\u0131lar\u0131 8-12 aras\u0131nda de\u011fi\u015fen bo\u015falt\u0131m kanal\u0131 vard\u0131r. Bunlardan en \u00f6ndeki (Bartholin kanal\u0131) <\/strong>di\u011ferlerine g\u00f6re daha geni\u015f olup, Wharton kanal\u0131 ile birlikte caruncula sublingualis\u2019e a\u00e7\u0131l\u0131r. Arkadaki daha k\u00fc\u00e7\u00fck kanalc\u0131klar ise (Rivinus kanalc\u0131klar\u0131), <\/strong>ayr\u0131 ayr\u0131 plika sublingualis\u2019e a\u00e7\u0131l\u0131rlar.<\/p>\n

T\u00dcKR\u00dcK BEZ\u0130 TRAVMALARI<\/strong><\/p>\n

Y\u00fcz ya da boyun travmalar\u0131n\u0131n bir k\u0131sm\u0131nda t\u00fckr\u00fck bezleri de travmaya u\u011frayabilmektedir. Submandib\u00fcler ve sublingual bezler mandibula ile korundu\u011fundan, en s\u0131k travmaya u\u011frayan bez parotisdir. \u00d6zellikle kesici yaralanmalardan sonra ortaya \u00e7\u0131kabilen a\u015fa\u011f\u0131daki durumlar, hasta i\u00e7in sorun olu\u015fturmaktad\u0131r:<\/p>\n

T\u00fckr\u00fck fist\u00fcl\u00fc:<\/strong><\/p>\n

A\u011f\u0131za bo\u015falmas\u0131 gereken t\u00fckr\u00fc\u011f\u00fcn y\u00fcz ya da boyundaki bir fist\u00fcl a\u011fz\u0131ndan drenaj\u0131 s\u00f6z konusudur. T\u00fckr\u00fck bezi kanal ya da parankiminin kesilerinde ilk tedavinin yetersiz yap\u0131lmas\u0131 sonucunda geli\u015fir. Bu vakalar\u0131n ilk tedavisinde kanal ve parankim tamiri iyi yap\u0131lmal\u0131d\u0131r. Sadece cilt ve ciltalt\u0131 tamiri yap\u0131l\u0131rsa , cilt alt\u0131nda biriken t\u00fckr\u00fck genellikle fist\u00fcl geli\u015fimine yol a\u00e7ar. Fist\u00fcl geli\u015ftikten sonra tamiri zor olup, tekrarlayan operasyonlar gerekebilir.<\/p>\n

Hemoraji:<\/strong><\/p>\n

\u00d6zellikle submandib\u00fcler ve parotis yaralanmalar\u0131ndan sonra yo\u011fun kanamalar olabilir. Kanaman\u0131n kayna\u011f\u0131 genellikle A. veya V. Fasialis\u2019dir. Tedavide, kanayan damar bulunarak ba\u011flan\u0131r.<\/p>\n

Periferik fasial paralizi:<\/strong><\/p>\n

Parotis ile VII. kafa \u00e7iftinin \u00e7ok yak\u0131n anatomik ili\u015fkisi nedeniyle, parotis travmalar\u0131ndan sonra ortaya \u00e7\u0131kabilir. K\u00fcnt travmadan sonra geli\u015firse, antiimflamatuar tedavi genellikle yeterlidir. Kesici yaralanma s\u00f6z konusu ise, mikroskopik olarak kesik sinir u\u00e7lar\u0131 s\u00fct\u00fcrle birle\u015ftirilir. Sinirde doku kayb\u0131 varsa, v\u00fccudun ba\u015fka yerinden al\u0131nan sinir grefi ile sinirin devaml\u0131l\u0131\u011f\u0131 sa\u011flan\u0131r.<\/p>\n

T\u00dcKR\u00dcK BEZ\u0130 TA\u015eLARI (S\u0130ALOL\u0130T\u0130AZ\u0130S)<\/strong><\/p>\n

Olu\u015fum nedenleri kesin olarak bilinmemektedir. T\u00fckr\u00fck ta\u015flar\u0131 en fazla (% 80) submandib\u00fcler bez ve Wharton kanal\u0131nda g\u00f6r\u00fclmektedir. Genellikle kalsiyum karbonat ve kalsiyum fosfat yap\u0131s\u0131ndad\u0131rlar.<\/p>\n

En \u00f6nemli klinik belirti, \u00e7i\u011fneme ile (\u00f6rne\u011fin yemeklerde) ta\u015f\u0131n bulundu\u011fu t\u00fckr\u00fck bezi b\u00f6lgesinde a\u011fr\u0131l\u0131 bir \u015fi\u015fli\u011fin ortaya \u00e7\u0131kmas\u0131d\u0131r. Ta\u015f\u0131n kanalda olu\u015fturdu\u011fu obstr\u00fcksiyona ba\u011fl\u0131 bu \u015fi\u015flik, t\u00fckr\u00fc\u011f\u00fcn yava\u015f bir \u015fekilde drenaj\u0131yla bir s\u00fcre sonra azal\u0131r, ancak sonraki \u00f6\u011f\u00fcnde tekrar ortaya \u00e7\u0131kar.<\/p>\n

Ay\u0131r\u0131m tan\u0131da Kusmaul Hastal\u0131\u011f\u0131 (kanal\u0131 t\u0131kayan mukus t\u0131kac\u0131 nedeniyle tekrarlayan parotis \u015fi\u015fmeleri) g\u00f6z \u00f6n\u00fcne al\u0131nmal\u0131d\u0131r.<\/p>\n

Tan\u0131da anamnez yan\u0131nda di\u011fer yard\u0131mc\u0131 y\u00f6ntemler \u015fu \u015fekildedir<\/p>\n

Palpasyon<\/strong>:<\/strong> T\u00fckr\u00fck bezi b\u00f6lgesi d\u0131\u015far\u0131dan ya da kanal b\u00f6lgesi a\u011f\u0131z i\u00e7inden palpe edilerek ta\u015f aran\u0131r. Wharton kanal\u0131 b\u00f6lgesinin palpasyonu iki elle (bimanuel) yap\u0131lmal\u0131d\u0131r (bir el d\u0131\u015far\u0131dan a\u011f\u0131z taban\u0131n\u0131 yukar\u0131 iterken di\u011fer el a\u011f\u0131z i\u00e7inden a\u011f\u0131z taban\u0131n\u0131 palpe eder. A\u011f\u0131z taban\u0131n\u0131n di\u011fer patolojilerinde de bu \u015fekilde palpasyon gerekir).<\/p>\n

Direkt grafi<\/strong>: Kalsiyum i\u00e7erdikleri i\u00e7in, belirli bir b\u00fcy\u00fckl\u00fc\u011fe eri\u015fmi\u015f ta\u015flar direkt grafilerde g\u00f6sterilebilir. K\u00fc\u00e7\u00fck ta\u015flar ise, etraftaki kemik yap\u0131lar\u0131n yo\u011funlu\u011fu nedeniyle genellikle g\u00f6sterilemez.<\/p>\n

Sialografi<\/strong>:<\/strong> Sadece ta\u015flar de\u011fil, t\u00fckr\u00fck bezlerinin di\u011fer patolojilerinde de kullan\u0131lan bir tan\u0131 y\u00f6ntemidir (\u015eekil 4). Bezinkanal\u0131na \u00f6zel bir kateter ile verilen radyoopak s\u0131v\u0131 madde, normalde kanal sistemini doldurur ve daha sonra \u00e7ekilen grafide bez g\u00f6r\u00fcn\u00fcr hale gelir. Kanaldaki ta\u015f durumunda radyoopak madde ta\u015f seviyesine kadar gidebilir ve \u00e7ekilen grafide dolma defekti saptan\u0131r.<\/p>\n

Ultrasonografi<\/strong>:<\/strong> Ta\u015flar yan\u0131nda di\u011fer t\u00fckr\u00fck bezi patolojilerinde de kullan\u0131lan ucuz, de\u011ferli ve kolay bir tan\u0131 y\u00f6ntemidir.<\/p>\n

Ta\u015flar\u0131n en \u00f6nemli komplikasyonu; bulunduklar\u0131 bezde tekrarlayan enfeksiyonlara, bazen absele\u015fmeye neden olmalar\u0131d\u0131r.<\/p>\n

Tedavide; ta\u015f\u0131n lokalizasyonuna g\u00f6re de\u011fi\u015fik y\u00f6ntemler ile ta\u015f \u00e7\u0131kar\u0131l\u0131r. Kanal a\u011fz\u0131na yak\u0131n ta\u015flar, kanal a\u011fz\u0131n\u0131n dilatasyonu ve arkada biriken t\u00fckr\u00fc\u011f\u00fcn bas\u0131nc\u0131 ile at\u0131labilir. Daha derin Wharton ta\u015flar\u0131nda a\u011f\u0131z taban\u0131 mukozas\u0131 ve kanal ensize edilerek ta\u015f \u00e7\u0131kar\u0131l\u0131r. Submandib\u00fcler ta\u015flarda ise, submandib\u00fcler b\u00f6lgede cilt ensizyonu ile girilip, bez t\u00fcm\u00fcyle \u00e7\u0131kar\u0131l\u0131r.<\/p>\n

T\u00dcKR\u00dcK BEZ\u0130 ENFEKS\u0130YONLARI (S\u0130ALADEN\u0130T)<\/strong><\/p>\n

AKUT S\u00dcP\u00dcRAT\u0130F S\u0130ALADEN\u0130T:<\/strong><\/p>\n

En s\u0131k parotis bezinde g\u00f6r\u00fcl\u00fcr. Nedeni lokal (ta\u015f, kom\u015fu dokular\u0131n enfeksiyonu, t\u00fckr\u00fck staz\u0131, vs) veya genel (ka\u015feksi, imm\u00fcn sistem yetersizli\u011fi gibi) olabilir. Bat\u0131n ameliyatlar\u0131ndan sonraki ilk haftada komplikasyon olarak akut parotitis geli\u015febilir. Bunun nedeni; bu hastalar\u0131n bir s\u00fcre nazogastrik t\u00fcple beslenmesi ve t\u00fckr\u00fck salg\u0131s\u0131n\u0131 uyaran \u00e7i\u011fneme hareketinin azalmas\u0131yla t\u00fckr\u00fck staz\u0131n\u0131n olu\u015fmas\u0131d\u0131r.<\/p>\n

Patojen etken genellikle Staf. Aureus\u2019dur. Daha nadiren Streptokok, E.Coli ve H.\u0130nfluenza g\u00f6r\u00fclebilir.<\/p>\n

Klinik bulgu olarak; enfekte bez b\u00f6lgesinde enfeksiyonun lokal belirtileri (\u00f6dem, k\u0131zar\u0131kl\u0131k, \u0131s\u0131 art\u0131m\u0131, a\u011fr\u0131) vard\u0131r. Ate\u015f y\u00fcksektir. L\u00f6kositoz ve periferik yaymada par\u00e7al\u0131 hakimiyeti (viral etyolojiden ay\u0131r\u0131m tan\u0131da \u00f6nemlidir) saptan\u0131r.<\/p>\n

Klinik bak\u0131da; bez palpasyonla hassasd\u0131r ve hamur k\u0131vam\u0131nda ele gelir. A\u011f\u0131z bak\u0131s\u0131 s\u0131ras\u0131nda beze masaj yap\u0131ld\u0131\u011f\u0131nda, bo\u015falt\u0131m kanal\u0131ndan p\u00fcr\u00fclan ak\u0131nt\u0131 geldi\u011fi genellikle izlenir (viral yang\u0131da p\u00fcr\u00fclan ak\u0131nt\u0131 yoktur). Komplikasyon olarak t\u00fckr\u00fck bezinde absele\u015fme, derin boyun enfeksiyon ve absesi, mediastenit g\u00f6r\u00fclebilir.<\/p>\n

Tedavide uygun antibiotik, analjezik verilir. Yeterli hidratasyon sa\u011flan\u0131r, oral hijyen d\u00fczeltilir, beze masaj uygulamalar\u0131 yap\u0131l\u0131r. Absele\u015fme varsa cerrahi drenaj da gerekir (parotis absesinin drenaj\u0131 s\u0131ras\u0131nda fasial siniri zedelememeye dikkat etmelidir).<\/p>\n

KRON\u0130K REK\u00dcRRENT S\u0130ALADEN\u0130T:<\/strong><\/p>\n

Bu hastal\u0131k da en s\u0131k parotis bezinde g\u00f6r\u00fcl\u00fcr. Patojenezinden t\u00fckr\u00fck sekresyonunun azalmas\u0131 ya da durmas\u0131 sorumlu tutulmaktad\u0131r. T\u00fckr\u00fck bezinde zamanla sialektazi, kanal ektazisi, asin\u00fcslerde y\u0131k\u0131m ve lenfosit infiltrasyonu ortaya \u00e7\u0131kar. Bezde progresif y\u0131k\u0131m sonucu normal doku \u00f6zellikleri kaybolur.<\/p>\n

Klinik olarak hastada tekrarlayan, hafif a\u011fr\u0131l\u0131 t\u00fckr\u00fck bezi \u015fi\u015fmeleri s\u00f6z konusudur.<\/p>\n

Ta\u015f veya di\u011fer predispozan fakt\u00f6rler varsa bunlar tedavi edilmelidir. Yeterli hidratasyon, bez masajlar\u0131 yan\u0131nda akut ataklar s\u0131ras\u0131nda antibiotik kullan\u0131l\u0131r. Konservatif tedavinin yetersizli\u011fi halinde bezin cerrahi ablasyonu (\u00e7\u0131kar\u0131lmas\u0131) gerekebilir. \u00c7ocuklarda da kar\u015f\u0131m\u0131za \u00e7\u0131kabilir ve ilk atak kabakulak ile kar\u0131\u015fabilir.<\/p>\n

V\u0130RAL ENFEKS\u0130YONLAR:<\/strong><\/p>\n

Kabakulak (parotitis epidemica) t\u00fckr\u00fck bezlerini en s\u0131k tutan viral hastal\u0131kt\u0131r. Bunun yan\u0131nda Sitomegalovir\u00fcs, Coxackie A, Echovir\u00fcs, \u0130nfluenza A vir\u00fcsleri de t\u00fckr\u00fck bezlerinde enfeksiyona neden olabilir.<\/p>\n

T\u00dcKR\u00dcK BEZLER\u0130N\u0130N GRAN\u00dcLOMAT\u00d6Z HASTALIKLARI<\/strong><\/p>\n

T\u00dcBERK\u00dcLOZ<\/strong>:<\/p>\n

\u00c7ok nadirdir. Genellikle tek tarafl\u0131 olarak parotis bezini tutar. Tonsil veya di\u015flerdeki bir odaktan kaynakland\u0131\u011f\u0131 d\u00fc\u015f\u00fcn\u00fclmektedir.<\/p>\n

SARKO\u0130DOZ:<\/strong><\/p>\n

Nedeni bilinmeyen gran\u00fclomat\u00f6z bir hastal\u0131k olup, vakalar\u0131n %6 s\u0131nda klinik olarak t\u00fckr\u00fck bezi tutulumu da vard\u0131r. T\u00fckr\u00fck bezi sarkoidozunun \u00f6zel bir \u015fekli; \u00fcveitis, parotisde \u015fi\u015fme ve fasial paralizi ile seyreden Heerfordt Sendromu\u2019dur (Uveoparotid fewer). Tedavi semptomatik olup, belirtilerin \u00e7o\u011fu aylar (bazen y\u0131llar) sonra kendili\u011finden ge\u00e7er.<\/p>\n

S\u0130ALADENOZ\u2019LAR:<\/strong><\/p>\n

T\u00fckr\u00fck bezlerinin yang\u0131sal ya da t\u00fcm\u00f6ral olmayan \u015fi\u015fliklerine verilen isimdir. Genellikle bilateral parotis hipertrofisi vard\u0131r. T\u00fckr\u00fck bezlerine y\u00f6nelik bir tedavi gerektirmez. G\u00f6r\u00fcld\u00fc\u011f\u00fc ba\u015fl\u0131ca durumlar:<\/p>\n

\u00b7Obesite,<\/p>\n

\u00b7Diabetes mellitus,<\/p>\n

\u00b7Akromegali,<\/p>\n

\u00b7Alkolik siroz,<\/p>\n

\u00b7Gastrointestinal emilim bozukluklar\u0131,<\/p>\n

\u00b7Hipotiroidi,<\/p>\n

\u00b7Gebelik ve laktasyondur.<\/p>\n

T\u00dcKR\u00dcK BEZ\u0130 T\u00dcM\u00d6RLER\u0130<\/strong><\/p>\n

Kistik ve solid t\u00fcm\u00f6rler olarak iki grupta incelenebilir.<\/p>\n

K\u0130ST\u0130K T\u00dcM\u00d6RLER:<\/strong><\/p>\n

RANULA (Kurba\u011fac\u0131k):<\/strong><\/p>\n

A\u011f\u0131z taban\u0131nda ortaya \u00e7\u0131kan, sublingual bez ya da Wharton kanal\u0131ndan kaynaklanan i\u00e7i t\u00fckr\u00fck dolu kesecik \u015feklindedir (\u015eekil 4).<\/p>\n

Zaman zaman patlayarak kaybolur, ancak daha sonra tekrar ortaya \u00e7\u0131kar. Tedavisi cerrahi olarak \u00e7\u0131kar\u0131lmas\u0131 ya da a\u011f\u0131z taban\u0131 mukozas\u0131na marsupialize edilmesidir.<\/p>\n

WHART\u0130N T\u00dcM\u00d6R\u00dc (papiller kistadenolenfomatozum):<\/strong><\/p>\n

\u00c7o\u011funlukla erkeklerde g\u00f6r\u00fclen ve s\u0131kl\u0131kla parotis kuyru\u011funda yerle\u015fen iyi huylu bir t\u00fcm\u00f6r olup, yar\u0131 kistik yap\u0131ya sahiptir. Zaman zaman enfekte olabilir.Radyon\u00fckleer incelemede Technetium 99 maddesini tutma \u00f6zelli\u011fi, ay\u0131r\u0131m tan\u0131da \u00f6nemlidir. Tedavisi cerrahi olarak \u00e7\u0131kar\u0131lmas\u0131d\u0131r.<\/p>\n

SOL\u0130D T\u00dcM\u00d6RLER:<\/strong><\/p>\n

En s\u0131k olarak mikst t\u00fcm\u00f6rlere ve kanserlere rastlan\u0131r.<\/p>\n

M\u0130KST T\u00dcM\u00d6R (Pleomorfik adenom):<\/strong><\/p>\n

T\u00fckr\u00fck bezlerine \u00f6zg\u00fc bir t\u00fcm\u00f6rd\u00fcr. Histolojik olarak olarak hem epitelial, hem ba\u011f dokusunu bir arada bulundurdu\u011fu i\u00e7in bu \u015fekilde adland\u0131r\u0131lm\u0131\u015ft\u0131r. En s\u0131k parotisde g\u00f6r\u00fcl\u00fcr, submandib\u00fcler bez ve damaktaki min\u00f6r bezlerden de kaynaklanabilir. \u0130yi huyludur, ancak malignle\u015fme \u015fans\u0131 vard\u0131r.<\/p>\n

Klinik olarak \u00e7ok yava\u015f b\u00fcy\u00fcyen, mobil, lastik k\u0131vam\u0131nda bir kitle olarakkar\u015f\u0131m\u0131za \u00e7\u0131kar (\u015eekil 5). Malignle\u015fme \u015fans\u0131 nedeniyle cerrahi olarak \u00e7\u0131kar\u0131lmal\u0131d\u0131r. Tan\u0131 klinik bulgular ve laboratuar testler (ultrasonografi, sialografi gibi) ile konur. Malignle\u015fmeye yol a\u00e7abilece\u011finden, biopsi kontrendikedir.<\/strong>Kesin tan\u0131 operasyon s\u0131ras\u0131nda veya postoperatif histolojik inceleme ile konur.<\/p>\n

Genellikle parotisin y\u00fczeyel lobundan kaynakland\u0131\u011f\u0131 i\u00e7in, tedavide y\u00fczeyel parotidektomi operasyonu yap\u0131l\u0131r ve operasyonda fasial siniri korumaya \u00f6zen g\u00f6sterilir. Komplikasyon olarak fasial paralizi (genellikle ge\u00e7ici) geli\u015febilir.<\/p>\n

MAL\u0130GN M\u0130KST T\u00dcM\u00d6R:<\/strong><\/p>\n

Primer geli\u015febilir veya iyi huylu mikst t\u00fcm\u00f6r\u00fcn malignle\u015fmesiyle ortaya \u00e7\u0131kabilir. Benign mikst t\u00fcm\u00f6r\u00fcn malignle\u015fti\u011fini g\u00f6steren ba\u015fl\u0131ca bulgular; b\u00fcy\u00fcmenin h\u0131zlanmas\u0131, mobilitenin kaybolmas\u0131, t\u00fcm\u00f6r\u00fcn \u00e7ok sertle\u015fmesi, b\u00f6lgesel (boyun lenf nod\u00fcllerine) ve uzak metastazlar\u0131n belirmesidir. Tedavide, tutulan t\u00fckr\u00fck bezi t\u00fcm\u00fcyle \u00e7\u0131kar\u0131l\u0131r (en \u00e7ok parotisde g\u00f6r\u00fcld\u00fc\u011f\u00fcnden, total parotidektomi yap\u0131l\u0131r). Boyun lenf nod\u00fcllerine y\u00fcksek oranda metastaz nedeniyle ayn\u0131 seansda boyun diseksiyonu da genellikle yap\u0131l\u0131r. Fasial siniri korumaya \u00f6zen g\u00f6sterilmez. Sinirin de rezeke edldi\u011fi vakalarda, sinir grefi ile tamir yap\u0131l\u0131r. Hastalara postoperatif radyoterapi de uygulan\u0131r. Bu tedavilere kar\u015f\u0131n prognoz k\u00f6t\u00fcd\u00fcr. N\u00fcks halinde paliatif ama\u00e7la kanser kemoterapisi yap\u0131labilir.<\/p>\n

KANSERLER:<\/strong><\/p>\n

\u00c7ok de\u011fi\u015fik histolojik tipleri vard\u0131r. Belirtileri ve tedavileri malign mikst t\u00fcm\u00f6r gibidir. Prognoz histolojiye g\u00f6re de\u011fi\u015fmekle beraber, genel olarak k\u00f6t\u00fcd\u00fcr<\/p>\n

<\/p>\n","protected":false},"excerpt":{"rendered":"

T\u00fckr\u00fck bezi hastal\u0131klar\u0131 Konu hakk\u0131nda detayl\u0131 ve g\u00fcncel bilgiler i\u00e7in bu makaleyi okuyun<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[18],"tags":[510,288,341,235,42],"class_list":["post-2942","post","type-post","status-publish","format-standard","hentry","category-kulak-burun-bogaz","tag-bez","tag-cikar","tag-kanal","tag-tas","tag-tedavi"],"_links":{"self":[{"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/posts\/2942","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/comments?post=2942"}],"version-history":[{"count":1,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/posts\/2942\/revisions"}],"predecessor-version":[{"id":2943,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/posts\/2942\/revisions\/2943"}],"wp:attachment":[{"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/media?parent=2942"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/categories?post=2942"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/tags?post=2942"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}