{"id":712,"date":"2024-04-28T18:24:06","date_gmt":"2024-04-28T15:24:06","guid":{"rendered":"https:\/\/odyova.com\/haberler\/?p=712"},"modified":"2024-04-28T18:24:06","modified_gmt":"2024-04-28T15:24:06","slug":"girtlak-kanseri","status":"publish","type":"post","link":"https:\/\/odyova.com\/haberler\/girtlak-kanseri\/","title":{"rendered":"G\u0131rtlak kanseri"},"content":{"rendered":"

G\u0131rtlak t\u00fcm\u00f6rleri selim T\u00fcm\u00f6rler ve habis t\u00fcm\u00f6rler olarak ikiye ayr\u0131l\u0131rlar.<\/span><\/p>\n

G\u0131rtla\u011f\u0131n Selim T\u00fcm\u00f6rleri<\/span><\/p>\n

\u00d6nem s\u0131ras\u0131yla:<\/span>
– Papillom,<\/span>
– Anjiom,\u00a0<\/span>
– Fibrom\u00a0<\/span>
– Kondrom,\u00a0<\/span>
– Miyom olarak s\u0131n\u0131flayabiliriz.<\/span><\/p>\n

G\u0131rtla\u011f\u0131n yukar\u0131da say\u0131lanlara ek olarak, ses bozuklu\u011fu yapan ancak ger\u00e7ek\u00a0<\/span>
t\u00fcm\u00f6r olmayan,vokal kord nod\u00fclleri, Polipleri, iltihabi ve alerjik nod\u00fclleri de\u00a0<\/span>
vard\u0131r.<\/span><\/p>\n

1)Vokal nod\u00fclleri- Ses Teli Nod\u00fclleri:\u00a0<\/span>
Seslerini k\u00f6t\u00fc kullanan ses sanatkarlar\u0131, dolmu\u015f kahyalar\u0131, \u00f6\u011fretmenler vs.\u00a0<\/span>
Meslek guruplar\u0131nda g\u00f6r\u00fcl\u00fcr. Epitel hipertrofisinden ibarettir .<\/span>
2)Polipler:\u00a0<\/span>
Miksomat\u00f6 tabiatta mukoza uzant\u0131lar\u0131d\u0131r\u00a0<\/span>
3)Papillomlar:\u00a0<\/span>
1. Juvenil Papillomlar:Larinks i\u00e7ini \u00fcz\u00fcm salk\u0131m\u0131 gibi dolduran, temasla\u00a0<\/span>
kanamaya, \u00e7evre yap\u0131lara yay\u0131lmaya \u00e7ok meyilli, selim te\u015fekk\u00fcllerdir. Virus\u00a0<\/span>
etyolojisi burada s\u00f6z konusudur. Malignle\u015fmez !<\/span>
2. Eri\u015fkin Papillomlar\u0131: Larinks i\u00e7ini yayg\u0131n olarak doldurmaz. Temasla\u00a0<\/span>
kanamaya fazla meyli yoktur. \u0130leri ya\u015flarda malignle\u015fme potensi \u00e7ok\u00a0<\/span>
y\u00fcksektir!\u00a0<\/span><\/p>\n

Klinik:<\/span>
-Disfoni ( Ses K\u0131s\u0131kl\u0131\u011f\u0131 )<\/span>
-Dispne ( Nefes Darl\u0131\u011f\u0131 )<\/span>
-Asfiksi ( Bo\u011fulma ) yapabilir.<\/span><\/p>\n

Tedavi:\u00a0<\/span>
1. Laringoskopi (\u00e7ocuklarda direkt, eri\u015fkinlerde direkt veya nadiren indirekt)\u00a0<\/span>
alt\u0131nda ekstirpasyon.\u00a0<\/span>
2. Tirotomi veya laringofiss\u00fcr ile a\u00e7\u0131lan larinksden t\u00fcm\u00f6r\u00fcn \u00e7\u0131kar\u0131lmas\u0131<\/span>
3. Ultrason ile papillom h\u00fccrelerinin tahribi<\/span>
4. Kriyoterapi<\/span>
5. Lazer cerrahisi<\/span>
6. Antiviral uygulamalar\u0131 (Sidofovir)<\/span>
T\u00fcm bu tedavilere ra\u011fmen \u00e7ocuklarda n\u00fckse son derece meyillidir.<\/span><\/p>\n

4)Anjiom (Hemanjiom, Lenfanjiom):<\/span>
Kanamaya meyilli, k\u00fc\u00e7\u00fck t\u00fcm\u00f6rlerdir. Organize hematomlarla kar\u0131\u015fabilir.\u00a0<\/span>
Tedavi:\u00a0<\/span>
1. Laringoskopi alt\u0131nda ekstirpasyon (b\u00fcy\u00fck ve kanamas\u0131 muhtemel\u00a0<\/span>
t\u00fcm\u00f6rlerde preventif trakeotomi!)<\/span><\/p>\n

5)Fibrom:\u00a0<\/span>
Saf fibromlar \u00e7ok kere pedik\u00fcll\u00fcd\u00fcr. S\u0131kl\u0131kla disfoni olup pedik\u00fcll\u00fc \u015fekillerde\u00a0<\/span>
bu de\u011fi\u015fici karakterdedir. Hastalarda dispne g\u00f6zlenir.<\/span><\/p>\n

Tedavi:\u00a0<\/span>
Ekstirpasyon<\/span><\/p>\n

6)Di\u011fer benign larenks patolojileri:<\/span><\/p>\n

B.G\u0131rtla\u011f\u0131n Habis T\u00fcm\u00f6rleri<\/span><\/p>\n

G\u0131rtla\u011f\u0131n habis t\u00fcm\u00f6rlerinin % 98-99 \u0091 u karsinom, % 1-2 Sarkom \u0091 dur<\/span><\/p>\n

Karsinom:\u00a0<\/span>
-B\u00fcy\u00fck \u00e7o\u011funlu\u011fu yass\u0131 epitel h\u00fccreli karsinomdur.\u00a0<\/span>
-\u00c7o\u011fu vokal kord kaynakl\u0131d\u0131r.\u00a0<\/span>
-Ayr\u0131ca kronik tahri\u015f ve infeksiyonlar di\u011fer k\u0131s\u0131mlardaki titrek t\u00fcyl\u00fc silindirik\u00a0<\/span>
epitelin yass\u0131 epitele metaplazisine yol a\u00e7ar.\u00a0<\/span>
-Daha seyrek olarak basal h\u00fccreli > adenokarsinom > endoteliomalar geli\u015fir. –\u00a0<\/span>
-% 90 erkeklerde, % 10 kad\u0131nlarda g\u00f6r\u00fcl\u00fcr.\u00a0<\/span>
-En s\u0131k 40-60 ya\u015flarda g\u00f6r\u00fcl\u00fcrse de, son senelerde \u00e7ok gen\u00e7 ya\u015flara kadar\u00a0<\/span>
g\u00f6r\u00fclmektedir. Ancak gen\u00e7lerde gene de nadirle\u015fir.\u00a0<\/span>
-Larenks b\u00f6lgeleri i\u00e7inde en s\u0131k glottik b\u00f6lgede (%70 oran\u0131nda) g\u00f6r\u00fcl\u00fcr.\u00a0<\/span>
-Larinks b\u00f6lgeleri aras\u0131nda t\u00fcm\u00f6r\u00fcn yay\u0131l\u0131m\u0131n\u0131 engelleyen \u00e7e\u015fitli bariyer\u00a0<\/span>
mekanizmalar\u0131 olmas\u0131 nedeni ile erken te\u015fhisi \u00e7ok \u00f6nemlidir.<\/span><\/p>\n

Etyoloji:<\/span><\/p>\n

T\u00fct\u00fcn ve Alkol, ba\u015f rol\u00fc oynamaktad\u0131r<\/span>
Hastalar\u0131n b\u00fcy\u00fck \u00e7o\u011funlu\u011fu 1-2 paket sigara i\u00e7mektedir.<\/span><\/p>\n

Patoloji:\u00a0<\/span>
Lokalizasyona g\u00f6re;\u00a0<\/span>
1.\u0130ntrinsik: Ses telleri, yalanc\u0131 ses telleri (band, ventrik\u00fcller), Morgagni\u00a0<\/span>
sin\u00fcsleri\u00a0<\/span>
2.Ekstrinsik: Epiglot, plica aryepiglottica, arytenoidler \u00fcst\u00fc ve aras\u0131<\/span>
3.Subglottik: Rima glottis alt\u0131nda kalan, trakea ba\u015flang\u0131c\u0131na kadar olanlar!<\/span><\/p>\n

Klinik Bulgular:\u00a0<\/span>
\u0130lk belirtiler:<\/span>
\u0130ntriksik olanlarda:Ses k\u0131s\u0131kl\u0131\u011f\u0131<\/span><\/p>\n

Ekstrinsik olanlarda: Yutkunma s\u0131ras\u0131nda bo\u011fazda tak\u0131lma hissi<\/span><\/p>\n

Subglottik olanlarda: Nefes darl\u0131\u011f\u0131<\/span>
G\u0131c\u0131k \u00f6ks\u00fcr\u00fc\u011f\u00fc g\u00f6r\u00fcl\u00fcr<\/span><\/p>\n

Daha ileri safhada:<\/span>
Bu belirtiler birbirleri ile kar\u0131\u015f\u0131r.<\/span>
-Tahri\u015f \u00f6ks\u00fcr\u00fc\u011f\u00fc (bilhassa subglottik) ve ufak kanamalar, bazen nekroze\u00a0<\/span>
t\u00fcm\u00f6r par\u00e7alar\u0131<\/span>
-Nefeste k\u00f6t\u00fc nekrotik koku<\/span>
-Zay\u0131flama<\/span>
-A\u011fr\u0131: Ekstriksik t\u00fcm\u00f6rlerde nispeten erken, genellikle ge\u00e7 ve kula\u011fa vuran\u00a0<\/span>
tarzda!<\/span>
-Boyunda lenfadenopati: Boyun derin lenf ganglionlar\u0131na (ekstrinsik t\u00fcm\u00f6rlerde\u00a0<\/span>
daha erken!) olu\u015fur.<\/span><\/p>\n

TNM S\u0131n\u0131fland\u0131r\u0131lmas\u0131 (T\u00fcm\u00f6r, Nod\u00fcl, Metastaz)<\/span>
T1: Bir anatomik alt birimde t\u00fcm\u00f6r<\/span>
T2: \u0130ki anatomik alt birimde t\u00fcm\u00f6r\u00a0<\/span>
T3: Bir alt birimin s\u0131n\u0131rlar\u0131n\u0131 a\u015fm\u0131\u015f, larinks i\u00e7inde, kord fiksasyonu var<\/span>
T4: Larinks s\u0131n\u0131rlar\u0131n\u0131 a\u015fm\u0131\u015f, ekstralarengeal veya kartilaj tutulumu ( sinus\u00a0<\/span>
priformis, dilk\u00f6k\u00fc, cilt, ciltalt\u0131, trakea)<\/span><\/p>\n

N0: Boyun derin zincirinde palpabl nod\u00fcl yok<\/span>
N1: 3 cm'den k\u00fc\u00e7\u00fck tek ipsilateral nod<\/span>
N2a: 3-6 cm'lik ipsilateral tek nod<\/span>
N2b: 3-6 cm'lik ipsilateral multipl nod<\/span>
N2c: Bilateral veya kontralateral nod<\/span>
N3: 6 cm'den b\u00fcy\u00fck servikal kitle\u00a0<\/span><\/p>\n

M0: Uzak metastaz yok<\/span>
M1: Uzak metastaz var<\/span><\/p>\n

Tedavi:<\/span>
A.Kemoterapi: Yetersiz! Lenfomalarda!\u00a0<\/span>
B.Radyoterapi: 1. \u0130yi se\u00e7ilen vakalarda k\u00fcratif olabilir!<\/span>
2. Cerrahi ile kombine (pre-, postoperatif)<\/span>
3. Palyatif<\/span>
-Radyoaktif: \u0130\u011fne implantasyonu (-)<\/span>
-R\u00f6ntgen:<\/span>
-Co 60 : 5-8 haftada, haftada 5-6 g\u00fcn 300 Rad\u00a0<\/span>
-Betatron: 5000 \u0096 8000 Rad<\/span><\/p>\n

C.Cerrahi:\u00a0<\/span><\/p>\n

-Parsiyel larenjektomi : Geri kalan k\u0131s\u0131m fizyolojik g\u00f6revlerini yapabilirse!<\/span>
-Kordektomi\u00a0<\/span>
-Epiglottektomi<\/span>
-Hemilarenjektomi\u00a0<\/span>
-Frontal-lateralarenjektomi v.s\u00a0<\/span><\/p>\n

-Total larenjektomi ve trakeostomi uygulamas\u0131\u00a0<\/span>
-T\u00fcm\u00f6r\u00fcn yay\u0131l\u0131m\u0131 ve boyundaki lenf nodlar\u0131 tutulumuna g\u00f6re boyun\u00a0<\/span>
diseksiyonu \u00e7e\u015fitleri eklenir.\u00a0<\/span>
-Cerrahi tedavilere radyoterapi ve\/veya kemoterapi eklenebilir.<\/span><\/p>\n

www.drselcukonart.com<\/span><\/p>\n

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

G\u0131rtlak kanseri 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":[146,24,234,279],"class_list":["post-712","post","type-post","status-publish","format-standard","hentry","category-kulak-burun-bogaz","tag-boyun","tag-ses","tag-tumor","tag-tumorler"],"_links":{"self":[{"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/posts\/712","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=712"}],"version-history":[{"count":1,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/posts\/712\/revisions"}],"predecessor-version":[{"id":713,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/posts\/712\/revisions\/713"}],"wp:attachment":[{"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/media?parent=712"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/categories?post=712"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/tags?post=712"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}