BENIGN AND MALIGNANT CYSTS AND TUMORS IN THE HEAD AND NECK REGION OF CHILDREN:
In childhood, there are benign cysts such as thyroglossal cyst and branchial cysts that occur congenitally. There are also benign tumors such as hemangioma and lymphangioma, as well as cancerous tumors originating from connective tissue, including sarcoma. Surgical treatment is crucial in these diseases. The main goal is to achieve complete treatment without leaving any sequelae in children. Experience is crucial in pediatric head and neck surgery.
Dr. Kayhan performs the treatment of pediatric tumors and cysts using transoral robotic surgery. The following international articles include case series on this topic:
Kayhan FT, Yigider AP, Koc AK, Kaya KH, Erdim I. Treatment of tongue base masses in children by transoral robotic surgery. Eur Arch Otorhinolaryngol. 2017;274(9):3457-3463."
"Kayhan FT, Kaya KH, Koc AK, Altintas A, Erdur O. Transoral surgery for an infant thyroglossal duct cyst. Int J Pediatr Otorhinolaryngol. 2013;77(9):1620-3."
PEDIATRIC ADENOID AND TONSIL (PHARYNGEAL AND PALATINE) DISEASES:
In children, the throat region is surrounded by lymphatic structures called the Waldeyer's ring, which is responsible for the immune system. The tissues on the sides of the oropharynx are called tonsils, the tissues in the nasopharynx are called adenoids, and the tissues located at the base of the tongue are called lingual tonsils. In children, these lymphatic tissues are more active and larger. After the age of ten, their activity decreases and these tissues start to shrink. The functions of these organs are performed by lymph nodes and other lymphatic tissues in the body.
If there is adenoid hypertrophy, it can cause nasal congestion, snoring, recurrent cold and sinusitis, and middle ear infections. Especially serous otitis media, which is a type of middle ear infection, is the most common cause of hearing loss in childhood. Surgical treatment can be applied for adenoid hypertrophy causing these complaints, regardless of the child's age.
Enlarged tonsil tissue is often seen in conjunction with adenoid hypertrophy and can cause problems such as snoring, apnea, mouth breathing, and jaw and dental development disorders. Adenotonsillectomy, the surgical removal of these tissues, is performed in children over the age of 3 who have these complaints and symptoms.
The recurrent infections of these organs are called chronic tonsillitis and adenoiditis. These conditions cause recurrent episodes of feverish sore throat, sinusitis, otitis, or bronchitis. Surgical treatment involves removing the diseased tissues in these complaints.
Lingual tonsils are normally limited lymphoid tissues located beneath the mucosa. In some individuals, they can be hypertrophic. This can cause swallowing difficulties, recurrent infections, snoring, and obstructive sleep apnea. In such cases, surgical removal of the lingual tonsil is necessary.
PEDIATRIC ALLERGIC RHINITIS AND SINUSITIS:
In childhood, viral and bacterial infections acquired from the community, allergic rhinitis, and enlarged adenoid and tonsil tissues that cause significant and chronic infection are common causes of rhinitis and sinusitis. In cases that do not respond to medication treatment, adenoid and tonsil surgeries may be necessary. Additionally, anatomical problems such as septal deviation in the nose can also cause sinusitis and chronic rhinitis. Important steps in the treatment of allergic rhinitis include identifying the agents causing the allergy, avoiding allergens, medication treatments, and immunotherapy. Immunotherapy is the only treatment method in allergy that provides permanent improvement and prevents the development of asthma. Immunotherapy involves converting the allergenic substances into a vaccine and administering them subcutaneously in increasing doses over a period of 2-3 years.
MIDDLE EAR INFECTIONS:
Middle ear infections are more common in childhood. Factors such as the anatomical structure of the Eustachian tube, the presence of adenoids, the frequency of upper respiratory tract infections, and the underdeveloped immune system contribute to the higher incidence of middle ear infections in children compared to adults. The main treatment for middle ear infections is antibiotics. In cases of subacute or chronic middle ear infections known as serous otitis media that do not respond to medication treatment, ventilation tubes are surgically inserted into the tympanic membrane. In cases of chronic otitis media resulting in permanent perforation of the eardrum, the closure of the perforation, known as tympanoplasty, is preferably delayed until adolescence for better outcomes.
UPPER RESPIRATORY TRACT INFECTIONS:
Upper respiratory tract infections include laryngitis when the vocal cords are affected, pharyngitis when the throat mucosa is affected, tonsillitis when the tonsils are affected, rhinitis when the nasal mucosa is affected, sinusitis when the sinus mucosa is affected, and otitis media when the middle ear mucosa is affected. Rhinoviruses, influenza, coronaviruses, and adenoviruses are the most common viral agents, while streptococci are the most common bacterial agents. In uncomplicated cases, appropriate antiviral and antibiotic medications are administered along with supportive symptomatic treatments. It is important to be cautious about complications and treat them early.