Pain and discomfort in the throat are common. Therefore, it is important to regularly use the painkillers recommended by your doctor. You can also relieve throat discomfort by consuming cold liquids or iced foods. You may have difficulty swallowing for the first few days after surgery.

Therefore, it is important to consume soft and liquid foods. You should also avoid hot and spicy foods. Resting and getting enough sleep after surgery can speed up the healing process. It is important to rest at home and avoid heavy physical activities for the first few days.

Tonsil Disease Symptoms

It manifests itself with symptoms that may occur as a result of inflammation and infection of the throat. Tonsils are lymphoid tissues located in the back of the throat. They function as part of the body's defense mechanism against infections. One of the most common symptoms of the disease is a sore throat.

Sore throat often increases and can cause discomfort when swallowing. Those infected may become red and swollen. Swelling and redness of the tonsils may occur at the back of the throat or at the base of the tongue. After tonsil surgery If infected, white spots or blisters may appear on it.

It could be a sign of inflammation. It is especially seen in infections such as strep throat caused by streptococcus bacteria. Their infections often cause fever. Fever is an indication that the body is trying to fight infection. Inflammation can lead to ear pain because the ears are connected to the same nerves.

How is Tonsil Surgery Performed?

On the day of surgery, the patient usually needs to receive general anesthesia. This is a type of anesthesia that allows the patient to sleep during the surgery. This prevents the patient from experiencing any pain or conscious experience.

The patient is placed on the operating table while under general anesthesia. It is then placed in a suitable position. This position allows surgery to be performed easily. The doctor usually gains access by opening the patient's mouth and lifting the tongue up.

In some cases, special tools such as a metal clamp or laser may be used. The doctor uses special surgical instruments to remove the tonsils. It is usually cut and removed with a heated tool called a cutter or cautery.

When the tonsils are removed, the doctor carefully closes the blood vessels to stop bleeding. After tonsil surgery It is important to prevent complications. After removal, the surgical area may be stitched or cauterized (burned with a heated tool). It helps cover the surgical site and promote healing.

Recovery Process After Tonsillectomy

Recovery process after tonsillectomy, may differ from person to person. But it can usually take a few weeks. Use painkillers recommended by your doctor regularly. Painkillers can relieve pain after surgery.

Resting and getting enough sleep after surgery can speed up the healing process. It is important to rest at home for the first few days. Consuming liquid or pureed foods during the first few days is better tolerated.

Avoid hard or irritating foods to avoid pain and difficulty swallowing. Hydration is important, so drink liquids such as water, juice and soup frequently. After tonsil surgery You can relieve nasal congestion by using recommended nasal sprays.

Nasal congestion can make it difficult to breathe through the mouth. A warm bath or shower can relax the muscles and aid the healing process. However, avoid exposure to extremely hot water as this can increase blood pressure. Pay attention to oral hygiene after surgery. Use mouthwash or oral care products recommended by your doctor. Oral care can reduce the risk of infection.

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If you are experiencing symptoms, it is important to see a doctor. Your doctor will evaluate you to make an accurate diagnosis and determine the appropriate treatment method.

Causes of Tonsil Swelling

Inflammation caused by streptococcus (tonsillitis) is one of the most common bacterial infections. This can lead to a painful throat infection. It can be infected with viral infections such as adenoviruses, influenza virus, Epstein-Barr virus. This can also be caused by infections.

Some people may experience allergic reactions. Swelling and inflammation occur especially in people who are allergic to pollen, house dust mites, animal dander or certain foods. tonsil swelling Tonsil stones form as a result of the accumulation of food particles and bacteria in the pit area. These stones can cause discomfort.

Stress can weaken the immune system. It can make the body more vulnerable to infections. In this case, it is possible for it to become more susceptible to infections and swell.

Your doctor will evaluate appropriate treatment options based on the severity of symptoms. Treatments such as painkillers, medications, and throat sprays may be prescribed. Methods such as rest, drinking plenty of fluids and gargling relieve symptoms.

If tonsil swelling If it becomes a recurring problem, the doctor will recommend tonsillectomy. This operation involves complete or partial removal. However, the decision for surgery is made by your doctor based on your specific situation.

Treatment Methods

There may also often be a feeling of fatigue and weakness. Therefore, it is important to rest and allow the body to heal. Consuming plenty of fluids hydrates and helps hydrate the body. Hot or cold drinks can relieve a sore throat. Your doctor may recommend painkillers to control pain and fever.

For discomfort caused by bacterial infections, doctors often prescribe antibiotics. These medications can relieve symptoms by controlling the infection. It is important to use antibiotics regularly and complete the full course of treatment. Your doctor recommends locally effective products such as throat sprays or gargle solutions. These products can reduce discomfort and provide relief.

Gargling with a salt water solution may relieve it. It can help clear the infection in the throat. You can gargle by adding half a teaspoon of salt to a glass of warm water. recurring infections tonsil swelling In this case, doctors recommend surgical removal. This surgical intervention allows permanent removal of the tonsils.

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What are Secondary Primary Tumors?

While local recurrence and metastases mostly affect the short-term survival of patients with head and neck malignancy, secondary primary tumors are now shown to be the most important factor affecting the long-term survival of these patients. The first publication drawing attention to the importance of secondary primary tumors was made by Billroth in 1889, followed by Warren and Gates's publication based on 1259 cases in 1932.' The definition of secondary primary carcinoma proposed by Warren and Gates is still accepted worldwide today. Accordingly, the criteria necessary to define a tumor as secondary primary are as follows:
1. Malignancy of the tumor must be proven histologically.
2. First and secondary primary tumors should be clearly separate topographically, and there should be no submucosal or intra-epithelial spread.

3. It should be determined that the second tumor is not metastatic. Secondary primary tumors, are described as simultaneous (synchronous) or at different times (metachronous) in terms of their emergence times. Synchronous are those diagnosed with the first tumor or within the first 6 months after the diagnosis of the first tumor. Differentiated tumors are tumors diagnosed at least 6 months after the diagnosis of the first tumor. There are also authors who group tumors diagnosed at the same time as the first tumor into a third group as simultaneous tumors.

PATHOGENESIS

Various theories have been proposed to explain the multifocal development of carcinomas. The field cancerization view put forward by Slauhter et al. in 1953 is the most accepted today. According to this view, the epithelium of the upper digestive tract, along with all respiratory tract, forms a common carcinogenic area where anatomical and pathological changes occur due to external influences, especially smoking and alcohol. Precancerous tissue changes may begin in more than one focus in this area, and different foci of cancer may appear at different times depending on the degree of precancerous changes.

There are studies showing that genetic predisposition, as well as external factors, is a very important factor in the development of multiple cancers. According to Faber, one of the pioneers of this view, cancer occurs as a result of step-like tissue changes that develop over a long period of time. Accordingly, there are three main periods in cancer development, defined as initiation, promotion and progression. In the initial period, a permanent change in the phenotype of a few target cells occurs due to carcinogenic external factors. During the growth period, these target cells proliferate and form proliferation foci similar to benignneoplasia.

These foci then either turn into normal tissue again or progress towards cancer. In some other studies, people with genetic deficiencies in DNA repair mechanisms secondary primary tumors It has been shown to develop more easily. This genetic deficiency can be revealed by investigating sensitivity to mutagens such as bleomycin. In conclusion; It is accepted that exposure to environmental carcinogenic factors and genetic predisposition play a role in the development of secondary primaries.

FREQUENCY

Literatürde baş boyun malignansilerindeki sekonder primer sıklığı olgu sayısı, izleme süresi ve coğrafik özelliklere bağlı olarak %2.4 ile %35 arasında değişmekle beraber, genel olarak %10-15 civarındadır. Sekonder tümörler histolojik olarak çoğunlukla skuamöz hücreli kanserlerdir. Metakron sekonder kanserler, senkronlara göre genellikle 3/2 oranında daha sıktır. Senkron tümörler daha çok oral kavite, larenks, farenks ve özofagusta, metakron olanlar ise daha çok akciğerde görülmektedir. İlk tümörün tanısı 60 yaşından önce konan olgularda sekonder tümör şansı daha çoktur. Sekonder tümörler en sık 60-70 yaş grubunda ortaya çıkmaktadır ve erkeklerde daha fazladır.

Annually after diagnosis of first tumor secondary primary tümörler gelişme riski çeşitli serilerde %1.5 ile %6 arasında değişmektedir ve bu risk oranı seneler boyunca sabit kalmaktadır. 1920 Sekonder tümörler büyük sıklıkla üst solunum ve sindirim yolları epiteli ile akciğerlerde görülmektedir. Daha nadir olarak gastrointestinal sistem, ürogenital sistem, deri, tiroid bezi, iskelet sistemi ve diğer bölgelerde de ortaya çıkabilir. Sekonder primerlerin genel olarak %40-50 kadarı üst solunum ve sindirim yollarında yerleşim gösterir. Oral kavite, orofarenks ve hipofarenkste görülme sıklığı, larenkse göre daha fazladır. Değişik çalışmalarda akciğerlerdeki sekonder tümör oranı %10 ile 50 arasında değişmektedir.

Initial tumor size, stage, histology and nodal metastasis factors and lung secondary tumor No relationship was found between the frequency of Lung secondary tumors are most often squamous cell cancers, more rarely adenocarcinoma and small cell cancers. Difficulties in differentiating a lung lesion from metastasis or secondary tumor still persist. Histological criteria are important in differentiation. Findings supporting a secondary tumor include the lesion being hilar or endobronchial, appearing a long time after the initial tumor, and the absence of metastasis in the neck. In addition, it is reported that isolated lung nodal opacities detected radiologically are mostly secondary primary rather than metastases. In recent years, molecular level research on cancer cells has been able to distinguish metastatic and secondary tumors more clearly.

RELATIONSHIPS BETWEEN THE FEATURES OF THE PRIMARY TUMOR AND SECONDARY TUMOR

Location of the first tumor in the head and neck, secondary primary tumors sıklığını etkileyen önemli bir faktör olarak görünmektedir. Sekiz yüz elli bir olguda yapılan bir çalışmada, sekonder primerler beş yıllık bir izleme süresi içinde en sık dil kökü kanserlerinde (%41), daha sonra sıklık sırasına göre piriform sinüs (%34), oral kavite (%27), larenks (%23) ve tonsil kanserlerinde (%15) ortaya çıkmıştır. İlk tümörün histolojisi ve diferensiyasyon derecesi, sekonder tümör sıklığını etkilememektedir.12 Ayrıca baş boyundaki ilk tümöre uygulanan tedavi şeklinin de (cerrahi ya da radyoterapi), sekonder tümör sıklığına etkisi yoktur.

"Larynx and oral cavity cancers are the most common head and neck malignancies in our country, as is the case around the world." Secondary primaries in laryngeal cancers frequently occur in the lung and esophagus. Although the possibility of secondary tumors in early stage (T1-T2) tumors with high local and regional control of the larynx is higher than in advanced stage tumors (T3-T4), the degree of differentiation of the tumor does not affect the frequency of secondary tumors.

The possibility of secondary tumors is slightly higher in supraglottic tumors than in glottic tumors. On the other hand, secondary primary tumors are twice as common in patients who underwent conservative surgery for laryngeal cancer compared to those who underwent total laryngectomy. In oral cavity cancers, secondary tumors are usually seen in the oral cavity and oropharynx. In oral cavity cancer, it is reported that the probability of secondary primary in the oral cavity is 75 times higher in men and 190 times more in women than in the normal population, and the chance of secondary primary in the esophagus is 25 times higher in men and 45 times higher in women. In cancers of the lower region of the oral cavity (floor of the mouth, lower alveolar ridge and retromolar trigone) that are more exposed to external factors such as smoking and alcohol, the possibility of secondary primary is higher than in other regions of the oral cavity.

In oropharynx and hypopharynx cancers secondary primers It most commonly develops in the oral cavity and hypopharynx, and in esophageal cancers, it often develops in the upper digestive tract, especially in the hypopharynx, oropharynx and buccal mucosa. On the other hand, secondary cancers located in the head and neck, especially the larynx, are common in lung cancers.

MONITORING OF PATIENTS WITH HEAD AND NECK MALIGNANCE IN TERMS OF SECONDARY PRIMARY

Since the risk of secondary tumors in head and neck malignancies continues at a constant rate over the years, patients need to be monitored periodically throughout their lives after the diagnosis and treatment of the first tumor. The recommendation of the American Cancer Society (ACS) on this subject is that patients should be checked monthly for the first year, every 2 months for the second year, every 3 months for the third year, and every 6 months for the remainder of their lives. In the follow-up of patients, it is important to examine the head and neck region, where secondary primary tumors are most common.

For this purpose, in addition to routine mouth and throat examination, indirect and direct laryngoscopy, rigid and flexible endoscopic examinations of the nasal cavities, nasopharynx, oropharynx and larynx should be performed. There are also authors who recommend esophageal abrasive cytological examinations in addition to routine panendoscopic examination, including esophagoscopy and bronchoscopy, at periodic check-ups. However, in our department and many other centers, esophagography and selective endoscopy are preferred instead of panendoscopy, considering the symptoms of the patients. Secondary primary tumors To evaluate the lungs where it is most common, radiological examination is recommended every 6 months.

This monitoring is especially important in laryngeal cancers, where lung secondary tumors are more common. Depending on the available resources, radiological examination can be performed as conventional radiography or computed tomography, but it is reported that computed tomography is much more sensitive in the early detection of lung secondary tumors. Nearly half of the secondary primaries other than the head, neck and lungs occur in the urogenital system.
Therefore, patients' complaints in this regard should be carefully evaluated during follow-up. There are many studies investigating the value of biological tumor markers (tumor markers) in monitoring patients with head and neck malignancy in terms of secondary primary, but today, a marker that has proven its value has not yet been found.

PROTECTION

Secondary in patients with head and neck malignancy primary tumor In order to reduce the possibility, emphasis is placed on the elimination of carcinogenic external factors such as smoking, alcohol, occupational and environmental irritants, as well as the benefit of chemoprevention with retinoid derivatives. It has been shown that high doses and long-term use of retinoid derivatives cause regression of precancerous lesions. However, it has side effects such as dry mouth, dysphagia, weight loss, and cachexia, and the lesions often recur after discontinuation of treatment.

PROGNOSIS

Baş boyun malignansilerinde sekonder primer varlığı, prognozu dramatik bir şekilde kötüleştirmektedir. Metakron tümörlerde prognoz senkronlara göre biraz daha iyidir.” Baş boyun yerleşimli sekonder tümörlerde 5 yıllık sağkalım şansının %20 civarında, özofagus ve akciğer yerleşiminde ise %5’in altında olduğu bildirilmektedir.10122 İlk tümörün tanı ve tedavisinden sonra periyodik olarak izlenen hastaların ortalama sağkalım şansı, ortaya çıkan semptomlarla kendiliğinden başvuranlara göre yaklaşık 2 kez daha fazladır.

SUMMARY

Secondary primary tumors günümüzde baş boyun malignansili hastalarda prognozu olumsuz yönde etkileyen önemli bir sorundur. Baş boyun malignansilerinde senkron ya da metakron olarak olguların %10-15’inde görülen sekonder primerler, en sık olarak yine baş boyun bölgesinde ve ikinci sıklıkla akcigerlerde ortaya çıkmaktadır. İlk tümörün tanısından sonra sekonder tümör olasılığının yıllarca sabit bir oranda sürmesi, baş boyun malignansili olguların ömür boyu periyodik izlenmelerini gerektirmektedir.

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1) Upper respiratory tract infections

The upper respiratory tract covers the area from the entrance of the nose and mouth to the trachea. Viral infections in this area (such as flu, cold or pharyngitis) can cause edematous discharge in the mucosal tissue. While the discharges that occur can indirectly affect the vocal cords, they can sometimes cause a condition that directly affects the vocal cords, which we call laryngitis. When treatment is applied for the diseases that usually occur, the problem of hoarseness disappears.

2) Reflux

Reflux is a condition in which stomach contents rise towards the esophagus. Acidic foods irritate the esophagus. Sometimes it can go up the esophagus and affect the larynx and vocal cords, causing hoarseness.

3) Postnasal drip

Postnasal drip, which causes habits that negatively affect the quality of life, such as a feeling of stuckness in the throat, constant swallowing, and constant throat clearing, can go lower and cause hoarseness.

4) Voice misuse and trauma

Intensive and incorrect use of the voice can cause nodules on the vocal cords. As the edema in the vocal cords progresses, polyps may form. Teachers, lawyers, voice artists and people who speak to the public, especially those who have to use their voices professionally, encounter this problem very often. High and incorrectly produced sound destroys this area as if it punches the vocal cords. Traumatized vocal cords are sometimes tried to be treated with voice therapy and sometimes with surgical methods.

5) Throat cancer

Smoking, alcohol consumption, some viral diseases and genetic factors are effective in the development of laryngeal cancer. These tumors, which affect the larynx and vocal cords, affect the movement and vibration of the vocal cords and affect the muscle, nerve and joint structure of the larynx. Because hoarseness it occurs.

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Both diseases are caused by viruses. However, while there is only one virus that causes flu, more than 200 viruses can cause the common cold. That's why there is no protection method like a vaccine for the common cold. While cold complaints are milder, influenza Since it affects the whole body, it can cause a more severe disease process. Alright flu How can we distinguish between a cold and a cold?

First of all, your doctor can easily distinguish this. However, when you look at the symptoms, you can see the differences:

• Fever is rarely seen in colds. In flu, the fever is high.
• There may be no headache or very little headache during a cold. Headaches occur with flu.
• A sore throat is not common with a cold. It is frequently seen in flu.
• Pain, fatigue and weakness throughout the body are more evident in flu.
• Nasal congestion is common with colds. There may be no such symptoms in flu.
• Cough is rare in colds and common in flu.
• While complications from the common cold are milder, the flu can cause more serious complications.
• While there is no vaccine for the common cold, the flu does.

For more information about flu flu Read our article.

For more information about colds cold Read our article.

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