The aim of this case study is to demonstrate the very rare coincidental existence and management of a Killian-Jamieson diverticulum (KJD) during thyroid surgery. A 57-year-old woman was referred to our clinic with a malignant thyroid nodule and the complaint of a sore throat. There were no suspicions concerning a diverticulum on examining her with flexible laryngoscopy or ultrasound imaging. During the right central neck dissection, we noticed a 3 × 3 cm KJD and resected it while preserving the recurrent laryngeal nerve. After the successful operation, we questioned the patient and learned that for 1 year she had an occasional complaint of dysphagia. Postoperatively, there was no vocal cord palsy or hypocalcemia, and there was no pharyngoesophageal leak after oral alimentation. There was no recurrence or complaint for KJD or papillary carcinoma for 8 years follow-up. Nonspecific symptoms like a sore throat should be investigated, and patients should be questioned for all aerodigestive symptoms. If necessary, further investigation should be undertaken for a differential diagnosis.

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Introduction: Prostate cancer metastasis to clivus and occipital condyle are extremely rare and only a few cases are published. We present a case with metastasis of prostate cancer to skull base causing occipital condyle syndrome (OCS). Case Presentation: A-56-year-old man was referred to our clinic with complaints of dysphagia for two months and headache on his right occipital region for five months. There was deviation of the tongue to the right side in his physical examination. He was performed surgery for prostate adenocarcinoma for 2 years ago. Magnetic resonance imaging and computed tomography showed a mass destructed to the clivus and right occipital condyle. Biopsy confirmed the prostate adenocarcinoma metastasis. The patient died after two months from diagnosis of skull base metastasis. Conclusion: Otolaryngologists and urologists should be aware for early diagnosis of OCS in a patient with prostate cancer. Early physical and radiological examination of the patients may improve the prognosis.

Objectives:To correlate the physical examination findings, Epworth Sleepiness Scale (ESS) and apnea-hypopnea index (AHI) in patients investigated for obstructive sleep apnea syndrome (OSAS). Materials and Methods: Patients who are investigated with a nocturnal polysomnography (PSG) for OSAS due to snoring, witnessed apnea, daytime sleepiness symptoms included in this study. Physical examination findings, ESS scores, AHI and minimum oxygen saturations (min: SpO 2 ) were noted. Results: One-hundred-twenty patients were diagnosed; simple snoring (44.2%, n=53), mild OSAS (18.3%, n=22), moderate OSAS (14.2%, n=17) and severe OSAS (23.3%, n=28). We found a positive correlation between body mass index (BMI), neck circumference and AHI (r=0.238, p=0.009; r=0.484, p<0.001 respectively). Neck circumference of severe OSAS patients were significantly higher than simple snoring patients (p=0.006). There was a negative correlation between AHI and min SpO 2 (r=-0.666, p<0.001). There was no correlation between AHI, OSAS diagnosis and ESS. There was no correlation between Friedman stages, palate positions and AHI. When the BMI is over 29.3, odds ratio was 3.13 (1.4-6.67) for OSAS diagnosis. Conclusion: Detailed physical examination is essential to patient selection for OSAS investigation and PSG as well as determining the severity of OSAS. BMI and neck circumference should be included in the routine physical examination since they are highly correlated with AHI. Although ESS was not correlated with AHI in our study population, it had helped patients realize their symptoms. AbstractAmaç: Obstrüktif uyku apnesi sendromu (OUAS) araştırılan hastalarda, fizik muayene bulguları ve Epworth Uykululuk Skalası (EUS)'nun apnehipopne indeksi (AHİ) ile korelasyonuna bakılması amaçlandı. Gereç ve Yöntem: Horlama, tanıklı apne, gündüz uykululuk şikayeti ile başvuran, OUAS araştırılan ve nokturnal polisomnografi (PSG) yapılan hastalar çalışmaya dahil edildi. Hastaların fizik muayene bulguları, EUS skorları, AHİ değerleri, minimum oksijen satürasyonları (minimum: SpO 2 ) kayıt edildi. Bulgular: Çalışmaya dahil olan 120 hastanın %44,2'si (n=53) basit horlama, %18,3'si (n=22) hafif OUAS, %14,2'si (n=17) orta OUAS, %23,3'sü (n=28) ağır OUAS tanısı aldı. AHİ ile vücut kitle indeksi (VKİ) ve boyun çevresi arasındaki pozitif korelasyon kuruldu (Sırasıyla r=0,238, p=0,009; r=0,484, p<0,001). Ağır OUAS tanılı hastaların boyun çevreleri, basit horlama tanılı hastaların boyun çevrelerinden anlamlı yüksek bulundu (p=0,006). AHİ ile minimum SpO 2 arasında negatif korelasyon kuruldu (r=-0,666, p<0,001). EUS ile AHİ ve OUAS tanısı almaları arasında ilişki kurulamadı. AHİ ile Friedman evreleri ve damak pozisyonları arasında ilişki kurulamadı. VKİ 29,3 ve üzerindeyken hastanın OUAS tanısı alması için tahmini rölatif risk (odds ratio) 3,13 (1,4-6,67) bulundu. Sonuç: OUAS riski taşıyan bireylerin belirlenmesinde, PSG için hasta seçiminde ve OUAS şiddetinin belirlenmesinde ayrıntılı fizik muayene büyük önem taşımaktadır. AHİ ile korelasyonu yüksek olan boyun çevr...

Background Retropharyngeal abscess (RPA) is a life-threatening, dangerous condition and uncommon in adults. The coexistence of RPA, cervical spinal epidural abscess (CSEA), and spondylodiscitis is extremely rare. Case presentation We present a case with a retropharyngeal and epidural abscess caused by spondylodiscitis. A 61-year-old man was referred to our clinic with the complaints of sore throat, limitation in neck range of motion, numbness, and weakness in the left arm and the left ear for one month. The airway was not obstructed. Neurological deficits were detected in his left arm. Cervical computed tomography revealed a 50 × 30 × 15 mm retropharyngeal abscess. Cervical magnetic resonance imaging showed abscess, C5–6 spondylodiscitis and epidural abscess, and myelopathic signal changes in the C3–7 spinal cord. The abscess was drained, and C5–6 discectomy was performed. The patient was discharged with cervical collar and antibiotics. Conclusions Multidisciplinary approach that consists of otolaryngologist, neurosurgeon, and infectious disease specialist is needed to avoid complications and any delay.