Nazofarinks, Oral Kavite ve Orofarinks Hastalıkları
Özet
Nazofarinks, oral kavite ve orofarinks bölgelerinin benign ve malign hastalıkları, üst aerodigestif sistemin başlangıç noktasını oluşturmaları sebebiyle klinik açıdan büyük önem taşımaktadır. Çocukluk çağında sıkça karşılaşılan adenoid doku hipertrofisi ve akut/kronik tonsillit süreçleri; tanı yöntemleri, adenoidektomi ve tonsillektomi endikasyonları ile olası cerrahi komplikasyonlarıyla birlikte ele alınmaktadır. Oral kavitenin kandidiazis, herpetik gingivostomatit ve aktinomikozis gibi enfeksiyöz durumlarının yanı sıra malignite riski taşıyan lökoplaki ve eritroplaki gibi premalign lezyonları incelenmektedir. Bölgedeki en sık malignite türü skuamöz hücreli karsinom (SCC) olup, nazofarinks kanserlerinde Epstein-Barr Virüsü (EBV), orofarinks kanserlerinde ise özellikle tip 16 olmak üzere Human Papilloma Virüsü (HPV) önemli etyolojik faktörler olarak öne çıkmaktadır. Malignitelerin evrelemesi AJCC TNM kriterlerine göre yapılmakta; tedavi yaklaşımları ise tümörün evresine ve yerleşimine göre cerrahi rezeksiyon, radyoterapi ve kemoradyoterapi kombinasyonlarını içermektedir. Ayrıca, dudak, dil, ağız tabanı ve damak kanserlerindeki cerrahi yaklaşımlar (COMMANDO ameliyatı gibi) ile flep ve greft uygulamalarını içeren rekonstrüksiyon yöntemleri detaylandırılmaktadır.
The benign and malignant diseases of the nasopharynx, oral cavity, and oropharynx carry significant clinical importance as they constitute the beginning of the upper aerodigestive system. Adenoid tissue hypertrophy and acute/chronic tonsillitis processes, commonly encountered in childhood, are evaluated along with diagnostic methods, indications for adenoidectomy and tonsillectomy, and potential surgical complications. Infectious diseases of the oral cavity such as candidiasis, herpetic gingivostomatitis, and actinomycosis are addressed, alongside premalignant lesions with malignant transformation risk like leukoplakia and erythroplakia. Squamous cell carcinoma (SCC) is the most frequent malignancy in this region, where Epstein-Barr Virus (EBV) in nasopharyngeal carcinomas and Human Papilloma Virus (HPV), particularly type 16, in oropharyngeal cancers stand out as major etiological factors. Staging of these malignancies is based on AJCC TNM criteria; treatment approaches incorporate combinations of surgical resection, radiotherapy, and chemoradiotherapy depending on tumor stage and localization. Furthermore, surgical approaches in lip, tongue, floor of the mouth, and palate cancers (such as the COMMANDO operation) are detailed, together with reconstruction methods including various flap and graft applications.
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