orhan Asya
After graduating from Marmara University School of Medicine, I completed my residency in Otorhinolaryngology–Head and Neck Surgery at the same institution. I am currently working at Marmara University as a faculty member . My special clinical and academic interests include rhinology, skull base surgery, and endocrine surgery. I have international experience in rhinology and skull base surgery, and I also received a scholarship from the European Society of Endocrine Surgeons, through which I completed advanced training in endocrine surgery at two different centers in Europe.
Sessions
Purpose / Aim
To illustrate the decision-making process and surgical techniques in managing locally advanced poorly differentiated thyroid cancer, including an organ-preserving strategy followed by salvage laryngectomy in the setting of radiation-induced laryngeal necrosis.
Background
I am a high-volume thyroid surgeon with dedicated experience in managing aggressive thyroid cancers. In this presentation, I will discuss a patient with locally advanced poorly differentiated thyroid carcinoma who underwent larynx-preserving resection followed by adjuvant radiotherapy. Three months postoperatively, the patient developed radiation-induced laryngeal necrosis that failed conservative management. Salvage total laryngectomy and tracheal resection with free-flap reconstruction were subsequently performed.
Description
Through operative video footage and perioperative documentation, ı will highlight:
Selection criteria for larynx-preserving surgery in locally advanced thyroid cancer
Oncologic and functional considerations
Management of post-radiation complications including laryngeal necrosis
Techniques and outcomes of salvage laryngectomy and tracheal resection with free-tissue reconstruction
Description
This presentation will focus on the surgical management of patients with non-localizing or discordant-imaging parathyroid adenomas, one of the most challenging scenarios in endocrine surgery. Using operative video and case examples, the session will demonstrate practical strategies for successful exploration when preoperative localization studies such as ultrasound, sestamibi, or 4D-CT are inconclusive or discordant. Emphasis will be placed on systematic bilateral neck exploration, recognition of anatomic variants, intraoperative PTH monitoring, and identification of ectopic glands, including mediastinal and intrathyroidal locations. Decision-making algorithms and intraoperative navigation techniques will also be discussed.
Outcome Objectives
By the end of this session, participants will be able to:
Plan and execute surgery for parathyroid adenomas with non-concordant imaging findings.
Apply safe and systematic bilateral neck exploration techniques.
Utilize intraoperative PTH monitoring to confirm surgical success.
Identify and manage ectopic and difficult parathyroid lesions effectively.
Background
While most parathyroid adenomas can be accurately localized preoperatively, a subset of patients present with discordant or negative imaging results. These cases require advanced surgical expertise and meticulous exploration to achieve cure. Sharing real operative experience provides valuable insights into intraoperative decision-making and problem-solving in complex parathyroid surgery.