Agenesis of Submandibular Glands: A Report of Two Cases with Review of Literature

Background. Congenital absence of the submandibular gland (SMG) is a rare condition. Although complaints such as dry mouth, dental problems, or difficulty in swallowing may be seen, the subjects may also be asymptomatic. The absence of the SMG may be associated with hypertrophy of the contralateral SMG. Case Report. We report the case of a 44-year-old woman with incidentally detected left SMG aplasia, with contralateral SMG hypertrophy mimicking a mass, and the case of a 46-year-old woman with incidentally detected bilateral SMG aplasia, demonstrated by computerized tomography (CT) and magnetic resonance imaging (MRI). Conclusion. It is important for the clinician to know that this very rare abnormality may exist. When such a case is encountered, symptoms and findings should be reevaluated and, if necessary, conservative therapy should be initiated. The possibility of observing additional deformities should be kept in mind and an evaluation should be done for other cases in the family

Safety and feasibility of lumbar spine for intralaminar screw fixation : a computed tomography-based morphometric study

Objective: The use of intralaminar screws (ILS) in spinal surgery has experienced a recent increase in popularity. The aim of this study is to define the morphological parameters of the lumbar laminas so that guidance may be defined for ILS placement.Methods: The study involved the evaluation of lumbar computed tomography (CT) images of patients. Two hundred thirty-five patients (127 male, 108 female) were included in the study. The mean patient age was 44.2 years (19-78 years). The measured parameters of the lamina were the transverse inner diameter, transverse outer diameter (lamina width), lamina length, subdural space (safe zone), and spinolaminar angle for each lumbar level (L1-L5).Results: The mean transverse outer diameter (L1-L5) ranged from 7.2-7.8 mm, and mean transverse inner diameter ranged from 2.5-3.0 mm. The lamina of L3 had the largest width and the lamina of L1 and L5 the smallest. The mean lamina length was 26.6 mm, ranging from 21.0-34.0 mm, and the mean spinolaminar angle was 124.7°, ranging from 111-135°. The L1 level had the shortest mean lamina length and L4 the lowest spinolaminar angle. Mean subdural space (safe zone), which was narrowest at the L5 level, was 2.4 mm, ranging from 1.3-3.6 mm.Conclusion: ILS of the appropriate size (3.5-4.5 mm) and length (20 and 25 mm) can be used safely in the lumbar spine. However, further biomechanical studies should be performed to measure strength of the fixationObjective: The use of intralaminar screws (ILS) in spinal surgery has experienced a recent increase in popularity. The aim of this study is to define the morphological parameters of the lumbar laminas so that guidance may be defined for ILS placement.Methods: The study involved the evaluation of lumbar computed tomography (CT) images of patients. Two hundred thirty-five patients (127 male, 108 female) were included in the study. The mean patient age was 44.2 years (19-78 years). The measured parameters of the lamina were the transverse inner diameter, transverse outer diameter (lamina width), lamina length, subdural space (safe zone), and spinolaminar angle for each lumbar level (L1-L5).Results: The mean transverse outer diameter (L1-L5) ranged from 7.2-7.8 mm, and mean transverse inner diameter ranged from 2.5-3.0 mm. The lamina of L3 had the largest width and the lamina of L1 and L5 the smallest. The mean lamina length was 26.6 mm, ranging from 21.0-34.0 mm, and the mean spinolaminar angle was 124.7°, ranging from 111-135°. The L1 level had the shortest mean lamina length and L4 the lowest spinolaminar angle. Mean subdural space (safe zone), which was narrowest at the L5 level, was 2.4 mm, ranging from 1.3-3.6 mm.Conclusion: ILS of the appropriate size (3.5-4.5 mm) and length (20 and 25 mm) can be used safely in the lumbar spine. However, further biomechanical studies should be performed to measure strength of the fixatio

Evaluation of lower extremity perfusion in organ scintigraphy in patients who are planned for amputation

Introduction: No method alone is enough to take the amputation decision in the lower extremity. Therefore, in our study, the contribution of organ perfusion scintigraphy to the evaluation of lower extremity perfusion was investigated.Methods:  Our study was retrospectively designed and investigated patients applying for evaluation before amputation, and with Tc-99m sestamibi organ perfusion scintigraphy performed. The research included a total of 21 patients (18 male, 3 female, mean age 67.2 ± 10.6 years). The patients had OPS results and the results of other investigation methods (DUSG and CTA) comparatively evaluated. Statistically the diagnostic value of OPS was compared with the other investigation methods.Results:  There was no statistically significant difference between patients in both groups in terms of demographic data, risk factors and accompanying diseases. Twenty-one patients had both OPS and DUSG performed while only eleven patients had CTA performed. The results of the evaluations found that 5 of the 21 patients had amputation performed. The results were positive in all three tests of amputated patients. Conclusion:  Considering that peripheral arterial disease is a functional problem, it is understood that weighted morphological and limited hemodynamic data are inadequate for clinical evaluation and therefore physiological and functional examination methods are needed. For this reason, OPS is a valuable nuclear medicine method that can be used additionally in patients with amputation planned especially in the evaluation of lower extreme perfusion

BILATERAL ANTERIOR INFERIOR CEREBELLAR INFARCTION PRESENTING SEVERE VERTIGO AND HEARING LOSS

Anterior inferior cerebellar (AICA) infarctions are rarely seen, and bilateral AICA infarctions are mostly seen in the literature as case reports. Herein, a rare case with bilateral AICA infarction with severe vertigo, nausea and vomiting is presented. A sixty-nine-year-old woman was seen with the complaints of vertigo, tinnitus,nause, vomiting and hearing loss. In neurological examination, a dysarthric speech, horizontal nystagmus, bilateral peripheral facial palsy, right trigeminal hypoesthesia and mild ataxia were also noted. Mild sensorineural hearing loss (%30) was detected in the left ear through audiogram examination. In cranial MR imaging, a bilateral AICA infarction was reported. In addition, there were also bilateral hypoplastic posterior cerebral artery (PCA) and basilar artery stenosis in cranial MR angiography. The sympomts were partially disappeared following anti-platelet treatment. As in this case, in a patient with vertigo, AICA infarct should be kept in mind and detailed neurological examination should be performed

Ağrılı Total Oftalmoparezi ile Seyreden İndirekt Karotikokavernöz Fistül Olgusu I

84 year old woman applied to our clinic with the complaints of right eye ptosis and pain. Her neurological examination revealed ptosis and limitation of movement in all directions in the right eye. Direct and indirect light reflex of the right eye was positive. Visual acuity of the case was normal. Dilatation in the superior ophthalmic vein and signal increase in cavernous sinus were observed in cranial magnetic resonance angiography (MRA) imaging of three-dimensional (3D) time-of- flight (TOF) slab sequence. Indirect carotid cavernous fistula (CCF) draining to superior ophthalmic vein and right inferior petrosal sinus fed by multiple meningeal branch of bilateral external carotid artery was detected at the level of cavernous sinus in the right in digital subtraction angiography (DSA). Total occlusion in fistula was achieved through transvenous cavernous sinus and inferior petrosal vein coil embolization method.Özet 84 yaşında kadın hasta iki haftadır sağ göz kapağında düşme ve ağrı şikayeti ile başvurdu. Nörolojik muayenesinde sağ gözde her yöne hareketlerinin kısıtlılık ve pitoz saptandı. Sağ gözde direkt ve indirekt ışık refleksi pozitifti. Olgunun görme keskinliği tam olarak değerlendirildi. Kraniyal magnetik rezonans anjiografi tetkikinde 3 D TOF slab sekansında ,superior oftalmik vende dilatasyon ve kavernöz sinüste sinyal artışı izlendi. Serebral anjiografide (DSA) sağda kavernöz sinüs düzeyinde bilateral eksternal karotid arterin multipl meningeal dalından beslenen sağ inferior petrosal sinüse ve superior oftalmik vene direne olan indirekt KKF saptandı. Transvenöz yolla kavernöz sinüs ve inferior petrosal ven koil embolizasyon yöntemi ile fistülde total oklüzyon sağlandı . Tedavi sonrası dördüncü haftada hastanın sağ göz ağrısı tamamen geçti, pitoz ve göz hareketlerindeki kısıtlılık tama yakın düzeldi

Right aortic arch with aberran left subclavian artery; accompanied with crossed pulmonary arteries: a rare association

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