Submandibular Lateral Ectopic Thyroid Tissue: Ultrasonography, Computed Tomography, and Scintigraphic Findings

Celiker, Metin/0000-0002-9833-402XWOS: 000215209500072PubMed: 26634164Ectopic thyroid can be encountered anywhere between the base of tongue and pretracheal region. the most common form is euthyroid neck mass. Herein, we aimed to present the findings of a female case with ectopic thyroid tissue localized in the left submandibular region. A 44-year-old female patient, who underwent bilateral subtotal thyroidectomy four years ago with the diagnosis of multinodular goiter, was admitted to our hospital due to a mass localized in the left submandibular area that gradually increased in the last six months. Neck ultrasonography, contrast-enhanced computed tomography, and scintigraphic examination were performed on the patient. on thyroid scintigraphy with Tc-99m pertechnetate, thyroid tissue activity uptake showing massive radioactivity was observed in the normal localization of the thyroid gland and in the submandibular localization. the focus in the submandibular region was excised. Pathological examination of the specimen showed normal thyroid follicle cells with no signs of malignancy. the submandibular mass is a rarely encountered lateral ectopic thyroid tissue. Accordingly, ectopic thyroid tissue should also be considered in the differential diagnosis of masses in the submandibular region

What Are We Missing From Asymmetric Relationship Between the Retinal Nerve Fiber Layer Thickness Profiles and Sphenoid Sinus Volume?

Ozdemir, Dogukan/0000-0003-2008-163XWOS: 000529353700041PubMed: 31633664Purpose/Aim of the Study:Detailed analysis of retinal structure such as the retinal nerve fiber layer can be performed by spectral-domain optical coherence tomography (OCT). There are no published studies concerning a relationship between retinal nerve fiber layer and human sphenoid sinus volumes. We investigated this relationship.Material and Methods:Spectral-domain OCT. the peripapillary retinal nerve fiber layer (RNFL) thickness and sphenoid sinus volume estimation of both sides of sex-matched patients were retrospectively analyzed.Results:The mean RNFL thicknesses at the left side (91.8 mu m) were significantly smaller than the right side (94.5 mu m) (P=0.040). However, the mean left sinus volume (44.5cm(3)) is larger than the right side, (34.5mm(3)) (P<0.005). Left and right differences of both parameters are statistically significant (P<0.05).Conclusion:There is a negative correlation between mean RNFL thicknesses and mean sinus volumes. To our knowledge, this article is the first report demonstrating the asymmetry relationship between RNFL and sphenoid sinus volumes

Tympanomeatal flap creation in endoscopic stapedotomy: cautery vs. cold instrumentation

DURSUN, Engin/0000-0002-2070-8677WOS: 000516048300001PubMed: 32048030Purpose Bleeding is one of the most challenging issues for surgeons performing endoscopic stapedotomy. During creation and elevation of the tympanomeatal flap (TMF) prevention or control of bleeding greatly facilitates the safety and comfort in the next steps of the surgery. the aim of this study was to compare the effects of cautery versus cold instrumentation during creation of TMF at endoscopic stapedotomy surgery. Methods We investigated 15 patients TMF created with cautery and 14 patients with cold instrument, and compared bleeding scores, operation time, postoperative hearing, pain and complications between groups. Results the mean bleeding score was significantly lower in cautery incised patients compared to cold instrument patients (1.2 +/- 0.9 vs. 2.3 +/- 1, p = 0.005). Mean duration of surgery was also significantly shorter in cautery used patients (35.3 +/- 6.8 vs. 48.8 +/- 9.2 min, p < 0.001). There was no significant difference between postoperative pain, complications, wound healing, and auditory outcomes. Conclusions Cautery may be a better choice for the creation of TMF in endoscopic stapedotomy surgery due to reduced bleeding, shorter operation time and increased comfort without causing any complications

The effects of choanal atresia on development of the paranasal sinuses and turbinates

WOS: 000411735800010PubMed: 28289870Purpose the objective of this study was to evaluate the volume of paranasal sinuses (PNS) and turbinate in patients with unilateral choanal atresia (CA). Materials and method Computed tomography images of PNS in 11 individuals with unilateral CA were evaluated retrospectively. Mucosal thickness and volume of the maxillary, frontal and sphenoidal sinuses were determined, in addition to the volume of the middle and inferior turbinate. the unaffected nasal side of patients was used as a control group for the measurements. the results comprised the measurements of the atresic side compared to those of the healthy side. Results There was no significant difference between the atresic and healthy side of the nose in patients with CA with respect to mucosal thickness and volume of the PNS (the maxillary, frontal and sphenoidal sinuses) and the middle and inferior turbinate (p > 0.050). Conclusion the complete absence of nasal unilateral airflow had no effect on the development of the PNS and the middle and inferior turbinate. Moreover, mucosal thickness in the sinuses was similar to that in the control group

Important aspect of hypoglossal nerve injury following gunshot wound; Can the clivus has a role? A case report

Kanat, Ayhan/0000-0002-8189-2877WOS: 000547674900001PubMed: 32654525Cranial nerve palsies after gunshot injury are not uncommon. We report the mechanism of isolated hypoglossal nerve paralysis caused by a gunshot. We report a 74 years old patient in whom a bullet entered through the right nostril and then ended up right occipital condyle. the only neurologic deficit was tongue deviation which resolved in one week. the bullet was not removed. the effect of clival slope may have an importance in this type of injury

Evaluation of vascular variations at cerebellopontine angle by 3D T2WI magnetic-resonance imaging in patients with vertigo

INECIKLI, MEHMET FATIH/0000-0002-9796-8223;WOS: 000402990100006PubMed: 29064830BACKGROUND: Vascular loops of the anterior-inferior cerebellar artery (AICA) at the cerebellopontine angle (CPA) are considered related to auditory-vestibular symptoms. Clinical association of these anatomical aberrations, which can be grouped together as vascular compression syndromes, is controversial. Magnetic resonance imaging (MRI) is widely used to visualize this anatomical region, given its high sensitivity and specificity. OBJECTIVE: To elucidate the clinical relationship of vertigo symptoms with vascular loop compression syndrome by evaluating the neurovascular contacts of the vestibulocochlear nerve (VCN) and AICA at the CPA and internal auditory canal via high-resolution MRI. METHODS: the study included 417 patients (178 with vertigo and 239 without vertigo) undergoing MRI for various clinical causes. MRI scans were assessed to study the presence of vascular abnormalities at the CPA. RESULTS: According to our findings, type 1 vascular variation was observed most frequently in both sides. MRI findings were similar for the patients with and without vertigo. CONCLUSIONS: Identifying the prevalence of the vascular loops of the AICA primarily depends on diagnostic technique, and our results identified a slightly higher prevalence than those of previous studies, which might be partly related to the high-sensitivity of 3-dimensional T2-weighted MRI

Investigation of soft palate-uvula volume using magnetic resonance imaging in patients with obstructive sleep apnea

WOS: 000423936400020Aim: MRI-based sleep studies have revealed that airway movement disorders are associated with obstructive sleep apnea syndrome (OSAS). High-quality airway images are crucial for the accurate interpretation and planning of airway obstruction treatments. Our aim is to compare soft palate and uvula volumes, measured using magnetic resonance imaging (MRI), in patients with mild and severe OSAS with those of normal individuals, and to examine the association between soft palate-uvula volume and OSAS. Material and Method: Retrospective evaluations were performed on MRI tests of 30 patients with mild OSAS and 30 patients with severe OSAS, all diagnosed using polysomnography and for whom cranial MRI was requested for various reasons. in addition, test subjects also included 30 individuals with no snoring symptoms who also underwent MRI tests. Soft palate and uvula volumes were measured on T2 sagittal images at cranial MRI using the Multiplanar Reformat (MPR) Roy free measurement technique. Results: the mean soft palate-uvula volumes of patients with mild and severe OSAS were 8.49 +/- 2.37 cm(3) and 11.29 +/- 4.22 cm(3), respectively, compared to 6.42 +/- 2.23 cm(3) for controls. Significant differences were determined in terms of soft palate and uvula volumes between the patients with mild and severe OSAS, as well as between the OSAS groups and the normal subjects (p< 0.05). Discussion: the significantly higher soft palate-uvula volume in patients with OSAS suggests that soft palate-uvula volume may play a role in the development of OSAS

The Efficacy of Magnetic Resonance Imaging for the Diagnosis of Superior Semicircular Canal Dehiscence

INECIKLI, MEHMET FATIH/0000-0002-9796-8223WOS: 000440344100016PubMed: 29283100OBJECTIVE: This study aimed to evaluate the efficacy of magnetic resonance imaging (MRI) for diagnosing superior semicircular canal dehiscence (SSCD). MATERIALS and METHODS: the radiological records of patients who were admitted to our clinic with complaints of otologic and neuro-otologic symptoms between October 2014 and December 2015 were retrospectively reviewed. Among these patients, those who underwent both computed tomography and MRI and were reported to have SSCD in the temporal bone on at least one side were included in the study group. MRI records of patients with a confirmed diagnosis were then assessed for the presence of SSCD. RESULTS: the left and right semicircular canals of 52 patients were evaluated in this study. the sensitivity and specificity of MRI in the diagnosis of SSCD was 89.06% and 90%, respectively. the positive and negative predictive values were 93.44% and 83.72%, respectively. CONCLUSION: the use of multiplanar reformats and angulation techniques during MRI assessment of patients with neuro-otologic symptoms can improve the diagnostic process for patients with SSCD. This may allow early diagnosis of the disease by using just one imaging method, which would also reduce the costs per patient during the diagnosis period

The relation between retrobulbar blood flow and posterior ocular changes measured using spectral-domain optical coherence tomography in patients with obstructive sleep apnea syndrome

INECIKLI, MEHMET FATIH/0000-0002-9796-8223; Aslan, Mehmet Gokhan/0000-0002-3250-1606; Findik, Huseyin/0000-0001-7343-8757WOS: 000467649400006PubMed: 29594838PurposeTo investigate the effect of posterior ocular hemodynamics on the retinal nerve fiber layer (RNFL), choroid thickness (CT) and central macular thickness (CMT) in patients with obstructive sleep apnea syndrome (OSAS) and to reveal the association with glaucomatous optic neuropathy.MethodsThe research was planned as a prospective, randomized study. the ophthalmic, retinal and posterior ciliary artery pulsatile index (PI) and resistive index (RI) were measured by colored Doppler sonography. RNFL thickness, CMT and CT were then measured by spectral-domain optical coherence tomography.ResultsSixty subjects were divided into four groupsmild, moderate and severe OSAS and a control group. There were 16 subjects in the control group, 14 in the mild OSAS group, 15 in the moderate OSAS group and 15 in the severe OSAS group. Ophthalmic artery and central retinal artery PI and RI values of the OSAS patients did not show statistically significant difference than those of the control group, but posterior ciliary artery (PCA) PI and RI values were significantly higher. in addition, mean, superior and inferior RNFL thickness values were significantly lower than those in the control group. Moreover, the glaucoma prevalence of the OSAS patients in this study was 6.8% and all of these patients were in the severe OSAS group.ConclusionPI and RI values of the PCA, which supplies the optic nerve, show a linear increase as the apnea hypoxia index values in OSAS. As the grade of OSAS improves, this situation leads to a more serious ischemic optic neuropathy. Furthermore, the prevalence of glaucoma in this study is found to be higher in the severe OSAS group

Can Wideband Tympanometry Be Used as a Screening Test for Superior Semicircular Canal Dehiscence?

Demir, Emine/0000-0003-4087-432X; INECIKLI, MEHMET FATIH/0000-0002-9796-8223; DURSUN, Engin/0000-0002-2070-8677WOS: 000474448600006PubMed: 30458602Objectives. We explored whether wideband tympanometry (WBT) could be used as a screening test for superior semicircular canal dehiscence (SSCD), and obtained new WBT data (given that the test is not yet in common clinical use) on patients with SSCD. Methods. We compared the WBT data of patients clinically and radiologically diagnosed with SSCD in our hospital between 2013 and 2018 to those of healthy volunteers. We compared the resonance frequency (RF), maximum absorbance frequency (MAF), and maximum absorbance ratio (MAR). M`he t-test was used for statistical analysis with the significance level set to P< 0.05. in addition, we used receiver operating characteristic analysis to derive cutoff values for SSCD diagnosis in terms of sensitivity and specificity. Results. Seventeen patients (four with bilateral and 13 with unilateral disease; 17 ears) diagnosed with SSCD and 27 healthy volunteers (47 ears) were included.The mean RFs of the SSCD patients and healthy subjects were 548.7 Hz (range, 243 to 853 Hz) and 935.1 Hz (range, 239 to 1,875 Hz), respectively (P<0.001). the mean MARs of the SSCD patients and healthy subjects were 89.4% (range, 62% to 100%) and 82.4% (range, 63% to 99%), respectively (P=0.005). the mean MAFs of the SSCD patients and healthy subjects were 1,706.3 Hz (range, 613 to 3,816 Hz) and 2,668 Hz (range, 876 to 4,387 Hz), respectively (P<0.001). in terms of SSCD diagnosis, a MAR above 86% afforded 81% sensitivity and 77% specificity; an RF below 728 Hz, 86% sensitivity and 81% specificity; and an MAF below 1,835 Hz, 79% sensitivity and 67% specificity. Conclusion. WBT may be a useful clinical screening test for SSCD. the RF and MAF were lower, and the MAR higher, in SSCD patients than in normal controls