Could the Cerebral Involvement of COVID-19 Disease be Related to Microstructural Changes that are not Reflected in Conventional MRI Images?

In patients with COVID-19, neurodegeneration may develop before clinical symptoms appear. Diffusion-weighted (DW) MRI is an important technique for analyzing microstructural changes such as gliosis. In this study, a quantitative evaluation of microstructural changes in the brain with apparent diffusion coefficient (ADC) values in patients presenting with a headache after the COVID-19 disease was analyzed and compared. DW MR images of patients of 20 COVID-19 patients (13 females, 7 males) who required imaging due to headache; 20 controls (16 females, 4 males) were retrospectively reevaluated. ADC measurements were taken from 16 regions of the brain, including right and left symmetrical in patients with COVID-19 infections and control groups. All regions of interest (ROIs) were taken from the hypothalamus, parahippocampus, thalamus, corpus striatum, cingulate gyrus, occipital gyrus, dentate nucleus, and medulla oblongata posterior. ADC values in the dentate nucleus right (784.6 ± 75.7 vs. 717.25 ± 50.75), dentate nucleus left (768.05 ± 69.76 vs. 711.40 ± 52.99), right thalamus (731.15 ± 38.14 vs. 701.60 ± 43.65), left thalamus (744.05 ± 39.00 vs. 702.85 ± 28.88), right parahippocampus (789.10 ± 56.35 vs. 754.75 ± 33.78), right corpus striatum (710.00 ± 39.81 vs. 681.55 ± 39.84) were significantly higher than those in the control group. No significant changes were observed in other areas. A significant increase in ADC values at many levels in the brain in patients with COVID-19 disease and headache was observed. Thus, this study indicates that cerebral involvement in COVID-19 disease may be related to microstructural changes that are not reflected in conventional MRI images.

Posterior longitudinal ligament suturation after lumbar discectomy provides postoperative a large intradural area: First report.

Background: Stability and flexibility of the spine are provided by the posterior longitudinal ligament (PLL). It plays a key role in the pathogenesis of lumbar disc herniation (LDH) by preventing disc protrusion. The effect of the suturing of the PLL on the intradural area was investigated. Patients and Methods: The patients were included in whom lumbar microdiscectomy was performed between January 2021 and July 1, 2022. The patients were randomly divided into two groups as PLLs were sutured and unsutured. Results: Forty-six (23 males and 23 females) patients were included. The PLLs were sutured in 22 patients (Group 1) and not sutured in 24 patients (Group 2). The levels, sides of LDHs, and ages and gender of patients were also analyzed in both groups, which were not statistically significant. Preoperative mean spinal intradural areas were 77.29 mm2 for the PLL unsutured group and 85.40 mm2 for the PLL sutured group (Groups 1 and 2). For patients in Groups 1 and 2, the postoperative mean spinal intradural areas grew to 134.73 mm2 and 96.12 mm2, respectively. The difference in preoperative mean spinal intradural regions between the two groups was not statistically significant; however, Group 1 showed a substantial difference (sutured PLL patients). Conclusions: This study first time indicates that suturing PLL has a protective and supportive role in patients who were operated on for LDH.

Spontaneous Thyroid Parenchymal Hemorrhage Causing Acute Airway Obstruction and Its Endovascular Treatment: A Case Report and Literature Review.

INTRODUCTION: Massive parenchymal hemorrhage of the thyroid gland is very rare. Some of these can reach a life-threatening level. CASE PRESENTATION: A 70-year-old female patient approached the emergency department with swelling and redness on her neck after a routine dialysis session. In the neck computed tomography obtained, there was a massive hematoma originating from the thyroid gland parenchyma. The hematoma was causing airway compression. We performed thyroid artery embolization and within days, hematoma dimensions and compression effect disappeared without surgical treatment. CONCLUSION: Massive hemorrhage of the thyroid gland parenchyma is very rare and can reach life-threatening dimensions. Effective and rapid treatment should be done. As an alternative to surgery, endovascular treatment can be life-saving.

The predictive value of temporal muscle thickness measured by ultrasonography for detecting moderate to severe malnutrition in chronic hemodialysis patients.

INTRODUCTION AND AIM: To determine the predictive value of temporal muscle thickness (TMT) measured by ultrasonography in the diagnosing of moderate to severe malnutrition in chronic hemodialysis (CHD) patients. MATERIALS AND METHODS: Adult patients (> 18 years) who had been on CHD for at least 3 months were included in this cross-sectional study. Patients with infection or inflammatory disease, malignancy, malabsorption syndrome, history of surgery within the last 3 months excluded. Demographic, anthropometric, laboratory parameters, and Malnutrition Inflammation Score (MIS) test results recorded. RESULTS: A total of 60 chronic hemodialysis (CHD) patients (median age: 66 years, 46.7% female) and 30 healthy individuals (median age: 59.5 years, 55% female) were examined. While there were no significant difference between the dry weight (70 vs 71 kg) and body mass index (BMI) (25.8 vs 26 kg/m2) of the CHD patients and healthy control group, we found that triceps skinfold thickness (TST) (16 vs 19 mm) and left and right TMT (9.6 vs 10.7 and 9.8 vs 10.9 mm) values were significantly lower in the CHD patients (p < 0.001). CHD patients were divided into two groups according to their MIS values as mild (MIS < 6) and moderate/severe malnutrition (MIS ≥ 6). Patients with moderate/severe malnutrition were older, predominantly female and with longer HD vintage. Left (8.8 vs 11 mm) and right TMT (9.1 vs 11.2 mm) values were lower in moderate/severe malnutrition group. In the correlation analysis, a negative correlation was found between TMT and age and MIS, and a positive correlation determined with dry weight, BMI, TST and serum uric acid. In the ROC curve analysis, we found that the optimal cut-off value of left and right TMT for predicting moderate/severe malnutrition were 10.05 and 10.45 mm, respectively. Multivariate regression analysis showed that HD vintage, URR, and TMT values were independently associated with moderate/severe malnutrition. CONCLUSION: TMT value measured by ultrasonography in CHD patients can be used as a reliable, easily accessible and non-invasive diagnostic method for predicting moderate/severe malnutrition.

Temporal muscle thickness predicts mortality in prevalent hemodialysis patients.

OBJECTIVE: Ultrasonographic temporal muscle thickness measurement has recently emerged as a promising method of nutritional assessment in various conditions; hence, we aimed to determine the relationship between temporal muscle thickness and mortality in prevalent hemodialysis patients. METHODS: Adult patients who were on a regular in-center hemodialysis program for ≥3 months were included, and patients with severe nonrenal organ failure or any recent significant disease inception were excluded. Baseline demographic; clinical, laboratory, and anthropometric data, including malnutrition inflammation score; and outcomes data were collected using a standardized form. RESULTS: A total of 60 patients (32 males, diabetes prevalence: 26.6%) who met the eligibility criteria participated in the study, with a mean follow-up of 33.3±11.5 months, a median age of 66.5 (interquartile range 52.7-74) years, time on hemodialysis of 36 months, and a body mass index of 25.9 kg/m². Infections and cardiovascular events were the most common causes of overall mortality that occurred in 41.6% of the patients. Temporal muscle thickness was significantly lower in nonsurvivors (8.8 vs. 10.6 mm, p<0.001). Multivariate Cox regression analysis involving age, albumin, spKt/V, and malnutrition inflammation score revealed that temporal muscle thickness was a significant predictor of mortality (hazard ratio=0.740, p=0.035). Receiver operating characteristic curve analysis has shown 68% of sensitivity and 81.8% of specificity for a cutoff value of 9.4 mm (p<0.001). Temporal muscle thickness was weakly or mildly correlated with hemodialysis vintage, body mass index, albumin, and malnutrition inflammation score and moderately correlated with age (r=-0.536, p<0.001). CONCLUSION: Ultrasonographic temporal muscle thickness has been found as a significant predictor of mortality in prevalent hemodialysis patients. Temporal muscle thickness could be a novel marker of nutritional status and predictor of mortality; hence, further studies are warranted.

The effects of long-term doppler ultrasound exposure in the prenatal period on renal tissue physiology in rats.

Doppler ultrasonography (DUSG) is widely used for fetal evaluations. This study investigated the effects of new generation Doppler ultrasound application at different frequencies during pregnancy on postnatal renal development. Six pregnant female rats were divided into three groups. No procedure was performed on the first (control) group. In the second group, transabdominal DUSG was performed continuously for 15 min every day from the first day of gestation until birth. In the third group, DUSG was applied for 15 min every two days. Twenty-four male pups were sacrificed after 60 days. Renal tissues were then collected and subjected to biochemical, histopathological, and immunohistochemical evaluation. Malondialdehyde, glutathione, urea, Ca, K, and Cl levels increased in the DUSG groups compared to the control group (p < .05). Histopathologically, tubular damage increased in the DUSG groups compared to the control group (p < .05). Immunohistochemically, an increase was determined in Caspase-3 expression in the DUSG groups compared to the control group (p > .05). The DUSG groups also exhibited an increase in the superficial areas of the proximal and distal tubules, although the difference compared to the control group was not significant (p > .05). Multiple administrations of new generation DUSG to pregnant rats resulted in deleterious effects on the development of postnatal renal tissue. This shows that DUSG should be applied for as short a time as possible and that re-exposure should be avoided.

Effects of long-term Doppler ultrasound exposure on cochlea and cochlear nucleus in prenatal period in an experimental model.

BACKGROUND: New generation Doppler ultrasonography (DUSG) application effects on cochlea and cochlear nucleus (CN) are unclear. We aimed to investigate the effects of new generation DUSG application at different frequencies in prenatal period on cochlea and CN in rats. OBJECTIVE: Twenty-four pregnant female rats were divided into three groups (n = 8). Group 1 was the control group and was not subjected to any treatment. Group 2 was determined as the USG every day (USGED) treatment group. Group 2 has received DUSG application every day from the 4th to 18th day (20 min/15 per day). Group 3 has received DUSG application as "2 days/one dose as every other day application" (USG2D1) from the 4th to 18th day (20 min/8 every other day). Twenty-four female rats were sacrificed in 21 days. Also, 24 pups were sacrificed after two days. First day after born, the cochlear activities of the right ears of all pups were examined using DPOAEs. Second day, neural tissues from CN were evaluated histopathologically and immunohistochemically. RESULTS: There was no any statistical difference between the groups in respect of histopathologically. USGED group showed mild caspase-3 positive neurons and glial cells. However, there was no significant difference between the USGED and other groups (p>.05). Similarly, the rats applied with USG2D1 had mild caspase-3 expression, but no significant difference between the USG2D1 and other groups (p>.05). Differences in DPOAE amplitudes, and therefore in cochlear activity, between the groups were revealed. The decrease in cochlear activity between the groups involved frequencies at 2, 8, 16, and 32 kHz (p<.05). CONCLUSIONS: Multiple administration of new generation DUSG to pregnant rats has not shown harmful effects on the cochlear neural tissue. High frequencies are more sensitive in cochlea to apply DUSG.

Temporal muscle thickness predicts mortality in prevalent hemodialysis patients

SUMMARY OBJECTIVE: Ultrasonographic temporal muscle thickness measurement has recently emerged as a promising method of nutritional assessment in various conditions; hence, we aimed to determine the relationship between temporal muscle thickness and mortality in prevalent hemodialysis patients. METHODS: Adult patients who were on a regular in-center hemodialysis program for ≥3 months were included, and patients with severe nonrenal organ failure or any recent significant disease inception were excluded. Baseline demographic; clinical, laboratory, and anthropometric data, including malnutrition inflammation score; and outcomes data were collected using a standardized form. RESULTS: A total of 60 patients (32 males, diabetes prevalence: 26.6%) who met the eligibility criteria participated in the study, with a mean follow-up of 33.3±11.5 months, a median age of 66.5 (interquartile range 52.7-74) years, time on hemodialysis of 36 months, and a body mass index of 25.9 kg/m². Infections and cardiovascular events were the most common causes of overall mortality that occurred in 41.6% of the patients. Temporal muscle thickness was significantly lower in nonsurvivors (8.8 vs. 10.6 mm, p<0.001). Multivariate Cox regression analysis involving age, albumin, spKt/V, and malnutrition inflammation score revealed that temporal muscle thickness was a significant predictor of mortality (hazard ratio=0.740, p=0.035). Receiver operating characteristic curve analysis has shown 68% of sensitivity and 81.8% of specificity for a cutoff value of 9.4 mm (p<0.001). Temporal muscle thickness was weakly or mildly correlated with hemodialysis vintage, body mass index, albumin, and malnutrition inflammation score and moderately correlated with age (r=−0.536, p<0.001). CONCLUSION: Ultrasonographic temporal muscle thickness has been found as a significant predictor of mortality in prevalent hemodialysis patients. Temporal muscle thickness could be a novel marker of nutritional status and predictor of mortality; hence, further studies are warranted.

Rationalization of Using the MR Diffusion Imaging in B12 Deficiency.

CONTEXT: The structural imaging of brain does not demonstrate any changes in the vast majority of patients with vitamin B12 deficiency, even in the advanced stages. AIMS: We investigated the microstructural changes in the brain with diffusion imaging among patients with biochemical evidence of B12 deficiency. PATIENTS AND METHODS: We retrospectively analyzed all diffusion-weighted MRI images between the periods 2014-2016 who had biochemical evidence of B12. The age-sex matched controls were chosen from the group with normal B12 levels. Patients with pathological findings in conventional MRI images were excluded from the study. RESULTS: About 37 patients were recruited (22 women, 15 men; mean age, 34.1 ± 9.9 years; age range). They were about thirty-four age-and sex-matched controls (with normal B12 levels), which were also included in the study. The mean apparent diffusion coefficient (ADC) value of amygdala (773.8 ± 49.9 vs. 742.2 ± 24.2, P = 0.01), hypothalamus (721.3 ± 39.2 vs. 700.2 ± 38.2, P = 0.02), striate cortex (737.6 ± 77.6 vs. 704.3 ± 58.2, P = 0.04), suprafrontal gyrus (740.7 ± 46.9 vs. 711.6 ± 40.7, P = 0.007) and medulla oblongata-olivary nucleus (787.3 ± 56.4 vs. 759.7 ± 46.2, P = 0.02) were significantly higher in B12 deficiency group compared to controls, whereas ADC values were similar at hippocampus, thalamus, insula, corpus striatum, cingulate gyrus, occipital gyrus, dentate nucleus, cerebral pedicle, tegmentum, pons, and posterior medulla oblongata. CONCLUSIONS: Our study indicates that a significant increase in ADC values occurs in multiple brain regions in patients with vitamin B12.

Noninvasive Assessment of Liver Parenchyma Using Gray-Scale Ultrasound-Based Histogram Analysis in Patients With Chronic Hepatitis B Infection.

The aims of this study were to examine the alterations of liver echo-intensity histogram parameters in chronic hepatitis B (CHB) patients and to assess the potential role of histogram parameters in the evaluation of hepatic fibrosis. A total of 52 patients with CHB who underwent liver biopsies were included in the study. The control group consisted of 30 healthy individuals. Histogram parameters were obtained from histogram analysis of gray-scale ultrasound images of both groups. The histogram parameters of the groups were compared. The association of histogram parameters with the grading and staging of histological activity index (HAI) in patients with CHB were evaluated. The patient group had statistically significant lower skewness, kurtosis, and higher variance, mean, 50th, and 90th percentile values compared with control group. When patients with CHB were divided into subgroups according to HAI stage, there was the increasing trend in skewness values and decreasing trend in kurtosis values across subgroups. The first percentile values showed negative correlation with HAI staging in patients with CHB. Ultrasound is a fast, inexpensive, and reproducible imaging method; histogram analysis of gray-scale ultrasound images may provide useful information for evaluation of hepatic fibrosis in CHB patients.

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

PURPOSE/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 µm) were significantly smaller than the right side (94.5 µm) (P = 0.040). However, the mean left sinus volume (44.5 cm) is larger than the right side, (34.5 mm) (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.

Assessment of the visual pathways in patients with neurofibromatosis-1 by 3S-space technique with 3-Tesla MRI

Background/aim/AIM: We aimed to evaluate the size/tortuosity of the optic nerve (ON) and the dilatation of the ON sheath (ONS) in neurofibromatosis type 1 (NF-1) patients with 3T-MRI, and to assess the usefulness of 3D-SPACE in imaging the optic pathway, ON, and ONS in NF-1 patients. Materials and methods: Twenty consecutive NF-1 patients without optic pathway glioma (OPG) (Group 1), 16 consecutive NF-1 patients with OPG (Group 2), and 19 controls were included in this study. The thickness and tortuosity of the ON and the diameter of the ONS were measured on STIR and 3D-SPACE images. Results: The thickness of the ON was similar in all groups on STIR images (P>0.05). The mean ONS diameter was higher in Group 2 with this sequence (P=0.009). Controls had significantly lower grades of ON tortuosity than Groups 1 and 2 (P=0.001), and Group 1 had significantly lower ON tortuosity compared to Group 2 (P=0.001). Severe tortuosity was only detected in Group 2. Conclusion: ON tortuosity and ONS diameter were increased in NF-1 patients in the presence of OPG. High-resolution cranium imaging with the 3D-SPACE technique using 3T-MRI seems to be helpful for detection of the optic pathway morphology and pathologies in NF-1 patients.

Effects of Gadodiamide and Gadoteric Acid on Rat Kidneys: A Comparative Study.

BACKGROUND: Gadolinium-based contrast agents are complex chelates to provide contrast in NRI. However, recent studies have highlighted the deposition of free Gd+3 ion in various tissues. PURPOSE: To evaluate the histopathological and immunohistochemical changes on rat kidney tissue following both macrocyclic (gadoteric acid) and linear (gadodiamide) agents under the hypothesis that gadolinium-based contrast agents (GBCA) lead to toxic, free Gd+3 accumulation in tissues. STUDY TYPE: The local Animal Care Committee approved the prospective animal study. ANIMAL MODEL: Thirty-two healthy Sprague-Dawley male rats were administered 2 mmol/kg gadodiamide and gadoteric acid for the first 4 days for 5 weeks. Group 1 received no drug (control, n = 8) and Group 2 (n = 8) was administered 0.1 ml/kg saline. Group 3 was administered 0.1 mmol/kg gadodiamide and Group 4 (n = 8) was administered 2 mmol/kg gadoteric acid. ASSESSMENT: Biochemical, histopathological, and immunohistochemical changes in testis kidney tissue were evaluated at the end of 10 weeks. STATISTICAL TESTS: Differences between groups were analyzed using the nonparametric Kruskal-Wallis test followed by one-way analysis of variance and the Tamhane test, also followed by Turkey's HSD test. RESULTS: Gadolinium increased serum urea, Ca+2 , and Caspase-3 positive tubular cell number. Larger Bowman capsules shrank proximal and distal tubules were revealed in the gadodiamide and gadoteric acid groups compared to the control group (P < 0.05). Histopathologic examination showed significantly more interstitial fibrosis, amyloid deposits, and vasocongestion in the gadodiamide group than the gadoteric acid and control groups, while the gadoteric acid group demonstrated significantly more leukocytic infiltration with atrophied proximal and distal tubules than the gadodiamide and control groups (P < 0.05). DATA CONCLUSION: GBCA administration causes significant histopathologic changes in kidney tissue. This study advocates additional investigation to assess the in vivo safety of GBCAs. LEVEL OF EVIDENCE: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:382-389.

Periportal hepatic involvement of non-Hodgkin lymphoma: a rare case report with magnetic resonance imaging findings.

Lymphoma with hepatic involvement can present with three morphological patterns: diffuse infiltrative, nodular, and mixed infiltrative-nodular. However, lymphoma with periportal infiltrative hepatic involvement is rare. There have been a few reports of cases with this type of hepatic involvement including ultrasound or computed tomography (CT) findings. In this case report, we present CT, magnetic resonance imaging (MRI), and diffusion-weighted MRI findings together with the histopathological results for a patient with periportal hepatic lymphoma presenting with obstructive jaundice.

Renal Artery Dissection in a Patient With Degenerative Scoliosis: A Rare Complication Caused by Lumbar Vertebra Osteophyte.

Isolated spontaneous renal artery dissection (RAD) without known trauma is rare, and its etiology has not been determined. However, notable risk factors including hypertension, strenuous exercise, connective tissue disorders, atherosclerosis, extracorporeal shock wave lithotripsy, and cocaine abuse have been reported. To the best of our knowledge, isolated RAD caused by lumbar vertebra osteophytes in patients with degenerative lumbar scoliosis has not been reported in the literature. In this article, we present a case of RAD caused by lumbar vertebra osteophyte in a patient with degenerative scoliosis and discuss the management of the disease.

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

OBJECTIVE: 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.

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

BACKGROUND: 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.

The Monitoring of Preoperative External Detorsion with Diffusion-Weighted Imaging in a Patient with Acute Testicular Torsion.

Testicular torsion is one of the main causes of acute scrotum and may result in permanent damage of the testicular tissue. Color Doppler imaging has been frequently used in the diagnosis of testicular torsion and posttreatment follow-up period of the disease. There are some studies reporting the value and usefulness of diffusion-weighted imaging in the diagnosis of testicular torsion. However, to the best of our knowledge, there is no report regarding the monitoring of preoperative external detorsion in testicular torsion with diffusion-weighted imaging examination. In this article, diffusion-weighted imaging findings in the management of preoperative external detorsion in a case with testicular torsion were presented.

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

PURPOSE: 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.