Olfactory bulb volume in patients with normal-pressure hydrocephalus: an MRI evaluation.

AIM: To investigate changes in olfactory bulb (OB) volume in patients with idiopathic normal-pressure hydrocephalus (NPH). MATERIALS AND METHODS: This multicentric retrospective study included a test group of 23 patients with NPH (10 male and 13 female patients) and a control group of 27 healthy participants without hydrocephalus. The OB volume in all participants had been measured using cranial magnetic resonance imaging (MRI). In the NPH group, positivity for disproportionately enlarged subarachnoid space hydrocephalus (DESH) was also evaluated. RESULTS: The OB volumes of the NPH group (R 38.29 ± 9.34 mm3 and L37.52 ± 9.59 mm3) were significantly lower than those of the control group (R 45.87 ± 7.33 mm3 and L48.41 ± 7.62 mm3) bilaterally. There were no significant differences between right and left OB volumes in the NPH group. Nine of the 23 patients were DESH positive and 14 were DESH negative. There were no significant differences between OB volumes of the DESH positive and DESH vpatients in the NPH group. In both groups, there was a positive correlation between right and left OB volumes. There were no significant correlations between OB volumes and age or gender. In the NPH group, there were no significant correlations between DESH positivity and OB volumes. CONCLUSION: OB volume decrease and olfactory problems should be taken into account in idiopathic NPH patients. When expanded ventricles and decreased OB volume are observed at cranial MRI, a diagnosis of idiopathic NPH should be considered.

Pectoralis major myofascial flap in salvage laryngectomy.

OBJECTIVE: The main purpose of this study was to evaluate the effect of the pectoralis major myofascial flap on pharyngocutaneous fistula formation and time to oral feeding. METHODS: This retrospective study reviewed 155 total laryngectomies. Patients were divided into two main groups. Group 1 included 110 patients who were treated primarily by total laryngectomy and group 2 comprised 45 patients who were treated by salvage laryngectomy with or without a pectoralis major myofascial flap. RESULTS: The use of a pectoralis major myofascial flap did not have a significant effect on pharyngocutaneous fistula formation in the salvage group (p = 0.376). When comparing the oral feeding day of patients with pharyngocutaneous fistula, a significant difference was observed between the salvage group with pectoralis major myofascial flap reinforcement and the salvage group without pectoralis major myofascial flap reinforcement (p = 0.004). DISCUSSION: Our study demonstrated that pectoralis major myofascial flap reinforcement did not decrease the rate of pharyngocutaneous fistula formation. Instead, it prevented the formation of large fistulas that would require surgical management, and showed a similar time to oral feeding and length of hospital stay to primary laryngectomy.