Radiological measurement of cochlear dimensions in cochlear hypoplasia and its effect on cochlear implant selection.

OBJECTIVE: To determine the effect of cochlear dimensions on cochlear implant selection in cochlear hypoplasia patients. METHODS: Temporal bone computed tomography images of 36 patients diagnosed with cochlear hypoplasia between 2010 and 2016 were retrospectively reviewed and compared with those of 40 controls without sensorineural hearing loss. RESULTS: Basal turn length and mid-modiolar height were significantly lower in the cochlear hypoplasia patients with subtypes I, II and III than in the control group (p < 0.001). Mid-scalar length was significantly shorter in subtype I-III patients as compared with the control group (p < 0.001). In addition, cochlear canal length (measured along the lateral wall) was significantly shorter in subtype I-IV patients than in the control group (subtypes I-III, p < 0.001; subtype IV, p = 0.002). CONCLUSION: Cochlear hypoplasia should be considered if basal turn length is less than 7.5 mm and mid-modiolar height is less than 3.42 mm. The cochlear implant should be selected according to cochlear hypoplasia subgroup. It is critically important to differentiate subtype II from incomplete partition type I and subtype III from a normal cochlea, to ensure the most appropriate implant electrode selection so as to optimise cochlear implantation outcomes.

Extremely rare R-I subtype coronary artery anomaly and accompanying incomplete myocardial bridging on the left anterior descending artery in a symptomatic patient: multidetector computed tomography and coronary angiography findings.

Myocardial bridging and single coronary artery (SCA) may both lead to myocardial ischemia and related secondary complications. We present multidetector computed tomography (MDCT) and catheter coronary angiography (CCA) findings of R-I subtype SCA, which is a distinctively rare congenital coronary anomaly, and accompanying incomplete myocardial bridging in a case with dyspnea and chest burning. In addition, CCA showed a thin milking effect at the tunneled artery.

A study on modelling cochlear duct mid-scalar length based on high-resolution computed tomography, and its effect on peri-modiolar and mid-scalar implant selection.

OBJECTIVE: To determine cochlear duct mid-scalar length in normal cochleae and its role in selecting the correct peri-modiolar and mid-scalar implant length. METHODS: The study included 40 patients with chronic otitis media who underwent high-resolution computed tomography of the temporal bone. The length and height of the basal turn, mid-modiolar height of the cochlea, mid-scalar and lateral wall length of the cochlear duct, and the 'X' line (the largest distance from mid-point of the round window to the mid-scalar point of the cochlear canal) were measured. RESULTS: Cochlear duct lateral wall length (28.88 mm) was higher than cochlear duct mid-scalar length (20.08 mm) (p < 0.001). The simple linear regression equation for estimating complete cochlear duct length was: cochlear duct length = 0.2 + 2.85 × X line. CONCLUSION: Using the mid-scalar point as the reference point (rather than the lateral wall) for measuring cochlear duct mid-scalar length, when deciding on the length of mid-scalar or peri-modiolar electrode, increases measurement accuracy. Mean cochlear duct mid-scalar length was compatible with peri-modiolar and mid-scalar implant lengths. The measurement method described herein may be useful for pre-operative peri-modiolar or mid-scalar implant selection.

The morphometry of the cavernous part of the internal carotid artery.

BACKGROUND: In the study, the morphometric evaluation of internal carotid artery (ICA) was performed in order to show the differences between the age groups and genders. MATERIALS AND METHODS: In the study, descriptive measurements of intercarotid distance on the computed tomography of 173 (88 male [M], 85 female [F]) pa- tients and the intercavernous distance on magnetic resonance images (MRIs) of 49 (19 M, 30 F) individuals were reviewed. RESULTS: Intercarotid distance was found to be close to the border of statistical significance and for results of the comparative measurements that were per- formed in the study; no significant sex-associated difference was observed for the distance between the gender and midpoint of the sella turcica and medial margin of the right ICA. Compared to gender, the distance between the base of the sella turcica and the base of the left ICA is found to be closed to of statistical significance. A statistically significant difference was obtained for the distance between the midpoint of sella turcica and medial margin of the left ICA and for the distance between the base of the sella turcica and the base of right ICA. Although it is observed that there is a weak correlation between the age and the distance between midpoint of the sella turcica and medial margin of the right ICA, statistically there is a significant difference between them. CONCLUSIONS: Obtained results, planning of surgical interventions are supportive and guiding in terms of prevention of damage of to ICA in three dimensional thinking and operations.

Juvenile nasopharyngeal angiofibroma: a single centre's 11-year experience.

OBJECTIVE: This study aimed to present the clinical features and surgical outcomes of juvenile nasopharyngeal angiofibroma patients who were surgically treated. METHODS: The medical records of 48 male patients histologically confirmed as having juvenile nasopharyngeal angiofibroma, who underwent transnasal endoscopic surgery between 2005 and 2016, were retrospectively reviewed. RESULTS: The overall recurrence rate was 20.8 per cent; however, the recurrence rate differed significantly between patients diagnosed aged less than 14 years (34.7 per cent) and more than 14 years (8 per cent) (p < 0.05). Advanced-stage tumours (Radkowski stage of IIC or more, and Önerci stage of III or more) were more aggressive than earlier stage tumours (p < 0.05 and p < 0.01, respectively). Pre-operative embolisation significantly prolonged mean hospitalisation duration, but had no effect on intra-operative blood loss in patients with advanced-stage tumours (p < 0.001 and p = 0.09, respectively). CONCLUSION: The findings show that transnasal endoscopic surgery could be considered the treatment of choice for juvenile nasopharyngeal angiofibroma. Patients diagnosed when aged less than 14 years and those with advanced-stage tumours are at risk of recurrence, and should be monitored with extreme care.