Evaluation of peripheral and central olfactory pathways in HIV-infected patients by MRI.

AIM: To investigate peripheral and central olfactory pathways using cranial magnetic resonance imaging (MRI) in human immunodeficiency virus (HIV)-infected patients. MATERIALS AND METHODS: The cranial MRI images of 37 HIV-infected adult patients and 37 adults without HIV infection having normal cranial MRI results were included in the study. In both groups, olfactory bulb (OB) volume and olfactory sulcus (OS) depth; and insular gyrus and corpus amygdala areas were measured using cranial MRI. In the HIV group, disease duration, HIV RNA, and CD4 lymphocyte count and levels as a percentage were also recorded. RESULTS: The HIV group had significantly lower bilateral OB volumes, insular gyrus and corpus amygdala areas compared to the control group. The HIV group showed positive correlations between OB volumes, OS depths, insular gyrus, and corpus amygdala areas bilaterally. Increases in OB volumes and OS depths were associated with an increase in the insular gyrus area. The corpus amygdala and insular gyrus areas increased similarly. There was no significant correlation between age, gender, disease duration, CD4 lymphocyte count and per cent, HIV RNA values, and the measurement values of the central and peripheral olfactory regions. CONCLUSION: A decrease in olfactory regions of OB, insular gyrus, and corpus amygdala in HIV-infected patients shows that HIV infection may cause olfactory impairment. There is no correlation between disease duration and olfactory impairment. It may be related to neuroinflammation, HIV-related brain atrophy, acquired immunodeficiency syndrome (AIDS) dementia complex, or neurocognitive impairment, which are the other explanations for the olfactory impairment in HIV. The possible toxicity from antiretroviral therapy (ART) may be another cause that should be investigated further.

Evaluation of the relationship between trochlear and patellar morphology and patellar chondromalacia with magnetic resonance imaging.

It was aimed to investigate the relationship between magnetic resonance imaging (MRI) measurements of trochlear and patellar morphology and grade 3-4 patellar chondromalacia. Grade 3-4 patellar chondromalacia group, and an age- and sex-matched control group with normal patellar joint cartilage were comprised. For trochlear morphology evaluation in MRI; sulcus angle, trochlear angle, lateral trochlear inclination angle and medial trochlear inclination angle were measured. For patellar morphology evaluation; patella trochlear ratio, insall-salvati ratio, modified Insall- Salvati ratio and Blackburne-Peel ratio were measured. Obtained measurements were statistically analyzed according to demographic characteristics. One hundred and twenty-five patients with chondromalacia and 125 controls participated. The sulcus angle and the trochlear angle were significantly higher in the patellar chondromalacia group (p<0.05). The lateral trochlear inclination angle was significantly less in the patellar chondromalacia group (p=0.011). There was no significant difference between the groups in terms of medial trochlear inclination angle (p=0.520). There was no significant difference between the groups in terms of patella-trochlear ratio (p=0.617). Insall-Salvati ratio was significantly higher in the patellar chondromalacia group (p=0.003). Modified Insall-Salvati ratio was significantly lower in the patellar chondromalacia group (p=0.001). The rate of Blackburne-Peel was significantly higher in the patellar chondromalacia group (p=0.004). Measurements of sulcus angle, trochlear angle, lateral trochlear inclination angle, Insall-Salvati ratio, modified Insall-Salvati ratio, Blackburne-Peel ratio have diagnostic value for grade 3-4 chondromalacia.

The evaluation of TheraBite and wooden tongue depressor in the treatment of trismus and health-related quality of life.

OBJECTIVE: This study aimed to compare the efficacy of TheraBite system and a wooden tongue depressor in head and neck cancer (HNC) patients and assess their quality of life (QoL) using modified questionnaires. PATIENTS AND METHODS: The effects of exercise using TheraBite and a wooden tongue depressor on trismus were evaluated in 40 HNC and 10 healthy individuals. All patients performed the exercise program for 3 weeks, with a follow-up session. The patients' pre-treatment and post-treatment mouth opening (MO) values were recorded. The HNC patients completed the QoL questionnaire after the treatment. RESULTS: The highest mean value of MO pre-treatment scores was recorded in the control group (p < 0.05). The differences among all the scores for QoL questionnaires were insignificant (p > 0.05). CONCLUSIONS: TheraBite system increased MO compared to a wooden tongue depressor. The questionnaire revealed that radiotherapy had side effects on patients.

Assessment of the optic nerve using strain and shear-wave elastography in patients with pseudotumour cerebri.

AIM: To evaluate the optic nerve using strain elastography (SE) and shear-wave elastography (SWE) in idiopathic intracranial hypertension (IIH) patients in comparison to participants in the control group. MATERIALS AND METHODS: Eighty eyes were evaluated in 40 cases consisting of 20 IIH patients and 20 participants in the control group. This study was conducted using SE and SWE in addition optic nerve sonography measurements of participants in the IIH patient group and the control group. SE patterns were categorised using three main types and two subtypes. Quantitative measurements of optic nerve stiffness with SWE were expressed in kilopascals. RESULTS: In the IIH patient group, type 2 and type 1 elasticity patterns were primarily observed, followed by type 3 patterns. In the control group, type 3 elasticity patterns were most often observed, while type 2 elasticity patterns were seen less frequently. Statistically significance differences in the types of elasticity strain patterns were observed between the groups (p<0.01). Quantitative analysis was also performed, and the SWE moduli were obtained for the control group (10.1±0.28 kPa) and the IIH patient group (26.97±1 kPa). A statistically significant difference in the SWE modulus was found between the groups (p<0.01). CONCLUSION: Biomechanical changes may have occurred in the optic nerve secondary to increased intracranial pressure in IIH patients. Strain and shear elastography may have potential as assistive diagnostic techniques for the detection and follow-up of these changes.

Is there a relationship between mastoid pneumatisation and facial canal dimensions?

OBJECTIVE: To evaluate mastoid pneumatisation and facial canal dimensions. METHOD: In this retrospective study, 169 multidetector computed tomography scans of temporal bone were reviewed. Facial canal dimensions were evaluated at the labyrinthine, tympanic and mastoid segments using axial and coronal multidetector computed tomography scans of temporal bone. Mastoid pneumatisation and facial canal dehiscence were evaluated. Facial canal dehiscence was measured if it was found to be present. RESULTS: This study showed that facial canal dimensions decreased in pneumatised mastoids. Facial canal dimensions in females were smaller than in males. Facial canal dehiscence was detected in 5.9 per cent and 6.5 per cent of the patients on the right and left sides, respectively. No correlations were found between facial canal dehiscence and mastoid pneumatisation. The length of dehiscence was 1.92 ± 0.44 mm (range, 0.86-2.51 mm) on the left side. In older subjects, left facial canal dehiscence was detected more, and the length of the dehiscence increased. CONCLUSION: This study concluded that during surgery, facial canal dehiscence should be kept in mind in order to avoid complications.