Limbic-Auditory Interactions of Tinnitus: An Evaluation Using Diffusion Tensor Imaging.

OBJECTIVE: Tinnitus is defined as an imaginary subjective perception in the absence of an external sound. Convergent evidence proposes that tinnitus perception includes auditory, attentional and emotional components. The aim of this study was to investigate the thalamic, auditory and limbic interactions associated with tinnitus-related distress by Diffusion Tensor Imaging (DTI). METHODS: A total of 36 tinnitus patients, 20 healthy controls underwent an audiological examination, as well as a magnetic resonance imaging protocol including structural and DTI sequences. All participants completed the Tinnitus Handicap Inventory (THI) and Visual Analog Scales (VAS) related with tinnitus. The fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were obtained for the auditory cortex (AC), inferior colliculus (IC), lateral lemniscus (LL), medial geniculate body (MGB), thalamic reticular nucleus (TRN), amygdala (AMG), hippocampus (HIP), parahippocampus (PHIP) and prefrontal cortex (PFC). RESULTS: In tinnitus patients the FA values of IC, MGB, TRN, AMG, HIP decreased and the ADC values of IC, MGB, TRN, AMG, PHIP increased significantly. The contralateral IC-LL and bilateral MGB FA values correlated negatively with hearing loss. A negative relation was found between the AMG-HIP FA values and THI and VAS scores. Bilateral ADC values of PHIP and PFC significantly correlated with the attention deficiency-VAS scores. CONCLUSION: In conclusion, this is the first DTI study to investigate the grey matter structures related to tinnitus perception and the significant correlation of FA and ADC with clinical parameters suggests that DTI can provide helpful information for tinnitus. Magnifying the microstructures in DTI can help evaluate the three faces of tinnitus nature: hearing, emotion and attention.

Radiological and audiometric evaluation of high jugular bulb and dehiscent high jugular bulb.

OBJECTIVE: To inform on the incidence of high jugular bulb and dehiscent high jugular bulb, and the symptoms related to these vascular anomalies. METHODS: A retrospective analysis was performed of temporal bone computed tomography scans of 3285 patients who attended our clinic with various symptoms. The medical records of patients with high jugular bulb and dehiscent high jugular bulb were analysed, and the clinical findings reviewed. Patients with dehiscent high jugular bulb were evaluated for hearing loss with pure tone audiometry. RESULTS: High jugular bulb was evident in 730 patients (22 per cent) (510 right-sided, 220 left-sided; p < 0.01). Twenty-six high jugular bulb patients had dehiscent high jugular bulb. Ten of these 26 patients had vertigo, 15 had tinnitus and 1 had hearing disturbance. Ten dehiscent high jugular bulb patients had undergone pure tone audiometry: seven patients had conductive hearing loss, two had sensorineural hearing loss and one had mixed hearing loss. CONCLUSION: The incidences of high jugular bulb and dehiscent high jugular bulb were 22 per cent and 3.5 per cent, respectively. Tinnitus was the most common symptom of all patients. Dehiscent high jugular bulb was associated with various degrees of hearing loss, but not hearing disturbance.

The Role of Mean Platelet Volume as an Inflammatory Marker in Children with Allergic Rhinitis

ABSTRACT Objective: The mean platelet volume (MPV) is a potential marker of platelet reactivity. Increased MPV levels are shown to be the predictors of inflammations. The aim of this study was to investigate whether MPV is an inflammatory indicator in children with allergic rhinitis. Methods: The study included 44 children with allergic rhinitis between the ages of 6 and 18 years (47.1% boys), and 45 healthy children between the ages of 6 and 18 years (52.9% boys), and the MPV, platelet (PLT), white blood cell (WBC), haemoglobin (Hb) values in their haemograms were compared. Results: No differences were found between the allergic rhinitis group and the healthy control group in terms of their age and their gender (p = 0.15 and 0.60, respectively). While the MPV value of the patient group was 6.9 fL (6-9), the MVP value of the control group was 7.0 fL (5.9-9.7). There was no statistically significant difference between the patient and the control groups in terms of their MPV data (p = 0.15). In addition, there were no differences between the patient and control groups in terms of PLT count, WBC count, or Hb data (p = 0.09, 0.22, and 0.22, respectively). Conclusion: To the best of our knowledge, this is the first study to analyse the role of MPV as an inflammatory indicator in children with allergic rhinitis. According to our results, MPV cannot be used as an indicator of inflammation in children with allergic rhinitis.

MDCT Assessment of the Cochlear-Carotid Interval.

The close anatomic course between the cochlea and the carotid artery presents a possible surgical risk during increasingly popular cohlear implant surgery. The purpose of this study was to determine the normal range of the this region termed "cohlear- carotid interval" (CCI) by 64-slice multi-detector computed tomography (MDCT) in the population. The study investigated 1105 patients who had undergone temporal MDCT. The CCI measured by two observers from 0.5 mm thick coronal images with confirmation on axial and sagittal planes. Among 1105 patients and 2210 temporal sides CCI measured 0.0 mm unilaterally in eight (0.7%) and bilaterally in two patients (0.1%) with a score of ten in the total population (0.9%). Total scores ranged from 0.0 to 6 mm for right CCI and 0.0 to 5.9 mm for left CCI. The CCI showed no significant relationship with sex (P=.096) and there were no significant differences between readers (P=.457) and sides (P=.879). A positive correlation (r=0.741) was found between right and left CCI. The present study demonstrated that the CCI varies considerably between 0.0 mm and 6 mm independently of sex in the population. Understanding the importance of CCI and preoperative knowledge of thin or absent bone allows the radiologist to play a crucial role in alerting the surgeon to prevent penetration of the carotid canal during cochlear implant surgery.