Comparison of anthropometric and conic beam computed tomography measurements of patients with and without difficult intubation risk according to modified mallampati score: New markers for difficult intubation.

BACKGROUND: The aim of this study was to compare the anthropometric and cone beam computed tomography (CBCT) measurements taken from risk-free and risky groups by using the modified Mallampati score (MMS). PATIENTS AND METHODS: A total of 176 volunteers between the ages of 18 and 65 in four different MMS classes were included in the study. The patients in classes MMS I and MMS II were accepted as risk-free and the patients in classes MMS III and MMS IV were accepted as risky for intubation. The Mann-Whitney U test was performed on the data to compare the anthropometric and radiological measurements taken from the risk-free and risky groups. A receiver operating characteristic (ROC) analysis was applied to the parameters that had a statistically significant difference. RESULTS: According to the analysis results, statistically significant differences were found in the neck circumference (NC), maximum interincisal distance (MID), thyromental distance (TMD) and sternomental distance (SMD) of the anthropometric measurements of men and women between the risk-free and risky groups (P < 0.05). In terms of CBCT measurements, the thickness of the tongue (TT), distance between the uvula and posterior wall of pharynx (U-Ph), distance between posterior nasal spine and nasopharynx (Snp-Nph) and length of the epiglottis (LE) were found to have statistically significant differences between the risk-free and risky groups of men and women (P < 0.05). CONCLUSION: The NC, MID, TMD and SMD anthropometric measurements and TT, U-Ph, Snp-Nph and LE radiologic measurements were found to support MMS, which is one of the most widely used bedside intubation prediction tests. In addition to the inclusion of CBCT for intubation prediction, U-Ph and Snp-Nph radiologic measurements were added as difficult intubation markers.

Evaluation of maxillary sinus anatomical variations and pathologies in elderly, young, posterior dentate and edentulous patient groups with cone-beam computed tomography.

BACKGROUND: The aim of this study was to evaluate the frequency of maxillary sinus pathologies and anatomic variations in elderly and edentulous patients by using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: The study included elderly and young patient groups. The elderly group involved posterior edentulous and dentate patients. CBCT images were assessed, and the presence of any pathological findings, septa, accessory maxillary ostium, and Haller cell in each maxillary sinus were recorded according to the groups. Chi-square test was used to analyse the intergroup differences (p < 0.05). RESULTS: There was no statistically difference between the young and elderly groups regarding the presence of a pathology (p = 0.077) and septa (p = 0.37), whereas accessory ostium (p = 0.009) was more common and Haller cell (p = 0.000) was less common in the elderly group when compared to the young group. There was no significant difference between the edentulous and dentate group regarding the presence of a pathology (p = 0.39), septation (p = 0.69) and Haller cell (p = 0.75); accessory ostium rate was found to be increased (p = 0,015) in edentulous patients. CONCLUSIONS: It was observed that the frequency of accessory maxillary ostium was increased in elderly, especially in edentulism. And the frequency of Haller cell was found to be decreased in elderly patients.

Evaluation of localisation of mandibular foramen in patients with mandibular third molar teeth using cone-beam computed tomography.

BACKGROUND: It is important to know the correct anatomical location of the mandibular foramen to obtain successful anaesthesia of inferior alveolar nerve and to prevent injury to the mandibular vessels and nerve, during a variety of oral and maxillofacial surgical procedures. The aim of this study is to evaluate localisation of the mandibular foramen in patients with the third molars using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: Cone-beam computed tomography was used to determine the location of the mandibular foramen in 67 patients (totally 99 sides) with unilateral or bilateral impacted mandibular third molars. RESULTS: The distance from the posterior border of the mandibular ramus to mandibular foramen did not differ significantly among the other angulations. But the difference between vertical and horizontal angulation of the impacted mandibular third molars according to 'fd' values (the shortest distance between mandibular foramen and the posterior border of mandibular ramus) was found to be statistically significant (p < 0.05). CONCLUSIONS: The present study provides new information to the literature concerning relationship between the location of the mandibular foramen and the mandibular third molars.

Evaluation of the anatomical variation in the nasal cavity and paranasal sinuses of patients with cleft lip and palate using cone beam computed tomography.

OBJECTIVE: The aim of this study was to evaluate the frequency of anatomical variation in nasal cavity and paranasal sinuses by comparing a unilateral cleft lip and palate (UCLP) group with a non-syndromic control group using cone beam computed tomography (CBCT). SUBJECTS AND METHODS: This study included 24 UCLP patients in the UCLP group and 24 non-syndromic patients in the control group. Coronal CBCT images were taken in all patients and were evaluated for anatomical variation. The measurements obtained in this study were analysed using chi-square and Fisher's exact tests to compare the two groups statistically. RESULTS: In the UCLP group, there were statistically lower frequencies of pterygoid process pneumatisation (p<0.05), higher wing pneumatisation (p<0.05), and sphenoid sinus over pneumatisation (p<0.05), and statistically higher frequencies of anterior nasal septal deviation (p<0.05) compared to the control group. CONCLUSION: A higher incidence of anterior nasal septal deviation was found in UCLP patients compared to the patients in the control group. It is likely that for this reason, UCLP patients might be predisposed to sinusitis. In UCLP patients, the incidence of neurovascular structures in the sphenoid sinus was lower than that in non-syndromic control patients (Tab. 1, Fig. 6, Ref. 33).

Consanguineous marriages in the province of Antalya, Turkey.

To assess the trends in the frequency and the medical effects of consanguinity in the south coast of Turkish population using local and national data in the last 11 years. This cross-sectional study was carried out in Manavgat province, which is a major tourism center on the Mediterranean coast of Turkey. The authors studied consanguineous marriages in rural and urban population in the Mediterranean coast, Manavgat province, Turkey, via a 1500 random survey sample of married couples. There has been a significant increase in the incidence of consanguineous marriages in rural areas (40.7%) since 1989 in the southern population of Turkey. The results showed that the most frequent type of marriage was between the first cousins. It is found that there is no statistically significant difference between the consanguineous and non-consanguineous marriages in the different age groups. The results were discussed on the basis of educational status, reasons for having consanguineous marriages and the general medical effects as well as with the relation of congenital malformations. The custom of consanguineous unions in the Mediterranean population of Turkey is still extremely high, and preventive measures should be done to decrease its frequency and associated complications.

Diffuse malignant epithelial peritoneal mesothelioma in pregnancy. A case report and literature review.

A 33-year-old pregnant woman of 38 weeks' gestation with massive peritoneal ascites presented. A cesarean section was performed and a viable 3.100 g male infant was delivered. Biopsy of the nodular enlargements from the omentum revealed a malignant epithelial peritoneal mesothelioma. Malignant mesothelioma is a rare malignancy which has not been described in term pregnancy and appears to be unaffected by the pregnant state.

Health and social inequities in Turkey.

Social and economic policies of governments directly influence the health of the people. These policies, in turn, are determined by the national and foreign controllers of power. Economic and social factors in Turkey during the late 1970s led to a new modelling of the economic system, from a Keynesian to a market-oriented and monetarist model. The state mechanism was also altered to form a centralized, authoritarian regime in order to enforce the requirements of the economy. As a result, the middle class diminished in size, inequalities in income distribution increased, unemployment climbed, the purchasing power of wage earners decreased, government spending for education and health was cut and new oppressive laws were enacted. Health services were already urban-biased and hospital-oriented, but new free-market measures were instituted which promoted private health institutions and attempted to transform state-owned and financed hospitals into self-supporting, independent business enterprises. The only school of public health was closed down; preventive medicine expenditures were lowered while hospital rates and drug prices were increased. All these changes affected the health status of the population. Mortality and morbidity inequalities had already existed between the rich and the poor, men and women, urban and rural settlements, educated and illiterate, West and East, always in favour of the former. However, the new policies exacerbated the inequities. Infectious diseases including tuberculosis increased, nutrition worsened, occupational diseases and work accidents rose to be the highest in Europe. The power-holding minority is not interested in the health of populations and is committed to pursue its social and economic policies. Ad hoc research, especially cross-sectional mortality studies repeated at regular intervals can provide data on the most vulnerable groups as no other valid information exists. There is little hope of these data being used for intervention unless democratic changes take place.

The frequency and medical effects of consanguineous marriages in Antalya, Turkey.

We investigated 2604 marriages in Antalya, a region in the Mediterranean coast of Turkey. The 1020 urban and 1584 rural families included in the study were randomly selected and interviewed at their homes by one of the authors. The total consanguinity was 35.2%, rates being 39.6 and 28.3% for rural and urban areas, respectively. The frequency of consanguinity in different age groups did not vary whereas level of education of the women appeared to have a negative correlation. Family pressure and love were stated as the main reasons for marrying with a relative. Differences were observed between consanguineous and non-consanguineous marriages in sterility, infant death, spontaneous abortion, child death and congenital malformations, these being significantly higher in consanguineous matings. Data from similar Turkish studies are also presented and discussed.