Evaluation of Eustachian tube dimensions by temporal bone computed tomography in patients with chronic otitis media.

OBJECTIVE: To clarify the relationship between Eustachian tube dimensions and chronic otitis media aetiology using temporal bone computed tomography. METHODS: The data of 231 adults who had undergone surgery for unilateral chronic otitis media were reviewed retrospectively. Diseased and healthy ears were enrolled in groups 1 and 2, respectively. Group 1A included chronic otitis media with cholesteatoma (n = 28) and group 1B included chronic otitis media without cholesteatoma (n = 203). The Eustachian tube dimensions of groups 1 and 2 were compared, to clarify the relationship between the Eustachian tube dimensions and chronic otitis media aetiology. Groups 1A and 1B were compared to assess the effect of Eustachian tube dimensions on cholesteatoma development. RESULTS: The Eustachian tube was shorter, narrower and located more horizontally in ears with chronic otitis media. No significant difference was found between groups 1A and 1B. CONCLUSION: Eustachian tube dimensions are closely related to chronic otitis media aetiopathology, but are not related to cholesteatoma development.

Utilizing shear wave elastography for the evaluation of optical nerve involvement in Behçet's disease.

In this study, we investigated the elasticity of the optic nerve using shear wave elastography (SWE) in patients with Behçet's Disease (BD) and compare findings with a healthy control group. Optic nerve measurements of 40 eyes in the BD group and 38 eyes in the control group were performed by SWE (SWE-right and SWE-left). The mean age of the individuals in the BD group was higher than controls (p = 0.022). The SWE measurement results in the right eye were significantly higher in the BD group (p = 0.005), while SWE-left values were similar in the two groups (p = 0.206). There was a moderate positive correlation between age and SWE-right (r = 0.347, p = 0.031), there was no correlation between SWE-left and age (p = 0.756). It was found that SWE-right had significant value in distinguishing between BD and healthy controls (sensitivity: 75%, specificity: 78.9%; p = 0.005); whereas, SWE-left did not (p = 0.206). In the multiple logistic regression analysis, after adjusting for age and sex, the performance of SWE-right to distinguish BD patients from controls was found to remain significant (OR: 15.045, 95% CI: 2.33-97.120, p = 0.004). Due to the fact that only SWE-right values appear to have significant discriminatory performance for BD, it is feasible to suggest that the frequency and severity of BD involvement are associated with SWE-related changes in the optic nerve. This finding indicates the need for more comprehensive studies evaluating optic nerve SWE values in this context.

Prepontine and Meckel's Cave Dermoid Cyst: MR and CT Findings with Literature Review.

Dermoid cysts (DCs) are benign, congenital tumors that comprise 0.04-0.6% of all intracranial tumors. DC rupture is a rare complication and usually occurs spontaneously. The most common localisations of intracranial DCs are the posterior fossa, and suprasellar and parasellar regions. The presentations of DCs are highly variable. They are often detected incidentally on computed tomography (CT) or magnetic resonance imaging (MRI) scans while investigating the cause of seizure or headache. Prepontine cystern is a rare localisation for intracranial DCs. To the best of our knowledge, only four cases have been reported in the literature so far. We present MRI and CT findings of a patient with DC, which ruptured into the subarachnoid space extending from the right Meckel's cave to the prepontine cistern. Key Words: Dermoid cysts, Meckel's cave, Prepontine cistern, Rupture.

Shear-Wave Elastography of Patellar Ligament and Achilles Tendon in Semiprofessional Athletes: Comparing With Nonexercising Individuals.

OBJECTIVES: To compare semiprofessional athletes and nonexercising individuals in terms of p-SWE properties of the patellar ligament and the Achilles tendon. METHODS: This case-control study was conducted in University of Health Sciences, Haseki Education and Research Hospital. A total of 58 individuals, with 29 in each group (according to power analysis), were included in the study. All relevant findings, including demographic characteristics, body mass index (BMI), and exercise (km run per week, km/w) were recorded. The MyLab 9 (Esaote, Genova, Italy) device was used for SWE. The QElaXto-p-SWE software was utilized for P-SWE interpretation and analyses. RESULTS: The mean age was 47.21 ± 12.16 years (range 22-70). Weight (P = .001) and BMI (P < .001) values were significantly higher in the nonathlete group than in the athlete group. There were no significant differences between groups in terms of age, gender, and height. Median SWE values of bilateral patellar ligaments (P < .001 and P < .001) and bilateral Achilles tendons (P < .001 and P < .001) were significantly higher in the athlete group than in the nonathlete group. CONCLUSIONS: We revealed normal p-SWE characteristics for the patellar ligament and Achilles tendon, which are frequently injured in athletes. These scores are important in early detection and follow-up of injuries in athletes.

Sacralization may be associated with facet orientation and tropism but not degenerative changes of the lumbar vertebrae.

PURPOSE: In this retrospective study, we aimed to investigate the possible effects of transitional vertebra anatomy on facet joint tropism and orientation by evaluating lumbar magnetic resonance imaging (MRI) studies performed at our institution. MATERIAL AND METHODS: We included 84 patients with sacralization of the L5 vertebra and an equal number of patients with a radiology report within normal limits as the control group in our study. We compared facet tropism (FT) and orientation between both groups. RESULTS: In both the sacralization group and the control group, the facet orientation angle showed a significant increasing trend from the L1-L2 level to the L5-S1 level (p < 0.001). The orientation angle of the L5-S1 level was higher in the sacralization group compared to the control group (p < 0.01). In the evaluation of FJ orientation between the sacralization and control groups, we found that coronal orientation was significantly more frequent at the L5-S1 level in the sacralization group. When the 2 groups were compared with regard to tropism at each spinal level, the sacralization group had a significantly higher FT frequency at the L5-S1 level (p < 0.001). CONCLUSIONS: To our knowledge, this is the first study to evaluate the relationship between sacralization and facet joint tropism. However, there were no relationships between facet degeneration, disc degeneration/herniation, and sacralization. Our results indicate that, although patients with sacralization and controls had similar characteristics in most assessments, they demonstrated significant differences at the L5-S1 level in terms of orientation and tropism.

Using CT scout view to scan illicit drug carriers may reduce radiation exposure.

OBJECTIVE: The aim of this study was to present our experience on the evaluation of suspected illicit drug carriers via computerized tomography scout view (CTSV) with analysis of detectability and features such as content, form and density. METHODS: A total of 120 individuals suspected of body packing were screened via CT in a university emergency department between January 2014 and December 2017. RESULTS: 88.3% of 120 body packing cases examined in the study were male. The median (1st quartile-3rd quartile) age of the cases was 35.5 (30-41) years. We found that solid packs have a 4.573-fold higher likelihood of detection in CTSV screening than liquid ones (95%CI: 1.879-11.134). Additionally, the number of CT scans needed were significantly associated with capsule localization (stomach) (OR:7.178, 95%CI: 2.420-21.293) and solid form packs (OR: 8.705, 95%CI: 2.318-32.692) are associated with number of CT scans. CONCLUSION: CTSVs have a successful detection rate, especially in solid form packs. Our results suggest that conclusive CTSV imaging for body packing may be recommended to delay the application of the next CT scan until the passage of the first capsule; thereby preventing unnecessary radiation exposure.

Eustachian tube diameter: Is it associated with chronic otitis media development?

OBJECTIVE: To evaluate the effect of ET diameter on Chronic Otitis Media (COM) pathogenesis. STUDY DESIGN: Retrospective. SUBJECTS AND METHODS: Patients with unilateral COM disease are included in the study. The connection between fibrocartilaginous and osseous segments of the Eustachian Tube (ET) on axial Computed Tomography (CT) images was defined and the diameter of this segment is measured. The measurements were carried out bilaterally and statistically compared. RESULTS: 154 (76 (49%) male, 78 (51%) female patients were diagnosed with unilateral COM and included in the study. The mean diameter of ET was 1947mm (Std. deviation±0.5247) for healthy ears and 1788mm (Std. deviation±0.5306) for diseased ears. The statistical analysis showed a significantly narrow ET diameter in diseased ear side (p<0.01). CONCLUSION: The dysfunction or anatomical anomalies of ET are correlated with COM. Measuring of the bony diameter of ET during routine Temporal CT examination is recommended for our colleagues.

Potential role of electrostimulation in augmentation of venous blood flow after total knee replacement: A pilot study.

AIM: To investigate the potential role of a novel electrostimulation device in augmenting the femoral vein venous blood flow following total knee replacement surgery. MATERIAL AND METHODS: A total of 30 consecutive patients undergoing total knee replacement were allocated to receive either peroneal nerve electrostimulation plus low molecular weight heparin and below-knee compression stockings (Group 1, electrostimulation group, n = 15, mean age: 63.40 ± 5.91 years, male: female ratio 9:6) or low molecular weight heparin and below-knee compression stockings alone (Group 2, control group, n = 15, mean age: 63.86 ± 7.47 years, male: female ratio 8:7). Electrostimulation was performed for 1 h in every 4 h after the operation. Peak blood velocity in the femoral vein was evaluated with Duplex ultrasonongraphy in supine position. Presence of leg edema and calf diameter was also taken into consideration as outcome measures, which were recorded both before surgery and at the time of discharge from hospital. RESULTS: Postoperative peak blood flow velocity in the femoral vein was significantly higher in electrostimulation group compared to control group (17.46 ± 2.86 cm/s vs. 13.84 ± 3.58 cm/s, p < 0.02). Electrostimulation group achieved a significant increase in peak blood flow velocity in the femoral vein after the operation (mean increase 67.48 ± 17.38%, p < 0.001). CONCLUSION: Electrostimulation of the common peroneal nerve enhanced venous flow in the lower limb and may potentially be of use as a supplementary technique in deep venous prophylaxis following lower limb orthopedic operations.

A rare cause of chronic cough: intrathoracic gossypiboma.

Intrathoracic gossypiboma, a retained surgical sponge in the thoracic cavity, is a rare but serious complication of thoracic surgeries. A 70-year-old man presented with an eight-month history of cough. He had undergone coronary artery bypass surgery eight years ago. The posteroanterior chest X-ray revealed a well-marginated homogeneous opacity at the left hemithorax with striped appearance in the center. Thoracic CT revealed a pleural-based mass at the left lower lobe with a hyperdense rim. After the diagnosis of gossypiboma, it was removed surgically. Although rare after thoracic surgery, gossypibomas need to be considered in the differential diagnosis in case of respiratory symptoms.

Primary orbital hydatid cyst: computed tomography and magnetic resonance imaging findings.

Orbital hydatid cyst is a rare form of hydatidosis, comprising less than 1% of all hydatid cysts reported. The first choice of treatment for orbital hydatid cyst is surgery. Preoperative diagnosis is important, so as to avoid rupture of the cyst and prevent the spread of the parasitic disease. Herein, we present the computed tomography and magnetic resonance imaging findings of a case of primary orbital hydatid cyst.

Atherosclerosis in male patients with ankylosing spondylitis: the relation with methylenetetrahydrofolate reductase (C677T) gene polymorphism and plasma homocysteine levels.

The aim of this study was to determine the intima-media thickness (IMT) in carotid arteries and to assess the relation of these values with plasma homocysteine (pHcy) levels and methylenetetrahydrofolate reductase (MTHFR) C677T gene polymorphism in patients with Ankylosing spondylitis (AS). Serum lipids, vitamin B12, folic acid, pHcy and acute phase protein levels were measured in all cases. MTHFR C677T gene polymorphisms were determined, and IMT of main carotid artery were evaluated ultrasonographically in all subjects. Bath Ankylosing Spondylitis Disease Activity Index, Ankylosing Spondylitis Disease Activity score and Bath Ankylosing Spondylitis Metrology Index were used to assess disease activity and spinal mobility. Fifty AS patients (mean age of 36.6 ± 4.79 years) and 50 control subjects (36.34 ± 4.72 years) were included in the study. Plasma homocysteine levels of AS patients and control group were also similar (14.26 ± 9.96 vs. 11.81 ± 5.53 µmol/L). Hyperhomocysteinemia was present in 11 subjects in patient group (22.0 %), while it was seen in 5 subjects in the control group (10.0 %). The MTHFR C677T genotype distribution was as follows: CC 31 (62 %), CT 14 (28 %), TT 5 (10 %) in AS patients. The mean carotid IMT values were also found to be similar between the groups. The most important factor influencing pHcy level was found as MTHFR 677TT genotype. We indicated no difference of atherosclerosis indices revealed by IMT values and pHcy levels AS patients and control subjects. But an association between MTHFR 677 gene polymorphism and pHcy levels was concluded, which may suggest that MTHFR 677 TT polymorphism may be a potential prognostic factor for cardiovascular disease in patients with AS.

Anatomical variations in branching pattern of arcus aorta: 64-slice CTA appearance.

PURPOSE: To review the 64-slice CTA (computed tomography angiography) appearance of anatomical variations in branching pattern of the arcus aorta, and to determine their prevalence in 1001 cases. MATERIALS AND METHODS: 1001 cases that underwent carotid CTA (performed by a 64-slice scanner) were included in the study. RESULTS: Seven types of aortic arch were found. In 853 cases (853/1001, 85.2 %) classical branching pattern of arcus aorta (three branches; TB, LCC, LS) was observed. Variations were present in 147 cases (147/1001, 14.7 %). One case (1/1001, 0.1 %) had right aortic arch. The most frequent variation was origination of LCC from TB (arch with 2 branches, TB with LCC and LS) which was observed in 78 cases (78/1001, 7.8 %). Origination of LV directly from the aortic arch (four branches; TB, LCC, LV, LS or TB, LCC, LS, LV) was observed in 51 cases (51/1001, 5.1 %). In two cases (2/1001, 0.2 %) truncus bicaroticus (3 branches; RS, common trunk for carotids, LS) was present. In seven cases (7/1001, 0.7 %) aortic arch had four branches in the order of RCC, RS, LCC and LS. In one case (1/1001, 0.1 %) left truncus brachiocephalicus (three branches; RS, RCC, LTB) was present. Seven cases (7/1001, 0.7 %) had aberrant RS (RCC, LCC, LS, RS). CONCLUSION: Variations in branching pattern of arcus aorta are not rare and being aware of them before surgical and interventional procedures of this region is important. CTA can depict the anatomical features of the aortic arch and is valuable as a road map.