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Background: Percutaneous transhepatic biliary drainage (PTBD) is a common procedure for biliary obstruction jaundice caused by biliary tract obstruction. PTBD can be performed using external or external-internal methods, by the right or left lobe approach. However, differences in both the method used and the hepatic approach may affect success rates and complications. Therefore, this study aimed to examine the outcomes and complications of PTBD and compare them according to different methods and hepatic approaches., Methods: Patients who underwent PTBD procedures in our interventional radiology department due to benign or malignant pathologies between March 2021 and March 2024 were included in the study. The diagnoses of the patients, and total and direct bilirubin values before and after the procedure were recorded. The clinical results and the complications of PTBD were compared statistically according to the hepatic approach and method. Univariate logistic regression analysis was performed to determine significant factors associated with PTBD success and complications., Results: Sixty patients were included in our study (32 men, 28 women; mean age: 67.14±13.61 y). The most common indication was malignant bile duct obstruction (90%). The obstruction was mostly at the level of the common bile duct (46.7%). The success rate of PTBD was the highest with the left-side external biliary drainage approach (left-side external biliary drainage, 81.2%; right-side internal-external biliary drainage, 77.8%; right-side external biliary drainage, 69.2%; P=0.596). The complication rate was higher for right-side access (right side 15.9%, left side 12.5%, P=0.744). Univariate logistic regression analysis revealed that PTBD success in females was 5 times higher than in males [Exp(B): 5.000, β: 1.609, P<0.05]. Univariate logistic regression analysis revealed that methods used, entry lobes, and entry levels did not significantly affect PTBD success and complication incidence (P>0.05)., Conclusion: All approaches and methods used during PTBD were associated with low complications and high success rates. Nevertheless, external biliary drainage with right hepatic access has the lowest clinical success rate and a higher complication rate than the left-lobe approach. We observed that left-sided external biliary drainage was the most successful method and had fewer complications., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objectives: We investigated volumetric changes in buccal fat pad (BFP) in age groups and sexes by cranial or neck computed tomography (CT) or cranial CT angiography., Methods: One hundred twenty patients underwent cranial or neck CT examinations or cranial CT angiography were retrospectively screened: 18-29 years old (group 1), 30-49 years old (group 2), and 50 years and older (group 3). Left buccal fat tissue measurements were performed in age groups, sexes, and body mass index (BMI) groups., Results: Left buccal fat volume in the 30-49 age group and the ≥50 age group was significantly higher than that in the 18-29 age group (P < 0.05). Across all groups and specifically within the 18-29 age group, females exhibited significantly lower buccal fat volume than males (P < 0.05). The left buccal fat volume of individuals classified as overweight and obese was significantly higher than that of the underweight and normal weight groups. There was a negative relationship between buccal fat volume and fat density. Moreover, as age increased, within age groups 1 to 3, there was a notable increase in body weight, body length, BMI, and BMI groups (underweight and normal weight to obesity), accompanied by a significant rise in buccal fat volume. Conversely, fat density exhibited a significant decrease with advancing age., Conclusions: Buccal fat volume, localized in the middle third of the face, increased with aging and increasing BMI values. Young females had lower buccal fat volume. Buccal fat tissue volume is important in facial rejuvenation procedures such as facial filler applications., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

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., (Copyright © 2023. Published by Elsevier Ltd.)

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.

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.

Objectives: We investigated senile volume and density changes in infraorbital fat to evaluate by computed tomography (CT)., Methods: CT examinations of a total of 120 patients (60 males and 60 females) were included in 3 age groups: 18-29 (group 1), 30-49 (group 2), and 50 years and older (group 3). Body weight and height and BMI were recorded, and infraorbital fat tissue volume and density were measured on CT., Results: Body weight and BMI of ≥50 years of age were significantly higher than the younger ones. In overweight and obesity groups, infraorbital fat volume increased and density decreased compared to the underweight and normal weight groups. In ≥50 years of age group, infraorbital fat volume was higher; density was lower than 18-29 years of age. Female's infraorbital fat volume was higher; density was lower than males. In each age group, the infraorbital fatty tissue density of the females was significantly lower than those in the males. There was a negative correlation between infraorbital fat volume and density. In older patients and as age groups, body weight and BMI increased, infraorbital fat volume increased, and infraorbital fat density decreased., Conclusion: By aging, BMI and body weight and infraorbital fat volume increased, and infraorbital fat density decreased, especially at ≥50 years of age that is thought to be one of the factors that play a role in the downward bulging of infraorbital fat tissue. Females' higher infraorbital fat volume and infraorbital fat density may be a reason for the females' bulging in the infraorbital fat region., Competing Interests: Declaration of Competing Interest The author MehmetHamdi ŞAHAN declares that he has no conflict of interest. The author Nuray BAYAR MULUK declares that she has no conflict of interest. The author Melih AKŞAMOĞLU declares that he has no conflict of interest., (Copyright © 2022 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)

Objectives: In the present study, we investigated the distance between adenoid tissue and internal carotid artery (ICA) in children with adenoid hypertrophy by magnetic resonance imaging., Methods: Cranial magnetic resonance images of 200 children with adenoid hypertrophy between the ages of 5 and 15 were included. In group 1 (5-9 years of age), there were 100 children, and in group 2 (10-15 years of age), there were 100 children. In both groups, adenoid thickness, adenoid/nasopharynx) ratio, and superior, middle, and inferior adenoid-ICA distances were measured., Results: Adenoid thickness is significantly higher in the 10-to-15 years age group than in the 5-to-9 years age group (P < 0.05). Adenoid-ICA distance got lower from the superior to the inferior part in both age groups and in both sexes: inferior < middle < superior adenoid-ICA distance. In the 5-to-9 years age group, the minimum adenoid-ICA distances were 2.40 mmsuperior, 0.90 mmmiddle, and 1.20 mminferior. In 10-to-15 years age group, the minimum adenoid-ICA distances were 2.50 mmsuperior, 1.00 mmmiddle, and 0.90 mminferior. As adenoid thickness increased, the inferior adenoid-ICA distance decreased bilaterally (P < 0.05). As the age got older, adenoid thickness increased, and the left superior and middle adenoid ICA distances and bilateral inferior adenoid-ICA distances decreased (P < 0.05)., Conclusion: The distance between adenoid and ICA decreased from superior to inferior. In 10- to 15-year-old children, the distance between adenoid and ICA was determined as lower than in the 5- to 9-year-old children. The minimum distances between adenoid and ICA were found to be between 0.9 and 2.5 mm in the 10-to-15 age group and between 0.9 and 2.4 mm in the 5-to-9 age group. It should be remembered that ICA can be very close to the adenoid tissue. In addition, because thermal injury can cause deeper damage to the tissue, bipolar cautery should be used with caution in this area and unipolar cautery should not be used., Competing Interests: The authors declare no conflict of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Objective  We investigated the effects of vitamin D deficiency in the peripheral and central smell regions by magnetic resonance imaging (MRI). Methods  This retrospective study included 29 patients (12 males, 17 females) with 25-dihydroxy vitamin D3 [25(OH) 2 D 3 ] deficiency (group 1) and 34 subjects without 25(OH) 2 D 3 deficiency (14 males, 20 females) (group 2). Using cranial MRIs, the peripheral (olfactory bulb [OB] volume and olfactory sulcus [OS] depth) and central (insular gyrus and corpus amygdala) smell regions were evaluated. Results  The OB volume and OS depth values of the 25(OH) 2 D3 deficiency group were significantly lower than those of the control group ( p  < 0.05). For the central smell regions, the insular gyrus and corpus amygdala areas of the 25(OH) 2 D3 deficiency group were nonsignificantly lower than those in the control group ( p  > 0.05). There were positive correlations between OB volumes, OS depths, and insular gyrus and corpus amygdala areas bilaterally in the 25(OH) 2 D3 deficiency group separately and in all subjects (groups 1 and 2) ( p  < 0.05). In the 25(OH) 2 D3 deficiency group, as the 25(OH) 2 D3 values became lower, the insular gyrus area values decreased bilaterally ( p  < 0.05). In females, the corpus amygdala area values were lower than in males ( p  < 0.05). Conclusion  Since vitamin D3 deficiency affected the peripheral and central smell regions negatively, we recommend evaluating patients' vitamin D levels as a health policy to prevent vitamin D3 deficiency-related cranial smell region problems. Moreover, sunlight exposure is very important to increase vitamin D levels, and the public should be informed about this topic., Competing Interests: Conflict of Interest None declared., (Thieme. All rights reserved.)

Objectives: The aim of this study is to investigate the scutum-cochleariform process (CP) and scutum-promontorium distances according to the mastoid pneumatization condition., Methods: Two hundred temporal multidetector computed tomography scans (90 males and 110 females) were evaluated retrospectively. The scutum-CP and scutum-promontorium distances were measured. Facial canal dehiscence (FCD) in the tympanic segment and mastoid pneumatization were also evaluated., Results: The distances between scutum-CP and scutum-promontorium were not different between males and females and between right and left sides. Facial canal dehiscence in the tympanic segment was detected: 5.6% (right) and 7.8% (left) in males and 5.5% (right) and 10.0% (left) in females. Grade 4 (100%) pneumatization was detected mainly in 55.6% to 57.8% of the patients in both genders. Grade 0 (0%) pneumatization (sclerosis) was detected in 22.2% to 28.2% of both males and females. In more pneumatized mastoids, the scutum-CP and scutum-promontorium distances increased. In sclerotic mastoids, the scutum-CP and scutum-promontorium distances decreased. Facial canal dehiscence rates were not related to the mastoid pneumatization levels., Conclusion: Cochleariform process is an important landmark to localize the tympanic segment of the facial canal. In sclerosed mastoids, scutum-CP and scutum-promontorium distances decreased. There was no relationship between FCD rates and mastoid pneumatization levels. It may be due to the development of FCD that occurs during the intrauterine period. In endoscopic and classic ear surgeries, mastoid pneumatization must be evaluated preoperatively to avoid facial nerve injuries.

Background/aim: The aim of this study was to compare renal and pancreatic apparent diffusion-coefficient (ADC) values of diabetic patients and control subjects and to examine their potential association with several diabetes-related clinical parameters., Materials and Methods: A total of 80 sex- and age-matched patients were included in the study. Of them, 40 were patients with type 2 diabetes and 40 were nondiabetic participants. Abdominal diffusion-weighted MRIs of both groups were retrospectively reviewed. Diabetes-related clinical parameters were recorded., Results: The difference between the mean ADC values of the patient group and the control group was significant (p = 0.012). It was also found that the mean pancreatic ADC values of diabetic patients and the control group significantly differed (p = 0.02). Besides, there were positive correlations between the mean pancreatic ADC values and age, Hb1Ac level, treatment type, and disease duration (p < 0.05). While eGFR values positively correlated with the mean renal ADC values (p < 0.05), there were negative correlations between such values and age, serum creatinine level, and disease duration (p < 0.05)., Conclusion: Renal and pancreatic ADC values of diabetic patients could potentially play a role, as markers of renal and pancreatic functions, in clinical decisions in the follow-up of such patients., (This work is licensed under a Creative Commons Attribution 4.0 International License.)

Purpose: The purpose of this study was to describe the elastic properties of the medial rectus muscle and optic nerve in Graves' patients without clinically apparent ophthalmopathy using strain elastography (SE) and shear wave elastography (SWE) and to determine whether these elastic properties could be used to aid in the diagnosis of the medial rectus muscle or optic nerve involvement., Materials and Methods: Thirty participants diagnosed with Graves' disease without ophthalmopathy and 30 healthy volunteers (control group) were prospectively examined between November 2018 and August 2019. SE and SWE findings in both groups were compared using the χ 2 test and the independent samples t test., Results: A statistically significant softening of the medial rectus muscle was observed in the SE patterns of the Graves' patients (p = 0.009). A statistically appreciable distinction was observed between the medial rectus muscle (7.64 ± 2.1 and 9.20 ± 1.7 kPa, p = 0.000) and the optic nerve (8.35 ± 2.8 and 9.37 ± 1.5 kPa, p = 0.019) in the SWE modulus of the Graves' patients and healthy volunteers., Conclusion: SE and SWE can be used to identify structural alterations to the medial rectus muscle and optic nerve before clinically apparent Graves' ophthalmopathy has developed.

Objectives: The presence of the internal carotid artery (ICA) near tonsils can also cause severe bleeding during a tonsillectomy. We investigated the relationship between tonsil width and volume; and superior, middle and inferior tonsil-ICA distances in 5-9 and 10-15 years of age children., Methods: Cranial MRI images of 200 children between 5 and 15 years of age were evaluated retrospectively. There were 100 children in group 1 (5-9 years of age) and 100 children in group 2 (10-15 years of age). Palatine tonsil width and volume; and superior, middle and inferior tonsil-internal carotid artery (ICA) measurements were performed bilaterally., Results: Our results showed that bilateral tonsil width and volume; and left superior, middle and inferior tonsil-ICA distance of 5-9 years of age group were lower than those of the 10-15 year-of age group (p < 0.05). The nearest distance between ICA and palatine tonsil is at the inferior tonsil-ICA distance side in both age groups. Especially mean inferior and middle tonsil-ICA distances were lower than 8 mm in 5-9 years of age group and lower than 9 mm in 10-15 years of age group. Minimum middle tonsil-ICA distances were 2.0-2.50 mm in smaller children and 2.0-3.50 mm in older children. Similarly, the minimum inferior tonsil-ICA distances were 2.00 mm in smaller children and 2.20-3.00 mm in older children. There were positive correlations between tonsil width, volume, and superior tonsil-ICA distance; and middle and inferior tonsil-ICA distances (p < 0.05)., Conclusion: In younger children, lower tonsil width; and in all children, lower tonsil volume can be a warning sign in terms of lower tonsil superior-ICA distance. During tonsillectomies, working at the middle and inferior tonsillary fossa, maximum attention must be performed for the possibility of the ICA being very closer to the tonsil to avoid unwanted bleedings., (Copyright © 2020 Elsevier B.V. All rights reserved.)

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., (Copyright © 2020 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.)

Objective  Tegmen tympani dehiscence in temporal multidetector computed tomography (MDCT) and superior semicircular canal dehiscence may be seen together. We investigated superior semicircular canal dehiscence in temporal MDCT and temporal magnetic resonance imaging (MRI). Methods  In this retrospective study, 127 temporal MRI and MDCT scans of the same patients were reviewed. In all, 48.8% ( n  = 62) of cases were male, and 51.2% ( n  = 65) of cases were female. Superior semicircular canal dehiscence and superior semicircular canal-temporal lobe distance were evaluated by both MDCT and MRI. Tegmen tympani dehiscence was evaluated by MDCT. Results  Superior semicircular canal dehiscence was detected in 14 cases (5.5%) by temporal MDCT and 15 cases (5.9%) by temporal MRI. In 13 cases (5.1%), it was detected by both MDCT and MRI. In one case (0.4%), it was detected by only temporal MDCT, and in two cases (0.8%), it was detected by only temporal MRI. Median superior semicircular canal-to-temporal distance was 0.66 mm in both males and females in temporal MDCT and temporal MRI. In both temporal MDCT and temporal MRI, as superior semicircular canal-to-temporal lobe distance increased, the presence of superior semicircular canal dehiscence in temporal MDCT and temporal MRI decreased. Tegmen tympani dehiscence was detected in eight cases (6.3%) on the right side and six cases (4.7%) on the left side. The presence of tegmen tympani dehiscence in temporal MDCT and the presence of superior semicircular dehiscence in MDCT and MRI increased. Conclusion  Superior semicircular canal dehiscence was detected by both MDCT and MRI. Due to the accuracy of the MRI method to detect superior semicircular dehiscence, we recommend using MRI instead of MDCT to diagnose superior semicircular canal dehiscence. Moreover, there is no radiation exposure from MRI., Competing Interests: Conflict of Interest None declared., (Thieme. All rights reserved.)

Objectives: In the present study, we investigated whether mastoid pneumatization affects facial canal dimensions and distances of facial tympanic segment and scutum, and lateral semicircular (LSS) canal and scutum., Methods: One hundred sixty-one temporal multidetector computed tomography scans were reviewed. Patients with unilateral sclerotic mastoid pneumatization (no aeration) (group 1, n = 81) and unilateral total mastoid pneumatization (100.0% aeration) (group 2, n = 80) were included. Facial canal dimensions at the labrythine, tympanic, and mastoid segments; facial canal dehiscence and length; and facial tympanic segment-scutum and LSS canal-scutum distances were evaluated., Results: In the present study, facial canal dimensions of labyrinthine, tympanic, and mastoid segments in total pneumatized mastoid group were significantly lower than sclerotic mastoids on axial and coronal images (P < 0.05). Facial tympanic segment and scutum distance of the sclerotic mastoid group was significantly lower than those of the total pneumatized mastoid group (P < 0.05). However, LSS canal-scutum distance was not different between both groups (P > 0.05). The LSS canal-scutum distance of the females was lower than those of the males (P < 0.05). Facial canal dehiscence ratio was 11.3% and 11.1% in sclerotic and total pneumatized mastoids, respectively. The mean ± SD length of the dehiscence was 2.46 ± 1.29 mm in pneumatized mastoids and 1.92 ± 0.68 mm in sclerotic mastoids., Conclusions: In cholesteatoma cases, scutum erosion may occur. Because facial tympanic segment and scutum distance decreased in sclerotic mastoids compared with completely pneumatized ones, maximum care must be taken in the operations for avoiding to damage facial canal and nerve. Revision cases may be more difficult because of distorted anatomy. However, in pneumatized mastoids, the mean length of the facial canal was more than 2 mm, which must be kept in mind during operations.

We investigated the sonoelastographic features of the lower lateral nasal cartilage lateral crus (LLNC-LC), auricular conchal cartilage (ACC), and costal cartilage (CC). In this prospective study, group 1 consisted of 60 participants (30 males and 30 females) between 18 and 35 years of age. Group 2 consisted of 60 participants (30 males and 30 females) between 35 and 50 years of age. Strain elastography (SE) and shear wave elastography (SWE) were performed. For all LLNC-LCs and ACCs, type I SE was detected more in group 2, type II SE was detected more in group 1, and type III SE was detected more in group 1 ( p  < 0.05). For CC, type I SE was detected more in both groups ( p  < 0.05). For LLNC-LC, type I SE was detected more in males compared with females in both groups ( p  < 0.05). For all LLNC-LC, ACC and CC, the SWE modulus of group 2 was significantly higher than that of group 1 ( p  < 0.05). In older participants, the SWE modulus increased. We recommend using ACC mainly in rhinoplasty operations for primary and revision cases as its SWE modulus is similar to that of the LLNC-LC. However, due to the higher SWE modulus of CC, CC grafts should not be used as the first choice in rhinoplasties, especially in the reconstruction of the nasal tip contour, but may be used in nasal dorsum augmentation., Competing Interests: None declared., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)

Aim: To investigate the utility of strain elastography and shear-wave elastography for assessing optic nerve involvement in pre-eclampsia., Material and Methods: A total of 120 eyes were evaluated in 60 cases consisting of 30 participants in the pre-eclamptic and 30 participants in the non-pre-eclamptic pregnant patient group. The findings of strain and shear-wave elastography, grey-scale sonography, and optical coherence tomography were compared between the groups., Results: There was a statistically significant difference for the average shear-wave elastography values between groups (17.6±4.1 and 9.4±2 kPa, p<0.01). The analysis of the strain elastography types also revealed a statistically significant difference between the groups (p<0.01). A statistically significant difference was found for the average values of the optic nerve sheath diameter between the two groups (p<0.05). A statistically significant difference was found in the average value of the superior quadrant of the retina nerve fibre layer between the groups in optical coherence tomography analysis (p=0.04). The peripapillary choroidal thickness values of pre-eclamptic pregnant women were higher than that of non-pre-eclamptic pregnant women, but the difference was not significant (p>0.05)., Conclusion: Stiffness of the optic nerve was greater in patients with pre-eclampsia in the study. Elasticity changes in the optic nerve may be generally attributed to microvascular and biomechanical changes secondary to increased hypertension in pre-eclamptic patients. Elastography could be used as assistive diagnostic techniques to evaluate the optic nerve structure changes in pre-eclampsia., (Copyright © 2019 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.)

Objectives: The authors investigated the olfactory fossa (OF) in patients with unilateral nasal septal deviation (NSD) and presented the lateral lamella-cribriform plate angle (LLCPA)., Methods: Paranasal sinus computed tomography images of 300 adult subjects with unilateral NSD (111 males, 189 females) were evaluated retrospectively. Septal deviation angle (SDA), Keros Classification, OF depth and width, LLCPA; and orbital plate and cribriform plate (OPCP) distance were measured., Results: The OF depth values (ipsilateral, contralateral) were found as Keros III >Keros II >Keros I (Padjusted <0.0175). The OF width values (ipsilateral) were detected as Keros I >Keros II and Keros I >Keros III (Padjusted <0.0175). In patients with higher SDA values, ipsilateral OF depth values decreased (P <0.05). The LLCPA and OPCP values were higher in Keros I and lower in Keros III (P <0.05)., Conclusion: In patients with lower LLCPA and OPCP, endoscopic sinus surgery will be more dangerous for trauma to lateral lamella and intracranial penetration.

Objectives: We investigated unilateral and bilateral cervical internal carotid artery (ICA) stenosis according to the North American Symptomatic Carotid Endarterectomy Trial (NASCET) and the European Carotid Surgery Trial (ECST)., Methods: We retrospectively investigated ICA stenosis on Head&Neck Computed Tomography Angiography (CTA); and their simultaneous brain computed tomography images were also evaluated. In unilateral ICA stenosis group (n=36), 17 of them had right ICA stenosis and 19 left ICA stenosis. In bilateral stenosis group, there were 24 patients. ICA stenosis was evaluated according to NASCET and ECST methods. We also evaluated vertebral artery dimension, plaque density and cerebral infarct (Cerebral kortex, white matter, basal ganglion-thalamus)., Results: Unilateral ICA stenosis according to the NASCET was 70.64% to 73.68% (right-left) and according to the ECTS was 65.52% to 71.15% (right-left). For bilateral stenosis, ICA stenosis according to the NASCET was 67.70 to 67.91 (right-left); according to the ECTS was 62.45% to 62.15% (right-left). Vertebral artery dimensions were 3.26 to 3.72 mm (right-left) in unilateral ICA stenosis; and 3.52 to 3.71 mm (right-left) in bilateral ICA stenosis. In bilateral stenosis group, mixt plaque; and in unilateral stenosis group, hard plaque was detected. In unilateral stenosis, white matter and basal ganglion-thalamus infarcts; in bilateral ICA stenosis, cerebral cortical infarct was detected. Left-vertebral artery diameter increased in higher L-ECTS ICA stenosis (unilateral) group., Conclusion: Increase in left vertebral artery diameter in unilateral L-ECTS ICA stenosis may be related to increase of the collateral flow by vertebral arteries to support brain blood-flow.

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.

In the present study, we investigated the relationship between sphenoid sinus, carotid canal, and optic canal on paranasal sinus computed tomography (PNSCT). This study was performed retrospectively. PNSCT images of 300 adult subjects (159 male, 141 female). Sphenoid sinus (pneumatisation, dominancy, septation, inter-sinus septa deviation), anterior clinoid process pneumatisation, Onodi cell, carotid and optic canals (width, dehiscence, classification) were measured. In males, type 3 pneumatised sphenoid sinus (in both sides) and in females type 2 pneumatised sphenoid sinus (right side) and type 3 pneumatised sphenoid sinus (left side) were detected more. Anterior clinoid pneumatisation was present 47.2% in males and 39.7% in females. In male group, more septation (i.e. 22.6%, ≥ 3 septa) in sphenoid sinus were detected. Onodi cell was present 26.6 and 19.1% in males and females, respectively. Carotid canal protrudation to the sphenoid sinus wall was present 23.9-32.1% in males and 35.5-36.2% in females. Dehiscence in carotid canal was detected more in females (34%) compared to males (22%). Optic canal protrudation was 33.3 and 30.5% in males and females. Type 4 optic canal was detected more in both gender. Optic canal dehiscence was detected 11.3 and 9.9% in males and females. Carotid and optic canal diameters were higher in males. In pneumatised sphenoid sinuses and in females, type 3 carotid canal (Protrudation to SS wall) (bilaterally) and type 1 optic canal type (No indentation) (ipsilateral side) were detected more. In elderly patients, carotid and optic canal width increased. When carotid canal protrudation was detected, there was no indentation in optic canals In pneumatised SS, carotid canal protrudation was observed with a greater risk in surgery. However, type 1 (non indentation) optic canal was present in highly pneumatised SS with lower risk for the surgery. In women, the risk of carotid canal protruding (about 1/3) is greater than that of males, and carotid canal dehiscence rates are also higher in females. Therefore, physicians should be very careful during the preparatory stages of the sphenoid sinus surgery. Otherwise, it may not be possible to prevent lethal carotid artery bleeds.

Objectives: To investigate the optic nerve's elastic properties using shear wave and strain elastography in patients with migraine compared to healthy individuals., Methods: The migraine group consisted of 30 patients (16 with visual auras and 14 without auras) who had previously had a diagnosis of migraine. These were age and sex matched with healthy participants to form the control group. The findings from shear wave and strain elastography in the groups were compared. The elastographic examination was performed with a 6-15-MHz multifrequency linear array transducer., Results: The evaluation involved 30 patients with migraine (3 male and 27 female), whose mean age ± SD was 34.63 ± 10 years, and 30 healthy participants (3 males, 27 females), whose mean age was 36.4 ± 10.5 years. In strain elasticity patterns, a statistically insignificant hardening of the optic nerve in the patients with migraine was observed (P = .052). Analysis of the shear wave elastic modulus values (9.8 ± 3.34 and 12.3 ± 5.25 kPa; P = .03) revealed that differences between the healthy participants and patients with migraine were statistically significant. The results for elasticity patterns and the shear modulus suggested that the differences between migraines with and without visual auras were insignificant (P > .05). A positive correlation was discovered between the duration of the disease and the shear modulus in the patients with migraine (r = 0.496; P < .01)., Conclusions: Histopathologic changes in the optic nerve may be seen in patients with migraine due to possible fibrotic changes. Elastographic techniques can be useful diagnostic tools for investigating these changes., (© 2018 by the American Institute of Ultrasound in Medicine.)

Objectives: We investigated the relationship between Onodi cells and optic canal by paranasal sinus computed tomography (PNSCT)., Methods: In this retrospective study, 508 PNSCT (265 males and 243 females) was examined. Onodi cell presence, pneumatization types, optic canal types; and also sphenoid sinusitis and anterior clinoid process pneumatization were evaluated., Results: The prevalence of Onodi cells was 21.2% of the patients. Onodi cells were observed 40.7% on the right side and 25.9% on the left side. In 33.4% of the patients, bilateral Onodi cells were present. Male/Female ratio was 24.5%/17.6%. Onodi cell types were detected as Type I > Type II > Type III bilaterally. There was a positive correlation between the right and left Onodi cell types (p < 0.05). Optic canal types were detected as Type IV > Type I > Type II > Type III. bilaterally. There was a positive correlation between right and left optic canal types. Onodi cell presence and ACP pneumatization were found as statistically significant (p < 0.05). In 65.5% of the patients, Onodi cells and ACP pneumatization were absent. ACP pneumatization was present in 35.4% of the cases. In nine cases, bilateral Onodi cells and ACP pneumatization were detected. Sphenoid sinusitis was detected in 11.4% of Type I and 13.8% of the Type II Onodi cells on the right side. On the left side, it was detected in 12.9% of the Type I and 19.0% of Type II Onodi cells., Conclusion: Identification of Onodi cell is very important clinically because of its proximity to optic nerve canal. We concluded that type IV Onodi-optic canal relationship was the most common finding in our study. Onodi cell presence and their patterns of pneumatization must be evaluated on PNSCT preoperatively to avoid optic canal damage.

Purpose: The purpose of this study was to investigate the clinical results of arthroscopic rotator cuff repair in patients with anterior greater tubercle cyst in magnetic resonance imaging (MRI)., Methods: The cyst-present group comprised 38 patients with anterior greater tubercle cyst in MRI, and age- and sex-matched 30 patients without cyst in humeral head were included in the control group. The cystic group was divided into two groups, smaller than 5 mm (21 patients) and larger than 5 mm (17 patients), according to the cyst size. A total of three groups were created. In the evaluation of clinical outcomes, modified University of California at Los Angeles (UCLA) and the Western Ontario Rotator Cuff Index (WORC) were used. The visual analog scale (VAS) was used to assess pain. One-way analysis of variance was used to compare VAS, UCLA, and WORC scores among the groups., Results: There was a statistically significant difference in the clinical results of VAS, UCLA, and WORC among the cystic and noncystic groups in the anterior greater tubercle ( p < 0.05). There was also a statistically significant difference in the clinical results of UCLA, WORC, and VAS scores according to the cyst sizes in the anterior greater tubercle cyst group ( p < 0.05)., Conclusion: Anterior greater tubercle cysts have negative effects on rotator cuff repair results. If the anterior greater tubercle cyst size is greater than 5 mm, the negative effects of rotator cuff repair results are more pronounced. An understanding of anterior greater tubercle cysts has a critical importance for rotator cuff surgery planning.

Background: We investigated thoracic masses with Computed Tomography (CT)- guided Percutaneous Co-Axial Trans-Thoracic Biopsy (PCTTB)., Methods: The retrospective data of 86 patients to whom CT-guided PCTTB had been applied were obtained. Eighty-four cases and their pathologic results were included in the study. Localization and appearance of the lesions, pathologic results, and complications were evaluated., Results: Diagnostic sensitivity of CT-guided PCTTB was 97.6%. In 60.7% of the cases, malign lesions and, in 39.3% of the cases, benign lesions were diagnosed. The mass size was on average greater than 2 cm, and one mass was detected as being more than ≥2 masses. Mainly, irregular contours were observed. Most of the malign tumors were primary malign tumors on both sides (91.7% on the right side and 88.9% on the left side). Squamous Cell Carcinoma (SCC) was the most often detected malign tumor on the right side, and adenocarcinoma was the most often detected malign tumor on the left side. In masses localized on the left inferior lobe, metastasis was often detected. When the number of the mass was ≥2 and the mass had the appearance of consolidation, metastasis was usually detected. Small and large masses were mainly localized on right and left upper lobes. In the small mass group, 75.0% of the cases were benign, and, in the large mass group, 64.5% of the cases were malign (p=0.031, χ2=4.666). Pneumothorax was the most commonly occurring complication (23.8%). In masses localized on the right lower lobe, the pneumothorax ratio increased in benign masses compared to malign masses. The hemorrhage detection rate was 13.0%, and hemoptysis occurred in 14.2% of the cases. Hemorrhage was detected during 11.8% of the large mass biopsies. In females, hemorrhage occurred more often than in males (p=0.026, r= 0.244)., Conclusion: CT-guided PCTTB is a safe method to utilize for lung biopsies. Co-axial method increased the diagnostic accuracy of CT-guided percutaneous trans-thoracic biopsies. A single cut also decreased the complication rates., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Objectives: In the present study, we investigated the relationship between olfactory fossa, cribriform plate, crista galli and nasal Septal Deviation (SD). Keros classification of olfactory fossa was also performed., Methods: This study was performed retrospectively. Computerized Tomography (CT) images of 200 adult subjects were observed. Unilateral nasal Septal Deviation (SD) cases were included into the study. On coronal CT scans, SD side and location, SD angle, cribriform plate width, olfactory fossa depth (Keros classification) and width, area of the olfactory fossa, crista galli length, width and pneumatization were evaluated., Results: Anterior and anteroposterior deviations were detected mainly. In females, 64.0% and in males, 45.3% of the SDs were located anteriorly. In males, anteroposterior SDs (40.0%) were detected more than females. In anteroposterior SDs, SD angle was higher than anterior SDs. With higher SD angle, crista galli width and height decreased. Cribriform plate width, olfactory fossa height, width and area values of contralateral side were significantly higher than those of the ipsilateral side. For Keros classification, in male group, type 1 (53.3%) and in females, type 2 (57.6%) was detected at ipsilateral side. For contralateral side, type 2 Keros was detected in both genders. Complete crista galli pneumatization was observed in 4.0% and partial pneumatization was detected in 12.0%. In 84% of the patients, there is no Crista galli pneumatization. With the presence of pneumatized crista galli, contralateral Keros values decreased. Crista galli height and contralateral olfactory fossa width showed positive correlation. In older patients, cribriform plate width decreased., Conclusion: In our study, there was no Keros type 3 olfactory fossa. In males' contralateral side of SD; and in females both ipsilateral and contralateral side of SD, Keros type 2 olfactory fossa were detected. Therefore, during sinus surgery, surgeons should work carefully not to made intracranial penetration., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Objective: To investigate olfactory bulb volume and olfactory sulcus depth in patients with Behçet's disease, using magnetic resonance imaging., Methods: Cranial magnetic resonance imaging scans of 27 adults with Behçet's disease (10 males and 17 females) and 27 healthy controls were examined. Olfactory bulb volume and olfactory sulcus depth were measured on coronal, T2-weighted, spectral pre-saturation with inversion recovery sequences., Results: Bilateral olfactory bulb volume and right-sided olfactory sulcus depth were significantly lower in the Behçet's disease group than in the control group (p < 0.05). Left-sided olfactory sulcus depth increased with Behçet's disease duration. In both groups, olfactory bulb volume was significantly higher in the left than the right side. There were no gender differences for olfactory bulb volume and olfactory sulcus depth. Positive correlations were determined between right- and left-sided olfactory bulb volume values and between right- and left-sided olfactory sulcus depth values., Conclusion: Behçet's disease may decrease olfactory functions, related to lower olfactory bulb volume and olfactory sulcus depth. The affected vascular system and possibly damaged neural system, nasal mucosal lesions, and prolonged nasal mucociliary clearance time may cause olfactory dysfunction. Patient follow up is recommended, with magnetic resonance imaging examinations of the olfactory system if necessary.

Objectives: In the present study, we investigated olfactory bulb (OB) volume and olfactory sulcus (OS) depth of the psychotic patients (predominantly schizophrenia) and patients with anxiety disorder/depression., Methods: This study was conducted retrospectively. Group 1 consisted of 30 psychotic patients (predominantly schizophrenia) (19 males and 11 females). Group 2 consisted of 37 patients with anxiety disorder/depression (10 males, 27 females). Group 3 consisted of 30 non-psychotic and non-anxiety disorder/depression subjects (9 males and 21 females). OB volume and OS depth measurements were performed on Cranial MRI., Results: OB volume (right and left) of the psychotic; and anxiety disorder/depression groups were significantly lower than those of the control group (p adjusted  < 0.0175). OS depth (Left) value of anxiety disorder/depression group was significantly lower than those of the control group (p adjusted  < 0.0175). In psychotic and anxiety disorder/depression groups, left OS depth values were significantly lower than those of the right side (p < 0.05). In each of the males and females of the anxiety disorder/depression group, left OS depth values were significantly lower than those of the right side (p < 0.05). In psychotic group, OS depth (left) values get lower in older patients (p < 0.05)., Conclusion: Decreased OB volume in the psychotic patients and decreased OB volume and OS depth in anxiety disorder/depression patients were detected. Lower OB volume and OS depth are related to the olfactory loss/or olfactory impairment. Physicians should be aware of the olfactory deficits in psychotic patients (mainly schizophrenia) and patients with anxiety disorder/depression. When reduced OB volume is detected on MRI, psychosis, schizophrenia or depression should also be kept in mind and the patients should be evaluated in detail for these diseases.

BACKGROUND The aim of this study was to investigate the effects of coracoid morphology, coracohumeral distance, coracoglenoid angle, and coracohumeral angle variabilities on subcoracoid impingement development using magnetic resonance imaging (MRI). MATERIAL AND METHODS A total of 200 patients (87 males with mean age of 51.1±15.2 years and 113 females with mean age of 52.6±10.7 years) undergoing shoulder MRI were included in this retrospective study. All MRI studies were performed with standard positioning. Coracoid morphology and subscapularis tendon were evaluated. Coracohumeral distance, coracoglenoid angle and coracohumeral angle were measured in all subjects. One-way ANOVA was used to assess the difference between the groups. For binary comparisons, Tukey post hoc analysis was done. Pearson correlation analysis was performed between variables. RESULTS Type C coracoid was more frequent in the tendinosis and tendon tear groups. There was a significant difference between type C coracoid and the other coracoid types for coracohumeral distance values (P=0.016). There was a statistically significant decrease in coracoglenoid angle values and coracohumeral distance in patients with subscapularis tendon pathologies (P=0.000). A statistically insignificant increase in coracohumeral angle values was found in the subscapularis tendon pathologies. There was a positive correlation between coracohumeral distance and coracoglenoid angle (R=0.749 P=0.000). There was a negative correlation between coracohumeral distance and coracohumeral angle (R=-0.668 P=0.000) and between coracoglenoid angle and coracohumeral angle (R=-0.605 P=0.000). CONCLUSIONS In subscapularis tendon pathologies, decrease in coracohumeral distance and coracoglenoid angle was observed. A new approach uses coracohumeral angle to evaluate subcoracoid impingement. A statistically insignificant increase in coracohumeral angle was noted.

Objectives: The aim of this study was to compare the cross-sectional area and ultrasound elastographic findings of the median nerve of patients with acromegaly and healthy participants., Methods: The acromegaly group comprised 15 patients with a previous diagnosis of acromegaly, and an age- and sex-matched control group included healthy participants. Strain elastographic and shear wave elastographic findings and the cross-sectional areas of the groups were compared. A 6-15-MHz multifrequency transducer was used for ultrasound evaluations., Results: A total of 30 hands of 15 patients with acromegaly (7 male and 8 female) with a mean age ± SD of 50.00 ± 10.17 years and 40 hands of 20 healthy control participants (9 male and 11 female) with a mean age of 49.50 ± 10.17 years were taken into consideration for statistical analyses. The cross-sectional area of the patients with acromegaly was significantly higher than that of the healthy controls (13.43 ± 3.12 versus 8.32 ± 1.94 mm 2 ; P < .05). Median nerve stiffness was significantly increased in the acromegaly group compared with the control group (axial and longitudinal, 37.15 ± 6.4 and 37.0 ± 6.19 versus 18.7 ± 4.1 and 19.2 ± 3.58 kPa, respectively; P < .001)., Conclusions: These preliminary results have demonstrated that patients with acromegaly seem to have increased stiffness and cross-sectional area of the median nerve compared with healthy participants., (© 2018 by the American Institute of Ultrasound in Medicine.)

Objectives: To compare the measurements of olfactory bulb volume and olfactory sulcus depth in patients with migraine and a control group., Methods: The study included the cranial MRI (1.5 T) images of 200 adults diagnosed with migraine and a control group of 100 subjects without migraine. The control group mainly consisted of the patients with non-migraneous headache. The measurements were obtained from coronal T2-weighted images for standard olfactory bulb (OB) volume and olfactory sulcus (OS) depth., Results: The OB volume and OS depth values were lower in the migraine group than in the control group. In the migraine group, left OB volume of the males was significantly lower than those of the females. In both the migraine and control groups separately, the left-side OB volume values and the right side OS depth values were significantly greater than those of the contralateral side. There were positive correlations between right and left OB volume, and right and left OS depth values. No change was seen in OB volume and OS depth values according to gender. In older patients, a decrease was determined in the right and left OB volume, and the left-side OS depth values. There was a negative correlation between osmophobia and OB volume values. In migraine patients with osmophobia, the OB volume values were significantly decreased., Conclusion: OB volume values were lower in migraine patients. When osmophobia was present, the OB volume was lower than that of the non-osmophobia migraine patients. Olfactory function monitoring with olfactory tests and olfactory volume monitoring on MRI can be recommended for all migraine patients to diagnose olfactory dysfunction earlier, especially those with osmophobia. Because their OB volume values were detected as lower than those of the migraine patients without osmophobia, it may be thought that blood flow changes and osmophobia may affect the olfactory bulb volume shrinkage in migraine patients.

Lip cancers can severely affect a person in terms of function, esthetics, and psychological trauma. After surgical resection, lip defects require special rehabilitation. This clinical report describes a neck prosthesis of a male patient diagnosed with lower lip squamous cell carcinoma with perineural involvement. The neck prosthesis was connected to the mandibular complete denture with cobalt samarium magnets. Both prostheses improved the patient's mastication, deglutition, and esthetics., (© 2016 by the American College of Prosthodontists.)

Aims: Our aim was to evaluate the elasticity features of the optic nerve using strain (SE) and shear wave elastography (SWE) in multiple sclerosis (MS) patients in comparison with healthy subjects., Material and Methods: One hundred and seven optic nerves from 54 MS patients and 118 optic nerves from 59 healthy subjects were examined prospectively by SE and SWE. Optic nerves were divided into three types in accordance to the elasticity designs, as follows: type 1 predominantly blue (hardest tissue); type 2 predominantly blue/green (hard tissue); and type 3 predominantly green (intermediate tissue). Quantitative measurements of optic nerve hardness with SWE were analyzed in kilopascals., Results: Elastographic images from healthy volunteers showed mostly type 3 optic nerves (61.9%); type 2 was also found (38.1%), but type 1 was not observed. Elastographic examination of MS patients showed mostly type 2 optic nerves (88%), while some type 1 (4.6%) and type 3 optic nerves (6.5%) were rarely observed. There was a statistically significant difference in terms of elasticity patterns between patients and healthy volunteers (p<0.001). Statistically significant differences were observed between patients and healthy volunteers in the analysis of SWE values (10.381±3.48 kPa and 33.87±11.64 p<0.001). The receiver operating characteristic curve analysis was perfect (0.993; 95% confidence interval [CI]=0.971-0.999), and a cut-off value of 18.3 kPa shear had very high sensitivity and specificity for the patient group. No significant differences were observed between patients with and without previous optic neuritis., Conclusion: SE and SWE examination findings concerning the optic nerve in MS patients demonstrated remarkable differences according to the healthy group.

Palatal myoclonus is an extremely rare disorder. Tinnitus is secondary to rhythmic involuntary movements of the soft palate. Clinical diagnosis is based on the confirmation of the soft palate movements synchronous with an audible clicking noise outside. In this article, we report a 38-year-old female case with a 10 year-history of continuing ear click, who was diagnosed with essential palatal myoclonus. The disease and its differential diagnosis from symptomatic palatal myoclonus were discussed in the light of literature data.