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Öğe Apparent diffusion coefficient variabilities of the optic nerve in multiple sclerosis: Optic nerve head and intraorbital segment(Yuzuncu Yil Universitesi Tip Fakultesi, 2019) Şahan M.H.; İnal M.; Asal N.; Gökçınar N.B.To investigate the diffusion alterations in the optic nerve head/intraorbital segment in Multiple sclerosis (MS) patients (with or without a history of optic neuritis) in comparison with healthy controls. MS group consisted of 57 patients who had previously been diagnosed with MS. A total of 234 eyes which consisted of 114 eyes of the MS patients and 120 eyes of the healthy controls, were investigated. In 16 of the MS patients had the history of optic neuritis in one eye. The control group was selected from healthy subjects who were matched with MS patients group in terms of gender and age. Echo planar imaging (EPI) sequence was benefitted to attain diffusion-weighted images (DWI). The optic nerve head/intraorbital segment apparent diffusion-coefficient (ADC) values of two groups were compared. The difference between the optic nerve head/intra-orbital segment ADC values of control group and MS patients was found statistically considerable (P=0.009, P=0.006, respectively). The difference between the optic nerve head/intra-orbital segment ADC values of MS patients without optic neuritis and control group was also found statistically considerable (P= 0.016, P= 0.026, respectively). It was found that there is a positive correlation between the ADC values and duration of the disease in MS patients (R=0.485/0.428, P<0.01). The ADC values of the optic nerve head/intraorbital segment measured by ocular DWI may have potential for MS patients in the future and this method deserves additional validation in the disease staging and more work to pred ict patients at risk of optic neuritis. © 2019, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.Öğe Can MDCT Scan of the Temporal Bone Looking at Pneumatization Predict Surgical Vulnerability of the Facial Nerve?(SAGE Publications Ltd, 2019) Inal M.; Muluk N.B.; Şahan M.H.; Asal N.; Şimşek G.; Arıkan O.K.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. © The Author(s) 2019.Öğe Is there a relationship between mastoid pneumatisation and facial canal dimensions?(Cambridge University Press, 2019) Inal M.; Bayar Muluk N.; Asal N.; Şahan M.H.; Şimşek G.; Arikan O.K.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. © 2019 JLO (1984) Limited.Öğe Sigmoid Colon Perforation Mimics a Tuboovarian Absces(2018) Sayan C.D.; Yeral M.I.; Ozkan Z.S.; Karaca G.; Asal N.; Aydın O.; Sagsoz N.Introduction: An adnexal mass may be diagnosed after a routine pelvic ultrasonographic examination or an emergent hospital admission due to rupture of ectopic pregnancy, adnexal torsion or rupture of tuboovarian abscess. It is necessary to evaluate the origin of the mass initially and to classify patients who need further evaluation and treatment for an urgent condition.Case presentation: We report a case of sigmoid colon rupture due to sigmoid colon adenocarcinoma presenting as acute abdomen with left adnexal mass in a 28 years old woman. Abdominopelvic computed tomography revealed a left adnexal mass with suspicion of tuboovarian abscess. In laparatomy, rupture of sigmoid colon was observed and resection of sigmoid colon was performed. Histological examination of resection part revealed diagnosis of sigmoid colon adenocarcinoma due to familial adenomatous polyposis.Conclusion: This case may be interesting for clinicians because pelvic pain, fever, increased infection markers in the laboratory and mass at ultrasonography or other screening methods could cause a misdiagnosis of tubaovarian abscess especially in reproductive age women. Before the operation of the pelvic mass of all age women with the diagnosis of tuboovarian abscess other causes of the pelvic abscess should come into mine and necessary preparation for operation must be done.
