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A Comparison of Diagnostic Accuracy of Superior Semicircular Canal Dehiscence in MDCT and MRI, and Coexistence with Tegmen Tympani Dehiscence
(Thieme Medical Publ Inc, 2021) Inal, Mikail; Muluk, Nuray Bayar; Sahan, Mehmet H.; Asal, Nese; Simse, Gokce; Arikan, Osman K.
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.
ADC evaluation of the corticospinal tract in multiple sclerosis
(Springer Heidelberg, 2015) Inal, Mikail; Unal, Birsen; Kala, Ibrahim; Turkel, Yakup; Bilgili, Yasemin Karadeniz
Apparent diffusion coefficient (ADC) values derived from diffusion-weighted MR imaging (DWI) provide important information about tissues. The goal of this study was to evaluate the ADC values in the corticospinal tract regions in multiple sclerosis (MS). The ADC values of 42 patients with multiple sclerosis and 46 healthy people were measured. The ADC values in the corticospinal tract at the capsula interna posterior crus from six points and mesencephalon from three points bilaterally in MS patients were compared with those of controls. An ANOVA post hoc test was used to analyse the differences in mean ADC values between the MS and control groups. The mean ADC values of the right (p = 0.008) and left internal capsules (p = 0.000) and right (p = 0.002) and left mesencephalons (p = 0.044) in MS patients were significantly lower than in the control group. There was no significant difference between the right and left side ADC values in MS (p = 0.313 vs. p = 0.223) and control groups (p = 0.756 vs. p = 0.105), respectively. The mean ADC values of the corticospinal tract in MS patients were significantly lower than in the control group. This decreased diffusion may be the result of cellular infiltration due to inflammation, cytotoxic oedema, demyelination or remyelination processes.
ADC evaluations of the hippocampus and amygdala in multiple sclerosis
(Asean Neurological Assoc, 2014) Inal, Mikail; Daphan, Birsen Unal; Bilgili, Yasemin Karadeniz; Turkel, Yakup; Kala, Ibrahim
Background & Objective: Diffusion-weighted MR imaging and apparent diffusion coefficient (ADC) values provide significant structural information about tissues in multiple sclerosis (MS). The goal of this study was to evaluate the ADC values in the hippocampus and amygdala in MS. Methods: Thirty-eight patients with MS and 41 healthy individuals were included in the study. ADC values were measured bilaterally from three different points in the hippocampus and amygdala in MS patients and were compared with those of the controls. An analysis of varianceposthoc test was used to analyse the differences among mean ADC values between MS and control groups. Results: The mean ADC values of both sides of the hippocampus and the left amygdala in MS patients were lower than the control group. The mean ADC values of the right amygdala in MS patients were lower than the control group, but the difference was not statistically significant. Conclusion: We observed restricted diffusion in the hippocampus and amygdala in MS patients contrary to information in the literature.
ADC evaluations of the hippocampus and amygdale in multiple sclerosis
(ASEAN Neurological Association, 2014) Inal, Mikail; Daphan, Birsen Unal; Bilgili, Yasemin Karadeniz; Turkel, Yakup; Kala, Ibrahim
Background & Objective:Diffusion-weighted MR imaging and apparent diffusion coefficient (ADC) values provide significant structural information about tissues in multiple sclerosis (MS).The goal of this study was to evaluate the ADC values in the hippocampus and amygdala in MS. Methods:Thirtyeightpatients with MS and 41 healthy individualswere included in the study. ADC values were measured bilaterallyfrom three different pointsin the hippocampus and amygdala in MS patients and were compared with those of the controls. An analysis of varianceposthoc test was used to analyse the differences among mean ADC values between MS and control groups.Results:The mean ADC values of both sides of thehippocampus and the left amygdala in MS patients were lower than the control group. The mean ADC values of the right amygdala in MS patients were lower than the control group, but the difference was not statistically significant.; Conclusion:We observed restricted diffusion in the hippocampus and amygdala in MS patients contrary to information in the literature. © 2014, ASEAN Neurological Association. All rights reserved.
Anatomical Considerations: The Relationship Between The Vertebral Artery And Transverse Foramina At Cervical Vertebrae 1 To 6 In Patients With Vertigo
(2018) Kültür, Turgut; Muluk, Nuray Bayar; Iyem, Cihan; Inal, Mikail; Burulday, Veysel; Alpua, Murat; Çelebi, Umut Orkun
Objective: In this study, we aimed to investigate the relationship between the size of the vertebral artery and that of the transverse foramina at the C1 to C6 vertebral level in patients suffering from vertigo thought to be related to vertebrobasilar insufficiency (VBI). Materials and Methods: In this retrospective study, two groups were compared in terms of cervical computed tomography (CT): 22 adult patients with vertigo; and a control group consisting of 23 healthy adult indivıduals. Measurement of the vertebral artery and transverse foramina (i.e. sagittal and transverse dimensions, plus area) were performed bilaterally at levels C (cervical vertebra) 1 to C6. Results: For the cases group, at C6 level the right vertebral artery area, sagittal and transverse diameter were larger than in the control group at the level of statistical significance. At C1 level, the area of the right transverse foramina in the cases group was significantly higher than in the control group. At levels C1 to C5, the values obtained for vertebral artery area were positively correlated with the values for the ipsilateral transverse foramina (transverse foramen sagittal and transverse dimensions plus areas). Where the sagittal or transverse dimensions of the transverse foramina, or the area of the transverse foramina were found to be decreased, vertebral artery areas were also observed to have decreased at C1 to C5 levels. Conclusion: We concluded that a decrease in diameter of the bony structures or transverse foramina may cause a decrease in the cross-sectional area of the vertebral artery on the ipsilateral side. Since it is only the left vertebral artery which is dominant for cerebral blood flow, any compensatory increase in right vertebral artery area cannot offset decreased cerebral blood flow. Decreased blood flow (i.e. VBI) on the left side may play a role in the development of vertigo.
Better Visualization of Vermiform Appendix With Tissue Harmonic Imaging Compared to Conventional Sonography
(Kowsar Publ, 2014) Inal, Mikail; Unal, Birsen; Bilgili, Yasemin Karadeniz
Background: Surgery of appendicitis carries 7-11% negative appendectomy rates. Sonographically visualized normal appendix precludes unnecessary computed tomography (CT) examination and may reduce negative appendectomy rates. Tissue harmonic imaging (THI) has been reported to improve the overall image quality. Objective: We aimed to assess whether THI is more successful than conventional ultrasonography (US) in detecting normal and pathologic appendices. Patients and Methods: The study was performed on 185 patients who applied for routine US examinations in whom clinical findings of appendicitis were detected in 25. We searched for the appendix; applying both THI and conventional US to each patient, one before and the other after the routine US examinations. Patients were divided into two groups; one was evaluated first with conventional US and the other first with THI. When the appendix was found, localization, diameter and time spent for visualization were recorded. Twelve patients were operated; all of whom had appendicitis pathologically. Two methods were compared for: 1. Success rates in all patients; female, male and child groups separately; 2. Visualization of pathologic and normal appendices; 3. Time for visualization of appendix; 4. Comparison of success rates in the adult and child population. The relationship between the rate of visualization and body mass index was evaluated. Results: The appendix was visualized better by THI in all patients, and in the female and male groups (P < 0.001). In children, both methods were more successful compared to adults (P < 0.001, compared to male group, P < 0.001, compared to female group), with no difference between the methods (P = 0.22). When only the normal appendices were concerned, there was significant difference between both methods (P < 0.000). Both methods detected pathologic appendices better than normal ones, with a higher ratio for THI (P = 0.022 for the THI group, and chi(2) = 7.22, P = 0.07 for the conventional US group). THI visualized the appendix faster. Both methods were more successful in lean patients (P = 0.004 for THI, P = 0.001 for conventional US imaging). Conclusions: THI visualizes appendix better than conventional US. It is a simple and time saving method that may eliminate further diagnostic imaging, and it may decrease negative appendectomy rates and related complications.
Carotid canal and optic canal at sphenoid sinus
(Springer, 2019) Asal, Nese; Muluk, Nuray Bayar; Inal, Mikail; Sahan, Mehmet Hamdi; Dogan, Adil; Arikan, Osman Kuersat
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.
Changes in Peripheral Olfactory Pathways in Rheumatoid Arthritis
(Lippincott Williams & Wilkins, 2022) Kultur, Turgut; Muluk, Nuray Bayar; Inal, Mikail; Erkmen, Selmin Perihan Komurcu; Rasulova, Gunel
Objectives We investigated olfactory bulb (OB) volumes and olfactory sulcus (OS) depths in patients with rheumatoid arthritis (RA). Methods In this retrospective study, cranial magnetic resonance images of 68 adult patients were included. Group 1 consisted of 34 adult patients with RA. The control group (group 2) consisted of 34 adult patients without RA. In both groups, peripheral odor pathways (OB volumes and OS depths) were measured by magnetic resonance imaging. Results Our results showed that the OB volumes of the RA group were significantly lower than those in the control group bilaterally (P < 0.05). In each of the RA and control groups, the OS depth of the right side was found to be significantly higher than those on the left side (P < 0.05). On the left side, OS depth values of RA patients who used biological agents were significantly higher than those RA patients who did not use biological agents (P < 0.05). Correlation tests showed that there were positive correlations between OB volumes and OS depths bilaterally. In older patients with RA, bilateral OS depth values were decreased (P < 0.05). Conclusions Our study has shown that the peripheral olfactory pathways in patients with RA can be affected to a degree that is reflected in anatomical measurements. The use of biological agents contributes to the protection of odor functions to a certain extent. The importance of evaluating the sense of smell in patients with RA clinically and radiologically should be emphasized.
Cribriform Plate, Crista Galli, Olfactory Fossa and Septal Deviation
(Bentham Science Publ Ltd, 2019) Sahan, Mehmet Hamdi; Inal, Mikail; Muluk, Nuray Bayar; Simsek, Gokce
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.
Critical Stenosis of the Internal Carotid Artery: Variability in Vertebral Artery Diameters and Areas of Cerebral Chronic Infarction in Computed Tomography
(Lippincott Williams & Wilkins, 2019) Sahan, Mehmet Hamdi; Asal, Nese; Muluk, Nuray Bayar; Inal, Mikail; Dogan, Adil
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.
The Diagnostic Value of CT-guided Percutaneous Co-axial Trans-thoracic Biopsy (PCTTB) and Evaluation of the Pathologic Examination
(Bentham Science Publ Ltd, 2019) Sahan, Mehmet Hamdi; Inal, Mikail; Muluk, Nuray Bayar; Dogan, Adil; Atasoy, Pinar
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 bad 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, chi(2)=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, 7 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.
Does Generalized Linear Model Support Functional Default Mode Network Studies
(Aves, 2019) Kocak, Orhan Murat; Ozdemir Rezaki, Hatice; Turkel, Yakup; Inal, Mikail; Buturak, Sadiye Visal
Introduction: A growing body of research has emerged on the resting state and the default mode of the brain. Functional connectivity studies, which lately dominate this research area, have confirmed that regions such as the cortical mid-line structures, as well as parietal-temporal regions are tightly interconnected within the default mode network (DMN). However, little is known about the activity patterns of resting state related brain regions detected in fMRI studies using the generalized linear model (GLM) in a whole brain analysis. The aim of the current study was to investigate the activity changes among brain regions identified through GLM during the transition from task to rest and the prolongation of rest. Methods: A picture imagination task, as a controlled thought content task, was used in order to minimize confounding factors such as a visual stimulus or a motor response. Results: The present study revealed a consistent fluctuating activation pattern of the dorsal anterior cingulate cortex (dACC), the posterior cingulate cortex (PCC), thalamus, primer motor area (PMA), insula, brain stem and bilateral putamen during the transition from task to the early phase of the resting state and the prolongation of the resting state. All regions showed increased activation during the detachment from task. However, this increased activation was not sustained during the extension of rest, replaced with a decreased activation at the late phase of rest. The increased activation of resting state regions might help with the detachment from the current task. Among these regions dACC, insula and putamen were correlated in all conditions. Conclusion: These findings underline the importance of the activation increase of the cortical mid-line regions and insula in the transition from task to the resting state.
Does Mastoid Pneumatization Affect Facial Canal Dimensions and Distances of Facial Tympanic Segment-Scutum and Lateral Semicircular Canal-Scutum?
(LIPPINCOTT WILLIAMS & WILKINS, 2020) Inal, Mikail; Muluk, Nuray Bayar; Asal, Nese; Sahan, Mehmet Hamdi; Simsek, Gokce; Arikan, Osman Kursat
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.
Evaluation of arthroscopic rotator cuff repair results in patients with anterior greater tubercle cysts
(Sage Publications Ltd, 2019) Sahan, Mehmet Hamdi; Serbest, Sancar; Tiftikci, Ugur; Durgut, Erdogan; Inal, Mikail
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.
Evaluation of Olfactory Sensation, Acoustic Rhinometry, and Quality of Life of the Patients With Nasal Septal Deviation
(Lippincott Williams & Wilkins, 2019) Akay, Hatice Guzelkucuk; Muluk, Nuray Bayar; Inal, Mikail; Simsek, Gokce; Kilic, Rahmi
Objectives: Nasal septum deviations are deformities that occur in the cartilage and bones of the septum. The aim of the present study is to evaluate the patients with septum deviation according to the acoustic rhinometry measurements in terms of changes in smell function and the effects on quality of life. Methods: Twenty patients with septum deviation between the ages18 to 75 years old and 20 subjects without septum deviation were included in the study. Control group consisted of the 20 subjects with no septal deviation. After ENT examinations, acoustic rhinometry measurements, the SF-36 quality of life scale, and the Brief Smell Identification Tests were applied to all patients. Type of septum deviation is classified according to Mladina classification by anterior rhinoscopy examination, nasal endoscopy, and paranasal computed tomography. Results: The study indicated that the most common deviation type was Mladina Type 3 (65%). Bilateral total smell score of the women in the septum straight group is significantly lower than the men in terms of total smell scores by gender (P< 0.05). The total smell score values in septum group were significantly lower than those of the control group (P< 0.05). According to the individual smell values, cinnamon, banana, and soap odors of the septum deviation group were seen to be significantly lower than the septum straight group (P< 0.05). Conclusion: The results of the study indicated that olfactory dysfunction occurs in patients with septum deviation. Therefore, treatment of septum deviation is necessary for the improvement of nasal obstruction besides the treatment of the smell dysfunction.
Evaluation Of Optic Nerve With Strain And Shear Wave Elastography In Patients With Behcet's Disease And Healthy Subjects
(Elsevier Science Inc, 2017) Inal, Mikail; Tan, Sinan; Demirkan, Serkan; Burulday, Veysel; Gunduz, Ozgur; Ornek, Kemal
The objective of this study was to investigate the elasticity characteristics of the optic nerve using strain and shear wave elastography in patients with Behc, et's disease and to compare the results with those of healthy volunteers. Forty-six optic nerves from patients with Behc, et's disease and 54 optic nerves from healthy volunteers were investigated prospectively in this study using strain and shear wave elastography. There was a statistically significant difference in terms of elasticity patterns between patients and healthy volunteers (p < 0.001). Elastographic images of healthy volunteers revealed most optic nerves to be type 3 (51.8%); however, type 2 (40.7%) and type 1 (7.5%) were also observed. Elastographic examination of Behc, et's disease patients revealed type 2 in 52.2%, type 1 in 43.5% and type 3 in 4.3% of patients. Statistically significant differences were observed between patients and healthy volunteers in the analysis of shear wave elastography values (p < 0.001). Receiver operating characteristic curve analysis was perfect (0.933) (95% CI = 0.885-0.980), and a cutoff value of 16.5 kPa shear had very high sensitivity and specificity for the patient group. Strain and shear wave elastography findings for the optic nerves of patients with Behc, et's disease were significantly different from those for healthy volunteers. (E-mail: inal_m@hotmail.com) (C) 2017 World Federation for Ultrasound in Medicine & Biology.
Evaluation of peripheral olfactory pathways in chronic autoimmune thyroiditis
(Springer, 2022) Inal, Mikail; Asal, Nese; Karahan, Irfan; Gungunes, Askin; Durmaz, Senay Arikan
Purpose In this study, we aimed to radiologically evaluate the olfactory bulb (OB) volume and olfactory sulcus (OS) depth of adult patients diagnosed with chronic autoimmune thyroiditis. Methods Sixty-eight patients over 18 years of age with Hashimoto's thyroiditis and 66 healthy controls with normal thyroid function tests were included in the study. OB volume and OS depth measurements were performed using cranial magnetic resonance imaging (MRI) obtained from coronal T2-weighted images. The relationship between thyroid function tests, autoantibodies, and measurements of the OB and OS were evaluated. Results The right and left OB volumes were significantly lower in the patients with Hashimoto's thyroiditis than in the control group (p < 0.05). No significant difference was found between the patient and control groups in terms of OS depth (p > 0.05). There were significantly negative correlations among TSH, thyroid antibodies, and the bilateral OB volume measurements. In the Bonferroni post hoc analysis, when people with euthyroid Hashimoto's thyroiditis and the control group were compared, there was no statistically significant difference between bilateral OB volumes and thyroid function tests. Conclusion Diminished bilateral OB volumes were found in our patients with chronic autoimmune thyroiditis. Interestingly, the OB volumes were not affected in patients with euthyroid Hashimoto's thyroiditis. When a decrease in OB volume is detected on MRI, it should be kept in mind that odor dysfunction in hypothyroid patients with Hashimoto's thyroiditis may occur and patients should be clinically evaluated.
Evaluation of putamen area and cerebral peduncle with surrounding cistern in patients with Parkinson's disease: is there a difference from controls in cranial MRI?
(Taylor & Francis Ltd, 2024) Say, Bahar; Muluk, Nuray Bayar; Inal, Mikail; Goncuoglu, Alper; Yorubulut, Serap; Ergun, Ufuk
Objectives Nigrostriatal dopaminergic neuron loss is essential in pathogenesis of Parkinson's disease (PD). The purpose of this study was to evaluate nigrostriatal structures including the putamen, cerebral peduncle, widths of interpeduncular cistern, and ambient cistern around the midbrain with conventional cranial magnetic resonance images (MRI) in patients with PD.Methods The MRI of 56 subjects was included, which was selected from the radiological data system for this retrospective study. The 29 patients with idiopathic PD were included and their disease duration, Hoehn&Yahr stage, and Levodopa equivalent dose (LED) were recorded. The 27 controls had a normal neurologic examination and cranial MRI. All subjects in the patient and control groups had right-hand dominance. Putamen and cerebral peduncle areas and widths of interpeduncular and ambient cisterns were measured in T2 sequences of MRI. Further statistical analysis was applied to exclude gender and age effect on areas.Results The areas of putamen and cerebral peduncles were significantly reduced in patients with PD compared to the control bilaterally (p < 0.001). Enlargement of interpeduncular and ambient cisterns in patients was higher than in controls, and it was significant (p < 0.001). A correlation was not observed between measurement results and clinical characteristics of patients with PD. Only the cerebral peduncle area/ambient cistern width ratio was significantly correlated with disease duration positively (right r = 0.46 p = 0.012, left r = 0.389 p = 0.037).Conclusion Clinicians should be careful with conventional MRIs of patients with idiopathic PD in practice. It may be different from controls without any neurological disorder, particularly putamen, cerebral peduncles, interpeduncular, and ambient cisterns.
Evaluation of tendinosis of the long head of the biceps tendon by strain and shear wave elastography
(Soc Romana Ultrasonografe Medicina Biologie-Srumb, 2018) Sahan, Mehmet Hamdi; Inal, Mikail; Burulday, Veysel; Kultur, Turgut
Aim: To investigate strain (SE) and shear wave elastography (SWE) characteristics of the long head of the biceps tendon (LHBT) tendinosis in comparison with magnetic resonance imaging (MRI) findings. Material and methods: Twenty patients with a MRI diagnosis of tendinosis and twenty healthy subjects with normal LHBT in MRI were prospectively examined by SE and SWE. SE color mapping was divided into four types in accordance with elasticity designs: type I predominantly blue (hardest tissue), type II predominantly blue-green (hard tissue), type III predominantly green (intermediate tissue), type IV predominantly green-yellow-red (soft tissue). Quantitative measurements of LHBT hardness with SWE were analyzed in kilopascals (kPa). Results: In the tendinosis group SE types in transverse scan were I in 24% of tendons, II in 50%, III in 25%, and in longitudinal scan I in 15%, II in 75%, and III in 10%. In the control group SE types in transversescan were II in 10% of tendons, III in 55%, IV in 35%, and in longitudinal scan II in 10%, III in 55%, and IV in 35%. SWE values in transverse scan were 38.32 +/- 7.2 kPa in the tendinosis group and 18.6 +/- 3.1 kPa in the control groupand in longitudinal scan 39.42 +/- 7.4 kPa in the tendinosis group, and 20.62 +/- 4.6 in the control group. There was a statistically significant difference in terms of elasticity patterns between the tendinosis and control groups (p<0.001). The receiver operating characteristic curve analysis was perfect and a cut-off value of tranverse 25.8 kPa and longitudinal, 24.6 kPa shear values had very high sensitivity and specificity for tendinosis. Conclusion: SE and SWE may be useful diagnostic tools for LHBT tendinosis when considering usability, cost effectiveness, and patient preference compared to MRI.
Evaluation of the Brachial Plexus With Shear Wave Elastography After Radiotherapy for Breast Cancer
(Wiley, 2018) Kultur, Turgut; Okumus, Muyesser; Inal, Mikail; Yalcin, Selim
ObjectivesThe aim of this study was to analyze the elasticity characteristics of the brachial plexus by shear wave elastography (SWE) in patients receiving radiation therapy (RT) for breast cancer and to compare them with their contralateral brachial plexus to evaluate whether elasticity properties can be used as supporting findings for the early diagnosis of brachial plexus involvement in patients receiving RT. MethodsA prospective analysis with electromyography and SWE was performed on 23 brachial plexuses of patients receiving RT for breast cancer and their contralateral brachial plexuses. An electromyographic device was used for nerve conduction studies. Evaluations were done by the same investigator, and superficial electrodes were used in the recordings. A quantitative analysis of the brachial plexus with SWE was performed, with values in kilopascals on a color scale ranging from 0 (red, soft) to 150 (dark blue, hard) kPa. ResultsMean SWE valuesSD were 51.0 +/- 14.0 kPa for the ipsilateral brachial plexuses of patients receiving RT and 18.0 +/- 4.2 kPa for the contralateral brachial plexuses. Statistically significant differences were observed between the groups in the analysis of SWE values (P<.001). No significant correlation was found between the nerve conduction parameters and elastographic values (P>.05). ConclusionsShear wave elastography showed that the brachial plexuses of patients receiving RT were stiffer than the unaffected brachial plexuses. Brachial plexus stiffening may be associated with fibrotic processes.

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