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    Calculation of an Optic Nerve Injury Risk Profile Before Sphenoid Sinus Surgery
    (Lippincott Williams & Wilkins, 2017) Cetinkaya, Erdem Atalay; Koc, Koray; Kucuk, Mehmet Fatih; Koc, Pinar; Muluk, Nuray Bayar; Cingi, Cemal
    Objectives: Our objective was to analyze variations in the optic nerve (ON) course and surrounding structures in an effort to construct an optic nerve injury risk profile before endoscopic intranasal sphenoidal, or endoscopic endonasal transphenoidal, skull-base surgery, and eventually to construct and formulate a common classification by combining the known classes. The authors used computed tomography (CT) toward this end. Methods: The authors retrospectively reviewed 200 consecutive CT scans (400 sides) of the paranasal sinuses. The pneumatization of the anterior clinoid process, the relationships of the ONs to the sphenoidal sinuses, and ON dehiscence were evaluated. The authors then created a formula by which risk profiles can be constructed for patients for whom sphenoid or parasellar surgery is planned. Results: Pneumatization of the anterior clinoid process was evident in 28.25%. Dehiscence of the bony wall of the ON was evident in 9.5%. The ON course lay adjacent to the sphenoidal sinus, causing sinus wall indentation, in 23%. Cumulative optic nerve injury risk scoring showed that, radiologically, surgery on 8.5% and 1.5% of sphenoid sinuses described here carried severe or critical risk of ON injury, respectively. Conclusions: Head-and-neck surgeons and neurosurgeons should be aware of variations in ON course. The authors composed an optic nerve injury risk classification category based on the sum of individual weights of each of these classes. Reductions in ON injuries require careful evaluation of potential variant anatomies. Preoperative CT scans must be meticulously reviewed to avoid ON injury.
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    Digital Infrared Thermal Imaging Analysis of Thyroid Nodules
    (Bentham Science Publ Ltd, 2018) Cetinkaya, Erdem Atalay; Koc, Koray; Atilgan, Sevgi; Muluk, Nuray Bayar; Cingi, Cemal
    Objectives: In this study, Digital Infrared Thermal Imaging (DITI) was designed based on a noninvasive system that could display and detect the relative temperature variations in patients suffering from thyroid nodules especially nonpalpables. Methods: In this prospective clinical trial, Infrared Thermal Camera (IRC) was used alternative to conventional clinical thermometers. 32 patients confirmed with thyroid nodules and volunteers as control were studied. Ultrasonography (US) was used for confirming the thyroid nodules while the DITI of thyroid surface skin temperature was obtained using the IRC. Results: The thermal image shows the variation of the patient thyroid surface skin temperature according to hypoechoic and hyperechoic nodules. The DITIs showed higher temperature for hypoechoic nodul sides and it correlated with nodule size. There was no significant temperature difference on the sex distribution. Conclusion: DITI is a valuable auxiliary to ultrasound, especially in thyroid hypoechoic nodul and if used in combination with other imaging modality, could play an extra role in the non-invasive diagnosis of thyroid nodules.