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    Important landmarks and distances for posterior fossa surgery measured by temporal MDCT
    (SPRINGER, 2020) Burulday, Veysel; Bayar Muluk, Nuray; Komurcu Erkmen, Selmin Perihan; Akgul, Mehmet Huseyin; Ozdemir, Adnan
    In this retrospective study, we aimed to present important anatomical structures and distances for posterior fossa surgery by temporal multidetector computed tomography (MDCT). The temporal MDCT images of 317 adult patients (158 males and 159 females) were retrieved from the hospital's picture archiving and communication system (PACS). In the coronal temporal MDCT views, the cochlea-carotid canal and jugular bulb-mastoid bone outer surface were measured. In the axial MDCT views, the carotid canal-jugular bulb and carotid canal-posterior fossa distances were measured; the carotid canal and jugular bulb anterior-posterior (AP) and transverse dimensions were also measured. The bilateral cochlea-carotid canal, jugular bulb-mastoid bone outer surface, and right carotid canal-jugular bulb distances were significantly greater in the males than those in the females (p < 0.05). The carotid canal-posterior fossa distance was not different in both genders (p > 0.05). The carotid canal-jugular bulb and the carotid canal-posterior fossa distances were greater on the left side than those on the right side in both genders (p < 0.05). In males, the outer surface distance was greater on the left jugular bulb-mastoid bone than that on the right side of that bone (p < 0.05). The difference between the carotid canal AP dimensions was not significant between males and females (p > 0.05). However, the carotid canal transverse dimension, jugular bulb AP, and transverse dimensions were significantly greater in the males than those in the females, bilaterally (p < 0.05). In each gender separately, the carotid canal AP and transverse dimensions were greater on the left side and the jugular bulb AP and transverse dimensions were greater on the right side than those on the left side (p < 0.05). Positive correlations were found between the cochlea-carotid canal, the jugular bulb-mastoid bone outer surface, and the carotid canal-jugular bulb distances as well as between the jugular bulb-mastoid bone outer surface and the carotid canal-posterior fossa distances (p < 0.05). In older patients, the carotid canal-posterior fossa distances were shorter on the left side (p < 0.05). Vascular and neural localizations should be well understood in the operative area before applying the surgical approach in the posterior fossa. Computed tomography (CT) has a greater role in the evaluation of bone structures and vascular canals in this area.
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    Peripheral and central smell regions in patients with stroke: an MRI evaluation
    (Springer-Verlag Italia Srl, 2022) Kultur, Turgut; Bayar Muluk, Nuray; Inal, Mikail; Komurcu Erkmen, Selmin Perihan; Rasulova, Gunel
    Objectives We aimed to determine how odor pathways in the stroke were affected. Measurements were performed by magnetic resonance imaging (MRI). Methods Cranial MRI images of 82 adult patients were included. Group 1 was consisted of 41 patients with stroke. The control group (Group 2) was consisted of 41 patients without stroke. In both groups, peripheral ( OB volume and olfactory sulcus (OS) depth) and central smell areas (insular gyrus area and corpus amygdala area) were measured by MRI. Results Peripheral and central smell regions were smaller in the stroke group compared to the control group, whereas right and left side measurements were not different. There were positive correlations between measurements of the peripheral and central smell regions. In older patients with stroke, left OB volume and bilateral OS depths, bilateral insular gyrus areas and bilateral corpus amygdala areas decreased. As the duration of stroke increased, left OB volume decreased. In males with stroke, left OB volume was lower than the females with stroke. Linear regression analysis (backward) showed that in longer stroke duration, OB-volume_R increased and OB volume_L decreased. In older patients, corpus amygdala area_R decreased. In females, OB volume_L increased. Conclusion Both central and peripheral odor pathways were affected, and left OB in the peripheral odor pathways was even more affected in case of longer duration of the stroke. Changes in central and peripheral olfactory pathways in patients with stroke may not be aimed at neuroplasticity and repair, but rather may be a reflection of inflammation and degenerative changes in stroke.