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    A new ventricular index based on coronal brain magnetic resonance images in patients with idiopathic normal pressure hydrocephalus
    (Tubitak Scientific & Technological Research Council Turkey, 2023) Yilmazsoy, Yunus; Arslan, Serdar; Ozdemir, Adnan; Korkmazer, Bora; Kizilkilic, Osman; Kafadar, Ali Metin
    Background/aim: The aim of this study was to assess the effectiveness of a new quantitative index for the diagnosis of idiopathic normal pressure hydrocephalus. Materials and methods: This retrospective study was conducted at Istanbul University Cerrahpasa Medical Faculty between January 2016 and November 2022. A total of 31 patients diagnosed with idiopathic normal pressure hydrocephalus were included in the study group and 48 patients were included in the control group. Measurement via the new Index was performed on a coronal section of magnetic resonance imaging at the level of the anterior commissure. Results: The new Index's mean diagnostic performance was 1.16 +/- 0.08 in the study group, significantly lower (p < 0.0001) than the mean of 1.43 +/- 0.10 in the control group. When a cutoff value of 1.23 was used for the new index, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy rates were 96.1%, 90.7%, 80.6%, 98%, and 91.3%, respectively. Conclusion: The new Index described here is an effective, feasible, reproducible, highly sensitive, and specific quantitative method that can contribute to the improved diagnosis of patients with idiopathic normal pressure hydrocephalus.
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    Deficits in peripheric and central olfactory measurements in smokers: evaluated by cranial MRI
    (Springer, 2023) Sarikaya, Pelin Zeynep Bekin; Muluk, Nuray Bayar; Baser, Selcuk; Ozdemir, Adnan; Yilmazsoy, Yunus
    Objectives Cigarette smoking remains a serious health problem all over the world. We investigated the peripheral and central olfactory pathways in young male smokers to determine whether there is a relationship between the amount of cigarettes smoked and duration of smoking and the dimensions of the olfactory areas. Methods In this retrospective study, cranial Magnetic Resonance Imaging (MRI) images of adult male smokers aged <= 40 years (n = 51) and 50 healthy male adults were analyzed. The olfactory bulbus (OB) volumes and olfactory sulcus (OS) depths, insular gyrus, and corpus amygdala areas were measured via cranial MRI. In the smoker group, the number of cigarettes smoked and duration of smoking were noted and the Brinkmann index was calculated. Results OB volume, OS depth, and the insular gyrus areas of the smokers were lower than in the control group (p < 0.05). There were no differences between the groups in terms of the corpus amygdala measurements (p > 0.05). No significant correlations were found between the number of cigarettes smoked daily, smoking duration, and the Brinkmann index and the peripheral and central olfactory measurements in our study (p > 0.05). Conclusions In smokers, OB volumes, the OS, and the central areas decrease bilaterally, regardless of smoking duration and number of cigarettes smoked daily. This could be related to inflammatory mediators that may be harmful to the olfactory neuroepithelium, gray matter atrophy in the brain, or endothelial damage related to smoking and its effects on blood support to the brain and olfactory regions.
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    Evaluation of optic nerve sheath complex by magnetic resonance imaging in patients with idiopathic normal pressure hydrocephalus
    (Asean Neurological Assoc, 2023) Yilmazsoy, Yunus; Ozdemir, Adnan; Arslan, Serdar
    Background: We aimed to evaluate the optic nerve and optic nerve sheath diameter of patients with idiopathic normal pressure hydrocephalus with magnetic resonance imaging and to compare with the normal population. Methods: Magnetic resonance images and clinical records of the patients were retrospectively evaluated between 01.01.2015 and 01.01.2020. Twenty one patients in the normal pressure hydrocephalus group and 47 patients in the control group were included. Measurements were performed from the images obtained by creating multiplanar reconstructions from thin-slice Fast Spin Echo T2-weighted images. Measurements were made of optic nerve from the 3 mm posterior to the optic globe, on the plane which is oriented perpendicular to the nerve. Results: There was no difference between the two groups in terms of optic nerve diameters. Optic nerve sheath diameters are significantly higher in the normal pressure hydrocephalus group (p<0.0001). Conclusion: Morphological analysis of the optic nerve sheath complex which contains cerebrospinal fluid will contribute to the diagnosis and understanding chronic effects of normal pressure hydrocephalus, a disease in which changes in brain compliance and cerebrospinal fluid absorption are suspected in its etiology.
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    Relation between optic and carotid canals with sphenoid sinus in patients with communicant hydrocephalus: a computed tomography evaluation study
    (SAGE PUBLICATIONS LTD, 2020) Sencan, Ziya; Muluk, Nuray Bayar; Yilmazsoy, Yunus; Özdemir, Adnan; Mutlucan, Havva Meltem
    Background There are neuro-ophthalmologic findings in patients with communicant hydrocephalus (CH). Purpose To investigate the relationships of the optic canal and carotid canal classifications at sphenoid sinus and anterior clinoid process (ACP) pneumatization in patients with CH. Material and Methods In this multicentric retrospective cross-sectional study, the cranial computed tomography (CT) images of 38 patients with CH (20 men, 18 women) and 40 controls (25 men, 15 women) were included. Optic and carotid canal classification at sphenoid sinus, ACP pneumatization, and sphenoid sinus septation were evaluated. Results In the CH group, type 3 optic canal was detected in 21.1% of the patients and type 4 optic canal was detected in 2.6% of the patients on the left side which was significantly different from the control group (P<0.05). In the CH group, type 3 carotid canal was detected in 21.1% of the patients (left) and 18.4% of the patients (right). ACP pneumatization was present in 13.2% of the patients in the CH group bilaterally. There were positive correlations between optic canal classifications and ACP pneumatization (P<0.05). There were also positive correlations between the right and left carotid canal classifications and ACP pneumatization (P<0.05). Conclusion To avoid complications, CT should be evaluated carefully in patients with CH before surgical interventions in sphenoid sinuses and surgeons should work carefully in the sphenoid sinus or adjacent structures. The protrusion possibility of the optic canal or carotid canal to the sphenoid sinus may be higher in pneumatized ACP patients.
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    Supraorbital ethmoid cells (SOECs), anterior ethmoid artery notch and ethmoid roof relation in PNSCT
    (Elsevier Sci Ltd, 2023) Ozdemir, Adnan; Muluk, Nuray Bayar; Sarikaya, Pelin Zeynep Bekin; Yilmazsoy, Yunus
    Objectives: We investigated supraorbital ethmoid cell (SOEC) presence and types in paranasal sinus computed tomography (PNSCT).Methods: The PNSCT images of 188 adult patients (93 males and 95 females) were evaluated as SOEC group (n = 87 sides), and non-SOEC group (n = 289 sides, control). In both groups, anterior ethmoid artery (AEA) notch-ethmoid roof distance and presence of AEA canal were evaluated. In the SOEC group, SOEC types (type 1 to 3) and SOEC angle are also examined.Results: SOEC was detected in 87 sides (23.13 %). SOEC type 2 was the most detected type (71.3 %). AEA notch-ethmoid roof distance of the SOEC group was significantly higher than those in the non-SOEC group. AEA notch-ethmoid roof distance of the SOEC Type 3 group was significantly higher than SOEC Type 2 group. AEA notch-ethmoid roof distance was 3.74 +/- 1.81 mm in the SOEC group and 0.68 +/- 1.16 mm in the non-SOEC group. When SOEC types were considered, this distance was 5.29 +/- 2.66 mm in type 3, 3.35 +/- 1.35 mm in type 2 and 3.48 +/- 0.92 mm in type 1. In higher SOEC types, SOEC angle; and AEA notch-ethmoid roof distance increased.Conclusion: In more pneumatized SOEC presence, SOEC angle increase, and AEA notch-ethmoid roof distance increases, AEA runs inferiorly in the ethmoid cells and freely below the skull base; and is more susceptible to injury. The surgeons should be more careful not to damage AEA in the FESS when detecting well-pneumatized SOECs (SOEC Type 3).
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    The Evaluation of the Cochlear Aqueduct and Internal Acoustic Canal in Patients with Unilateral Subjective Tinnitus and Normal Hearing
    (Aves, 2023) Yilmazsoy, Yunus; Muluk, Nuray Bayar; Ozdemir, Adnan; Sencan, Ziya
    Objective: We investigated the relationship between idiopathic subjective tinnitus and internal acoustic canal, cochlear aqueduct, vestibule, and lateral semicircular canal measurements by temporal magnetic resonance imaging. Methods: In this retrospective study, temporal magnetic resonance imaging sections of 25 patients (8 males and 17 females) with unilateral tinnitus and normal hearing were included. The internal acoustic canal, cochlear aqueduct, vestibule, and lateral semicircular canal measurements and internal acoustic canal and cochlear aqueduct shape classification were determined in the ipsilateral tinnitus side and contralateral non-tinnitus side. Results: The cochlear aqueduct length and width and internal acoustic canal opening width, length, width, and area of the ipsilateral tinnitus side were not different from the contralateral side. Similarly, the vestibule area and lateral semicircular canal height and width values were not different between the ipsilateral tinnitus side and the contralateral side. The main cochlear aqueduct type was type 2 in both ipsilateral and contralateral sides. For the internal acoustic canal types, cylindrical and funnel shapes were the most common types for the ipsilateral tinnitus side and contralateral side. There were positive correlations between the internal acoustic canal and vestibule areas; cochlear aqueduct length and internal acoustic canal areas; cochlear aqueduct width and width of the lateral semicircular canal; internal acoustic canal area and length and cochlear aqueduct length; internal acoustic canal opening width and height of the lateral semicircular canal; and width of the lateral semicircular canal dimensions. In older patients, the ipsilateral internal acoustic canal area was found to be smaller. Conclusions: In idiopathic subjective tinnitus, there were no important pathologies detected in the internal acoustic canal, cochlear aqueduct, vestibule area, and lateral semicircular canal. We concluded that there are no statistically significant morphometric differences compared to the healthy side in the internal acoustic canal, cochlear aqueduct, vestibule, and lateral semicircular canal areas detected by temporal magnetic resonance imaging in patients with unilateral subjective tinnitus and normal hearing.