Computed Tomography and Magnetic Resonance Imaging for Congenital Hearing Loss: A Retrospective Study.

OBJECTIVE: The aim of this study is to evaluate the relationship between the cochlear nerve and the anatomical structures of the cochlea and internal acoustic canal in patients with congenital hearing loss. MATERIALS AND METHODS: Temporal tomography and magnetic resonance images of 44 patients (88 ears) with non-syndromic congenital hearing loss were retrospectively analyzed between 2018 and 2021. Patients were divided into 2 groups according to cochlear nerve hypoplasia. Cochlear nerve canal width, cochlear basal/ middle turn widths, and internal auditory canal widths were examined. RESULTS: Cochlear nerve hypoplasia was detected in 18.2% (n=16) of the patients and all of the patients with cochlear nerve hypoplasia had severe hearing loss. A statistically significant difference was found between the structures' widths in patients with and without cochlear nerve hypoplasia, in cochlear nerve canal and coronal width of the internal auditory canal. When stenosis is accepted as <1.4 mm for cochlear nerve canal and <3.80 mm for coronal width of the internal auditory canal, cochlear nerve hypoplasia differs statistically between the groups in measurements (respectively; P < .001, P=.018). CONCLUSIONS: In patients with sensorineural hearing loss, cochlear nerve hypoplasia may accompany. Anatomical structures are important in predicting cochlear nerve hypoplasia from temporal computed tomography. Cochlear nerve hypoplasia should be suspected if the cochlear nerve canal and coronal width of the internal auditory canal are less than 1.4 mm and 3.8 mm, respectively, on temporal computed tomography.

The usefulness of the Hounsfield unit and stone heterogeneity variation in predicting the shockwave lithotripsy outcome.

PURPOSE This study aimed to evaluate the use of stone density variation coefficient (SDVC) as an indicator of stone heterogeneity and previously reported parameters for predicting extracorporeal shock wave lithotripsy (ESWL) outcome in urinary calculi. Moreover, a new formula that could be used to predict ESWL success was suggested. METHODS A total of 850 patients, who underwent the first session of ESWL for urinary stones between 2015 and 2020, were examined, and 220 eligible patients were included in the study. Stone density variation coefficient and other parameters associated with stone attenuation values and stone size parameters were studied as potential predictors based on noncontrast com- puted tomography (NCCT). Extracorporeal shock wave lithotripsy success was considered after 3 months by radiography or NCCT. Logistic regression analysis was performed to determine the factors contributing to treatment success. RESULTS For the 220 patients, ESWL success rate was 39.5%. The receiver operating characteristic analysis showed that SDVC (AUC=0.82; 95% confidence interval [CI]: 0.76-0.87; P < .001), mean stone density (AUC=0.81; 95% CI:0.75-0.87; P < .001), maximum stone density (AUC=0.70; 95% CI: 0.63-0.78; P < .001), stone volume (AUC=0.70; 95% CI: 0.62-0.77; P < .001), and major diam- eter (AUC=0.67; 95% CI: 0.59-0.74; P < .001) had significant prediction accuracy from high to low. Additionally, SDVC was found to be successful in predicting ESWL success, especially for patients with high mean stone density (OR = 10; 95% CI: 3.55-28.57; P < .001). The logistic regres- sion model, in which the "stone disintegration probability" (SDP) formula was found, correctly predicted ESWL success with a single session by 79.1%. CONCLUSION In conclusion, size and attenuation values were predictors of treatment success, and the best predictor was SDVC. Evaluation of SDP formula prior to ESWL could predict treatment outcomes and facilitate the decisions regarding treatment strategies.

Role of hepatosteatosis in the prognosis of COVID 19 disease.

PURPOSE: To measure the degree of fatty liver using non-contrast enhanced chest computed tomography (CT) and investigate its relationship with the severity and prognosis of coronavirus disease 2019 (COVID-19) in adult patients. METHODS: This retrospective study included consecutive patients who had been diagnosed with COVID-19 using real-time reverse-transcription polymerase chain reaction (RT-PCR) and subsequently underwent non-contrast enhanced chest CT between October 10 and December 10, 2020. Hepatic attenuation values were measured from Couinaud segments 2, 4, and 8 based on the CT images and the relationships between these values and the Pneumonia Severity Score (PSS), requirement of hospitalization, and the length of hospital and intensive care unit (ICU) stay were analyzed. RESULTS: The study included 414 patients (182 were female, 43.96%), among whom 106 (25.6%) were diagnosed with hepatosteatosis (HS). In the patients with HS, the PSS scores were higher (10.8 ± 4.96 vs. 8.07 ± 5.12; p < 0.001), and 69 (65%) received inpatient care. Moreover, the number of HS patients who received inpatient care was 1.99 (95% confidence interval (CI) 1.26-3.15, p < 0.003) times higher than that of the non-HS patients. No significant difference was found between the HS and non-HS patients with regard to the length of hospital or ICU stay. CONCLUSION: HS can be easily evaluated using non-contrast enhanced chest CT in COVID-19 patients and can be used as a prognostic marker to determine the requirement of hospitalization.

Merkel cell carcinoma of the gluteal region: A rare case report and literature review.

Merkel cell carcinoma (MCC) is a rare cutaneous neuroendocrine cancer that shows aggressive biological behaviour. Although it usually occurs on sun-exposed areas, it can sometimes be seen on non-sun-exposed sites. Here, we present the case of a 66-year-old woman with MCC arising from the right gluteal region that was treated with excision and adjuvant chemoradiotherapy. On follow-up after the 24 months, the patient was disease- and recurrence-free, representing the longest survival among patients with gluteal MCC. Early diagnosis and treatment are important to improve survival rates in patients with non-sun-exposed MCC.

Frequency of typical and atypical computed tomography findings of COVID-19 and their effect on hospitalization.

Objective: This study aimed to determine the frequency of typical and atypical computed tomography (CT) findings of COVID-19 and their effect on hospitalization. Methods: We retrospectively assessed 414 patients who were diagnosed with COVID-19 by real-time reverse transcription-polymerase chain reaction and who had lung involvement in their admission chest CT. We evaluated the frequency of typical and atypical chest CT findings and analyzed the relationship between typical and atypical findings of COVID-19 in patients treated in ambulatory versus inpatient settings. Results: Ground-glass opacities were the most common typical finding of COVID-19 chest CT scans. The frequencies of other typical findings, including consolidation, air bronchogram, pulmonary vascular enlargement (PVE), airway changes, crazy paving pattern, and reticular pattern, were similar to those reported in the literature. Atypical findings were less common and found at varying frequencies. Crazy paving pattern, air bronchogram, reticular pattern, and PVE were significantly more common in hospitalized patients (p<0.001). The frequencies of other typical and atypical findings were not significantly different between ambulatory and hospitalized patients. Conclusion: Increased recognition of typical and atypical findings of COVID-19 and their frequencies, as well as knowledge of admission chest CT findings that are associated with hospitalization, will facilitate medical care during the pandemic.

Nutcracker syndrome complicating with renal abscess.

The nutcracker syndrome refers to compression of left renal vein between the superior mesenteric artery and aorta. Renal abscess consists of purulent and necrotic material localised to the renal parenchyma. These two entities are extremely rare and their coincidence has not previously been described in literature. Here, we report a case of a 10-year-old girl who developed left renal abscess probably due to nutcracker syndrome.