Prevalence of chronic maxillary atelectasis: a radiological study.

OBJECTIVES: Chronic maxillary atelectasis is an infrequent entity and data on its prevalence are lacking. This study investigated the prevalence of chronic maxillary atelectasis and aimed to determine the bilaterality of this entity. METHODS: The data for 5835 patients who underwent paranasal sinus computed tomography from 2016 to 2020 were retrospectively analysed. RESULTS: Fifty-four patients were diagnosed with chronic maxillary atelectasis; its prevalence was 0.92 per cent. The mean age of these 54 patients was 42.98 ± 18.89 years (range, 18-85 years); 17 of the patients were female and 37 were male. Chronic maxillary atelectasis was unilateral in 42 patients and bilateral in 12 patients (22.2 per cent). Eight patients were found to have enophthalmos with apparent facial asymmetry. CONCLUSION: The prevalence of bilateral chronic maxillary atelectasis may be higher than previously reported and bilaterality may increase as the number of diagnosed cases increases. A unified classification is also proposed, which describes the silent sinus syndrome as chronic maxillary atelectasis IIIS.

Comparison of three different noninvasive ventilation strategies as initial respiratory support in very low birth weight infants with respiratory distress syndrome: A retrospective study.

BACKGROUND: There is inadequate evidence regarding which noninvasive ventilation (NIV) is superior for initial respiratory support of preterm infants with respiratory distress syndrome. OBJECTIVES: To compare the failure of noninvasive ventilation (NIV) and neonatal outcomes between nasal continuous positive airway pressure (NCPAP), bi-level positive airway pressure (BiPAP), and nasal intermittent positive pressure ventilation (NIPPV) as the initial respiratory support with less invasive surfactant administration (LISA) in very low birth weight (VLBW) infants. METHODS: Medical records of 419 VLBW infants born at 26-30weeks' gestation who did not require intubation in the delivery room and were initially supported with either NCPAP (n=221), BiPAP (n=101), or NIPPV (n=97) were retrospectively reviewed. The LISA approach was preferred in cases of surfactant requirement. The primary outcome was the failure of NIV within the first 72h of life. Failure of NIV was defined as the persistence or recurrence of one or more of the following: hypoxemia, respiratory acidosis, more than one episode of apnea requiring bag and mask ventilation or more than six episodes of apnea requiring stimulation over a 6-h period. Data were analyzed using univariate and multivariate logistic regression analysis. RESULTS: Failure of NIV within the first 72h of life was significantly higher in the NCPAP group (29.4%) compared with the BiPAP (12.9%) or NIPPV (12.4%) group (P<0.001). However, the BiPAP and NIPPV groups were not different in terms of NIV failure (P=0.91). Multivariable logistic regression analysis showed that antenatal steroid administration (OR: 0.49, 95% CI: 0.27-0.90; P=0.02) and gestational age˂28weeks (OR: 2.03, 95% CI: 1.18-3.49; P=0.01) were independent factors that influence failure of NIV within the first 72h of life. CONCLUSION: Compared with NCPAP, the use of NIPPV/BiPAP strategies for initial respiratory support can reduce the need for invasive ventilation in infants born at 26-30weeks' gestation.

Volumetric evaluation of temporal bone structures in the cases with bilateral tinnitus: clinical and morphometrical study.

BACKGROUND: Tinnitus is the recognition of sound in the absence of any external auditory stimulus to the noise of ringing in the ears. Middle ear aeration carries important role for ossicular coupling and normal hearing. There is restricted morphometric data on the cases with bilateral tinnitus. MATERIALS AND METHODS: In this study we evaluated hearing findings of 18 cases with subjective nonpulsatile bilateral tinnitus and also morphometry and volumetry of temporal bone substructures on the computed tomography images using stereological method compared with the gender and age matched 12 healthy subjects. Duration of tinnitus, exposing acoustic trauma or/and high level noise levels, evaluation of middle ear volume, jugular bulb levels, distances between jugular bulb and both oval window and middle ear were evaluated. RESULTS: Both males and females with tinnitus showed worse hearing thresholds through bone and air conductions than healthy subjects but it was not statistically significant. Pure tone thresholds through bone and air conductions were not statistically different in both sexes with bilateral tinnitus. Right middle ear volume of the cases with bilateral tinnitus was mean 5.57 cm3 for males and 5.64 cm3 for females; and also the left middle ear volume of the cases with bilateral tinnitus was mean 5.87 cm3 for males and 5.65 cm3 for females. There were no significant differences between the cases with bilateral tinnitus and the control subjects according to the side of the body. CONCLUSIONS: The data on the hearing findings and morphometrical evaluation of the cases with bilateral tinnitus may be important for anatomists and clinicians. (Folia Morphol 2018; 77, 1: 57-64).

Bladder pheochromocytoma encountered on sonography.

Pheochromocytomas of the bladder are rare neoplasms, constituting < 0.06% of all vesical tumours. Common presenting features of this tumour include episodes of sweating, hypertension, haematuria and postmicturition syncope. We describe a case of bladder pheochromocytoma in a 66-year-old man whose only symptom of macroscopic haematuria was initially assessed with ultrasonography. Clinical presentation highlights the need for a high index of suspicion during sonographic evaluation of bladder neoplasms because such tumours might present without symptoms of adrenergic excess.

Spontaneous rupture and thrombosis of an intrahepatic portal vein aneurysm.

Aneurysm of the portal venous system, a localized fusiform or saccular dilatation, is a rare clinical abnormality. Most aneurysms are located in the extrahepatic segment and rarely in intrahepatic branches. Portal vein aneurysms are usually uncomplicated and asymptomatic and detected incidentally during diagnostic work-up. We describe a case of a bleeding intrahepatic portal vein aneurysm studied with ultrasonography, color Doppler, computed tomography, and percutaneous transhepatic portography in a noncirrhotic patient. Although there are 43 published cases of portal vein aneurysm in the English-language literature, neither rupture and spontaneous thrombosis of an intrahepatic portal vein aneurysm nor its nonsurgical conservative treatment has been reported.

Percutaneous biliary drainage: an alternative treatment for biliary fascioliasis.

Fascioliasis initially involves the liver parenchyma and then the biliary ducts. The disease can mimic most hepatobiliary diseases at different stages of involvement. We report a case in which the final diagnosis was reached by microscopic demonstration of Fasciola hepatica eggs in bile obtained by percutaneous transhepatic biliary drainage. Computed tomographic findings that were misinterpreted as metastatic liver disease are presented, and the roles of percutaneous transhepatic cholangiography and biliary drainage are discussed.

Aplasia of bilateral uncinate processes with a bilateral nasomaxillary cavity.

Aplasia or hypoplasia of the uncinate process is associated with maxillary sinus aplasia or hypoplasia. It is of particular clinical importance to recognize the presence of normal or abnormal uncinate processes in patients who will undergo surgical procedures for paranasal sinus diseases. In this report, we present a case of aplasia of bilateral uncinate processes, discuss the variations of uncinate processes, and review related literature.