Are there any differences at gray matter sites between severe obstructive sleep apnea patients and healthy controls?

OBJECTIVES: Obstructive sleep apnea (OSA) is a disease that may cause many medical conditions. Neurocognitive disorders may be triggered by OSA. In recent studies, selectively decreased gray matter tissue was observed in patients with OSA. We aimed to determine if there was a substantial difference in patients with extreme OSA by comparing the microstructural changes in different gray matter sub-areas with healthy controls using diffusion-weighted imaging methods. METHODS: We studied 15 diagnosed severe OSA subjects before any treatment and 32 healthy control subjects. High resolution Magnetic Resonance Imaging (MRI) T1 and T2-weighted scans were visually examined to assess any major brain lesions. RESULTS: There were no statistically significant differences of age and gender between the groups.The left and right globus pallidus, putamen and thalamus values did not differ significantly between OSA and control subjects. Right putamen values was negatively correlated with Apnea Hypopnea Index (AHI), supine AHI and non-REM AHI in OSA subjects, but no correlations appeared with left putamen values. The other gray matter parameters did not show any correlations with PSG parameters. AHI, Supine AHI, Non-Supine AHI, REM and NON-REM AHI values was not show any correlation with Right and Left Putamen volume sizes. CONCLUSIONS: We made a morphological comparison of various gray matter areas of OSA patients and healthy volunteers in our study. We observed a significant decrease in right putamen gray matter volumes in patients with higher AHI values. Decreased cognitive functions are found in patients with OSA. In order to demonstrate this cognitive loss in patients with morphologically there is a need for further prospective studies with larger sample sizes.

The role of TAS2R38 genotype in surgical outcomes and culturable bacteria in chronic rhinosinusitis with or without nasal polyps.

BACKGROUND: Recent studies reported the relationship between genetic variations and TAS2R38, which is a bitter taste receptor expressed in the cilia of human sinonasal epithelial cells, among the predisposing factors playing role in immune response to upper respiratory tract bacterial infection. The present study aims to examine the relationship of TAS2R38 genotype with the active microorganism and the effect of genotype on the surgical outcomes among chronic rhinosinusitis patients. METHODOLOGY: 34 patients undergoing endoscopic sinus surgery (ESS) for chronic rhinosinusitis with or without polyps (23 CRSwNP, 11 CRSsNP) and 30 patients undergoing septoplasty surgery for isolated nasal septum deviation were included. All the patients were genotyped for TAS2R38. Scoring was made using endoscopic Modified Lund-Kennedy and radiological Lund-Mackay systems preoperatively. Sino-Nasal Outcome Test with 22 items (SNOT-22) was implemented preoperatively and postoperatively. Nasal swab culture samples were taken intraoperatively from CRS patients and the active microorganism were isolated. RESULTS: In the TAS2R38 genotyping of the study group, PAV/PAV was found in 32.4% of patients, PAV/AVI in 47.1%, and AVI/AVI in 20.6%. In the control group, PAV/PAV was found in 26.7%, PAV/AVI in 36.7%, and AVI/AVI in 36.7%. In the study group, there was no statistically significant difference between the CRS and CRS subgroups in terms of TAS2R38 genotype distributions. The changes in patients' preoperative and postoperative SNOT-22 scores were similar between the genotypes. Proliferation was detected in culture in the whole AVI-AVI group, 81.8% of PAV-PAV group, and 56.3% of PAV-AVI group but the difference was not found to be statistically significant. The proliferation level of Staphylococcus epidermidis by TAS2R38 genotype was found to be statistically significantly higher among patients, who had AVI-AVI genotype, in CRSwNP. CONCLUSIONS: We did not find a statistically significant relationship between the TAS2R38 genotype and CRS subtype, sinonasal bacterial infection risk increase and surgical success rate in CRS patients. Long-term and large-scale studies are needed, which are to be carried out by individual genotyping and sequencing to provide more information on the effects of these genetic variants.

The relationship between dimensions of the Eustachian tube and acquired attic cholesteatoma.

OBJECTIVE: This study investigated the relationship between physical dimensions of the Eustachian tube and the emergence of primary attic cholesteatoma. METHODS: A total of 31 patients with unilateral attic cholesteatoma were selected for radiological comparison. Standard point measurements as well as specific measurements were performed using imaging software. The length, narrowest diameter and bony segment volume, and pharyngeal orifice diameter of both sides of the Eustachian tube (attic cholesteatoma and healthy control ears) were measured and compared. RESULTS: Comparison of the values did not reveal any statistically significant difference between the attic cholesteatoma ears and the healthy control ears in terms of: Eustachian tube height, narrowest diameter, bony segment volume or pharyngeal orifice diameter. CONCLUSION: No statistically significant difference was found between the cholesteatoma ears and the healthy control ears in terms of the osseous Eustachian tube size. The findings indicate that the Eustachian tube bony segment dimensions and pharyngeal orifice diameter are not factors in attic cholesteatoma development.

Submandibular lateral epidermoid cyst: imaging findings of a rare case.

Epidermoid cysts (EC) represent less than 0.01% of all oral cavity cysts. Lateral epidermoid cysts in the neck are very rare. A male patient aged forty-five had a complaint of painless swelling in the neck. A well-circumscribed hypo-echoic mass with internal echoes was detected in the right submandibular regionby ultrasonography. There were round areas inside the cyst with acoustic shadowing. The tissue hardness and the internal nature of the mass were evaluated with sono-elastography. Magnetic resonance imaging showed the mass's location and tissue properties in more detail. Magnetic resonance images revealed a well-circumscribed mass--hyperintense on T2-weighted images, hypo-intense on T1-weighted images--in the right submandibular region that had displaced the submandibular gland and mylohyoid muscle. There was no contrast enhancement in the mass on the contrast-enhanced fat-suppressed T1-weighted MR images. In this case report, we present the imaging features of a rare lateral EC in the submandibular region.

Mesh repair of a pelvic bone defect caused by a migrated acetabular cup.

Conventional transacetabular removal of the migrated acetabular cup can be hazardous due to intraoperative injury to iliac vessels. We present a case of a migrated acetabular cup, in which we used a combined preperitoneal and acetabular approach for its removal. With a bimanual approach, the procedure was safer and easier and allowed mesh repair of the pelvic bone defect. The preperitoneal mesh repair is a well-known method for inguinofemoral hernias. However, it has not been used before in the repair of an acetabular defect after removal of a migrated cup.