Sürdürülebilir Kalkınma Amaçları
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- MakaleAçık Erişim2026Longitudinal Magnetic Resonance Imaging Evaluation of Craniofacial Muscle Changes Following Radiotherapy in Nasopharyngeal Carcinoma
Medişoğlu, M.Sabri; Öçbe, Melisa
Aim: Nasopharyngeal carcinoma (NPC) is a radiosensitive head and neck malignancy typically arising in the Rosenmüller fossa. Radiotherapy (RT), while effective, is associated with adverse effects such as dysphagia and muscle atrophy. While pharyngeal constrictors have been extensively studied, the impact of RT on masticatory and suprahyoid muscles remains underexplored. This study aimed to quantitatively assess MRI-based changes in the thickness of masticatory and suprahyoid muscles in NPC patients before and 18–24 months after RT and to compare these findings with healthy controls. Material and Methods: MRI data from 31 NPC patients and 50 healthy controls were retrospectively analyzed. Muscle thickness was measured bilaterally on standardized T1- and T2-weighted sequences for the masseter, medial/lateral pterygoid, temporalis, geniohyoid, mylohyoid, digastric (anterior belly), and genioglossus muscles. Statistical analyses included paired and independent t-tests, ANOVA, and Chi-square tests (Python v3.11; p < 0.05). Results: Pre-RT patients showed significantly reduced left masseter thickness compared to controls (p = 0.0022). Post-RT, the masseter and medial pterygoid muscles demonstrated up to 30.61% atrophy (p < 0.00001). Minor, non-significant increases were seen in the lateral pterygoid and digastric muscles. Right-sided tumors showed higher ipsilateral muscle thickness. Genioglossus hypertrophy was observed in bilateral cases. Males had thicker muscles than females, and muscle thickness declined with age. Conclusion: RT leads to significant atrophy in key masticatory muscles in NPC patients. Muscle asymmetry may precede treatment and reflect tumor laterality. MRI-based assessment offers valuable insights.
- MakaleAçık Erişim2026Magnetic resonance imaging of Rosenmüller Fossa morphology in nasopharyngeal carcinoma
Medişoğlu, M.Sabri; Öçbe, Melisa
The Rosenmüller Fossa (RF) is the most common site of origin for nasopharyngeal carcinoma (NPC); however, its morphometric characteristics remain underinvestigated in clinical imaging studies. This study aimed to evaluate the morphological and dimensional differences in the RF between patients with NPC and healthy controls using magnetic resonance imaging (MRI). A retrospective analysis of MRI data from 41 patients with NPC and 49 age- and sex-matched controls without nasopharyngeal pathology was performed. Measurements included RF height, width, inter-fossa distance, and nasopharyngeal depth on axial and sagittal MR images. RF morphology was classified as Type A (shallow), Type B (deep and narrow), or Type C (deep and wide). The mean age of patients with NPC was 51.22 ± 13.81 years, and 68.29% were men. Tumor laterality was bilateral in 56.10% of the cases, and RF involvement was observed in 70.73% of the cases. No significant differences were found in right RF dimensions or R-L distance (p>0.05); however, left RF height was significantly reduced in patients with NPC (3.49 vs. 5.42 mm; p=0.013). Nasopharyngeal depth was also shorter in patients with NPC (17.40 mm vs. 19.03 mm; p=0.006). The RF morphology distribution did not differ significantly (p=0.381), although Type C fossae were more common in patients with NPC (26.83% vs. 14.29%). MRI revealed significant reductions in the left RF height and nasopharyngeal depth in patients with NPC, suggesting asymmetrical nasopharyngeal involvement. Detailed RF assessment using MRI may contribute to the early detection and improved staging of NPC.
- MakaleAçık Erişim2025Metabolic imaging of head and neck lesions: Differentiating dental and maxillofacial conditions using positron emission tomography/computed tomography
Medişoğlu, M.Sabri; Öçbe, Melisa
Aim: Fluorine-18-labeled fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (FDG-PET/CT) is an essential oncologic imaging modality, but its uptake patterns may also be seen in benign inflammatory or structural oral conditions, leading to diagnostic confusion. This study aims to compare metabolic activity with maximum standardized uptake value (SUVmax) among common dento-maxillofacial conditions---dental artifacts, periodontal infections, maxillary sinus pathologies, and temporomandibular joint (TMJ) disorders---against confirmed malignant lesions, to guide differential diagnosis and improve clinical interpretation. Materials and Methods: A total of 100 FDG-PET/CT scans were retrospectively analyzed. Inclusion criteria comprised pre-treatment scans with available CT or magnetic resonance imaging (MRI) acquired within four weeks. Patients were categorized into five groups: Dental Artifacts (n=19), Periodontal Infections (n=23), Maxillary Sinus Pathologies (n=21), TMJ Pathologies (n=19), and Malignant Dento-maxillofacial Lesions (n=18; control group). All scans were reviewed by an oral and maxillofacial radiologist and a radiologist. SUVmax were calculated using a 42% threshold. Statistical analyses were conducted using Kruskal-Wallis and MannWhitney U tests with Bonferroni correction. Results: Significant differences in SUVmax were observed across all groups (χ² = 77.4, p<0.000001). The malignant lesion group demonstrated the highest metabolic activity (mean SUVmax = 12.5 ± 3.0), significantly greater than all other groups (p<0.000001). Among nonmalignant conditions, maxillary sinus pathologies showed the highest SUVmax (4.2 ± 1.0), followed by periodontal infections (3.5 ± 0.8). TMJ pathologies and dental artifacts exhibited the lowest FDG uptake (2.0 ± 0.6 and 2.5 ± 0.7, respectively), suggesting minimal metabolic activity. Conclusion: This study confirms that malignant dento-maxillofacial lesions exhibit significantly higher FDG uptake compared to inflammatory and mechanical conditions. Understanding these uptake patterns is crucial to avoiding false-positive interpretations, especially in oncologic patients. Multimodal imaging and interdisciplinary evaluation are recommended for accurate differentiation of dental and maxillofacial pathologies in FDG-PET/CT interpretation.
- MakaleAçık Erişim2025An underrecognized aspect of oncology care: temporomandibular joint evaluation in patients with head and neck cancer
Medişoğlu, M.Sabri; Öçbe, Melisa; Öçbe, Çetin Batuhan
Aims: This study aimed to evaluate and compare temporomandibular joint (TMJ) disc position and condylar morphology on magnetic resonance imaging (MRI) and computed tomography (CT) images of patients with head and neck cancer (HNC) and healthy controls, to determine the prevalence and coexistence of soft-tissue and osseous alterations and to explore their potential clinical relevance. Methods: In this retrospective case-control study, 145 HNC patients and 147 controls that underwent standardized maxillofacial CT and MRI. Anterior disc displacement (ADD) was defined on mid-sagittal MRI; condylar morphology (normal, flattening, erosion, osteophyte) was classified on sagittal CT. Results: Two hundred ninety-two individuals were analyzed (HNC 49.7%). Age was similar (mean difference -3.11 years; p=0.097; Mann-Whitney p=0.0737). ADD prevalence was higher in HNC: right 49.0% vs 37.4% (RD +11.6 percentage points [pp]; RR 1.31; χ² p=0.046), left 52.4% vs 32.7% (RD +19.8 pp; RR 1.61; χ² p=0.00064), and any ADD 60.7% vs 46.9% (RD +13.8 pp; RR 1.29; χ² p=0.018); significance was retained after Holm–Bonferroni adjustment. Condylar morphology distributions differed on both sides (right χ² p=9.6×10-⁵; left p=8.1×10-¹⁰), driven by more erosion in HNC (right 26.9% vs 11.6%; left 27.6% vs 13.6%). “Any condylar pathology” was more frequent in HNC (93.8% vs 85.7%; RD +8.1 pp; OR 2.52; χ² p=0.023; Fisher p=0.033). ADD showed no lateral preference within groups (McNemar p>0.30). Controls, but not HNC patients, exhibited right-greater-than-left discordance for “any condylar pathology” (McNemar p=2.5×10-⁵ vs 1.000). Conclusion: HNC is associated with a high burden of TMJ abnormalities; particularly ADD and an erosive change in condyle; consistent with treatment- and disease-related vulnerability of joint tissues. Providing TMJ assessment into HNC imaging, coupled with early jaw-mobilization and masticatory-muscle–sparing strategies, may help preserve function.
- MakaleAçık Erişim2025Scopus SJRQ4Computed Tomographic Analysis of Anterior Clinoid Process Morphology and Pneumatization
Medişoğlu, M.Sabri; Öçbe, Melisa
The anterior clinoid process (ACP) is a critical anatomical landmark for skull base surgery. Pneumatization of the ACP can affect surgical planning and outcomes. Morphometric evaluation provides essential data for safer interventions. A total of 154 CT images from individuals aged 1–79 years were retrospectively analyzed. ACP pneumatization types (Type 0–3), bilateral height and width, and inter-ACP distance were evaluated. Morphometric values were stratified by age and gender. Among 154 patients, 54.5% were female and 45.5% male. Pneumatization was more common in males, with statistically significant differences observed for both left (p < 0.001) and right (p = 0.021) sides. ACP widths showed a moderate positive correlation with age. Males had wider ACPs, whereas females had greater ACP heights. Logistic regression indicated male gender and younger age as predictors of ACP pneumatization. ACP pneumatization is significantly influenced by gender but not by age. Morphometric differ ences exist between sexes and age groups. Knowledge of these variations is essential for minimizing intraoperative complications during skull base surgeries.
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