Sürdürülebilir Kalkınma Amaçları

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• MakaleAçık Erişim2026/r/kostu/10863
  Longitudinal 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.

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  İncele
• MakaleAçık Erişim2026/r/kostu/10833
  Magnetic 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.

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  İncele
• MakaleYayıncıda açık erişim2026Scopus SJRQ2/r/kostu/10747
  Evaluation of the pterygoid process pneumatization and sclerosis with Vidian canal morphology using computed tomography: a comparative study in nasopharyngeal carcinoma patients and healthy controls

  Medişoğlu, Mahmut Sabri; Öçbe, Melisa

  BACKGROUND: To evaluate the morphological characteristics of the pterygoid process - including pneumatization and sclerosis - alongside vidian canal (VC) type and length in patients with nasopharyngeal carcinoma (NPC) compared to healthy controls using computed tomography (CT). MATERIALS AND METHODS: This retrospective study included 200 subjects, comprising 38 patients with histopathologically confirmed NPC and 162 age- and sex-matched healthy controls. All CT scans were acquired using a standardized protocol with thin-slice axial images and multiplanar reconstructions. Evaluated features included pterygoid process pneumatization and sclerosis, VC type (classified as Type 1-3), and VC length bilaterally. RESULTS: Pterygoid process pneumatization showed no statistically significant difference between the NPC and control groups (right: 21.1% vs 24.7%, p = 0.794; left: 21.1% vs 18.5%, p = 0.898). In contrast, right-sided pterygoid plate sclerosis was significantly more frequent in NPC patients (68.4%) than in controls (4.9%) (p < 0.005). Significant differences in VC types were found between groups. Type 3 canals were more common in NPC patients (right: 39.5%, left: 39.5%) than in controls (right: 21.0%, left: 23.5%), while Type 2 was reduced in the NPC group (right and left: 15.8%) vs controls (right: 33.3%, left: 34.6%); significant for both sides (right: p = 0.024; left: p = 0.038). VC length was also significantly greater in the NPC group (right: 14.18 mm; left: 13.08 mm) compared to controls (right: 12.25 mm; left: 12.35 mm). The VC length positively correlated with age (right: r = 0.267; left: r = 0.339). CONCLUSIONS: Sclerosis of the right pterygoid plate and an increased prevalence of Type 3 VCs were significantly associated with NPC. Anatomical variations in VC type and length may have diagnostic implications in radiological interpretation and radiotherapy planning in NPC patients.

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  AtıfScopus1·WoS1

  İncele
• MakaleAçık Erişim2026Scopus SJRQ2/r/kostu/10573
  Morphologic variations of the sigmoid sinus on computed tomography: a classification-based study

  Medişoğlu, Mahmut Sabri; Öçbe, Melisa

  Purpose: The sigmoid sinus is a vital dural venous structure whose anatomical variability has direct implications for lateral skull base and otologic surgeries. Understanding the sinus’s positional variations is considered important for minimizing surgical risks. This study aimed to evaluate the morphological classification of the sigmoid sinus using a surgical reference-based system and to assess its relationship with demographic variables. Methods: A retrospective analysis was conducted on high-resolution temporal bone CT scans of 241 patients (114 females [47.30%], 127 males [52.70%]) with an age range of 18–92 years (mean age: 47.95 ± 17.84). The morphology of the sigmoid sinus was classified into four types based on the system defined by Dong-Il Sun et al., using three anatomical reference lines. The width and depth of the sigmoid sinus were measured bilaterally and analyzed in relation to age and gender. Statistical analysis included paired tests for bilateral measurements, chi-square tests and ordinal logistic regression for associations with age and sex, and reliability assessment using Cohen’s kappa and intraclass correlation coefficients. Results: A total of 241 patients were included. Mean sigmoid sinus depth and width were 6.57 ± 1.73 mm and 14.55 ± 4.06 mm on the right, and 6.33 ± 1.52 mm and 15.18 ± 4.93 mm on the left, respectively. Left-sided width was significantly greater than the right (p < 0.05), whereas depth did not differ. Type 3 and Type 4 configurations predominated bilaterally; Type 1 was not observed. Age was significantly associated with left-sided sigmoid sinus type (p = 0.0048), with more medial configurations in older individuals. Ordinal regression showed decreasing odds of higher-type anatomy with increasing age (OR = 0.84 per decade). Gender was associated with left-sided type distribution but not independently predictive after adjustment. Inter- and intraobserver reliability was excellent. Conclusion: The positional morphology of the sigmoid sinus varies significantly with age and gender. The absence of Type 1 and predominance of high-risk configurations in younger individuals suggests the potential relevance of individualized preoperative assessment. This classification system may provide additional anatomical insight for radiologic evaluation; however, its direct impact on surgical decision-making requires further validation.

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  İncele
• MakaleYalnız künye2026Scopus SJRQ4/r/kostu/10365
  Radiologic-anatomical correlation of sphenoid sinus and sella turcica variations

  Medişoğlu, Mahmut S.; Öçbe, Melisa; Genç, Mediha Gülden

  The sphenoid sinus displays variable pneumatization patterns and complex morphology, situated near vital vascular and neural structures. Understanding its anatomical variations is essential for accurate radiological diagnosis and safe surgical planning in otolaryngology and neurosurgery. Different pneumatization types may influence surgical outcomes and complication risks. This retrospective study analyzed 408 CT scans from patients aged ≥18 years to assess sphenoid sinus pneumatization and morphometry. Pneumatization types were classified as conchal, presellar, incomplete sellar, and complete sellar. Morphometric parameters (width, height, and angle) were measured on sagittal CT images. Intraobserver reliability showed excellent agreement. Statistical analyses included descriptive statistics, ANOVA, t-tests, Pearson correlation, and Chi-square tests. Incomplete (41.42%) and complete sellar (40.44%) were the most frequent pneumatization types. Males had greater posterior wall width (p = 0.0008), and age positively correlated with width (p = 0.0125), height (p < 0.0001), and angle (p = 0.0068). Pneumatization types differed significantly by gender (p = 0.0439). Posterior wall height varied significantly across sphenoid sinus pathologies (p = 0.0024), with higher values in cases of polypoid tissue and cysts. Significant correlations existed between width and height (p = 0.0251), and width and angle (p = 0.0053). Incomplete sellar pneumatization was most common, with notable gender differences in type prevalence. While sellar morphometry correlated with age and gender, it was not associated with pneumatization types. Variations in posterior wall height across sinus pathologies may reflect anatomical variability, showing the importance of detailed imaging evaluation.

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  İncele
• MakaleAçık Erişim2025/r/kostu/10887
  Metabolic 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.

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  İncele
• MakaleAçık Erişim2025/r/kostu/10877
  An 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.

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  İncele
• MakaleAçık Erişim2025Scopus SJRQ2/r/kostu/10613
  Magnetic Resonance Imaging of Submental and Masticatory Muscle Morphology and Its Relationship with Temporomandibular Joint Structures

  Öçbe, Melisa; Medişoğlu, Mahmut Sabri

  Introduction: This study aimed to evaluate the submental and masticatory muscles in patients of different age groups using magnetic resonance imaging (MRI) and computed tomography (CT) methods, and investigate potential associations between muscle morphology, temporomandibular joint (TMJ) structures, and disc displacement. Materials and Methods: A total of 185 MRI scans were retrospectively analyzed to assess the thickness of the digastric, geniohyoid, mylohyoid, medial pterygoid, masseter, and lateral pterygoid muscles bilaterally. TMJ hard tissue changes were classified using computed tomography (CT). Correlations between muscle thickness and TMJ structures were analyzed using Pearson correlation coefficients, with statistical significance set at p < 0.05. Results: The study population included 110 females and 75 males, with a mean age of 50.08 ± 20.15 years. The largest age group was 51–75 years (41%), followed by 18–35 years (28%). Significant correlations were observed between muscle thickness and TMJ structures as follows: Right digastric muscle showed a significant association with right disc–condyle position (p = 0.02). Right mylohyoid muscle exhibited a strong correlation with right disc–condyle position (p = 0.004). Left medial pterygoid muscle was significantly correlated with left condyle pathology (p = 0.02). Left masseter muscle showed a significant correlation with left condyle pathology (p = 0.014). Condylar flattening was the most frequent pathology, observed in 58% of right condyles and 53% of left condyles. Disc displacement was present in 41% of right TMJs and 34% of left TMJs. Conclusions: This study highlights the important associations between masticatory and submental muscle morphology and TMJ structures, suggesting that muscle function may play a role in condylar positioning and disc alignment. These findings emphasize the need for comprehensive muscle evaluation in TMJ disorder (TMD) diagnosis and treatment planning.

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  AtıfScopus2·WoS2·OpenAlex2

  İncele
• MakaleYalnız künye2025Scopus SJRQ2/r/kostu/10606
  Multimodal Imaging of the Nasopalatine Canal: Morphometric Characteristics and Signal Intensity Assessment

  Öçbe, Melisa; Medişoğlu, Mahmut Sabri

  Objective: – The nasopalatine canal (NPC) is an essential anatomical structure in the anterior maxilla, linking the nasal and oral cavities. Its morphology is critical for oral surgery, anesthesia, and implant planning. This study aimed to provide a comprehensive evaluation of the NPC by combining computed tomography (CT) and magnetic resonance imaging (MRI) to assess canal morphology and signal characteristics. Methods: – A total of 346 CT and MRI images from patients aged 18 years and older (173 males, 173 females; mean age 53.35 ± 19.8 y) were analyzed. Axial and coronal MRI and sagittal CT sections were evaluated for canal shape, number, length, and signal intensity. Results: – The mean lengths of the incisive and nasopalatine foramina were found as 6.66 ± 2.2 mm and 3.2 ± 1.5 mm, respectively. Axial canal shapes were predominantly round or oval (63.01%), while 47.69% exhibited a Y-shaped configuration in the coronal plane. Anterior tooth loss was present in 39.5% of patients and was significantly associated with changes in foramen dimensions (P < 0.001). The mean FLAIR T2 MRI signal intensities for the incisive and nasopalatine foramina were 643.64 ± 246.38 and 585.46 ± 214.27, respectively. Diagnostic thresholds for normal signal intensity were calculated as 1.136 for the incisive foramen and 1.013 for the nasopalatine foramen. Conclusions: – These findings suggest that FLAIR T2 MRI signal intensity may serve as a diagnostic marker for NPC assessment. Furthermore, anterior tooth loss appears to influence the dimensions of the incisive foramen. Future studies should validate these MRI thresholds and explore longitudinal changes in NPC morphology.

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  AtıfScopus2·WoS2·OpenAlex2

  İncele
• MakaleAçık Erişim2025Scopus SJRQ4/r/kostu/10344
  Computed 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.

  AtıfScopus1

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