Zeliha Fazliogullari

Purpose The aim of this study was to determine the morphometric characteristics and spatial variations of the carotid sinus (CS) using computed tomography angiography (CTA) images. Methods In the study, cervical CTA images of a total of 100 individuals (200 sides) comprising 55 men and 45 women were examined. The diameters of the proximal and distal segments of the common carotid artery (CCA) and the internal carotid artery (ICA), as well as the proximal diameter of the external carotid artery (ECA), were measured. In addition, measurements of the maximum transverse diameter and length of the CS were taken; the resulting data were compared according to the variables of age, gender and side. Results All artery diameters, CS length (mean 8.78 ± 1.33 mm), and maximum CS diameter (mean 8.27 ± 1.10 mm) were found to be significantly higher in men than in women (p < 0.001). It was determined that the diameters of the CCA and ICA on the left side were statistically significantly wider than those on the right side (p < 0.001). It was found that CS localization was asymmetric in 29% of cases and most commonly occurred in the proximal ICA (Type I) in 74.5% of cases. In addition, a positive and statistically significant correlation (r = 0.554; p < 0.001) was found between age and CS length. Conclusion Understanding the morphological variations of the CS is of critical importance in preventing unintended CS stimulation and related complications during surgical procedures in this region, particularly carotid endarterectomy.

Background/Objectives: Microtia is frequently associated with temporal bone malformations, but the extent to which external ear phenotype reflects underlying CT-defined anatomy remains uncertain. This study aimed to compare the relationships of Marx severity grading and Nagata morphological classification with temporal bone anatomy in patients with microtia. Methods: This retrospective study included 26 patients with 27 affected ears who had both preoperative external ear photographs and temporal bone computed tomography (CT) examinations. Each affected ear was classified according to the Marx and Nagata systems, and temporal bone anatomy was assessed using the modified Jahrsdoerfer CT scoring system. Associations were evaluated using Spearman rank correlation and permutation-based Jonckheere–Terpstra analysis, with an additional patient-level sensitivity analysis. Results: Considerable variation in Jahrsdoerfer scores was observed within external ear phenotypic categories, with substantial overlap between Marx Grades II and III and lower scores concentrated in Grade IV. The inverse association between Marx grade and Jahrsdoerfer score did not reach conventional statistical significance (ρ = −0.380, p = 0.051), whereas the Jonckheere–Terpstra test identified an overall decreasing trend (permutation p = 0.025). This trend no longer reached statistical significance in the patient-level sensitivity analysis. Nagata classification did not significantly discriminate CT-based radiological severity. Conclusions: Greater external auricular severity may be associated with less favorable temporal bone anatomy, but the relationship was not uniform across successive Marx grades. Marx and Nagata classifications provide complementary phenotypic information, but neither consistently reflected the extent of underlying temporal bone malformation. These preliminary findings emphasize phenotype–CT variability and support individualized CT-based anatomical assessment when imaging is clinically indicated.

Aim Knowledge of the mental foramen (MF) and accessory mental foramen (AMF) is crucial for preventing complications such as paresthesia, bleeding, and anesthesia failure during dental implant placement and surgical procedures. This study aimed to analyze the morphometric measurements of the MF and AMF, as well as the prevalence and location of the AMF in detail. Methods In this study, multi-detector computed tomography (MDCT) images of 350 patients (700 mandibles) were retrospectively examined. Measurements included the heights, widths, and distances between the MF and AMF. The positions of the AMF relative to the teeth and MF were also examined. Results A total of 16 AMFs were detected in 15 patients (one bilateral), with a prevalence of 2.29%. The height and width of the MF were statistically significantly greater in men than in women (p<0.05). The mean AMF height was 1.23±0.40 mm, the width was 1.51±0.45 mm, and the AMF-MF distance was 2.39±2.08 mm. AMFs were most commonly located between the first and second premolar teeth (37.50%). The most common locations relative to the MF were infero-posterior (31.25%) and supero-anterior (31.25%). Conclusion Although AMF prevalence is low (2.29%), it is clinically significant due to its relationship with neurovascular structures. The notable frequency of superior-anterior locations, in particular, requires attention in implant and maxillofacial surgical planning. Therefore, the use of three-dimensional (3D) imaging methods prior to surgery may help reduce the risk of complications.

Accessory bones are generally considered to be developmental anomalies consisting of unfused ossification centers. These ossicles, which have no clearly defined function, can become infected and dislocated and can also be confused with avulsion fractures. In this study, we aimed to determine the morphometric characteristics and frequency of accessory bones in the foot. Foot computed tomography (CT) images (187 right, 213 left) of 400 individuals (239 men and 161 women) aged 18–86 years who underwent foot CT scans for various reasons were retrospectively reviewed. The surface area and the long and short diameters of the accessory bones were measured and recorded. Of the 400 ft, 270 (67.5%) had at least one accessory bone. The incidence was 57.6% in younger individuals, increasing to 81.4% in older individuals. 2.75% of accessory bones were bipartite. The most common were the accessory navicular bone (41.5%), os trigonum (14%) and os peroneum (13%). One accessory bone was identified that was not described in the available literature. Accessory bones have been proven to be quite common and may increase further in older age groups. The morphometric data obtained and the discovered accessory bone can contribute to the literature and guide clinicians in the diagnosis of related foot pathologies.

Objective: Sesamoid bones are structures embedded in a tendon that reduce friction and provide mechanical advantages to joints. In this study, we aimed to determine the frequency and morphometric characteristics (surface area, long diameter, short diameter) of sesamoid bones in the foot using computed tomography (CT) and to investigate the effects of gender, side, and age factors. Methods: Foot CT images (187 right, 213 left) of 400 individuals (239 males and 161 females) aged 18-86 years who underwent foot CT scans for various reasons were retrospectively reviewed. In axial sections, the surface area, long and short diameter of the sesamoids on the plantar surface of the metatarsophalangeal (MTP I) joint of the hallux were measured, while the presence of sesamoids in the other MTP and interphalangeal (IP) joints was recorded. Results: Hallux sesamoids were found to be bilateral (medial and lateral) in all cases (100%), while the bipartite rate was determined to be 7%. The frequency of other sesamoids was found to be; MTP II 2.75%, MTP III 0.5%, MTP IV 1.5%, MTP V 9.75%, and Hallux IP 22.50%. All morphometric lengths of hallux sesamoids were found to be larger in males than in females (p<0.05). Hallux sesamoids were larger in individuals aged 60 years and older compared to those aged 18-29 years (p<0.05). Conclusion: Morphometric lengths of sesamoid bones were determined, proving that they may be larger in males and with increasing age. This age-related increase brings to mind periarticular osteophytic formations secondary to chronic mechanical stress. The data obtained provide an objective anatomical reference in the differential diagnosis of sesamoid pathologies and in planning forefoot surgeries such as hallux valgus.

Objectives: Tracheobronchial foreign-body aspiration is a clinically significant condition in adults. Although classical teaching attributes the right-sided predominance to the steeper, shorter, and wider morphology of the right main bronchus, this explanation has not been empirically validated in patients with confirmed foreign-body aspiration. Methods: This retrospective study included adult patients (≥18 years) who underwent bronchoscopic removal of foreign bodies from the right or left main bronchus between 2012 and 2025. Only individuals with available preoperative chest radiographs were analyzed. Measurements included tracheobronchial angles, bronchial and tracheal diameters, bronchial lengths, and estimated airway volumes calculated under cylindrical assumptions. Results: Of 35 included patients, 26 (74.3%) had right-sided and 9 (25.7%) had left-sided bronchial foreign bodies. At the population level, the right main bronchus was significantly steeper, wider, and shorter than the left; however, these anatomical differences did not distinguish patients with right- versus left-sided foreign bodies. Tracheobronchial angles, tracheal dimensions, bronchial diameters, and diameter ratios were all similar between the two groups (p > 0.05). In contrast, right bronchial length and volume were significantly greater in patients with right-sided foreign bodies (p = 0.004 for both). Exploratory ROC analysis further suggested that a right bronchial length exceeding 23.28 mm may be associated with an increased tendency toward right-sided migration within this cohort. Conclusions: Increased right bronchial length and volume may facilitate a preferential pathway for airflow continuity toward the right bronchial tree. These findings challenge long-standing anatomical assumptions and highlight the need to incorporate geometric and airflow-dynamic factors into future models of aspiration mechanics.

Background: The spleen is an important organ in the evaluation of systemic diseases due to its hematologic and immunologic functions. Changes in splenic volume and surface area have diagnostic significance in various clinical conditions. This study aimed to evaluate age- and sex-related changes in splenic volume and surface area in an adult population. Material: A total of 304 abdominal CT scans (153 females, 151 males) were retrospectively evaluated. Participants aged 19–89 years were stratified by decades. Changes in splenic surface area and volume were analyzed according to age and sex using measurements obtained from these images with the 3D Slicer software package. Results: Splenic volume showed significant differences across age groups in females, whereas no statistically significant age-related difference was observed in males. Splenic surface area differed significantly according to age groups in both sexes. The highest mean splenic volume and surface area were observed in the 19–29 age group in both sexes. The lowest mean values were detected in the 80–89 age group in females and in the 70–79 age group in males. Conclusions: Splenic volume is higher in males than in females. A statistically significant decrease in splenic volume with advancing age was observed in females, whereas only a non-significant decreasing trend was noted in males. A marked reduction in splenic volume and surface area was observed particularly after the age of 70 years. This finding is associated with age-related immune decline and functional hyposplenism and carries clinical significance in terms of increased susceptibility to infections and diminished immune response in elderly individuals. Furthermore, splenic shrinkage should be considered in the assessment of hematological reserve and in the differentiation of changes related to chronic diseases.

Background and Objectives: Understanding the structural differences in the sacroiliac joint (SIJ) is essential for distinguishing inflammatory from degenerative disorders. This study aimed to evaluate disease-related morphological patterns and morphometric characteristics of the sacroiliac joint. Additionally, machine learning models were applied to classify inflammatory, degenerative, and control groups based on the morphological and morphometric characteristics of the sacroiliac joint. Materials and Methods: This retrospective study included Magnetic Resonance Imaging (MRI) images of 209 individuals (a total of 418 sacroiliac joints) between the ages of 18 and 75. Participants’ age, sex, disease-related sacroiliac joint morphological features (joint surface type), erosion, sclerosis and inflammation in the joint were determined. Right/left joint space and right/left joint length were measured. According to these anatomical features, machine learning models and a deep neural network were used to classify joints as control, inflammatory, or degenerative. Stratified 5-fold cross-validation was used. Results were reported as mean ± SD with macro averaged precision, recall, and F1-score. Results: The degenerative group was significantly higher than the other groups in terms of mean age (p = 0.001). Both right and left sacroiliac joint spaces were significantly narrower in the inflammatory and degenerative groups than in controls (right SIJ space: p = 0.002; left SIJ space: p = 0.001). Erosion was significantly more frequent in pathological groups (p = 0.001). Although the iliosacral complex was the most common joint type in all groups, no significant difference was observed between the disease groups (right, p = 0.852; left, p = 0.935). In classification, SVM (RBF) and XGBoost achieved the highest accuracy (both: 0.9518 ± 0.0380 and 0.9518 ± 0.0436, respectively) and macro-F1 (0.9509 ± 0.0387 and 0.9506 ± 0.0443). Conclusions: Disease-related morphological and morphometric changes in the sacroiliac joint can be reliably assessed with MRI. These features can then be used in machine learning models to differentiate between inflammatory and degenerative joint disorders. Carefully examining these anatomical features plays a key role in reaching an accurate diagnosis. Machine learning supports this process by helping to interpret the findings in a more consistent and objective way.