Accepted Manuscript Evaluation of the superior semicircular canal morphology using cone-beam computed tomography: A possible correlation for TMJ symptoms Hakan Kurt, Kaan Orhan, Secil Aksoy, Sebnem Kursun, Nihat Akbulut, Burak Bilecenoglu PII:
S2212-4403(14)00014-5
DOI:
10.1016/j.oooo.2014.01.011
Reference:
OOOO 823
To appear in:
Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Received Date: 27 September 2013 Revised Date:
20 December 2013
Accepted Date: 5 January 2014
Please cite this article as: Kurt H, Orhan K, Aksoy S, Kursun S, Akbulut N, Bilecenoglu B, Evaluation of the superior semicircular canal morphology using cone-beam computed tomography: A possible correlation for TMJ symptoms, Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology (2014), doi: 10.1016/j.oooo.2014.01.011. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT
Evaluation of the superior semicircular canal morphology using cone-beam computed tomography: A possible correlation for TMJ symptoms Hakan Kurta*, Kaan Orhana,b, Secil Aksoyb, Sebnem Kursuna, Nihat Akbulutc,
a
Ankara University, Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Besevler,
SC
Ankara, Turkey b
RI PT
Burak Bilecenoglud
Near East University, Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Mersin 10,
M AN U
Turkey c
Gaziosmanpaşa University, Faculty of Dentistry, Oral and Maxillofacial Surgery
Department, Tokat, Turkey. d
Ankara University, Faculty of Dentistry, Department of Anatomy, Besevler, Ankara, Turkey
Word Count-Abstract: 150
Number of references: 42
TE D
Complete manuscript word count (to include body text and figure legends):5426
EP
Number of figures/tables: 1 Table, 6 figures
*Corresponding author: Dr. Hakan Kurt
AC C
Ankara University, Faculty of Dentistry, DentoMaxillofacial Radiology Department, 06500 Ankara, Turkey. Tel:+905334811997
e-mail: [email protected]
M AN U
SC
RI PT
ACCEPTED MANUSCRIPT
Evaluation of the superior semicircular canal morphology using cone-beam computed
AC C
EP
TE D
tomography: A possible correlation for TMJ symptoms
ACCEPTED MANUSCRIPT
Abstract Objective. To assess the superior semicircular canal (SSCC) morphology and to determine whether the SSCD correlate with the temporomandibular joint (TMJ) symptoms.
RI PT
Study Design. Clinical data and CBCT of 175 patients were retrospectively examined by two observers. The distribution and thickness measurements of the different types of bone cover of the SSCC were performed.
SC
Results: Five radiological SSCC pattern was identified from CBCT data. 147 cases (42 %), defined as normal (0.6 -1.7 mm thickness), 62 cases (17.71%) as papyraceous-pattern (1.8 mm), and pneumatized-pattern in 42 cases (12 %). Observer 1 and 2 diagnosed SSCD in 22 of 350 (6.28%) temporal bones individually and had no discordances between the two reviews. All patients with SSCD had identified as having TMJ sign and symptoms (p 0.05). Overall intra-observer consistency for observer 1 was 92.4% between two examinations, 94.4% the detection of SSCC and 92.1% TMJ morphology and 100% for the detection of SSCD cases while the consistency for observer 2 was found 89.8% between two examinations, 90.2% the detection of SSCC and 90.2% TMJ morphology
TE D
and 100% for the detection of SSCD cases, respectively. All measurements were found to be highly reproducible for both observers and no significant difference was obtained from two measurements of the observers (p > 0.05).
EP
Inter-observer consistency
There was no discordances in detecting the SSCD between the two reviews (ICC 1.0). The
AC C
intra-observer as well as inter-observer detection of SSCD were 100%. The ICCs for the measurements between Observer 1 and Observer 2 which ranged from 0.972 (CV-1.98%). There was a high inter- observer agreement, while a high ICC and low CV demonstrated that the procedure was standardized between the evaluations and measurements of the observers. No statistical differences were found among observers evaluations and measurements (p0.05) (Figure 6). SSCD length varied between 1.2 and 5.8 mm (mean 3.29 mm). No significant difference for defect length was found for left (mean 3.4 mm) and right (mean 3.1 mm) sides (p>0.05). Five of the defects were smaller than 2 mm, 9
TE D
were between 2 and 4mm and 8 were larger than 4mm.
Following this, the clinical files of these patients were retrieved and the TMJ symptoms of patients were noted for further correlation. From patients’ records, it was
EP
retrieved that in total there were 28 patients with TMJ symptoms. Of all these patients, all patients (n=20) with SSCD had identified as having TMJ sign and symptoms (p>0.05). The
AC C
SSCC of the rest eight patients were identified as; normal (n=5) and pneumatized pattern (n=3) bilaterally. Although no difference was found among age, sex and location (p>0.05), all patients (n=20) with SSCD had identified as having TMJ sign and symptoms with statistical significant (p3mm) in terms of the symptoms of this phenomenon as conductive hearing loss,
ACCEPTED MANUSCRIPT
vestibular symptoms e.g.39-40. We observed 17 dehiscence cases with the size of >2mm that consisted almost most of the cases. Patients with superior semicircular canal dehiscence syndrome may have some
17, 27, 36-40,
RI PT
symptoms or causes such as vertigo and/or nystagmus, oscillopsia, (Tullio phenomenon),8, 15autophony, disequilibrium due to loud noise, fistula symptoms,27 conductive
hearing loss, tinnitus, vestibular symptoms,8, 15-17, 27, 36-40. Present study interestingly reported
SC
that all of the SSCD patients had TMJ symptoms with statistically significant results (p
S2212-4403(14)00014-5
DOI:
10.1016/j.oooo.2014.01.011
Reference:
OOOO 823
To appear in:
Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Received Date: 27 September 2013 Revised Date:
20 December 2013
Accepted Date: 5 January 2014
Please cite this article as: Kurt H, Orhan K, Aksoy S, Kursun S, Akbulut N, Bilecenoglu B, Evaluation of the superior semicircular canal morphology using cone-beam computed tomography: A possible correlation for TMJ symptoms, Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology (2014), doi: 10.1016/j.oooo.2014.01.011. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT
Evaluation of the superior semicircular canal morphology using cone-beam computed tomography: A possible correlation for TMJ symptoms Hakan Kurta*, Kaan Orhana,b, Secil Aksoyb, Sebnem Kursuna, Nihat Akbulutc,
a
Ankara University, Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Besevler,
SC
Ankara, Turkey b
RI PT
Burak Bilecenoglud
Near East University, Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Mersin 10,
M AN U
Turkey c
Gaziosmanpaşa University, Faculty of Dentistry, Oral and Maxillofacial Surgery
Department, Tokat, Turkey. d
Ankara University, Faculty of Dentistry, Department of Anatomy, Besevler, Ankara, Turkey
Word Count-Abstract: 150
Number of references: 42
TE D
Complete manuscript word count (to include body text and figure legends):5426
EP
Number of figures/tables: 1 Table, 6 figures
*Corresponding author: Dr. Hakan Kurt
AC C
Ankara University, Faculty of Dentistry, DentoMaxillofacial Radiology Department, 06500 Ankara, Turkey. Tel:+905334811997
e-mail: [email protected]
M AN U
SC
RI PT
ACCEPTED MANUSCRIPT
Evaluation of the superior semicircular canal morphology using cone-beam computed
AC C
EP
TE D
tomography: A possible correlation for TMJ symptoms
ACCEPTED MANUSCRIPT
Abstract Objective. To assess the superior semicircular canal (SSCC) morphology and to determine whether the SSCD correlate with the temporomandibular joint (TMJ) symptoms.
RI PT
Study Design. Clinical data and CBCT of 175 patients were retrospectively examined by two observers. The distribution and thickness measurements of the different types of bone cover of the SSCC were performed.
SC
Results: Five radiological SSCC pattern was identified from CBCT data. 147 cases (42 %), defined as normal (0.6 -1.7 mm thickness), 62 cases (17.71%) as papyraceous-pattern (1.8 mm), and pneumatized-pattern in 42 cases (12 %). Observer 1 and 2 diagnosed SSCD in 22 of 350 (6.28%) temporal bones individually and had no discordances between the two reviews. All patients with SSCD had identified as having TMJ sign and symptoms (p 0.05). Overall intra-observer consistency for observer 1 was 92.4% between two examinations, 94.4% the detection of SSCC and 92.1% TMJ morphology and 100% for the detection of SSCD cases while the consistency for observer 2 was found 89.8% between two examinations, 90.2% the detection of SSCC and 90.2% TMJ morphology
TE D
and 100% for the detection of SSCD cases, respectively. All measurements were found to be highly reproducible for both observers and no significant difference was obtained from two measurements of the observers (p > 0.05).
EP
Inter-observer consistency
There was no discordances in detecting the SSCD between the two reviews (ICC 1.0). The
AC C
intra-observer as well as inter-observer detection of SSCD were 100%. The ICCs for the measurements between Observer 1 and Observer 2 which ranged from 0.972 (CV-1.98%). There was a high inter- observer agreement, while a high ICC and low CV demonstrated that the procedure was standardized between the evaluations and measurements of the observers. No statistical differences were found among observers evaluations and measurements (p0.05) (Figure 6). SSCD length varied between 1.2 and 5.8 mm (mean 3.29 mm). No significant difference for defect length was found for left (mean 3.4 mm) and right (mean 3.1 mm) sides (p>0.05). Five of the defects were smaller than 2 mm, 9
TE D
were between 2 and 4mm and 8 were larger than 4mm.
Following this, the clinical files of these patients were retrieved and the TMJ symptoms of patients were noted for further correlation. From patients’ records, it was
EP
retrieved that in total there were 28 patients with TMJ symptoms. Of all these patients, all patients (n=20) with SSCD had identified as having TMJ sign and symptoms (p>0.05). The
AC C
SSCC of the rest eight patients were identified as; normal (n=5) and pneumatized pattern (n=3) bilaterally. Although no difference was found among age, sex and location (p>0.05), all patients (n=20) with SSCD had identified as having TMJ sign and symptoms with statistical significant (p3mm) in terms of the symptoms of this phenomenon as conductive hearing loss,
ACCEPTED MANUSCRIPT
vestibular symptoms e.g.39-40. We observed 17 dehiscence cases with the size of >2mm that consisted almost most of the cases. Patients with superior semicircular canal dehiscence syndrome may have some
17, 27, 36-40,
RI PT
symptoms or causes such as vertigo and/or nystagmus, oscillopsia, (Tullio phenomenon),8, 15autophony, disequilibrium due to loud noise, fistula symptoms,27 conductive
hearing loss, tinnitus, vestibular symptoms,8, 15-17, 27, 36-40. Present study interestingly reported
SC
that all of the SSCD patients had TMJ symptoms with statistically significant results (p
