Background: Surgical and transcatheter techniques represent the two principal approaches for atrial septal defect (ASD) closure. Although both are widely used, comparative evidence regarding their mid-term effects on cardiac remodeling and right ventricular (RV) function remains limited. Objectives: To compare mid-term cardiac structural remodeling and right ventricular functional recovery after surgical versus transcatheter ASD closure in pediatric patients using serial color Doppler echocardiographic assessment. Additionally, to determine whether either technique leads to faster or greater improvement in right heart morphology and function. Methods: We retrospectively evaluated 69 pediatric patients who underwent ASD closure at a single center. A total of 39 patients underwent surgical repair (Group 1), and 30 patients underwent transcatheter closure (Group 2). Transthoracic color Doppler echocardiography was performed before the procedure and at 3 and 12 months after intervention. Measures of atrial and ventricular morphology and function were analyzed. Results: At 3 months, the surgical group showed significantly greater improvement in right atrium (RA) major axis, RA volume, interventricular septal thickness in diastole, interventricular septal thickness in systole, and RV end-diastolic diameter (RVEDd) compared with the transcatheter group (all p < 0.05). At 12 months, surgical repair remained superior regarding improvement in RA major axis, RA volume, and RVEDd (all p < 0.05). Residual shunt was identified in only one patient in each group at 12 months. Conclusions: urgical ASD closure was associated with earlier and more consistent recovery of right atrial and ventricular geometry and function compared with transcatheter closure. These findings indicate that surgical closure may offer advantages for selected patients, particularly in relation to right heart remodeling during the first postoperative year.

Background/Objectives: The anatomical relationship between the oval window (OW) and the facial nerve (FN) is of significant importance in the context of stapes and middle ear surgery. However, the influence of mastoid pneumatization on OW morphology and FN proximity remains to be elucidated. Methods: This retrospective study included 220 radiologically normal temporal bones from 110 adults. OW width, OW height, OW niche width, FNt–OW distance, FNm–OW distance, OW–mastoid cell distance, and OW–FNm–FNt corridor area were measured on HRCT images. Mastoid pneumatization was classified using a sigmoid sinus-based grading system. RASCI was developed by integrating OW morphology, OW niche width, and mastoid pneumatization. Results: The mean width of the OW, the height of the OW, and the width of the OW niche were 2.41 ± 0.92 mm, 1.38 ± 0.36 mm, and 1.03 ± 0.38 mm, respectively. The mean FNt–OW and FNm–OW distances were recorded as 0.93 ± 0.33 mm and 2.78 ± 0.94 mm, respectively. It was established that larger OW dimensions and FN-OW distances were associated with higher levels of mastoid pneumatization. The radiological–anatomical constraint was categorised as low in 21.4% of cases, moderate in 69.5%, and high in 9.1% of the temporal bones (RASCI). Conclusions: Mastoid pneumatization appears to be associated with OW morphology and FN–OW spatial relationships. The RASCI could provide an initial HRCT-based framework for grading the constraints of the OW-FN corridor; however, prospective surgical validation is required.

Background: The posterosuperior maxillary region poses a challenge in orthognathic surgery due to its complex three-dimensional anatomy. The pterygomaxillary suture (PMS) is a key landmark for various procedures. Understanding its anatomical relationships is essential to improving surgical precision. Methods: A retrospective analysis of CBCT images from 120 patients aged 18–70 years at Ankara Medipol University was conducted. Patients were categorized into skeletal Classes I, II, and III according to the ANB angle. Linear and angular measurements of the PMS and adjacent structures were performed. The statistical analysis included the Shapiro–Wilk, Independent t-test, Mann–Whitney U test, and regression analysis (p < 0.05). Results: There were clear differences between the skeletal groups. Class II and III patients had a lesser lateral PMS–baseline intersection distance (IV–VI) and Class II had a lesser medial PMS–baseline perpendicular distance (VV′) compared to Class I (p < 0.05). Additionally, the angle V–IV–VI was significantly narrower in Class II and III groups, indicating altered PMS orientation in these skeletal patterns. Conclusions: PMS morphology, including thickness, width, and angulation, is influenced by skeletal pattern. A preoperative CBCT assessment and individualized surgical planning are essential to ensure the safety and accuracy of Le Fort I osteotomies, especially in Class II and III patients.

Resumo Fundamento: As técnicas cirúrgica e percutânea representam as duas principais abordagens para o fechamento do defeito do septo atrial (DSA). Embora ambas sejam amplamente utilizadas, as evidências comparativas sobre seus efeitos em médio prazo no remodelamento cardíaco e na função do ventrículo direito (VD) permanecem limitadas. Objetivos: Comparar o remodelamento estrutural cardíaco em médio prazo e a recuperação funcional do ventrículo direito após o fechamento cirúrgico versus percutâneo do DSA em pacientes pediátricos, utilizando avaliação seriada por ecocardiografia com Doppler colorido. Adicionalmente, determinar se alguma das técnicas promove melhora mais rápida ou mais pronunciada da morfologia e da função das câmaras cardíacas direitas. Métodos: Avaliamos retrospectivamente 69 pacientes pediátricos submetidos ao fechamento de DSA em um único centro. Um total de 39 pacientes foi submetido à correção cirúrgica (Grupo 1) e 30 pacientes ao fechamento percutâneo (Grupo 2). A ecocardiografia transtorácica com Doppler colorido foi realizada antes do procedimento e aos 3 e 12 meses após a intervenção. Foram analisadas medidas de morfologia e função atrial e ventricular. Resultados: Aos 3 meses, o grupo cirúrgico apresentou melhora significativamente maior no eixo maior do átrio direito (AD), volume do AD, espessura do septo interventricular na diástole, espessura do septo interventricular na sístole e diâmetro diastólico final do VD (dDFVD) em comparação ao grupo percutâneo (todos p < 0,05). Aos 12 meses, a correção cirúrgica manteve superioridade quanto à melhora do eixo maior do AD, volume do AD e dDFVD (todos p < 0,05). Shunt residual foi identificado em apenas um paciente em cada grupo aos 12 meses. Conclusões: O fechamento cirúrgico do DSA esteve associado a recuperação mais precoce e mais consistente da geometria e da função atrial e ventricular direitas em comparação ao fechamento percutâneo. Esses achados indicam que o fechamento cirúrgico pode oferecer vantagens para pacientes selecionados, particularmente em relação ao remodelamento do coração direito durante o primeiro ano pós-operatório.