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Öğe The anatomic analysis of the vidian canal and the surrounding structures concerning vidian neurectomy using computed tomography scans(ASSOC BRASILEIRA OTORRINOLARINGOLOGIA & CIRURGIA CERVICOFACIAL, 2019) Açar, Gülay; Çiçekcibaşı, Aynur Emine; Çukurova, İbrahim; Özen, Kemal Emre; Şeker, Muzaffer; Güler, İbrahimIntroduction: The type of endoscopic approach chosen for vidian neurectomy can be specified by evaluating the vidian canal and the surrounding sphenoid sinus structures. Objective: The variations and morphometry of the vidian canal were investigated, focusing on the functional correlations between them which are crucial anatomical landmarks for preoperative planning. Methods: This study was performed using paranasal multidetector computed tomography images that were obtained with a section thickening of 0.625 mm of 250 adults. Results: The distributions of 500 vidian canal variants were categorized as follows; Type 1, within the sphenoid corpus (55.6%); Type 2, partially protruding into the sphenoid sinus (34.8%); Type 3, within the sphenoid sinus (9.6%). The pneumatization of the pterygoid process is mostly seen in vidian canal Type 2 (72.4%) and Type 3 (95.8%) (p < 0.001). The mean distances from the vidian canal to the foramen rotundum and the palatovaginal canal were greater in the vidian canal Type 2 and 3 with the pterygoid process pneumatization (p < 0.001). The prevalence of the intrasphenoid septum between the vidian canal and the vomerine crest and lateral attachment which ending on carotid prominence were much higher in vidian canal Type 3 than other types (p < 0.001). The mean angle between the posterior end of the middle turbinate and the lateral margin of the anterior opening of the vidian canal was measured as 33.05 +/- 7.71 degrees. Conclusions: Preoperative radiologic analysis of the vidian canal and the surrounding structures will allow surgeons to choose an appropriate endoscopic approach to ensure predictable postoperative outcomes. (c) 2017 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial. Published by Elsevier Editora Ltda.Öğe Carpenter sendromu ve çift çıkışlı sağ ventrikül birlikteliği(2017) Güvenç, Osman; Çimen, Derya; Arslan, Derya; Güler, İbrahimCarpenter sendromu (Akrosefalopolisindaktili tip 2, OMIM 201000), nadir görülen ve otozomal resesif olarak geçen bir hastalıktır. Akrosefali, kraniyosinostoz, fasiyal asimetri polidaktili ve sindaktili, obezite, hipogonadizm, mental gerilik ve kornea opasitesi gibi anomalilerin yanında en sık olarak ventriküler septal defekt, patent duktus arteriyozus ve pulmoner stenoz olmak üzere doğuştan kalp hastalıklarıyla da birlikte olabilir. Çift çıkışlı sağ ventrikül, her iki büyük damarın tamamen veya büyük oranda morfolojik sağ ventrikülden çıktığı bir hastalıktır. Bildiğimiz kadarıyla bu sendromla birlikte çift çıkışlı sağ ventrikül hastalığı literatürde tanımlanmamıştır. Bu yazıda, Carpenter sendromu ve çift çıkışlı sağ ventrikül birlikteliği olan bir hasta sunuldu.Öğe Computed tomography based analysis of the lamina papyracea variations and morphology of the orbit concerning endoscopic surgical approaches(ASSOC BRASILEIRA OTORRINOLARINGOLOGIA & CIRURGIA CERVICOFACIAL, 2019) Açar, Gülay; Büyükmumcu, Mustafa; Güler, İbrahimIntroduction: Radiologic evaluation is mandatory to assess the type of endoscopic approach concerning sinonasal pathology and reconstruction of fractured defects before any treatment modalities are instituted related to medial wall of the orbit. Objective: The goal was to provide improved understanding of the lamina papyracea variations and the relationship with the orbital morphometry. Methods: This retrospective study was performed using computed tomography scans of 200 orbits and results were compared with respect to age, sex, laterality and LP variations. Results: Lamina papyracea variations were categorized as type A, 80.5% (161/200); type B, 16% (32/200); type C, 3.5% (7/200). For medial wall the anterior and posterior lamina papyracea heights and angles were found as 17.14 mm, 147.88 degrees and 9.6 mm, 152.72 degrees, respectively. Also, the length of the lamina papyracea, the mean area of the orbital floor, medial wall, lamina papyracea and orbital entrance were 33.3 mm, 7.2 cm(2), 6.89 cm(2), 4.51 cm(2) and 12.46 cm(2) respectively. The orbital height and width were measured as 35.9 mm and 39.2 mm respectively. The mean orbital cavity depth was 46.3 mm from optic foramen to the orbital entrance and the orbital volume was 19.29 cm(3). We analyzed the morphometric measurements tending to increase with aging and greater in men and the relationship of them with lamina papyracea types. Conclusion: Precise knowledge of the lamina papyracea anatomy using computed tomography is essential for safer and more effective surgery and preforming the dimensions of an implant. In this way, the postoperative complications can be decreased and the best outcome can be provided. (C) 2019 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial. Published by Elsevier Editora Ltda.Öğe Computed tomography evaluation of the morphometry and variations of the infraorbital canal relating to endoscopic surgery(ASSOC BRASILEIRA OTORRINOLARINGOLOGIA & CIRURGIA CERVICOFACIAL, 2018) Açar, Gülay; Özen, Kemal Emre; Güler, İbrahim; Büyükmumcu, MustafaIntroduction: The course of the infraorbital canal may leave the infraorbital nerve susceptible to injury during reconstructive and endoscopic surgery, particularly when surgically manipulating the roof of the maxillary sinus. Objective: We investigated both the morphometry and variations of the infraorbital canal with the aim to show the relationship between them relative to endoscopic approaches. Methods: This retrospective study was performed on paranasal multidetector computed tomography images of 200 patients. Results The infraorbital canal corpus types were categorized as Type 1: within the maxillary bony roof (55.3%), Type 2: partially protruding into maxillary sinus (26.7%), Type 3: within the maxillary sinus (9.5%), Type 4: located anatomically at the outer limit of the zygomatic recess of the maxillary bone (8.5%). The internal angulation and the length of the infraorbital canal, the infraorbital foramen entry angles and the distances related to the infraorbital foramen localization were measured and their relationships with the infraorbital canal variations were analyzed. We reported that the internal angulations in both sagittal and axial sections were mostly found in infraorbital canal Type 1 and 4 (69.2%, 64.7%) but, there were commonly no angulation in Type 3 (68.4%) (p < 0.001). The length of the infraorbital canal and the distances from the infraorbital foramen to the infraorbital rim and piriform aperture was measured as the longest in Type 3 and the smallest in Type 1 (p < 0.001). The sagittal infraorbital foramen entry angles were detected significantly smaller in Type 3 and larger in Type 1 than that in other types (p = 0.003). The maxillary sinus septa and the Haller cell were observed in 28% and 16% of the images, respectively. Conclusion: Precise knowledge of the infraorbital canal corpus types and relationship with the morphometry allow surgeons to choose an appropriate surgical approach to avoid iatrogenic infraorbital nerve injury. (C) 2017 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial. Published by Elsevier Editora Ltda.Öğe CT Evaluation of the Intraorbital Structures Concerning Endoscopic Approaches to the Lamina Papyracea(AMBER PUBLICATION, 2018) Açar, Gülay; Büyükmumcu, Mustafa; Güler, İbrahimBackground: The relationship between the intraorbital structures and medial wall of the orbit is essential for surgical approaches. Objective: The goal was to provide an improved understanding of the dimensions of extraocular muscles and the approximate location of the intraorbital structures with respect to the lamina papyracea (LP). Material and Methods: This retrospective study was performed using the multiplanar reconstruction of Computed Tomography (CT) scans of 200 orbits. Results: We measured the mean diameters of intraorbital structures. The mean horizontal distances from LP to medial and inferior rectus muscles, globe, and infraorbital canal were found as 3.9 +/- 1.2 mm, 11.5 +/- 1.6 mm, 7.8 +/- 1.5 mm and 16.1 +/- 2.0 mm and as 0.6 +/- 0.4 mm, 4.7 +/- 1.3 mm, 7.2 +/- 1.8 mm, 12.5 +/- 2.3 mm at the depth of the anterior (AEF) and posterior ethmoidal foramen, respectively. All morphometric results were compared with respect to age, sex and laterality and higher in males than females. The measurement results indicated that subjects in first and second age groups showed statistically significant differences in distances from the LP to the globe, medial and inferior rectus muscles at the depth of AEF (p<0.05). But, there was no difference between right and left. Conclusion: CT imaging which can offer an accurate understanding of the regional anatomy of and around the LP may be helpful in preoperative planning and prediction of postoperative outcomes. It can allow the surgeon to prevent possible orbital injury during surgical interventions.Öğe Epicardial Adipose Tissue and Atherosclerosis In Patients With Familial Mediterranean Fever(WILEY-BLACKWELL, 2013) Küçük, Adem; Solak, Yalçın; Akıllı, Hakan; Yıldırım, Oğuzhan; Güler, İbrahim; Uçar, Ramazan; Arıbaş, Alpay[Abstract not Available]Öğe Manyetik rezonans görüntüleme ile supraspinatus kas alanı değerlendirmede iki farklı yazılımın karşılaştırılması(2015) Nayman, Alaaddin; Erdoğan, Hasan; Allahverdiyev, Ilgar; Güler, İbrahimAmaç: Rotator manşet yaralanmalarında en sık etkilenen tendon supraspinatus (SPS) tendonudur. SPS tendonunda rüptür sonrasında kasın kendisinde atrofi meydana gelmektedir. SPS kas alanının doğru ölçümünün, kas atrofisinin erken tanı ve tedavisinde önemli bir ölçüt olduğu düşünülmektedir. Alan ölçümleri genel olarak özel yazılımlar gerektiren iş istasyonlarında yapılmaktadır ve bu da yüksek maliyet gerektirmektedir. Bu çalışmada, SPS kas alanı ölçümünün değerlendirilmesinde bir iş istasyonu olan syngo.via ile hastanemizde de halen kullanılmakta olan yerli bir görüntü arşivleme ve bağlantı sistemi (PACS) olan EnlilPacs yazılımının sonuçları karşılaştırılmıştır. "Alan ölçümü yapmak için, iş istasyonu kullanılmadan, rütin rapor okumada kullanılan Enlilpacs ile iş istasyonu kadar güvenilir sonuçlar elde edilebilir mi?" sorusunun cevabını bulmak amaçlanmıştır. Gereç ve yöntem: SPS tendonunda tam kat rüptür olan 50 hastanın omuz manyetik rezonans (MR) görüntüleri değerlendirildi. Omuz MR görüntülemede rütin çekim protokolü kullanıldı. Sagital oblik T2 ağırlıklı görüntüler üzerinden, supraskapüler olukta, Y şekli içerisinde SPS kas alanları ölçüldü. Ölçümler kas iskelet radyolojisinde deneyimli iki farklı radyolog tarafından, iki farklı yazılım (syngo.via ve EnlilPacs) kullanılarak yapıldı. Elde edilen sonuçların ortalamaları karşılaştırıldı. Korelasyon ve güvenilirlik analizleri yapıldı. Bulgular: Ortalamalar arasında istatistiksel olarak anlamlı fark saptanmadı. Güvenilirlik analizinde ölçüm sonuçları açısından gruplar birbirleri ile iyi derecede tutarlı bulundu (Cronbach alfa0.970). Korelasyon analizlerinde aynı yazılım kullanıldığında radyologlar arasında ve farklı yazılımlar kullanıldığında, yazılımlar arasında oldukça iyi korelasyon tespit edildi. En iyi korelasyonlar her iki kullanıcı için de iki farklı yazılım arasında idi. Sonuç: Alan ölçümü yapmak için yüksek maliyet gerektiren iş istasyonları yerine, yerli bir PACS sistemi olan EnlilPacs güvenle kullanılabilir.Öğe Perianal fistülün tanısında, sınıflandırılmasında ve değerlendirilmesinde Manyetik Rezonans Görüntüleme'nin önemi(2017) Sivri, Mesut; Koplay, Mustafa; Nayman, Alaaddin; Cebeci, Hakan; Güler, İbrahim; Uysal, Emine; Paksoy, YahyaAmaç: Manyetik rezonans görüntüleme (MRG) perianal bölgenin değerlendirilmesinde yüksek güvenilirliğe sahip non-invaziv bir yöntemdir. Bu çalışmada, perianal fistül tanısı alan hastaların preoperatif MRG bulguları ve özellikle sınıflandırmanın görüntülerle birlikte sunulması amaçlandı. Yöntemler: Perianal fistül tanısı alan 57 hastanın demografik özellikleri ve kontrastlı konvansiyonel ve difüzyon MRG bulguları retrospektif olarak değerlendirildi. Perianal fistül sınıflandırılması MRG bulgularını temel alan 'St James Üniversite Hastanesi (SJUH) Sınıflaması' referans alınarak yapıldı. Bulgular: Çalışmaya 57 hasta (44 erkek ve 13 kadın: yaş aralığı 18-72 yıl; ortalama yaş 45,7 yıl) dahil edildi. Hastaların büyük çoğunluğunun esas yakınması makatta ağrı ve akıntı idi. Bazı hastalar ek olarak makatta kaşıntı, şişlik ve kızarıklık semptomları da bildirdi. 37 hastada tip 1, dokuz hastada tip 2, dört hastada tip 3, beş hastada tip 4, iki hastada ise tip 5 fistül saptandı. Anal kanala açılım yerleri 21 hastada saat 6, 10 hastada saat 7 olarak saptandı. Konvansiyonel ve difüzyon MRG ile fistül traktı, apse varlığı, rektuma açılım yeri, sfinkterle veya komşu anatomik yapılarla ilişkisi tüm hastalarda net olarak değerlendirildi. Sonuç: Anal kanal ve perine derisi arasında meydana gelen anormal bağlantı perianal fistül olarak adlandırılmaktadır. Genellikle tekrarlayan anorektal apselerin komplikasyonudur. Crohn, tüberküloz, malignite gibi inflamatuar süreçlere sekonder de gelişebilir. Tedavide esas yöntem cerrahidir. Cerrahi yetersizliğine bağlı rekürrens oldukça sıktır. MRG bulgularının iyi bilinmesi ve cerrahın iyi yönlendirilmesi ile rekürrens oranı en aza indirgenebilmektedir.Öğe The Relationship Between Periaortic Adipose Tissue Volume and Aortic Sclerosis(EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC, 2017) Muştu, Mehmet; Büyükterzi, Zafer; Alpaydın, Mehmet Sertaç; Karaarslan, Şükrü; Güler, İbrahim; Büyükterzi, Meral[Abstract not Available]Öğe The role of Onodi cells in sphenoiditis: results of multiplanar reconstruction of computed tomography scanning(ASSOC BRASILEIRA OTORRINOLARINGOLOGIA & CIRURGIA CERVICOFACIAL, 2017) Şentürk, Mehmet; Güler, İbrahim; Azgın, İsa; Sakarya, Engin Umut; Övet, Gültekin; Alataş, Necat; Tolu, İsmetIntroduction: Onodi cells are the most posterior ethmoid air cells and extend superolateral to the sphenoid sinus. These cells are also intimately related with the sphenoid sinus, optic nerve, and carotid artery. Radiologic evaluation is mandatory to assess for anatomic variations before any treatment modalities related to the sphenoid sinus. Objective: To evaluate the effect of Onodi cells on the frequency of sphenoiditis. Methods: A retrospective analysis was performed in 618 adult patients who underwent high resolution computed tomography between January 2013 and January 2015. The prevalence of Onodi cells and sphenoiditis was evaluated. Whether the presence of Onodi cells leads to an increase in the prevalence of sphenoiditis was investigated. Results: Onodi cell positivity was observed in 326 of 618 patients and its prevalence was found to be 52.7%. In the study group, 60.3% (n =73) were ipsilaterally (n =21) or bilaterally (n = 52) Onodi-positive, whereas 39.7% (n=48) were Onodi-negative (n=35) or only contralaterally Onodi-positive (n= 13). Of the control group, 48.3% (n=240) were Onodi-positive and 51.7% (n=257) were Onodi negative. The co-existence of Onodi cells ipsilaterally was observed to increase the identification of sphenoiditis 1.5-fold, and this finding was statistically significant (p < 0.05). Conclusion: The prevalence of sphenoiditis appears to be higher in patients with Onodi cells. However, it is not possible to state that Onodi cells are the single factor that causes this disease. Further studies are needed to investigate contributing factors related to sphenoiditis. (C) 2016 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial. Published by Elsevier Editora Ltda.Öğe Sphenoethmoid Cell: The Battle for Places Inside of the Nose Between a Posterior Ethmoid Cell and Sphenoid Sinus: 3D-Volumetric Quantification(BENTHAM SCIENCE PUBL LTD, 2017) Şentürk, Mehmet; Güler, İbrahim; Azgın, İsa; Sakarya, Engin Umut; Öcal, Ramazan; Ağırgöl, Betül; Alataş, NecatBackground: Sphenoethmoid cells may be above the sphenoid sinus with/or without contact to optical nerve. Although sphenoethmoid cells are theoretically considered to possibly influence the sphenoid sinus volume, we could not find any study in the literature on this issue. Aims: The aim of our study was to detect sphenoethmoid cells and measure the sphenoid sinus volume using multiplanar computerized tomography and also investigate the correlation between the presence of sphenoethmoid cells and the sphenoid sinus volume. Methods: Retrospectively 141 patients who had available paranasal computerized tomography images were included in this study. The sphenoid sinus volumes of each patient were calculated individually for each side, and the relationship between the presence of sphenoethmoid cell and sphenoid sinus volume was investigated. Results: Sphenoethmoid cells were detected at 106 (37.5%) of the total 282 sides in 141 patients. No gender difference was observed. The total sphenoid sinus volume was significantly lower in the group of patients who had bilateral sphenoethmoid cells than in the sphenoethmoid cell negative group. In patients with a unilateral sphenoethmoid cell, a significant decrease in the sphenoid sinus volume was observed only for the side where the sphenoethmoid cell was located. Conclusion: It was observed that the sphenoethmoid cells caused a significant reduction in the sphenoid sinus volume on the side where they were located. In the case of low sphenoid sinus aeration, the sphenoethmoid cell should be kept in mind. Further studies with an extended patient series are required to explore this issue.Öğe Volumetric analysis of the maxillary sinus in pediatric patients with nasal septal deviation(DEOMED PUBL, ISTANBUL, 2015) Şentürk, Mehmet; Azgın, İsa; Öcal, Ramazan; Sakarya, Engin Umut; Güler, İbrahim; Övet, Gültekin; Alataş, NecatObjective: Reasons such as nasal deviation, which reduces airflow in nose and impairs oxygenation, may affect the maxillary volume. In this study, we aimed to perform a retrospective study between the degree of nasal septal deviations and maxillary sinus volume. Methods: The files of 103 male and 124 female patients (total n=227) who applied to otorhinolaryngology clinic with nasal septal deviation without coexisting sinonasal morbidity were investigated, and compared with those without nasal septal deviation and coexisting sinonasal morbidity. Three-dimensional paranasal sinus CTs were performed for the diagnosis (CTs were found to be normal, and etiology of chronic intracranial headache could not be determined) and they were evaluated retrospectively. Maxillary sinus volume was calculated for each case in the groups. The relationship between nasal septal deviation and maxillary sinus volume was evaluated. Results: Our study determined that there was statically no significant difference between the maxillary volumes of the group with (29.34 +/- 7.46 cm(3)) or without nasal septal deviation (27.89 +/- 8.51 cm(3)) (p>0.05). No matter what the right nasal septal deviation angle is, it did not affect the right, left and total maxillary sinus volumes. Both left-and right-sided nasal septal deviations did not have any effect on the right, left and total maxillary volumes. Conclusion: Any difference was not observed between the maxillary sinus volumes of the children in the pediatric age group with and without nasal septal deviations, and it was concluded that the existence or severity of the septal deviation did not have any effect on the maxillary sinus volume.
