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    Comparison of Local Steroid Injection and Pulsed Radiofrequency Neuromodulation for the Treatment of Mild Idiopathic Carpal Tunnel Syndrome
    (JOURNAL NEUROLOGICAL SCIENCES, 2016) Suslu, Husnu; Turan Suslu, Hikmet; Guclu, Bulent; Ozdogan, Selcuk; Duzkalir, Ali Haluk; Karabagli, Hakan
    Aim: The aim of this study was to compare the effectiveness of local steroid injection and pulsed radiofrequency neuromodulation for the treatment of mild idiopathic carpal tunnel syndrome. Methods: Fifty-nine patients investigated retrospectively. The results of local steroid injection for the treatment of idiopathic carpal tunnel syndrome in 28 patients were compared with pulsed radiofrequency neuromodulation in 31 patients. The visual analogue scale and neuropathic pain scale scores were evaluated before and 1, 3 and 6 months after treatment in both groups. Results: Following the procedure, each patient reported an absence of pain, disappearance or reduction of paraesthesia and improvement in hand function. At 1, 3 and 6 months after the procedure, there was significant improvement in visual analog scale and neuropathic pain scale scores compared to the preprocedure states in both groups. The improvement rates of preprocedure and postprocedure visual analog scale scores and neuropathic pain scale scores were similar for both groups except postprocedure sixth month scores. There was a statistically significant difference in neuropathic pain scale scores at postoperative sixth month between the local steroid injection and pulsed radiofrequency neuromodulation groups so that local steroid injection reported more effective. Conclusion: Local steroid injection gives better long-term results than pulsed radiofrequency neuromodulation for the treatment of idiopathic carpal tunnel syndrome.
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    Laboratory Training in Bifrontal and Frontolateral Approaches Using Cadaveric Silicone-Injected Cow Craniums
    (JOURNAL NEUROLOGICAL SCIENCES, 2015) Tatarli, Necati; Turan Suslu, Hikmet; Ceylan, Davut; Seker, Askin; Karabagli, Hakan; Kotktekir, Ender; Ozdogan, Selcuk
    Background: A microneurosurgical laboratory training model was designed for trainees in neurosurgery to help them to learn how to handle surgical microscopes and microneurosurgical instruments. A silicone-injected fresh cadaveric cow cranium is a suitable alternative to using a cadaveric human brain for gaining familiarity with the frontal cranial nerves and vascular structures for bifrontal and frontolateral approaches. Methods: A silicone-injected cadaveric cow cranium was prepared by irrigating the major vessels, followed by the injection of silicone colored either red or blue. Results: A three-step approach was designed to simulate microneurosurgical dissection along the frontal lobe and for the dissection of cranial nerves and vascular structures. This laboratory training model is useful for trainees to gain experience in the use of an operating microscope and become more familiar with the anterior neural and vascular structures in bifrontal and frontolateral approaches. Conclusion: The aim of this study was to develop an innovative model to create a life-like microneurosurgical training system. This model simulates bifrontal and frontolateral approaches performed on the human brain.
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    Vascular Silicone Injection of Fresh Cadaveric Cow Cranium: Alternative Training Model For The Human Brain
    (JOURNAL NEUROLOGICAL SCIENCES, 2015) Tatarli, Necati; Suslu, Hikmet Turan; Ceylan, Davut; Seker, Askin; Karabagli, Hakan; Koktekir, Ender; Ozdogan, Selcuk
    Background: Anatomical and physiological variations of the human brain's vascular system can be observed via silicone injection of the arterial and venous systems. As a novel method, the injection of a fresh cadaveric cow cranium with silicone is an alternative to using the human brain for microanatomical studies. Objective: To report on an improved method for the colored silicone injection of a fresh cadaveric cow cranium using a silicone injection technique. Methods: Five fresh cow crania were injected as an alternative to human brains for microanatomical dissection, in which the preparation consisted of the irrigation of the major vessels and the injection of colored silicone. Cannulation of the internal carotid arteries and the internal jugular veins with catheters was performed, and the vasculature was irrigated with water (major arteries and veins). The fixation of the specimen with either formaldehyde or alcohol, and the colored injection of the arteries and veins with red and blue silicone, respectively, was then performed. Results: The silicone injections resulted in the deeper penetration of the colored solutions into the small cerebral vessels and mesenchymal structures of the fresh cadaveric cow crania. Of the five injected specimens, four exhibited successful injections, while one had suboptimal results. Conclusion: Silicone injection of the cadaveric cow brain, based on the anatomical and physiological assessment of the vasculature of the specimen for microanatomical studies, is suggested as an alternative to using human brain specimens.