Trigeminal nevraljili hastalarda nervus trigeminus ve komşuluğundaki yapıların anatomisinin incelenmesi
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Tarih
2021
Yazarlar
Dergi Başlığı
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Cilt Başlığı
Yayıncı
Selçuk Üniversitesi Sağlık Bilimleri Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Tic douloureux olarak da bilinen trigeminal nevralji (TN), yüz ağrısının en yaygın nedenlerinden biridir. Anatomik olarak n. trigeminus'un pons'tan çıktığı bölge sinirin kök kısmı olarak tarif edilmekte olup bölgenin anatomisi TN hastalarına yönelik yapılan cerrahi girişimlerde ve hastalığın etyopatogenezi açısından önem arz etmektedir. Çalışmamızda TN tanısı almış 25 hasta ve yaş ve cinsiyet eşleştirmesi yapılmış 25 kontrol grubu olgusunun n. trigeminus ve komşuluğundaki anatomik yapılarına ait MR ve MRA görüntüleri üzerinden retrospektif bir inceleme yapılması amaçlandı. Bu amaçla TN hastalarında etkilenen taraftaki sinirin morfometrik uzunluk, açı ve hacim parametreleri, etkilenmeyen tarafla ve kontrol grubuyla karşılaştırıldı. Ayrıca tanı, sisternal sapma indeksi ve incelenen morfometrik parametreler arasındaki korelasyon değerlendirildi. TN'li hastalarda etkilenen taraftaki sisternal sinir uzunluğu ve cisterna pontocerebellaris hacmi, etkilenmeyen taraf ve kontrollere göre daha küçük bulundu (p<0,05). Etkilenen taraftaki sisternal sinir uzunluğunun, cisterna pontis'in ön-arka uzunluğu ve sisterna pontocerebellaris ile pozitif korelasyon gösterdiği görüldü (p<0,05). Kontrol grubu vakalarında ise sağ ve sol taraf arasında parametrelerin hiçbirinde farklılık yoktu (p>0,05). TN'li hastalarda kontrollere göre pons hacmi daha yüksek iken, n. trigeminus hacminin daha küçük olduğu bulundu (p<0,05). Sonuç olarak TN hem n. trigeminus'un anatomik yapısı ile hem de pons ve cisterna pontocerebellaris hacmi gibi truncus cerebri'nin anatomisiyle yakından ilişkilidir. Bu nedenle TN'li hastaların tedavi planlamalarında n. trigeminus'un radyolojik, fonksiyonel ve klinik anatomisi ve truncus cerebri'nin de incelenmesinin göz önünde bulundurulması tedavide başarıyı artıracağı düşüncesindeyiz.
Trigeminal neuralgia (TN), also known as Tic douloureux, is one of the most common causes of facial pain. Anatomically, the region where the trigeminal nerve originates from the pons is described as the root part of the nerve, and the anatomy of the region is important in surgical procedures for TN patients and in terms of the etiopathogenesis of the disease. In our study, it was aimed to perform a retrospective analysis of the trigeminal nerve and its adjacent anatomical structures on MRI and MRA images of 25 patients with TN and 25 controls who were matched with age and sex. Morphometric length, angle and volume parameters of the nerve on the affected side in TN patients were compared with the unaffected side and the control group. In addition, the correlation between pain duration, cisternal deviation index and examined morphometric parameters was evaluated. In patients with TN, the cisternal nerve length and cerebellopontin cistern volume on the affected side were found to be smaller than the unaffected side and controls (p<0,05). It was observed that the length of the cisternal nerve on the affected side was positively correlated with the anteroposterior length of the cisterna pontis and the cerebellopontin cistern (p<0,05). On the other hand, in the control group cases, none of the parameters differed between the right and left sides (p>0,05). While pons volume was higher in patients with TN compared to controls, it was observed that trigeminal nerve volume was smaller (p<0,05). As a result, TN is closely related to both the anatomical structure of the trigeminal nerve and the anatomy of the brainstem, such as the pons and cerebellopontin cistern volume. For this reason, we think that considering the radiological, functional and clinical anatomy of the trigeminal nerve and the examination of the brainstem in the treatment planning of patients with TN will increase the success in treatment.
Trigeminal neuralgia (TN), also known as Tic douloureux, is one of the most common causes of facial pain. Anatomically, the region where the trigeminal nerve originates from the pons is described as the root part of the nerve, and the anatomy of the region is important in surgical procedures for TN patients and in terms of the etiopathogenesis of the disease. In our study, it was aimed to perform a retrospective analysis of the trigeminal nerve and its adjacent anatomical structures on MRI and MRA images of 25 patients with TN and 25 controls who were matched with age and sex. Morphometric length, angle and volume parameters of the nerve on the affected side in TN patients were compared with the unaffected side and the control group. In addition, the correlation between pain duration, cisternal deviation index and examined morphometric parameters was evaluated. In patients with TN, the cisternal nerve length and cerebellopontin cistern volume on the affected side were found to be smaller than the unaffected side and controls (p<0,05). It was observed that the length of the cisternal nerve on the affected side was positively correlated with the anteroposterior length of the cisterna pontis and the cerebellopontin cistern (p<0,05). On the other hand, in the control group cases, none of the parameters differed between the right and left sides (p>0,05). While pons volume was higher in patients with TN compared to controls, it was observed that trigeminal nerve volume was smaller (p<0,05). As a result, TN is closely related to both the anatomical structure of the trigeminal nerve and the anatomy of the brainstem, such as the pons and cerebellopontin cistern volume. For this reason, we think that considering the radiological, functional and clinical anatomy of the trigeminal nerve and the examination of the brainstem in the treatment planning of patients with TN will increase the success in treatment.
Açıklama
Anahtar Kelimeler
Ağrı, Atrofi, Atrophy, Brainstem, Nervus trigeminus, Trigeminal nevralji, Truncus cerebri, Pain, Trigeminal nerve, Trigeminal neuralgia
Kaynak
WoS Q Değeri
Scopus Q Değeri
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Künye
Kundakcı, Y. E. (2021). Trigeminal nevraljili hastalarda nervus trigeminus ve komşuluğundaki yapıların anatomisinin incelenmesi. (Doktora Tezi). Selçuk Üniversitesi, Sağlık Bilimleri Enstitüsü, Konya.
