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Öğe Changes in the Anatomical Nomenclature of Sella Turcica: Turkish Saddle(Bentham Science Publ Ltd, 2018) Akgul, Mehmet Huseyin; Burulday, Veysel; Muluk, Nuray BayarBackground: 'Sella turcica' was first described in 1543. The "De humani corporis fabrica" is the name of a book by Andreas Vesalius that first described the 'sella turcica'. After this date, it was called the 'sella ephippi', 'sphenoidis sella', or 'sella equine'. In 1627, the famous anatomist Adrianus Spigelius developed the current definition of the term. Discussion: The Ottoman military power was at its highest level and a serious threat to Europe at the time so it was indicative of the sense of Turkish power to use 'sella turcica' as a medical term. Spigelius had investigated Turkish daily life, art, and culture in the sixteenth century, and Turks were common exemplars of an orientalist fashion that was being pioneered in Europe, which may be how this term came about. 'Sella' was used because of its similarity to the Turkish saddle; other such similarities included the amygdala and pear, hippocampus and almond, and priformis and seahorse. Conclusion: In this study, the anatomical, hormonal, and historical characteristics of 'sella turcica' are reviewed.Öğe Esthesioneuroblastoma located in the thoracic extradural space: Case report(Elsevier Sci Ltd, 2016) Akgul, Mehmet Huseyin; Gezen, Ferruh; Uzunlar, Ali KemalOBJECTIVE: Esthesioneuroblastoma accounted for only 6% of the malignant nasal cavity neoplasms (ENB) is a rare tumor which originates from the olfactory epithelium. ENB's are locally agresive and can metastasize by lymphatic and hematogenous routes. A patient with the mass on the nasal dorsum was reported in this article. CASE HISTORY: A 52-year-old-man admitted to the hospital with a 3 months history of progressive nasal obstruction, epistaxis and mass on the nasal dorsum. On rhinoscopy, a polypoid mass was seen in the both nasal cavity and intrana sal biopsy with local anesthesia was performed. Hi stopathologic diagnosis of the tumor was Kadish stage B esthesioneuroblastoma. Tumor was excised by using bilateral endoscopic endonasal resection and lateral rhinotomy approach and paranasal radiotherapy performed postoperatively. Ten months after surgery, neck metastasis was occured and patient was underwent neck dissection. Twenteeth months after initial treatment, distant metastasis was identified on the T 10 vertebra and following the cranial and spinal radiotherapy to the neck he was free of local recurrence at follow up 13 months after surgery. CONCLUSION: It has been known that the metastasis of the ENB to the spinal cord is an uncommon event, and it occurs often years after initial diagnosis. MRI scan is helpful for making the diagnosis, and surgery is the treatment of choice for obtaining diagnostic tissue and debulking the tumor. Radiotherapy is also a mainstay of postoperative treatment. (C) 2016 Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.Öğe Evaluation of posterior clinoid process pneumatization by multidetector computed tomography(Springer, 2017) Burulday, Veysel; Akgul, Mehmet Huseyin; Muluk, Nuray Bayar; Ozveren, Mehmet Faik; Kaya, AhmetIn the present study, we investigated the types and ratio of posterior clinoid process (PCP) pneumatization in paranasal sinus multidetector computed tomography (MDCT). Paranasal MDCT images of 541 subjects (227 males, 314 females), between 15 and 65 years old, were included into the study. Pneumatization of anterior clinoid process and pneumatization types (I, II, or III) were evaluated in the males and females. PCP pneumatization was detected in 20.7 % of the males and 11.5 % of the females. Right, left, and bilateral PCP pneumatizations were detected in 7.9, 5.7, and 7.0 % of the males and 2.9, 3.2, and 4.5 % of the females, respectively. PCP pneumatization of the males is significantly higher than the females. The most detected type of pneumatization was type I (61.2 %) for all groups. In right, left, and bilateral pneumatizations separately, type I pneumatization was the most detected pneumatization type with the ratio of the 70.4, 65.2, and 50.0 %, respectively. In males, type I (61.7 %), and similarly in females, type I (60.6 %) pneumatization were detected more. Type II and type III pneumatizations were detected in decreasing order in both groups. In younger subjects, pneumatization of posterior clinoid process was found as higher, and in older subjects, PCP pneumatization was found as lower. Sclerosis process related to the aging may be responsible for the lower pneumatization ratios in older subjects. Structure of the surrounding regions of PCP is important for surgical procedures related to cavernous sinus, basilar apex aneurysms, and mass lesions. Preoperative radiological examinations are useful for operative planning. Any anomalies to PCP can cause unnecessary injury to the neurovascular complex structure around the cavernous sinus or postclinoidectomy CSF fistulas. Posterior clinoidectomies should be avoided in patients with type III PCP pneumatization to prevent CSF fistulas.Öğe An Evaluation of the Quality of Sleep Before and After Surgical Treatment of Patients with Cervical Disc Herniation(Korean Neurosurgical Soc, 2018) Ogden, Mustafa; Akgul, Mehmet Huseyin; Yuksel, Ulas; Bakar, Bulent; Kamasak, Kagan; Ozveren, Mehmet FaikObjective : It has been reported in recent studies that 50-80% of patients with cervical disc hernia have concomitant sleep disorders. The aim of this study was to evaluate the quality of sleep before and after surgical treatment in patients with cervical disc hernia and to assess the effects on treatment. Methods : The study included 32 patients performed discectomy and fusion with an intervertebral cage through the right anterior cervical approach. Oswestry Disability Index (ODI), Visual Analog Scale (VAS) and Pittsburgh Sleep Quality Index (PSQI) were applied to all patients preoperatively and at one month postoperatively. Results : The postoperative PSQI total points and all the PSQI subscale points, the ODI and VAS scores were significantly reduced compared to the preoperative values. A positive correlation was determined between the preoperative ODI points and the PSQI total points and sleep duration, sleep latency and daytime functional loss subscale points. A positive correlation was also found between preoperative ODI points and VAS points. A positive correlation was determined between the preoperative VAS points and and the PSQI total points and sleep duration, and sleep latency subscale points. A negative correlation was determined between the postoperative ODI and the daytime functional loss subscale points. Conclusion : The results of the study showed that in patients with cervical disc hernia, sleep quality and daytime functionality were negatively affected by severity of pain that limited daily activities. Bringing the pain under control with surgical treatment was observed to increase sleep quality. It can be concluded that when planning treatment for these patients, it should be taken into consideration that there could be a sleep disorder in addition to the complaints and symptoms such as pain, hypoestesia and loss of strength.Öğe The importance of medial-lateral styloid process angulation/coronal plane angle in symptomatic eagle syndrome(Wiley, 2017) Burulday, Veysel; Akgul, Mehmet Huseyin; Muluk, Nuray Bayar; Yagdiran, Burak; Inal, MikailWe used three-dimensional computerized tomography (3DCT) to obtain images of Eagle Syndrome (ES) cases and measurements of relevant variables. Twenty-five subjects with ES and 25 controls were included in this retrospective study. Styloid process length, anterior-posterior styloid process angulation (Sagittal plane angle) (APA), medial-lateral styloid process angulation (Coronal plane angle) (MLA), tonsil-stiloid distance and carotid-stiloid distance were measured on CT and 3DCT images, and cranial and neck angiography was obtained, from a total of 580 images. The styloid process lengths were 40.3 and 40.5 mm on the right and left sides in the ES group. The left MLA was lower in symptomatic (Median: 67.0 degrees) than asymptomatic (Median: 72.6 degrees) ES patients. In ES patients with styloid process length above 3 cm, MLA (coronal plane angle) is important, and the symptoms are more intense when this angle is smaller. Clin. Anat. 30:487-491, 2017. (c) 2017 Wiley Periodicals, Inc.Öğe Important landmarks and distances for posterior fossa surgery measured by temporal MDCT(SPRINGER, 2020) Burulday, Veysel; Bayar Muluk, Nuray; Komurcu Erkmen, Selmin Perihan; Akgul, Mehmet Huseyin; Ozdemir, AdnanIn this retrospective study, we aimed to present important anatomical structures and distances for posterior fossa surgery by temporal multidetector computed tomography (MDCT). The temporal MDCT images of 317 adult patients (158 males and 159 females) were retrieved from the hospital's picture archiving and communication system (PACS). In the coronal temporal MDCT views, the cochlea-carotid canal and jugular bulb-mastoid bone outer surface were measured. In the axial MDCT views, the carotid canal-jugular bulb and carotid canal-posterior fossa distances were measured; the carotid canal and jugular bulb anterior-posterior (AP) and transverse dimensions were also measured. The bilateral cochlea-carotid canal, jugular bulb-mastoid bone outer surface, and right carotid canal-jugular bulb distances were significantly greater in the males than those in the females (p < 0.05). The carotid canal-posterior fossa distance was not different in both genders (p > 0.05). The carotid canal-jugular bulb and the carotid canal-posterior fossa distances were greater on the left side than those on the right side in both genders (p < 0.05). In males, the outer surface distance was greater on the left jugular bulb-mastoid bone than that on the right side of that bone (p < 0.05). The difference between the carotid canal AP dimensions was not significant between males and females (p > 0.05). However, the carotid canal transverse dimension, jugular bulb AP, and transverse dimensions were significantly greater in the males than those in the females, bilaterally (p < 0.05). In each gender separately, the carotid canal AP and transverse dimensions were greater on the left side and the jugular bulb AP and transverse dimensions were greater on the right side than those on the left side (p < 0.05). Positive correlations were found between the cochlea-carotid canal, the jugular bulb-mastoid bone outer surface, and the carotid canal-jugular bulb distances as well as between the jugular bulb-mastoid bone outer surface and the carotid canal-posterior fossa distances (p < 0.05). In older patients, the carotid canal-posterior fossa distances were shorter on the left side (p < 0.05). Vascular and neural localizations should be well understood in the operative area before applying the surgical approach in the posterior fossa. Computed tomography (CT) has a greater role in the evaluation of bone structures and vascular canals in this area.Öğe Investigation of the calcification at the petroclival region through Multi-slice Computed Tomography of the skull base(Churchill Livingstone, 2016) Inal, Mikail; Muluk, Nuray Bayar; Burulday, Veysel; Akgul, Mehmet Huseyin; Ozveren, Mehmet Faik; Celebi, Umut Orkun; Daphan, Birsen UnalObjectives: The aim of this paper was a retrospective investigation of calcification at the petroclival region using Multi-slice Computed Tomography (MSCT). Methods: One hundred thirty skull bases were reviewed. The images were acquired with a 64 slice CT (MSCT). At first images were taken at the axial plane; and then coronal and sagittal reconstructions of raw data were performed. Later investigations were carried out on these 3-dimensional images (3-D imaging). Petrosphenoidal ligament (PSL) (Gruber's ligament) and posterior petroclinoid ligament (PPCL) calcifications were evaluated as "none, partial or complete calcification" for the right and left sides. Results: In the right PSL, there were partial calcifications in 9.8% and complete calcifications in 2.3%. Calcification ratio was 9.8% partial and 2.9% complete in the left PSL. In the right side, there were 26.6% partial and 5.2% complete calcifications of PPCL. In the left side, there were 29.5% partial and 4.6% complete PPCL calcifications.. PPCL calcification was detected more in males compared to females in the right and left sides. In older patients, left PSL; right and left PPCL calcification were detected more. Conclusion: PPCL calcifications cannot be differentiated from PSL calcifications in MSCT slices. The distinction can be easily done in 3-D views. The presence of ossified ligaments may make surgeries in this region difficult, and special care has to be taken to avoid injuries to structures which pass under these ossified ligaments. Particularly in elderly patients, the appropriate surgical instrument for the PSL calcifications should be prepared preoperatively. If PSL is calcified, 6th cranial nerve palsy may not occur even though increased intracranial pressure syndrome is present. Whereas, in lateral trans-tentorial herniations, 3rd cranial nerve palsy occurs in earlier periods when PSL is calcified. Moreover, in sub temporal and transtentorial petrosal approaches, knowing the PSL calcification preoperatively is important to avoid damaging the 6th cranial nerve during surgery. (C) 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.Öğe Is there a relationship between basilar artery tortuosity and vertigo?(Elsevier Science Bv, 2019) Burulday, Veysel; Dogan, Adil; Akgul, Mehmet Huseyin; Alpua, Murat; Cankaya, ImranObjective: The aim of this study was to investigate the relationship between basilar artery (BA) tortuosity, hypogenesis/agenesis of the vertebral artery (VA), and vertigo, with the use of magnetic resonance imaging (MRI). Patients and methods: This case-control study included patients admitted to the outpatient clinics, who were aged 18-80 years, without any known systemic diseases. All patients were evaluated with a 1.5-tesla MRI system. BA Tortuosity, VA agenesis, and VA asymmetry were noted. BA diameter (central) and length (longitudinal) were measured. Results: A total of 154 vertigo patients (46 M, 108 F; mean age of 48.95 +/- 17.3 years) and 346 control subjects (112 M, 234 F; mean age of 45.12 +/- 17.0 years) were included. The mean age of the vertigo patients was significantly higher than that of the control group (48.95 vs 45.12 years) (p = 0.021). The rate of BA tortuosity was higher in patients with vertigo (p = 0.030). When the participants were divided into two groups according to median age ( < 45 vs. >= 45 years) there was no statistically significant difference between the groups in terms of VA asymmetry (p = 0.070) and hypogenesis/agenesis (p = 0.577). There was a statistically significant difference between the groups in respect of BA tortuosity (p = 0.033), BA diameter (p < 0.001), and BA length (p < 0.001). When the study populations were divided into two groups according to the presence of vascular tortuosity, the mean age, BA diameter, and BA length values were higher in the tortuosity ( + ) group (all p < 0.001). Conclusion: These results demonstrated that vertigo and BA tortuosity rates seem to increase with age. Likewise, BA diameter and length increased with age, although there was no significant relationship with vertigo. Patients with tortuosity were significantly older, and had higher rates of VA asymmetry/agenesis, and increased BA diameter compared to subjects without tortuosity.Öğe Is there a relationship between sphenoid sinus types, septation and symmetry; and septal deviation?(Springer, 2016) Akgul, Mehmet Huseyin; Muluk, Nuray Bayar; Burulday, Veysel; Kaya, AhmetIn the present study, we investigated whether there is a relationship between sphenoid sinus (SS) types, septation (lobulation) and symmetry; and septal deviation (SD) by multidetector computed tomography (MDCT). Paranasal MDCT images of 202 subjects (131 males, 71 females), between 10- and 88-year-old, were included into the study. SS type (conchal, presellar or sellar), SS symmetry, SS septation (lobulation) and SD were evaluated by MDCT images. In the present study, in both males (83.2 %) and females (85.9 %); and in all age groups (80.4-85.7 %), sellar type sphenoid sinus were more detected. Conchal type was detected in two cases of the males (1.5 %) and none of the females. SS was detected mainly as multi-septated (multi-lobulated) (51.9 % in males and 56.3 % in females; in all age groups as 51.0-56.8 %; and both SD (+) and SD (-) groups as 51.2-56.8 %). In subjects with SD, asymmetric SS was detected in 80.2 %. Whereas in SD (-) subjects, asymmetric SS was detected in 50.6 %. Sellar type SS pneumatization is the most detected type in our cases. Presence of SD was related to the higher SS asymmetry values. In SD (-) subjects, SS was detected as symmetric. Nasal septal deformities such as SD may influence the development of the SS pneumatization and asymmetric septation. For well anatomic orientation of the surgeons, good anatomy knowledge and preoperative detailed examination of the CT scans are very important.Öğe Sonoelastographic evaluation of the sciatic nerve in patients with unilateral lumbar disc herniation(Springer, 2019) Celebi, Umut Orkun; Burulday, Veysel; Ozveren, Mehmet Faik; Dogan, Adil; Akgul, Mehmet HuseyinObjectiveThe aim of this study was to compare strain elastography (SE) and shear wave elastography (SWE) findings of the sciatic nerve in patients with unilateral lumbar disc herniation (LDH) and healthy control subjects.Materials and methodsThe study group included patients with complaints of unilateral sciatica for 3-12months, with foraminal stenosis due to one level of LDH (L4-L5 or L5-S1). An age- and gender-matched control group was formed of healthy subjects. Evaluations were performed on both the axial and longitudinal planes from the bilateral gluteal region using a 5-9MHz multifrequency convex probe.ResultsThere were 40 patients (20 male, 20 female) with a mean age of 43.112.7years in the study group, and 40 healthy subjects (22 male, 18 female) with a mean age of 42.9 +/- 10.7years in the control group (p>0.05). The sciatic nerve stiffness assessed on both the axial (12.3 +/- 3.7 kPA) and longitudinal (14.3 +/- 3.8 kPA) planes of the involved side was significantly higher than non-involved side (axial: 6.8 +/- 2.1 and longitudinal: 8.3 +/- 2.3 kPA) in the patient group (p<0.001).Conclusions p id=Par4 Patients with unilateral LDH have increased stiffness of the sciatic nerve compared to healthy control subjects. Although the findings in this preliminary study show that shear wave elastography can detect a change in sciatic nerve stiffness in patients with unilateral LDH, larger studies are required to determine the clinical utility of this technique.Öğe The effectiveness of organic vegetable oils with high biocompatibility in preventing epidural fibrosis: An experimental study(Literatura Medica, 2023) Akgul, Mehmet Huseyin; Akgun, Mehmet Yigit; Anteplioglu, Tugce; Kul, OguzBackground and purpose - Epidural fibrosis after all spinal surgeries is an important surgical issue. Various biological and non-biological materials have been tried to inhibit epidural fibrosis, which is deemed to be the most important cause of pain after spinal surgery. Olive oil, nigella sativa oil and soybean oil employed in oral nutrition in clinics involving liquid fatty acids, palmatic acid, linoleic acid, stearic acid and palmitoleic acid. The effectiveness of olive oil, nigella sativa oil and soybean oil on epidural fibrosis was researched on for the first time in laminecto- my model. Methods - Fifty adult male Wistar albino rats weighing between 300 and 400 grams were used in the research. A total of 5 groups were formed: sham (Group I) (n = 10), no application was created; Group II (n = 10) 1 cc saline; Group III (n = 10) 1 cc olive oil; Group IV (n = 10) 1 cc nigella sativa oil; Group V (n = 10); 1 cc soybean oil was applied topically to the epidural region after laminectomy. The total spine of the rats was dissected, histopathological and immunochemical measurements were conducted. Neuro-histopathological results were scored semi-quantitatively in terms of vascular modification, neuron degeneration, gliosis and bleeding criteria.Results - The lowest level of fibrosis and connective tissue proliferation was observed in the group where nigella sativa oil was used after the operation, followed by the group treated with olive oil and lastly with the group given soybean oil.Conclusion - Nigella sativa oil and olive oil are very efficient for lowering the degree of epidural fibrosis and adhesions following laminectomy and can be employed as a sim- ple, inexpensive and highly biocompatible material in clinical practice.
