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Öğe Anatomical landmarks regarding sacrospinous colpopexy operations performed for vaginal vault prolapse(Elsevier Sci Ireland Ltd, 2002) Sağsöz, N.; Ersoy, M.; Kamaci, M.; Tekdemir, I.Aim: To investigate the anatomical relationships of the structures and the topographic anatomy or the sacrospinous ligament and validate Current anatomic knowledge of this area. Materials: Nine embalmed half female cadaver pelvises were dissected to reveal the anatomy of the sacrospinous ligament. Results: The average length of the sacrospinous ligament was measured to be 43.04 +/- 6.58 mm. The inferior gluteal complex emerges from the infrapiriform foramen at a distance of 17.02 +/- 3.08 mm from the ischial spine and courses to inferior laterally with a slight curve. During this course, it passes close to the upper-lateral half of the sacrospinous ligament. The pudendal complex passes above the spine in six of the nine cases (66.6%) and lies maximum of 5.5 mm medial to the spine. Oil average the sciatic nerve is measured to he 25.14 +/- 3.94 mm lateral to the ischial spine. Conclusion: Placing the suture inferomedially and close to sacrum, the risk of complication will be minimal. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.Öğe Certain anatomical relations and the precise morphometry of the infraorbital foramen-canal and groove: An anatomical and cephalometric study(Lippincott Williams & Wilkins, 2001) Kazkayasi, M.; Ergin, A.; Ersoy, M.; Bengi, O.; Tekdemir, I.; Elhan, A.Objectives: To determine and to standardize the certain anatomical relations, and the precise size, course, and location of the infraorbital foramen, canal, and groove for facilitating surgical and invasive procedures. Study Design: This anatomical study consisted of two main steps, namely, the examination of skulls and the cephalometric analysis of the skulls. Measurements of the skulls and of the radiograms were performed. Methods: Thirty-five adult bony heads (70 sides) were studied regarding the localization and dimensions of the infraorbital groove (IOG), infraorbital canal (IOC), and infraorbital foramen (IOF) as well as their relationships with different anatomical landmarks. The cephalometric analysis of the skulls was measured for evaluating the relationships of certain anatomical points and the distances of the skulls in the cephalometric analysis. For this purpose, 13 different distances and two angles were measured on anteroposterior and lateral craniographies. Differences between data of skull and cephalogram measurements were analyzed by the Student t test. The Pearson correlation test was used in the statistical analysis of the 15 values in the cephalogram. Results: Examination of the 70 sides of the 35 bony heads revealed that the shape of the IOF was oval in 34.3%, round in 38.6%, and semilunar in 27.1% of all skulls. The IOF was single in 94.3% and double in 5.7% of the cases. The average distance from the IOF to the infraorbital margin and to the lateral process of the canine tooth in vertical direction and to the lateral nasal border in horizontal direction were 7.19 +/- 1.39 mm, 33.94 +/- 3.15, and 17.23 +/- 2.64 mm, respectively. In cephalometric analysis, when S-N (the distance between the center of the sella turcica and the nasion) and N-ANS (the distance between the nasion and the anterior nasal spine) distances were used as independent parameters for the linear analysis, the correlation of the three values for both independent parameters were statistically significant. Conclusion: While the IOF has no statistically significant changes with regard to the size of the skull, expressive changes take place in the course and the length of the IOG and IOC. Meticulous preoperative evaluation of the IOF and the route of the infraorbital nerve are necessary in patients who are candidates for maxillofacial surgery and regional block anesthesia If these measurements are taken into account, there will be little surgical risk, and this will be helpful in identifying the extent of the operative field.Öğe Comprehensive microsurgical anatomy of the jugular foramen and review of terminology(Elsevier Sci Ltd, 2001) Tekdemir, I.; Tuccar, E.; Aslan, A.; Elhan, A.; Ersoy, M.; Deda, H.The microsurgical anatomy of the jugular foramen was studied in 12 formalin preserved cadavers (24 foramina) and 40 dry-skulls (80 foramina). The jugular foramen was exposed by microsurgical dissection with drilling from a superior to inferior direction. Observations regarding dural architecture of the jugular foramen and relationships between neurovascular structures passing through the foramen were noted in cadavers. Normal bony construction of the foramen and its variational anatomy were examined in dry-skull specimens. Using photographs and drawings, the anatomy of the jugular foramen is presented and related terminology is discussed in the light of a literature review. (C) 2001 Harcourt Publishers Ltd.Öğe Epipteric bones in the pterion may be a surgical pitfall(Georg Thieme Verlag Kg, 2003) Ersoy, M.; Evliyaoglu, C.; Bozkurt, M.C.; Konuşkan, B.; Tekdemir, I.; Keskil, I.S.Background: The pterion, the most commonly used neurosurgical landmark, is defined as the junction of frontal, parietal, and greater wing of the sphenoid and the squamous part of temporal bones. Our aim was to identify the variations of the pterion which may be a potential surgical pitfall. Methods: Both sides of 300 adult skulls were examined but 110 sides were eliminated since their pterion could not be identified owing to a damage. The shortest distance between the lateral orbital rim and the most anterior junction of the four bones forming the pterion was measured on all sides. Results: Out of 490 sides the pterion was found to contain epipteric bones in 44 (9%), and in these skulls the most anterior junction of the bones may be as close as 16 mm to the lateral orbital rim. Conclusion: In skulls with an epipteric bone variation, particularly the anterius and proprium types; the pterion can mistakenly be assessed to be at the most anterior junction of bones and a burr hole placed over there may cause inadvertent penetration into the orbit.Öğe Important anatomical structures used in paravaginal defect repair: cadaveric study(Elsevier, 2004) Ersoy, M.; Sagsoz, N.; Bozkurt, M.C.; Apaydin, N.; Elhan, A.; Tekdemir, I.Objective: To examine the variations and the anatomical characteristics of the tendinous arch of pelvic fascia (TAPF), the tendinous arch of levator ani (TALA) and the obturator fascia (Ofa) that are important structures in paravaginal defect repair and their relations with important neurovascular structures. Study design: We carried our study on 10 pelvic halves of five female cadavers fixed in 10% formaldehyde. Results: TALA could show a very high location or a low location near to inferior edge of obturator internus. TAPF was not observed in four of the cases. It was examined as a quite weak structure in two of the cases. The location of obturator vessel-nerve bundle could show difference. Obturator artery (OA) and vein sometimes do not course parallel to obturator vein (OV) and make an inclination and extend to the obturator foramen (OF). The distance between TAPF and the pectineal ligament (PL) (Cooper ligament) was measured as 5 cm on average. The distance between TAPF and the entrance of obturator canal was measured as 3.2 cm on average. While the distance of pudendal vessel-nerve bundle from levator am (LA) at the anterior border of the spine was 0 mm, 2 cm anteriorly it was measured as 4.4 mm on average. Conclusion: Since TAPF does not develop in every case, it is not a safe structure to be used in surgery. If TALA develop downward as a variation, it could be difficult to distinguish from TAPE Since the obturator fascia is a thin membrane, it is not a strong structure for suture placement. The region that is 2 cm in front of the ischial spine (IS) is a dangerous zone for pudendal vessel-nerve bundle. (C) 2003 Elsevier Ireland Ltd. All rights reserved.
