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Öğe Bilateral variation of the parotid gland in cadaver: a case report(Nagoya Univ, Sch Med, 2023) Anlı, Serpil Çilinğiroğlu; Kazak, ZuhalBilateral variation of the parotid gland is an anatomically rare entity. In this study, we present a 91-year-old female cadaver with aplasia of the parotid gland on the left side of the face and hypoplasia of the parotid gland on the right side of the face. The accessory parotid glands on both sides were of normal size, while bilateral submandibular glands were found to be larger than normal. The surgical anatomy of the parotid gland is very important because this region of the face is a complex structure intertwined with important vessels and nerves. Patients with aplasia, atresia, agenesis, or hypoplasia of the parotid gland should be diagnosed early and proper treatment must be planned. Consequently, this case was found to be remarkable in terms of the coexistence of parotid gland aplasia and hypoplasia.Öğe Anatomical Considerations: The Relationship Between The Vertebral Artery And Transverse Foramina At Cervical Vertebrae 1 To 6 In Patients With Vertigo(2018) Kültür, Turgut; Muluk, Nuray Bayar; Iyem, Cihan; Inal, Mikail; Burulday, Veysel; Alpua, Murat; Çelebi, Umut OrkunObjective: In this study, we aimed to investigate the relationship between the size of the vertebral artery and that of the transverse foramina at the C1 to C6 vertebral level in patients suffering from vertigo thought to be related to vertebrobasilar insufficiency (VBI). Materials and Methods: In this retrospective study, two groups were compared in terms of cervical computed tomography (CT): 22 adult patients with vertigo; and a control group consisting of 23 healthy adult indivıduals. Measurement of the vertebral artery and transverse foramina (i.e. sagittal and transverse dimensions, plus area) were performed bilaterally at levels C (cervical vertebra) 1 to C6. Results: For the cases group, at C6 level the right vertebral artery area, sagittal and transverse diameter were larger than in the control group at the level of statistical significance. At C1 level, the area of the right transverse foramina in the cases group was significantly higher than in the control group. At levels C1 to C5, the values obtained for vertebral artery area were positively correlated with the values for the ipsilateral transverse foramina (transverse foramen sagittal and transverse dimensions plus areas). Where the sagittal or transverse dimensions of the transverse foramina, or the area of the transverse foramina were found to be decreased, vertebral artery areas were also observed to have decreased at C1 to C5 levels. Conclusion: We concluded that a decrease in diameter of the bony structures or transverse foramina may cause a decrease in the cross-sectional area of the vertebral artery on the ipsilateral side. Since it is only the left vertebral artery which is dominant for cerebral blood flow, any compensatory increase in right vertebral artery area cannot offset decreased cerebral blood flow. Decreased blood flow (i.e. VBI) on the left side may play a role in the development of vertigo.Öğe A morphometric evaluation of the humeral component in shoulder arthroplasty(Scientific Publishers India, 2017) Iyem, Cihan; Serbest, Sancar; Inal, Mikail; Burulday, Veysel; Kaya, Ahmet; Kultur, Turgut; Tiftikci, UgurPurpose: Aim of the study is to make a clinical evaluation of parameters used in prosthesis design for the humeral component applied in arthroplasty of the proximal upper extremity. Methods: In our study the plain shoulder radiographs were used of 195 (101 male, 94 female) patients aged 18-65 years (mean age, 38.8 +/- 11.5 years; males 35.4 +/- 11.6 years, females 42.5 +/- 10.2) with soft tissue trauma, but no degenerative or structural disorder in the shoulder joint (fracture, tumour, osteoarthritis etc.). Measurements were made on the radiograph of Head Height (HH), Frontal Base Diameter of the Head (FBD), 3 points at 3 cm intervals from proximal to distal of the medullar canal at surgical neck Endosteal Diameter (ED1, ED2 and ED3 respectively), Neck-Shaft Angle (NSA) and Head-Neck Angle (HNA). Results: According to the results, in the comparison of Groups I and III except the mean values of HH and ED1 in other parameters, no statistically significant difference was determined. In the comparison of Groups II and IV except the mean values of FBD and ED1 in other parameters no statistically significant difference was determined. Conclusions: In conclusion, the success of shoulder arthroplasty is explained well by the anatomic structure and proximal humerus morphometric parameters examined in this study. In prosthesis design, the differences in age and populations should be taken.Öğe A variant course of the superficial palmar branch of the radial artery(Springer France, 2012) Tagil, Suleyman Murat; Bozkurt, Mehmet Cem; Kuvat, Samet Vasfi; Cicekcibasi, Aynur EmineThe objective of this report was to present a case of superficial palmar branch of the radial artery (SPBRA) with a variant course, which to the best of our knowledge, has not been reported in the literature. During anatomical dissections that were carried out in the Department of Anatomy of Suleyman Demirel University School of Medicine to demonstrate the superficial palmar arch, a variation in the course of the SPBRA was noted in the right hand of an adult cadaver. This variant branch ran superficial to, and in contact with, the flexor retinaculum, and ran transversely to join the ulnar artery.Öğe Anatomic variations of popliteal artery that may be a reason for entrapment(Springer France, 2009) Ikiz, Z. Asli Aktan; Üçerler, Hülya; Özgür, ZuhalThe aim of this study was to demonstrate some anatomic variations of popliteal artery and its surrounding structures that may be important especially for popliteal artery entrapment (PAE) syndrome. A cadaveric study in 46 lower limbs was performed to improve the understanding of anatomy of the popliteal artery and its relations with surrounding structures. The popliteal artery was lateral to the popliteal vein in four specimens (8.7%) and deep to popliteal vein in three specimens (6.5%). An aberrant accessory head of gastrocnemius was present in three specimens (6.5%). The popliteal artery and vein were tethered at the adductor magnus hiatus very tightly in one specimen (2.2%). An aberrant medial arterial course around normal medial head of gastrocnemius muscle was seen in one specimen (2.2%). Various anomalous anatomic relationships between muscle and arteries in the popliteal fossa results in arterial compression. We believe that a review of the anatomic variations of the popliteal artery and its surrounding structures will be beneficial for the surgical approaches in PAE.Öğe Superficial palmar communications between the ulnar and median nerves in Turkish cadavers(Wiley, 2007) Tagil, Süleyman Murat; Bozkurt, Mehmet Cem; Özcakar, Levent; Ersoy, Mehmet; Tekdemir, Ibrahim; Elhan, AlaittinThe superficial palmar communicating branch between the ulnar and median nerves, the ramus communicans (RC), has been investigated by anatomical dissections in 30 hands of 15 cadavers in the Turkish population. A communicating branch between the ulnar and median nerves was found in 18 hands (60%). It was classified into 4 types: Type 1-RC emerging from the ulnar 4th common digital nerve (CDN) and uniting with the median 3rd CDN, Type 2-RC emerging from the median 3rd CDN and uniting with the ulnar 4th CDN, Type 3-RC extending horizontally between the 3rd and 4th CDN, Type 4-a plexiform RC formed by multiple twigs. Twelve hands (40%) showed the Type 1 arrangement, one was Type 2 (3.3%), two were Type 3 (6.7%) and three (10%) were Type 4, based on the classification devised by Meals and Shaner ([1983] 3 Hand Surg Am 8:411-414) and modified by Bas and Kleinert ([1999] 3 Hand Surg Am 24:1171-1184). Knowledge of the anatomical characteristics of this branch is important for surgical interventions, especially in carpal tunnel release operations.Öğe Cadaveric observation of an aberrant left subclavian artery: A possible cause of thoracic outlet syndrome(Wiley, 2005) Konuşkan, Bahadır; Bozkurt, M. Cem; Tağıl, Süleyman Murat; Özçakar, LeventWe report a rare anomaly of the left subclavian artery, Coursing through the scalenus anterior muscle, that may cause thoracic outlet syndrome. We also discuss the anatomical basis of the possible diagnostic maneuvers for patients with thoracic outlet syndrome. (c) 2005 Wiley-Liss, Inc.Öğe Anatomical Variations as Potential Risk Factors for Ulnar Tunnel Syndrome: A Cadaveric Study(Wiley, 2005) Bozkurt, M. Cem; Tağıl, Süleyman Murat; Özçakar, Levent; Ersoy, Mehmet; Tekdemir, İbrahimThe aim of this study was to assess the anatomical variations, especially the anomalous muscles passing through Guyon's canal and the fibrous arch forming the piso-hamate hiatus, which may play a role in ulnar tunnel syndrome. We have also focused on the relation of these structures with specific concern to the ulnar nerve. Nineteen embalmed cadavers (37 hands and forearms) were dissected. A fibrous arch extending between the pisiform and the hook of the hamate was observed in 21 hands. In majority of the cases flexor digiti minimi muscle was found to originate only from this arch. An anomalous muscle was disclosed in six hands with four of them passing through the piso-hamate hiatus with the deep branch of the ulnar nerve. In two of four cases, the superficial branch of the ulnar nerve was also accompanying the deep branch of the ulnar nerve beneath the anomalous muscle and through the piso-hamate hiatus. Because these anomalous muscles were generally found to course through the piso-hamate hiatus with the branches of the ulnar nerve, we conclude that the distal portion of the Guyon's canal has a relatively higher risk for ulnar nerve entrapment. We believe that surgeons operating on this region should take into account these various anatomic structures. (c) 2005 Wiley-Liss, Inc.Öğe Insight into understanding the anatomical and clinical aspects of supernumerary rectus capitis posterior muscles(Wiley, 2005) Tağil, Süleyman M.; Özçakar, Levent; Bozkurt, M. CemRectus capitis posterior muscles are located in the suboccipital triangle and function in extension and lateral rotation of the head and neck. There are two of these muscles on each side: the rectus capitis posterior major and the rectus capitis posterior minor. This study describes the presence of a third suboccipital muscle in a 55-year-old cadaver. In addition to highlighting the possible relationship between these muscles and cervicogenic headaches or balance in an individual, we also relate this observation to similar musculature in the cat that have been shown to effect crucial functions. (c) 2005 Wiley-Liss, Inc.Öğe The innervation of patella: anatomical and clinical study(Springer France, 2005) Maralcan, Göktürk; Kuru, İlhami; Issi, Sinan; Esmer, Ali Fırat; Tekdemir, İbrahim; Evcik, DenizAs much interest has been focused on afferent innervation of knee than that of patella, there are few articles about patellar innervation. But in clinical practice anterior knee pain due to patellar disorders is a quite frequent problem. Our aim was to review the innervation pattern of patella and to give the topographic anatomy of the nerves. We dissected 30 knees of 15 formaldehyde-fixed cadavers. Two nerves from vastus medialis and lateralis were found to reach patellar edge. Apart from these, we were unable to find any other neural structures around patellae. Mean distances between the tuberosity of the tibia and medial and lateral nerve entry points were 90.1(range 74-102) and 96.3 mm (range 76-109), respectively. The angles between lines which join the entry points of nerves and vertical line to the center point of patella were measured in frontal plane. It was approximately 60 degrees medially and 40 degrees laterally. To confirm that these nerves are patellar pain afferents, we performed a local anesthesia test in 32 knees of 20 patients with patellofemoral pain. Clinically, there was a significant difference between the visual analogue scale (VAS) scores before and after local anesthetic injections (p < 0.01). Previous studies have emphasized especially the medial innervation. We found that both superomedial and superolateral nerves were important for patellar innervation. We described precisely the entry points of these nerves to patella for selective denervation.Öğe Muscle variations and abnormal branching and course of the ulnar nerve in the forearm and hand(Wiley-Liss, 2004) Bozkurt, MC; Tagil, SM; Ersoy, M; Tekdemir, IDuring dissection of the right forearm of a 27-year-old female cadaver, variations in the form and insertion of the palmaris longus muscle were observed. The tendon of the palmaris longus muscle, which demonstrated a centrally placed belly, split into two tendons: one inserted into the palmar aponeurosis and the other into the proximal part of the flexor retinaculum. Additionally, we found an accessory muscle extending between the flexor retinaculum and the tendon of the abductor digiti minimi muscle. This accessory muscle was located deep to the ulnar artery but superficial to the superficial and deep branches of the ulnar nerve at the wrist. Finally, an aberrant branch of the ulnar nerve was identified in the forearm; it travelled distally alongside the ulnar artery and in the palm demonstrated communications with common palmar digital nerves from the ulnar and the median nerves. No variations were observed in the contralateral upper limb.Öğe Internal anal sphincter: An Anatomic study(Wiley-Liss, 2004) Uz, A; Elhan, A; Ersoy, M; Tekdemir, IThe anatomy of the internal anal sphincter and surrounding structures was investigated in 24 cadavers using a surgical microscope (6-25x magnification). An understanding of the anatomy of the internal anal sphincter is helpful in avoiding complications during surgical procedures in the anorectal region. The external anal sphincter was composed of three ellipsoid rings of skeletal muscle (subcutaneous, superficial, and deep) that encircle the anal canal; in contrast, we found that the internal anal sphincter was composed of flat rings of smooth muscle bundles stacked one on top of the other, like the slats of a Venetian blind. In each anal canal, the average number of ring-like slats observed was 26.33 +/- 2.93 (range = 20-30) and each was covered by its own fascia. The smooth muscle fibers and fascia coalesced at three equidistant points around the anal canal to form three columns that extended distally into the lumen and differed in form from the other anal columns. When viewed from an anterior position, the columns were located anteriorly at the observer's right (5 o'clock position), posteriorly at the right (1 o'clock position), and laterally at the left (9 o'clock position). This heretofore unreported anatomy of the internal anal sphincter may play an important role in closing off the lumen of the anal canal and maintaining bowel continence.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 An unusual termination of the ulnar nerve in the palm(Urban & Fischer Verlag, 2002) Bozkurt, M.C.; Cezayirli, E.; Tagil, S.M.During the dissection of the left forearm and hand of a 57-year old male cadaver fixed in 10% formalin, it has been noted that the medial proper palmar digital nerve to the little finger arose from the dorsal branch of the ulnar nerve, instead of the superficial branch of the same nerve. The dorsal branch, given off by the ulnar nerve in the forearm, coursed distally and dorsally deep to the flexor carpi ulnaris muscle. Some 2 cm proximal to the pisiform, it pierced the deep fascia on the posteromedial side of the muscle to become superficial. At this point, one of the three branches given off travelled distally on the palmar-ulnar side of the hand to the skin of the little finger. There were connections between this branch and the branches of the superficial branch of the ulnar nerve which innervated the skin of the hypothenar eminence. Further, another branch of the superficial branch of the ulnar nerve passed under the fibrous arch of the flexor digiti minimi brevis muscle origin and the opponens digiti minimi muscle to re-unite with its parent nerve.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 Microscopic anatomy of the infraorbital canal, nerve, and foramen(SAGE Publications Inc., 2003) Kazkayaşı Mustafa; Ergin A.hmet; Ersoy Mehmet; Tekdemir İbrahim; Elhan AlaittinOBJECTIVE: We performed this study to investigate the morphologic and topographic anatomy, and variations of the infraorbital canal (IOC), infraorbital nerve (ION), and infraorbital foramen (IOF). STUDY DESIGN AND SETTING: This study was performed at the Anatomy Department of Ankara University School of Medicine between 1999 and 2000. The morphometry of these anatomic areas on cadaver heads were studied microscopically. The morphologic and topograpic anatomies of IOC, ION, and IOF were carried out microscopically with ×25 to ×40 magnification on 10 cadaver heads (20 sides). RESULTS: We found the shape of the IOF as oval in 30% (6 sides), round in 40% (8 sides), and semilunar in 30% (6 sides) of the cadaver heads. We detected the IOF as single in 90% (18 sides), double in 5% (1 side), and triple in 5% (1 side) of the cases. We determined a complete roof (we called it as "canal") in 50% of cases and groove plus canal in 50% of the heads. The mediolateral relationship of the vessels to the nerve while emerging from the IOF was investigated, and the artery was always found in a mediosuperior position and the vein was inferior to it. In all specimens, the ION was found to be consisting of 3 to 8 fascicles interwoven with the artery and the vein in the loose connective tissue sheath. CONCLUSION: A detailed knowledge of the anatomic morphometry of this area is necessary for a surgeon while performing maxillofacial surgery and regional block anesthesia. Anatomic variations on this area may take place and a surgeon must take this into consideration so as to increase the surgical success.
