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Öğe The anatomic analysis of the vidian canal and the surrounding structures concerning vidian neurectomy using computed tomography scans(Assoc Brasileira Otorrinolaringologia & Cirurgia Cervicofacial, 2019) Acar, Gulay; Cicekcibasi, Aynur Emine; Cukurova, Ibrahim; Ozen, Kemal Emre; Seker, Muzaffer; Guler, IbrahimIntroduction: The type of endoscopic approach chosen for vidian neurectomy can be specified by evaluating the vidian canal and the surrounding sphenoid sinus structures. Objective: The variations and morphometry of the vidian canal were investigated, focusing on the functional correlations between them which are crucial anatomical landmarks for preoperative planning. Methods: This study was performed using paranasal multidetector computed tomography images that were obtained with a section thickening of 0.625 mm of 250 adults. Results: The distributions of 500 vidian canal variants were categorized as follows; Type 1, within the sphenoid corpus (55.6%); Type 2, partially protruding into the sphenoid sinus (34.8%); Type 3, within the sphenoid sinus (9.6%). The pneumatization of the pterygoid process is mostly seen in vidian canal Type 2 (72.4%) and Type 3 (95.8%) (p < 0.001). The mean distances from the vidian canal to the foramen rotundum and the palatovaginal canal were greater in the vidian canal Type 2 and 3 with the pterygoid process pneumatization (p < 0.001). The prevalence of the intrasphenoid septum between the vidian canal and the vomerine crest and lateral attachment which ending on carotid prominence were much higher in vidian canal Type 3 than other types (p < 0.001). The mean angle between the posterior end of the middle turbinate and the lateral margin of the anterior opening of the vidian canal was measured as 33.05 +/- 7.71 degrees. Conclusions: Preoperative radiologic analysis of the vidian canal and the surrounding structures will allow surgeons to choose an appropriate endoscopic approach to ensure predictable postoperative outcomes. (c) 2017 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial. Published by Elsevier Editora Ltda.Öğe Anatomical variations of the aortic arch branching pattern using CT angiography: a proposal for a different morphological classification with clinical relevance(Springer, 2022) Acar, Gulay; Cicekcibasi, Aynur Emine; Uysal, Emine; Koplay, MustafaThe aortic arch (AA) branching pattern variations are usually asymptomatic, but they may lead to complications during cardiovascular procedures. In this retrospective study, we aimed to analyze the frequency of anatomical variations of the AA and to develop a different approach of morphological classification based on radiological criteria. 1026 computed tomography angiography scans of adults were evaluated and the presence of left-sided (LAA) and right-sided (RAA) AA were determined in 1023 (99.71%) and 3 (0.29%) of patients, respectively. According to the number of branches, LAA branching pattern of each patient was subclassifed in five morphological types. Based on the order and type-specific reference points, an anomalous LAA variants were classified into 20 subtypes. Type 1 (Typical branching pattern) LAA was identifed in 781 (76.12%) of the patients. Among 242 aberrant LAA variants (four types, 23.58%), the most common subtypes; Type 2A with brachiocephalico-carotid trunk (BCT), Type 4A(1) with an aberrant left vertebral artery (ALVA), and Type 3A(1), in which BCT coexisted with ALVA, were observed in 17.6%, 3.6%, and 0.88% of the cases, respectively. The frequency of remaining LAA variants ranged from 0.39% to 0.097%. In addition, Type 3B(2) and Type 4C were first identified in our study. We observed Type I and II RAA in one female (0.097%) and two cases (male and female, 0.19%), respectively. Knowledge of AA branching variations is of great interest in neck and thoracic surgery and the new morphological types in clinically applicable form recommended in this study can be used in endovascular interventions.Öğe Anatomical Variations of the Celiac Trunk and Hepatic Arteries with a New Classification, Based on CT Angiography(Coll Physicians & Surgeons Pakistan, 2022) Acar, Gulay; Cicekcibasi, Aynur Emine; Koplay, Mustafa; Seher, NusretObjectives: To analyse the distribution of anatomical variations in both celiac trunk (CeT) and hepatic artery (HA) branching patterns on computed tomography (CT) angiography images; as well as to propose a new classification by unifying the already reported classifications of the CeT and HA vascular anatomy. Study Design: Observational study. Place and Duration of Study: Department of Radiology, Faculty of Medicine, Selcuk University, Konya, Turkey, from February 2019 to March 2020. Methodology: CT angiography-based evaluation of the CeT and HA branching patterns was performed in patient undergoing routine contrast-enhauced CT of abdomen. Types of variation were determined and classified into five types (1-5) and ten subtypes. Distribution was also sorted by age and gender. Results: Type 1 (classic CeT and HA branching pattern) was detected in 240 (70.6%) out of 340 cases (126 females, 214 males). Sixty-five (19.12%) had Type 2 subtypes, in which HA branching pattern coexists with normal CeT configuration; whereas, Type 3a and 3d, Type 4 and 5 having anomalous CeT variants, with typical HA pattern, were observed in 5.87% (20/340) of the cases. The frequency of the concurrent variations (Type 3b and 3c) was 4.41% (15/340). The least frequent subtypes, Type 4 and 5, were observed in one (0.29%) and three (0.88%) cases, respectively. There was no significant differences in branching types frequency by gender and age (p>0.05). Conclusion: Awareness of the range of anatomical variation in both the CeT and HA branching patterns, especially concurrent variations, is vital when planning surgical and radiological interventions to prevent possible iatrogenic injury and complications.Öğe Assessment of the prelacrimal recess in different maxillary sinus pneumatizations in relation to endoscopic prelacrimal recess approaches: a computed tomography study(Springer France, 2023) Soyal, Rukiye; Acar, Gulay; Cicekcibasi, Aynur Emine; Goksan, Ahmet Safa; Aydogdu, DemetPurposeTo assist in planning before the endoscopic prelacrimal recess (PLR) approach, we aimed to investigate the relationship between morphometry and variations of PLR in maxillary sinus (MS) pneumatizations.MethodsRetrospective analysis of the paranasal sinus computed tomography images of 150 patients was conducted to determine the pneumatization patterns of the MS, PLR variations, and the applicability of the PLR approach. The results were compared based on lateralization, gender, and age groups.ResultsThe PLRwidth, the anteroposterior diameter of the nasolacrimal duct (NLD), the vertical and horizontal diameters of the MS were the highest in hyperplasic MS, and decreased significantly with increasing age (p = 0.005, p = 0.017, p = 0.000), respectively. Most of the morphometric measurements were higher in hyperplasic MS, while the medial wall thickness of PLR was higher in hypoplasic MS. The PLRwidth for feasibility of the PLR approach were Type I (48%) in hypoplasic MS and Type III (80%) in hyperplasic MS (p < 0.001), respectively. The PLR medial wall thickness was higher in Type I, while the piriform aperture angle (PAA), MS volume, length, and slope of the NLD were higher in Type III PLRwidth (p = 0.000), respectively. The highest anterior and separation-type variations of the PLR were observed in hyperplasic MS, whereas 31.0% of hypoplasic MS had no PLR (p < 0.001).ConclusionThis study revealed that PLRwidth and PAA were the highest in hyperplasic MS, which allows the endoscopic PLR approach to be performed more easily. For safer and uncomplicated surgery, surgeon should be aware of the PLR anatomy in different MS pneumatization patterns.Öğe Assessment of the prelacrimal recess in different maxillary sinus pneumatizations in relation to endoscopic prelacrimal recess approaches: a computed tomography study (vol 45, pg 963, 2023)(Springer France, 2023) Soyal, Rukiye; Acar, Gulay; Cicekcibasi, Aynur Emine; Goksan, Ahmet Safa; Aydogdu, Demet[Abstract Not Availabe]Öğe Computed tomography based analysis of the lamina papyracea variations and morphology of the orbit concerning endoscopic surgical approaches(Assoc Brasileira Otorrinolaringologia & Cirurgia Cervicofacial, 2019) Acar, Gulay; Buyukmumcu, Mustafa; Guler, IbrahimIntroduction: Radiologic evaluation is mandatory to assess the type of endoscopic approach concerning sinonasal pathology and reconstruction of fractured defects before any treatment modalities are instituted related to medial wall of the orbit. Objective: The goal was to provide improved understanding of the lamina papyracea variations and the relationship with the orbital morphometry. Methods: This retrospective study was performed using computed tomography scans of 200 orbits and results were compared with respect to age, sex, laterality and LP variations. Results: Lamina papyracea variations were categorized as type A, 80.5% (161/200); type B, 16% (32/200); type C, 3.5% (7/200). For medial wall the anterior and posterior lamina papyracea heights and angles were found as 17.14 mm, 147.88 degrees and 9.6 mm, 152.72 degrees, respectively. Also, the length of the lamina papyracea, the mean area of the orbital floor, medial wall, lamina papyracea and orbital entrance were 33.3 mm, 7.2 cm(2), 6.89 cm(2), 4.51 cm(2) and 12.46 cm(2) respectively. The orbital height and width were measured as 35.9 mm and 39.2 mm respectively. The mean orbital cavity depth was 46.3 mm from optic foramen to the orbital entrance and the orbital volume was 19.29 cm(3). We analyzed the morphometric measurements tending to increase with aging and greater in men and the relationship of them with lamina papyracea types. Conclusion: Precise knowledge of the lamina papyracea anatomy using computed tomography is essential for safer and more effective surgery and preforming the dimensions of an implant. In this way, the postoperative complications can be decreased and the best outcome can be provided. (C) 2019 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial. Published by Elsevier Editora Ltda.Öğe Computed tomography evaluation of the morphometry and variations of the infraorbital canal relating to endoscopic surgery(Assoc Brasileira Otorrinolaringologia & Cirurgia Cervicofacial, 2018) Acar, Gulay; Ozen, Kemal Emre; Guler, Ibrahim; Buyukmumcu, MustafaIntroduction: The course of the infraorbital canal may leave the infraorbital nerve susceptible to injury during reconstructive and endoscopic surgery, particularly when surgically manipulating the roof of the maxillary sinus. Objective: We investigated both the morphometry and variations of the infraorbital canal with the aim to show the relationship between them relative to endoscopic approaches. Methods: This retrospective study was performed on paranasal multidetector computed tomography images of 200 patients. Results The infraorbital canal corpus types were categorized as Type 1: within the maxillary bony roof (55.3%), Type 2: partially protruding into maxillary sinus (26.7%), Type 3: within the maxillary sinus (9.5%), Type 4: located anatomically at the outer limit of the zygomatic recess of the maxillary bone (8.5%). The internal angulation and the length of the infraorbital canal, the infraorbital foramen entry angles and the distances related to the infraorbital foramen localization were measured and their relationships with the infraorbital canal variations were analyzed. We reported that the internal angulations in both sagittal and axial sections were mostly found in infraorbital canal Type 1 and 4 (69.2%, 64.7%) but, there were commonly no angulation in Type 3 (68.4%) (p < 0.001). The length of the infraorbital canal and the distances from the infraorbital foramen to the infraorbital rim and piriform aperture was measured as the longest in Type 3 and the smallest in Type 1 (p < 0.001). The sagittal infraorbital foramen entry angles were detected significantly smaller in Type 3 and larger in Type 1 than that in other types (p = 0.003). The maxillary sinus septa and the Haller cell were observed in 28% and 16% of the images, respectively. Conclusion: Precise knowledge of the infraorbital canal corpus types and relationship with the morphometry allow surgeons to choose an appropriate surgical approach to avoid iatrogenic infraorbital nerve injury. (C) 2017 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial. Published by Elsevier Editora Ltda.Öğe CT Evaluation of the Intraorbital Structures Concerning Endoscopic Approaches to the Lamina Papyracea(Amber Publication, 2018) Acar, Gulay; Buyukmumcu, Mustafa; Guler, IbrahimBackground: The relationship between the intraorbital structures and medial wall of the orbit is essential for surgical approaches. Objective: The goal was to provide an improved understanding of the dimensions of extraocular muscles and the approximate location of the intraorbital structures with respect to the lamina papyracea (LP). Material and Methods: This retrospective study was performed using the multiplanar reconstruction of Computed Tomography (CT) scans of 200 orbits. Results: We measured the mean diameters of intraorbital structures. The mean horizontal distances from LP to medial and inferior rectus muscles, globe, and infraorbital canal were found as 3.9 +/- 1.2 mm, 11.5 +/- 1.6 mm, 7.8 +/- 1.5 mm and 16.1 +/- 2.0 mm and as 0.6 +/- 0.4 mm, 4.7 +/- 1.3 mm, 7.2 +/- 1.8 mm, 12.5 +/- 2.3 mm at the depth of the anterior (AEF) and posterior ethmoidal foramen, respectively. All morphometric results were compared with respect to age, sex and laterality and higher in males than females. The measurement results indicated that subjects in first and second age groups showed statistically significant differences in distances from the LP to the globe, medial and inferior rectus muscles at the depth of AEF (p<0.05). But, there was no difference between right and left. Conclusion: CT imaging which can offer an accurate understanding of the regional anatomy of and around the LP may be helpful in preoperative planning and prediction of postoperative outcomes. It can allow the surgeon to prevent possible orbital injury during surgical interventions.Öğe Incidental Detection of Inguinoscrotal Bladder Hernia with Associated Factors on 18F-fluorodeoxyglucose PET/CT Scans(Coll Physicians & Surgeons Pakistan, 2022) Acar, Gulay; Sahin, OzlemObjective: To evaluate the associated factors of inguinoscrotal bladder hernia (ISBH), which was detected on F-18-fluorodeoxyglu-cose positron emission tomography/computed tomography (F-18-FDG PET/CT) scans. Study Design: An observational study. Place and Duration of Study: Department of Nuclear Medicine, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey, from August 2010 to April 2021. Methodology: In this study, 60 cases were subclassified in three age-matched groups; 15 patients diagnosed with ISBH in Group Ia, 15 cases with inguinoscrotal herniation (ISH) of bowel in Group Ib, and 30 patients without ISH in Group II. In the reconstructed PET/CT images, the prostate volume (PV), abdominal subcutaneous fat (SFV), and visceral fat (VFV) volumes were measured, and body mass index (BMI) was calculated. Results: There was a statistically significant relationship between subgroups of Group I in the measurements of BMI, PV, SFV, and VFV, which were higher in Group Ia than Group Ib. The lower SFV/VFV value in Group Ib was considered as the most important risk factor in developing ISH of the bowel. A significant statistical difference was found between Group I and II in terms of PV, VFV, and SFV/VFV parameters. Conclusions: This study reiterated the impact of PV and the parameters representing abdominal fat distribution on ISBH development. PET/CT scan provided valuable information regarding both the hernia contents and the associated factors in which the higher PV had a significant association for the development of ISBH as well as lower SFV/VFV that was more prominent in ISH with bowel.Öğe Morphometric analysis of sphenopalatine foramen on computed tomography images with clinical significance(Springer France, 2022) Seker, Busra; Acar, Gulay; Cicekcibasi, Aynur Emine; Aydogdu, DemetPurpose This study aimed to investigate the effect of anatomical variations in the sphenopalatine foramen and the lateral nasal wall on sphenopalatine foramen-related morphometric measurements. Methods Paranasal sinus multidetector computed tomography records of 153 patients were evaluated. Morphometric measurements were made between the fixed bony landmarks and the sphenopalatine foramen. Number, shape, localization variations of the sphenopalatine foramen, concha bullosa, and septum deviation were noted and the results were compared with respect to sex, age, and laterality. Results No significant difference was detected with respect to laterality, whereas most of the measured distances were higher in males than females. There was a significant difference between the obtained morphometric data according to age groups. In our study, 91.2% single, 7.8% double, and 1% triple sphenopalatine foramen were detected and the most common irregularly shaped (37.3%). The location of sphenopalatine foramen was reported as the most common type II. Septum deviation types have no potential influence on the location of the foramen, but most of the measured parameters were found to be significantly smaller in the presence of concha bullosa, whereas the angle was found to be higher. Conclusion This study revealed a significant relationship between the morphometric measurements of the sphenopalatine foramen and concha bullosa, while septum deviation types did not affect these results. For a safer and more effective surgery with prevention of iatrogenic complications, a surgeon should be aware of this correlation, especially in endoscopic transnasal approaches.Öğe A Rare Anomalous Origin of the Right Vertebral Artery from the Right Aortic Arch with the Left Aberrant Subclavian Artery Arising from Kommerell's Diverticulum(Wolters Kluwer Medknow Publications, 2022) Acar, Gulay; Koplay, MustafaRight-sided aortic arch (RAA) with left aberrant subclavian artery (LASA) is a rare vascular variant due to the failure in regression process during embryologic development of the aortic arch. The prevalence of it ranges from 0.04% to 0.1% in radiology series. We report the case of a 44-year-old female shown to have the presence of a RAA with LASA arising from the Kommerell's diverticulum, and also in association with an aberrant aortic origin of the right vertebral artery using computed tomography angiography. Considering the diameter of the diverticulum <5 cm and the absence of severe external esophageal or tracheal compression, thoracic surgery was not indicated and it was decided to keep the patient under clinical follow-up at regular intervals. Based upon this present case and literature review, the knowledge of this anomalous anatomy and its embryologic basis appear to be important for diagnostic endovascular interventions and planning thoracic surgery.Öğe The Relationship Between the Pneumatization Patterns of the Frontal Sinus, Crista Galli and Nasal Septum: A Tomography Study(Turkish Neurosurgical Soc, 2020) Acar, Gulay; Cicekcibasi, Aynur Emine; Koplay, Mustafa; Kelesoglu, Kazim SerhanAIM: To provide detailed information about anterior skull base anatomy. MATERIAL and METHODS: Interms of gender and laterality, the drainage pathways and anatomical variations of the frontal sinus, crista galli and nasal septum in 402 patients were evaluated via computed tomography scans. RESULTS: The pneumatization patterns of the frontal sinus were as follows: absent, 3.7%; unilateral, 8%; bilateral, 75.1% and triple, 13.2%. The pneumatized crista galli was identified in 120 (29.8%) patients, and its drainage pathway was observed in 54.1% of patients. The sinus septi nasi was identified in 92 (22.8%) and its drainage pathway was observed in 16.3%. The prevalences of the position types of crista galli regarding the cribriform plate were as follows; type 1,18.3%; type II,64.9%; type III, 16.8%. CONCLUSION: Despite meticulous knowledge of anatomy, preoperative radiologic evaluation creates the base for successful treatment of anterior skull base pathologies with safer and effective surgery.Öğe Surface anatomy and lumbar lordosis angle(Springer, 2021) Acar, Gulay; Cicekcibasi, Aynur Emine; Koplay, Mustafa; Seher, NusretAwareness of the anatomical variations in abdominal surface anatomy with emphasis on relation to the abdominal planes may facilitate anatomical education and physical examination and inconvenience surgical intervention by giving surgeons more insight in surgical planning and training. This study was designed to verify whether the anatomical planes promote to the comprehension of surface anatomy and how the lumbar lordosis angle affects the vertebral level of the bifurcation of great vessels. This retrospective study was performed using computed tomography angiography images of 155 patients ranging from 18 up to 82 years. The vertebral levels of the celiac truncus, superior mesenteric artery, portal vein confluence, right and left renal arteries were within the transpyloric plane in 60%, 70%, 56.1% and 48.3-36.2% of patients, respectively. The inferior mesenteric artery was below the subcostal plane in 58% of patients. The aortic bifurcation (AB) was mostly corresponded to the level of L4 and was located within the umbilical plane in 73.1% of patients. The level of the inferior vena cava (IVC) confluence was within the supracristal plane in 54% of patients. We measured the mean value of the AB, IVC and lumbar lordosis angles as 39.54 degrees, 58.05 degrees and 54.26 degrees, respectively. The AB and IVC levels showed a downward shift with decreasing lumbar lordosis angle. Precise knowledge of these relationships is crucial in clinical practice and surgical approaches to the anterior lumbosacral spine for safer and effective surgery.
