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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 APPENDIX INVAGINATION MIMICKING ILEOCECAL INTUSSUSCEPTION IN A PEDIATRIC PATIENT: A CASE REPORT(Elsevier Science Inc, 2016) Aybay, Muhsin Nuh; Erol, Seyit; Kaya, Hasan Emin; Guler, IbrahimBackground: Appendix invagination is a rare cause of right lower quadrant abdominal pain. Clinical findings are not specific and can mimic a wide range of diseases. Case Report: An 8-year-old girl was admitted with abdominal pain lasting for 2 weeks. Clinical and radiologic findings suggested ileocecal intussusception initially. A failed hydrostatic reduction attempt and subsequent abdominal ultrasound and computed tomography studies showed that the underlying pathology was invagination of the vermiform appendix. The patient was managed conservatively and spontaneous reduction was observed during follow-up. She underwent appendectomy 9 months later due to chronic appendicitis. Why Should An Emergency Physician Be Aware of This?: Appendix invagination should be kept in mind while evaluating patients with suspected ileocecal intussusception. In distinguishing between these two conditions, a blind-ending invaginating segment is an important clue in favor of appendix intussusception. (C) 2016 Elsevier Inc. All rights reserved.Öğe Association of pulmonary artery obstruction index with elevated heart-type fatty acid binding protein and short-term mortality in patients with pulmonary embolism at intermediate risk(Turkish Soc Radiology, 2012) Gul, Enes Elvin; Can, Ilknur; Guler, Ibrahim; Yesildag, Ahmet; Abdulhalikov, Turyan; Kayrak, Mehmet; Ozdemir, KurtulusPURPOSE Heart-type fatty acid binding protein (H-FABP) is a sensitive marker of myocardial injury and predictor of worse prognosis in patients with pulmonary embolism (PE). Assessment of right ventricular dysfunction and pulmonary artery obstruction index (PAOI) with computed tomography (CT) has been reported as a predictor of mortality in PE. Therefore, we aimed to assess the correlation between H-FABP and CT angiographic PAOI in PE patients at intermediate risk. MATERIALS AND METHODS Sixty-one patients (28 males; mean age, 62 +/- 17 years) with diagnosis of PE were included in this study. CT was performed in all patients, and the following parameters were evaluated: right ventricle/left ventricle ratio (RV/LV), pulmonary artery axial diameter, superior vena cava axial diameter, and PAOI determined with Qanadli score. Blood samples were assessed for H-FABP and troponin levels. Patients were followed for 30 days after discharge. RESULTS Mean PAOI was 57 +/- 18%. Eleven patients died during the follow-up period due to PE (18% mortality rate). H-FABP was positive in 21 patients (35%). There was no difference in CT parameters between patients with positive H-FABP and negative H-FABP. In addition, CT parameters were similar between patients who survived and those who did not. RV/LV ratio correlated with PAOI score. Among the biomarkers, troponin levels correlated with both RV/LV ratio and PAOI. H-FABP was an independent predictor of mortality. PAOI and RV/LV ratio did not predict 30-day mortality. CONCLUSION Although H-FABP positivity confers a bad prognosis on PE patients at intermediate risk, PAOI did not predict mortality in this group.Öğe Classification and volumetric study of the sphenoid sinus on MDCT images(Springer, 2019) Pirinc, Busra; Fazliogullari, Zeliha; Guler, Ibrahim; Unver Dogan, Nadire; Uysal, Ismihan Ilknur; Karabulut, Ahmet KaganPurpose We aimed to determine the position and size of the sphenoid sinus (SS) in our study and compare the results of the measurements relative to age, gender, and the presence of pituitary adenoma using multidetector computerized tomography (MDCT). Methods We retrospectively evaluated the paranasal sinus computerized tomography (CT) images of 200 individuals (age range of all the individuals 4-84 years; 101 females, 99 males; age range of individuals with pituitary adenoma 15-63 years; 15 females, 9 males) with 24 pituitary adenomas. The shape of SS were identified and classified, volume were measured by MDCT also for individuals with pituitary adenoma. Results It was determined that the volume averages were significantly affected by the type of SS. Among all the individuals studied, the sellar type of SS was most frequently observed (41.5%), followed by the postsellar type (38.5%), and the least observed was the presellar type (9%). The volume of the SS is bigger in males than females although the volume is not affected by the presence of pituitary adenomas. The development of the SS continues until the age of nine. Conclusion The morphology and morphometry of the SS show individual differences. These anatomic variations are important for decision making and application for surgical interventions (especially transsphenoidal surgery).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 Cystic and Cavitary Lung Lesions in Children: Radiologic Findings with Pathologic Correlation(Medknow Publications & Media Pvt Ltd, 2013) Odev, Kemal; Guler, Ibrahim; Altinok, Tamer; Pekcan, Sevgi; Batur, Abdussamed; Ozbiner, HuseyinA number of diseases produce focal or multiple thin-walled or thick-walled air- or fluid-containing cysts or cavitary lung lesions in both infants and children. In infants and children, there is a spectrum of focal or multifocal cystic and cavitary lung lesions including congenital lobar emphysema, congenital cystic adenomatoid malformation, pleuropulmonary blastoma, bronchogenic cyst, pulmonary sequestration, Langerhans cell histiocytosis, airway diseases, infectious diseases (bacterial infection, fungal infection, etc.), hydatid cysts, destroid lung, and traumatic pseudocyst. For the evaluation of cystic or cavitary lung lesion in infants and children, imaging plays an important role in accurate early diagnosis and optimal patient management. Therefore, a practical imaging approach based on the most sensitive and least invasive imaging modality in an efficient and cost-effective manner is paramount. We reviewed the conventional radiographs and computed tomography findings of the most common cystic and cavitary lung lesions in infants and children.Öğe Epicardial Adipose Tissue and Atherosclerosis In Patients With Familial Mediterranean Fever(Wiley-Blackwell, 2013) Kucuk, Adem; Solak, Yalcin; Akilli, Hakan; Yildirim, Oguzhan; Guler, Ibrahim; Ucar, Ramazan; Aribas, Alpay[Abstract Not Availabe]Öğe A novel modified PAIR technique using a trocar catheter for percutaneous treatment of liver hydatid cysts: a six-year experience(Aves, 2016) Nayman, Alaaddin; Guler, Ibrahim; Keskin, Suat; Erdem, Tuba Berra; Borazan, Hale; Kucukapan, Ahmet; Ozbiner, HuseyinPURPOSE We aimed to demonstrate the success and reliability of a novel puncture, aspiration, injection, and reaspiration (PAIR) technique in liver hydatid cysts. METHODS Percutaneous treatment with ultrasonographic guidance was performed in 493 hepatic hydatid cysts in 374 patients. Patients were treated with a new PAIR technique by single puncture method using a 6F trocar catheter. The results of this novel technique were evaluated with regards to efficacy and safety of the procedure and complication rates. RESULTS Out of 493 cysts, 317 were Gharbi type I (WHO CE 1) and 176 were Gharbi type II (WHO CE 3A). Of all cysts, 13 were referred to surgery because of cystobiliary fistulization. Recurrence was observed in 11 cysts one month later. Therefore, the success rate of the PAIR technique was 97.7% (469/480). Minor complications (fever, urticaria-like reactions, biliary fistula) were seen in 44 treated patients (12%, 44/374); the only major complication was reversible anaphylactic shock which was observed in two patients (0.5%, 2/374). CONCLUSION This novel modified PAIR technique may be superior to catheterization by Seldinger technique due to its efficiency, easier application, lower severe complication rate, and lower cost. Further comparative studies are required to confirm our observations.Öğe PERI-AORTIC FAT TISSUE THICKNESS IN PERITONEAL DIALYSIS PATIENTS(Oxford Univ Press, 2012) Turkmen, Kultigin; Ozbek, Orhan; Kayrak, Mehmet; Samur, Cigdem; Guler, Ibrahim; Tonbul, Halil Zeki[Abstract Not Availabe]Öğe Radiofrequency ablation of a rare pathology: vertebral intraosseous lipoma(Elsevier Science Inc, 2016) Ozbek, Orhan; Keskin, Fatih; Kaya, Hasan Emin; Guler, Ibrahim; Nayman, Alaaddin; Koc, Osman[Abstract Not Availabe]Öğe Spontaneously Thrombosed Polar Renal Artery Aneurysm: Multidetector Computed Tomography Findings(Lippincott Williams & Wilkins, 2013) Kerimoglu, Ulku; Guler, Ibrahim; Ozbek, Orhan[Abstract Not Availabe]Öğe Sturge-Weber syndrome without facial nevus(Georg Thieme Verlag Kg, 2013) Guler, Ibrahim; Kucukapan, Ahmet; Kiresi, DemetSturge-Weber syndrome is a rare neurocutaneous disorder. Coexistence of facial nevus with epilepsy often suggests the diagnosis of Sturge-Weber syndrome. However, the diagnosis becomes more difficult when there is no facial nevus. Radiologic examinations are often used for diagnosis and management. Especially in cases without skin findings, the radiological examinations with typical findings become more important. In this paper, we report case of a 12-year-old girl who was followed with the diagnosis of epilepsy since the age of two years, had complaints of weakness of the left arm and left leg without skin findings, and was diagnosed with Sturge-Weber syndrome after radiological examinations.Öğe An unusual cause of acute paraplegia: epidural granulocytic sarcoma(Elsevier Science Inc, 2016) Kucukapan, Ahmet; Kucukapan, Hasibe Uygun; Kiresi, Demet Aydogdu; Guler, Ibrahim; Pasa, Mehmet[Abstract Not Availabe]Öğe The use of axial diameters and CT obstruction scores for determining echocardiographic right ventricular dysfunction in patients with acute pulmonary embolism(Springer, 2014) Aribas, Alpay; Keskin, Suat; Akilli, Hakan; Kayrak, Mehmet; Erdogan, Halil Ibrahim; Guler, Ibrahim; Yildirim, OguzhanTo evaluate the accuracy of cardiac computed tomography (CT) parameters and pulmonary artery (PA) obstruction (OS) scores in determining the echocardiographic right ventricular dysfunction (RVD) in hemodynamically stable patients with acute pulmonary embolism (PE). A total of 120 patients with acute PE were included in the study. Right ventricle/left ventricle ratio (RV/LV); PA axial diameter; superior vena cava (SVC) axial diameter; and Ghanima, Miller, Qanadli, and Mastora obstruction scores were obtained using CT. RVD was assessed by echocardiography. The patients were divided into two groups based on the presence or absence of RVD. RV/LV ratio, SVC axial diameter, PA axial diameter, and Miller, Qanadli, and Mastora scores were significantly increased in the RVD group. Multivariate logistic regression analysis showed that RV/LV ratio [OR 6.36 (2.02-279.46 95 % CI), p = 0.01] and PA axial diameter [OR 5.02 (1.02-1.26 95 % CI), p = 0.03] were independent predictors of echocardiographic RVD. Predictive values of these parameters were improved when combined with other intragroup cutoff values. A cutoff value for the RV/LV ratio of > 1.08 had 81.43 % sensitivity, 52.08 % specificity, 71.3 PPV, and 65.8 NPV for prediction of RVD. Tomographic axial diameters enable more accurate predictions of RVD than OS scores do.Öğe The Value of Axial Diameters and Obstruction Scores for Determining the Echocardiographic Right Ventricular Dysfunction in Acute Pulmonary Embolism(Elsevier Science Inc, 2013) Aribas, Alpay; Keskin, Suat; Akilli, Hakan; Kayrak, Mehmet; Erdogan, Halil Ibrahim; Guler, Ibrahim; Yildirim, Oguzhan[Abstract Not Availabe]
