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Digilli Ayaş B, Çiçekcibaşı AE, Gökşan AS, Açar G, Aydoğdu D. Clinically relevant morphometric analysis of pterygopalatine fossa and its volumetric relationship with adjacent paranasal sinuses: a CT-based study. Oral Radiol 2024; 40:285-294. [PMID: 38236559 DOI: 10.1007/s11282-023-00735-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/18/2023] [Indexed: 01/19/2024]
Abstract
OBJECTIVES This study aimed to perform morphometric measurements of the pterygopalatine fossa (PPF), the transition zone to critical neurovascular structures. The second aim was to investigate the relationship between the volumes of the PPF and the paranasal sinuses and the effect of nasal septum deviation (NSD) types on all these measurements. METHODS We performed PPF's morphometry and all volume measurements on the CT images of 260 patients (130 male and 130 female, age range 18-79). RESULTS All volumetric measurements and the angle between foramen rotundum (FR) and pterygomaxillary fissure (PMF) were significantly higher in males than females. In contrast, the distance between sphenopalatine foramen (SPF) and PMF was considerably higher in females than in males. The PPF volume, the distance between the pterygoid canal (PC) and maxillary sinus, and the angle between FR and PMF were significantly higher on the right side than on the left. In contrast, the angle between PC and SPF and between greater palatine canal and PPF were considerably higher on the left side than on the right. The angle between PC and SPF decreased markedly with age. Only sphenoidal sinus volume was significantly smaller on the same side as the septal deviation. There was no correlation between PPF volume with maxillary and sphenoid sinus volumes from adjacent paranasal sinuses. CONCLUSIONS Volumetric and morphometric data obtained from PPF and paranasal sinuses can aid clinicians in diagnosing and treating patients by guiding them in selecting the right surgical approach or tools, especially in endoscopic procedures.
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Affiliation(s)
- Betül Digilli Ayaş
- Department of Anatomy, Faculty of Medicine, Necmettin Erbakan University, Meram, Konya, Turkey.
| | - Aynur Emine Çiçekcibaşı
- Department of Anatomy, Faculty of Medicine, Necmettin Erbakan University, Meram, Konya, Turkey
| | - Ahmet Safa Gökşan
- Department of Anatomy, Faculty of Medicine, Necmettin Erbakan University, Meram, Konya, Turkey
| | - Gülay Açar
- Department of Anatomy, Faculty of Medicine, Necmettin Erbakan University, Meram, Konya, Turkey
| | - Demet Aydoğdu
- Department of Radiology, Faculty of Medicine, Necmettin Erbakan University, Meram, Konya, Turkey
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Akyıldız İ, Açar G, Çiçekcibaşı AE, Mutluer M. Association between the digit ratio (2D:4D), handgrip strength, wrist ratio, and body fat distribution in women with different carpal tunnel syndrome severity. Early Hum Dev 2024; 190:105972. [PMID: 38377882 DOI: 10.1016/j.earlhumdev.2024.105972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/12/2024] [Accepted: 02/13/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND To evaluate the relationship of the second to fourth digit ratio (2D:4D), a biomarker of prenatal sex hormone exposure, with wrist ratio (WR), wrist-palm ratio (WPR), body mass index (BMI), waist-hip ratio (WHR), and handgrip strength (HGS) in different carpal tunnel syndrome (CTS) severity. METHOD This study involved 90 female participants (aged 18 to 83) with CTS. According to CTS severity, the participants were divided into four groups: normal, mild, moderate, and severe. All parameters of hand anthropometry and body fat distribution were measured, and the mean 2D:4D, WR, WPR, HGS, BMI, and WHR values were compared based on CTS severity. Data were collected with a visual analog scale (VAS) for pain and a Likert (LS) scale for numbness severity. RESULTS The mean age, 2D:4D, WD, WW, WR, WPR, BMI, and HGS values showed a significant differences between CTS severity groups. We found that lower 2D:4D and higher WPR and BMI were associated with increased risk of CTS (AUC = 0.728) after removing the effect of age. Bilateral hands were affected in 38.9 % (70/180) of participants. Regression analysis showed that lower HGS can be used as independent variable for predicting the females having bilateral affected hands. The LS score was considerably higher in the severe and moderate groups. Also, the VAS score was significantly higher in the severe group. CONCLUSION The findings of the study demonstrated an association between 2D:4D, WPR, and BMI among women, emphasizing the effect of intrauterine sex hormone exposure on late life CTS severity.
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Affiliation(s)
- İrfan Akyıldız
- Department of Anatomy, Faculty of Medicine, Necmettin Erbakan University, 42090 Meram, Konya, Turkey
| | - Gülay Açar
- Department of Anatomy, Faculty of Medicine, Necmettin Erbakan University, 42090 Meram, Konya, Turkey.
| | - Aynur Emine Çiçekcibaşı
- Department of Anatomy, Faculty of Medicine, Necmettin Erbakan University, 42090 Meram, Konya, Turkey
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Soyal R, Açar G, Çiçekcibaşı AE, Gökşan AS, Aydoğdu D. Correction to: Assessment of the prelacrimal recess in different maxillary sinus pneumatizations in relation to endoscopic prelacrimal recess approaches: a computed tomography study. Surg Radiol Anat 2023; 45:973. [PMID: 37395761 DOI: 10.1007/s00276-023-03194-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Affiliation(s)
- Rukiye Soyal
- Department of Anatomy, Meram Faculty of Medicine, Necmettin Erbakan University, Meram, Turkey
| | - Gülay Açar
- Department of Anatomy, Meram Faculty of Medicine, Necmettin Erbakan University, Meram, Turkey.
| | - Aynur Emine Çiçekcibaşı
- Department of Anatomy, Meram Faculty of Medicine, Necmettin Erbakan University, Meram, Turkey
| | - Ahmet Safa Gökşan
- Department of Anatomy, Meram Faculty of Medicine, Necmettin Erbakan University, Meram, Turkey
| | - Demet Aydoğdu
- Department of Radiology, Meram Faculty of Medicine, Necmettin Erbakan University, 42090, Meram, Konya, Turkey
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Soyal R, Açar G, Çiçekcibaşı AE, Gökşan AS, Aydoğdu D. Assessment of the prelacrimal recess in different maxillary sinus pneumatizations in relation to endoscopic prelacrimal recess approaches: a computed tomography study. Surg Radiol Anat 2023:10.1007/s00276-023-03181-0. [PMID: 37306725 DOI: 10.1007/s00276-023-03181-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/02/2023] [Indexed: 06/13/2023]
Abstract
PURPOSE To 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. METHODS Retrospective 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. RESULTS The 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). CONCLUSION This 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.
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Affiliation(s)
- Rukiye Soyal
- Department of Radiology, Meram Faculty of Medicine, Necmettin Erbakan University, 42090, Meram, Konya, Turkey
| | - Gülay Açar
- Department of Radiology, Meram Faculty of Medicine, Necmettin Erbakan University, 42090, Meram, Konya, Turkey.
| | - Aynur Emine Çiçekcibaşı
- Department of Radiology, Meram Faculty of Medicine, Necmettin Erbakan University, 42090, Meram, Konya, Turkey
| | - Ahmet Safa Gökşan
- Department of Radiology, Meram Faculty of Medicine, Necmettin Erbakan University, 42090, Meram, Konya, Turkey
| | - Demet Aydoğdu
- Department of Radiology, Meram Faculty of Medicine, Necmettin Erbakan University, 42090, Meram, Konya, Turkey
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Şeker B, Açar G, Çiçekcibaşı AE, Aydoğdu D. Morphometric analysis of sphenopalatine foramen on computed tomography images with clinical significance. Surg Radiol Anat 2022; 44:1521-1529. [PMID: 36394641 DOI: 10.1007/s00276-022-03044-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 11/07/2022] [Indexed: 11/18/2022]
Abstract
PURPOSE 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.
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Affiliation(s)
- Büşra Şeker
- Department of Anatomy, Yunus Emre Mh. Unzile Sk. Meram Faculty of Medicine, Necmettin Erbakan University, 42090, Meram, Konya, Turkey.
| | - Gülay Açar
- Department of Anatomy, Yunus Emre Mh. Unzile Sk. Meram Faculty of Medicine, Necmettin Erbakan University, 42090, Meram, Konya, Turkey
| | - Aynur Emine Çiçekcibaşı
- Department of Anatomy, Yunus Emre Mh. Unzile Sk. Meram Faculty of Medicine, Necmettin Erbakan University, 42090, Meram, Konya, Turkey
| | - Demet Aydoğdu
- Department of Radiology, Meram Faculty of Medicine, Necmettin Erbakan University, 42090, Meram, Konya, Turkey
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Açar G, Çiçekcibaşı AE, Uysal E, Koplay M. Anatomical variations of the aortic arch branching pattern using CT angiography: a proposal for a different morphological classification with clinical relevance. Anat Sci Int 2021; 97:65-78. [PMID: 34505990 DOI: 10.1007/s12565-021-00627-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 09/02/2021] [Indexed: 01/10/2023]
Abstract
The 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 4A1 with an aberrant left vertebral artery (ALVA), and Type 3A1, 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 3B2 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.
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Affiliation(s)
- Gülay Açar
- Department of Anatomy, Meram Faculty of Medicine, Necmettin Erbakan University, Yunus Emre Mh. Unzile Sk, 42090, Meram, Konya, Turkey.
| | - Aynur Emine Çiçekcibaşı
- Department of Anatomy, Meram Faculty of Medicine, Necmettin Erbakan University, Yunus Emre Mh. Unzile Sk, 42090, Meram, Konya, Turkey
| | - Emine Uysal
- Department of Radiology, Faculty of Medicine, Selcuk University, 42075, Selçuklu, Konya, Turkey
| | - Mustafa Koplay
- Department of Radiology, Faculty of Medicine, Selcuk University, 42075, Selçuklu, Konya, Turkey
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Abstract
Awareness 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°, 58.05° and 54.26°, 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.
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Affiliation(s)
- Gülay Açar
- Department of Anatomy, Meram Faculty of Medicine, Necmettin Erbakan University, 42090, Meram, Konya, Turkey.
| | - Aynur Emine Çiçekcibaşı
- Department of Anatomy, Meram Faculty of Medicine, Necmettin Erbakan University, 42090, Meram, Konya, Turkey
| | - Mustafa Koplay
- Department of Radiology, Faculty of Medicine, Selcuk University, 42075, Selçuklu, Konya, Turkey
| | - Nusret Seher
- Department of Radiology, Faculty of Medicine, Selcuk University, 42075, Selçuklu, Konya, Turkey
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Açar G, Çiçekcibaşı AE, Çukurova İ, Özen KE, Şeker M, Güler İ. The anatomic analysis of the vidian canal and the surrounding structures concerning vidian neurectomy using computed tomography scans. Braz J Otorhinolaryngol 2019; 85:136-143. [PMID: 29337014 PMCID: PMC9452270 DOI: 10.1016/j.bjorl.2017.11.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 11/08/2017] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION 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 0.625mm 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°. 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.
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Affiliation(s)
- Gülay Açar
- Necmettin Erbakan University, Meram Faculty of Medicine, Department of Anatomy, Konya, Turkey.
| | - Aynur Emine Çiçekcibaşı
- Necmettin Erbakan University, Meram Faculty of Medicine, Department of Anatomy, Konya, Turkey
| | - İbrahim Çukurova
- Health Sciences University, Izmir Tepecik Trainig and Research Hospital, Department of Otolaryngology-Head and Neck Surgery, Izmir, Turkey
| | - Kemal Emre Özen
- Katip Çelebi University, Faculty of Medicine, Department of Anatomy, Izmir, Turkey
| | - Muzaffer Şeker
- Necmettin Erbakan University, Meram Faculty of Medicine, Department of Anatomy, Konya, Turkey
| | - İbrahim Güler
- Selcuk University, Faculty of Medicine, Department of Radiology, Konya, Turkey
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