Mehmet Hüseyin Akgül

The importance of medial-lateral styloid process angulation/coronal plane angle in symptomatic eagle syndrome

We used three‐dimensional computerized tomography (3DCT) to obtain images of Eagle Syndrome (ES) cases and measurements of relevant variables. Twenty‐five subjects with ES and 25 controls were included in this retrospective study. Styloid process length, anterior‐posterior styloid process angulation (Sagittal plane angle) (APA), medial‐lateral styloid process angulation (Coronal plane angle) (MLA), tonsil–stiloid distance and carotid–stiloid distance were measured on CT and 3DCT images, and cranial and neck angiography was obtained, from a total of 580 images. The styloid process lengths were 40.3 and 40.5 mm on the right and left sides in the ES group. The left MLA was lower in symptomatic (Median: 67.0°) than asymptomatic (Median: 72.6°) ES patients. In ES patients with styloid process length above 3 cm, MLA (coronal plane angle) is important, and the symptoms are more intense when this angle is smaller. Clin. Anat. 30:487–491, 2017.

Esthesioneuroblastoma located in the thoracic extradural space: Case report

Objective Esthesioneuroblastoma accounted for only 6% of the malignant nasal cavity neoplasms (ENB) is a rare tumor which originates from the olfactory epithelium. ENB’s are locally agresive and can metastasize by lymphatic and hematogenous routes. A patient with the mass on the nasal dorsum was reported in this article. Case history A 52–year-old-man admitted to the hospital with a 3 months history of progressive nasal obstruction, epistaxis and mass on the nasal dorsum. On rhinoscopy, a polypoid mass was seen in the both nasal cavity and intranasal biopsy with local anesthesia was performed. Histopathologic diagnosis of the tumor was Kadish stage B esthesioneuroblastoma. Tumor was excised by using bilateral endoscopic endonasal resection and lateral rhinotomy approach and paranasal radiotherapy performed postoperatively. Ten months after surgery, neck metastasis was occured and patient was underwent neck dissection. Twenteeth months after initial treatment, distant metastasis was identified on the T 10 vertebra and following the cranial and spinal radiotherapy to the neck he was free of local recurrence at follow up 13 months after surgery. Conclusion It has been known that the metastasis of the ENB to the spinal cord is an uncommon event, and it occurs often years after initial diagnosis. MRI scan is helpful for making the diagnosis, and surgery is the treatment of choice for obtaining diagnostic tissue and debulking the tumor. Radiotherapy is also a mainstay of postoperative treatment.

Traumatic intraventricular hemorrhage with a good prognosis.

We report a 10-year-old girl with an isolated traumatic intraventricular hemorrhage following a traffic accident, who had a good prognosis. Her neurological examination upon arrival was normal and she had no complaint other than headache and vomiting. Computed tomography on admission showed a hemorrhage in the lateral and fourth ventricles. She had a Glasgow Coma Score of 15, and she was thus given only antiepileptic drugs for prophylaxis and followed. Computed tomography that was repeated 5 days after admission showed no blood and all ventricles were of normal size. There was no vascular pathology on magnetic resonance imaging and magnetic resonance angiography. The patient remains well 5 months after her accident. Intraventricular hemorrhage does not always have a poor prognosis.

An Evaluation of the Quality of Sleep Before and After Surgical Treatment of Patients with Cervical Disc Herniation

Objective It has been reported in recent studies that 50-80% of patients with cervical disc hernia have concomitant sleep disorders. The aim of this study was to evaluate the quality of sleep before and after surgical treatment in patients with cervical disc hernia and to assess the effects on treatment. Methods The study included 32 patients performed discectomy and fusion with an intervertebral cage through the right anterior cervical approach. Oswestry Disability Index (ODI), Visual Analog Scale (VAS) and Pittsburgh Sleep Quality Index (PSQI) were applied to all patients preoperatively and at one month postoperatively. Results The postoperative PSQI total points and all the PSQI subscale points, the ODI and VAS scores were significantly reduced compared to the preoperative values. A positive correlation was determined between the preoperative ODI points and the PSQI total points and sleep duration, sleep latency and daytime functional loss subscale points. A positive correlation was also found between preoperative ODI points and VAS points. A positive correlation was determined between the preoperative VAS points and and the PSQI total points and sleep duration, and sleep latency subscale points. A negative correlation was determined between the postoperative ODI and the daytime functional loss subscale points. Conclusion The results of the study showed that in patients with cervical disc hernia, sleep quality and daytime functionality were negatively affected by severity of pain that limited daily activities. Bringing the pain under control with surgical treatment was observed to increase sleep quality. It can be concluded that when planning treatment for these patients, it should be taken into consideration that there could be a sleep disorder in addition to the complaints and symptoms such as pain, hypoestesia and loss of strength.

HİDROSEFALİLİ BİR HASTADA VENTRİKÜLOPERİTONEAL ŞANT KATETERİNİN DİSTAL UCUNUN İNGUİNAL HERNİ KESESİNE MİGRASYONU

Literaturde ventrikuloperitoneal (VP) sant kataterinin intestinal perforasyon, inguinal herni, peritonit gibi abdominal komplikasyonlara neden olabilecegi bildirilmistir. Hidrosefali nedeniyle VP sant takilmis 2 aylik erkek hastanin klinik takibinde, sant ameliyatindan otuz gun sonra sol kasiginda sislik saptandi. Yapilan abdominal ultrasonografi ve direkt grafi tetkiklerinde hastanin sol skrotumu icerisinde VP sant kateterinin distal ucunun izlenmesi uzerine hasta Cocuk Cerrahisi Bolumu tarafindan degerlendirildi. Hastaya sol inguinoskrotal herni tanisi koyularak ameliyat edildi. Kateter ucu karin icerisine redukte edilerek yuksek ligasyon ile inguinal herni onarimi yapildi. Hastanin ameliyat sonrasi uc aylik takibi sonunda nuks ve/veya komplikasyon izlenmedi. Sonuc olarak VP sant takilan hastalarda inguinoskrotal komplikasyonlar akilda tutulmalidir. VP sant ameliyati sonrasi kasik bolgesindeki sislikler inguinal herni acisindan degerlendirilmeli ve erken tani ve tedavi icin aile bilgilendirilmelidir.