Mehmet Tugrul Yilmaz

Morphometric analyses of the development of nasal cavity in human fetuses: An anatomical and radiological study

OBJECTIVE It was aimed to research the morphometric development of the nasal cavity with dissection and radiological scanning methods and to detect anatomical variations. DESIGN Retrospective study. SETTING Departments of Anatomy and Radiology, Meram Medical Faculty, Selcuk University. PATIENTS Dissection stage was performed on 80 spontaneously aborted fetuses (40 males and 40 females) (63 second trimesters and 17 third trimesters) between 13 and 40 weeks of gestation. Radiological scanning stage was carried out on 40 spontaneously aborted fetuses (19 males and 21 females) (12 second trimesters and 28 third trimesters) with multi-detector computed tomography. METHODOLOGY One hundred and sixty nasal cavities and related structures were examined by means of bilateral dissection. Reference images were obtained in the axial plane with 3-mm collimation using multi-detector computed tomography (MDCT; Sensation 64, Siemens, Erlangen, Germany). These reference images were sent to the workstation (Leonardo, Siemens, Germany) and three-dimensional (axial, sagittal, and coronal) reformatted images with 1mm thickness were obtained via multiplanar imaging method. RESULTS In the dissected fetuses 16 suprema nasal conchae were determined. Six (15%) NSDs (four towards the left and two towards the right) were detected on radiological sections. The angle between the virtual line from sphenoidal sinus ostium through limen nasi and the horizontal plane was 32.72+/-3.3 degrees on average. CONCLUSION It was thought that some anatomic variations (e.g. suprema nasal concha, nasal septum deviation) occur in the fetal period; however, other certain differences (e.g. Onodi, Haller, and Agger nasi cells, concha bullosa) might be with effects of environmental factors (trauma and chronic infections) in postnatal period.

The Levator Claviculae Muscle and Unilateral Third Head of the Sternocleidomastoid Muscle: Case Report

Durante una diseccion de rutina, se observo en un cadaver de sexo masculino de 70 anos de edad, la presencia de una tercera cabeza unilateral del musculo esternocleidomastoideo y de un musculo elevador clavicular accesorio. En el lado izquierdo del cuello, se observo que el musculo esternocleidomastoideo poseia una tercera cabeza, ademas de las cabezas esternal y clavicular . El musculo elevador de la clavicula, tenia su origen en el tuberculo posterior del proceso transverso de la tercera vertebra cervical y se insertaba en el margen posterior de la clavicula. El conocimiento de estas variaciones pueden ser importantes debido a su estrecha relacion con las estructuras neurovasculares del cuello durante las operaciones.

Unilateral Variations of Vessels and Nerves in the Neck

Durante una diseccion de rutina, fue obserada en el lado izquierdo del cuello de un cadaver de sexo masculino de 65 anos de edad variaciones anatomicas vasculares y nerviosas. Se observo que el tronco linguofacial se originaba de la arteria carotida externa y que la arteria faringea ascendente se origina en la arteria occipital. Se determino que los ramos laringofaringeos originadas desde el ganglio cervical superior, giraban en torno al origen de la arteria tiroidea superior. Como una variacion adicional, la vena jugular interna se encontro dividida. El asa cervical y el vientre inferior del musculo omohioideo pasaban a traves de las partes de la dividion de la vena. Creemos que este tipo de variaciones supone dificultades importantes durante procedimientos radiologicos y quirurgicos de la region del cuello, y por tanto, es importante que los cirujanos conozcan estas variaciones.

The Mandibular Landmarks about the Facial Artery and Vein with Multidetector Computed Tomography Angiography (MDCTA): an Anatomical and Radiological Morphometric Study

El objetivo de este estudio fue investigar el curso de los vasos faciales de acuerdo con varios puntos de referencias mandibulares en sujetos vivos mediante angiografia por tomografia computarizada multidetector (ATCM) para determinar si estos estan relacionados con el sexo y el lado. El estudio se llevo a cabo en el Departamento de Radiologia, Facultad de Medicina de Meram en Necmettin Erbakan (Konya, Turkey). En total, sesenta caras de 30 sujetos (15 hombres y 15 mujeres), que presentaban sintomas y signos de la enfermedad vascular fueron evaluados para explorar los vasos faciales por ATCM. Los parametros sobre los vasos faciales se midieron en relacion a puntos de referencia (angulo de la mandibula, proceso mental, foramen mental y linea mediana facial). La distancia desde el punto en el que la arteria facial aparece por primera vez en el margen inferior de la mandibula hasta el angulo mandibular de la arteria facial derecha y izquierda fueron 3,53±0,66 cm y 3,31±0,73 cm en hombres, respectivamente. En mujeres fueron 2,91±0,52 cm y 3,35± 0,48 cm. La ATCM es un examen nuevo, poderoso, seguro y no invasivo para demostrar la vascularizacion de la cabeza. Las estructuras oseas y la morfologia de los vasos vecinos pueden ser evaluados por esta tecnica en casos de trauma con sospecha de lesiones de los vasos y se puede considerar de seleccion en pacientes para realizar cirugias de colgajo.

The evaluation of morphometry of nasal bone and pyriform aperture using multidetector computed tomography.

Introduction The aim of this study was to measure nasal bone (NB) and pyriform aperture (PA), morphometrically. Besides, the different types of NB and PA were classified and determined the sexual differences. Materials and Methods Our study was performed on 120 (60 women, 60 men) multidetector computed tomography images obtained from patients who underwent radiologic examination in the Department of Radiology of Meram Faculty of Medicine, Necmettin Erbakan University. The right, left, and median heights of NB; the superior and inferior widths of NB; the width of PA; and the distance between rhinion and anterior nasal spine (as the height of PA) were measured. Frontonasal and internasal angles were also determined. All data were analyzed statistically using Student’s t-test. Results The other data of men were higher than of women except for the superior and inferior widths of NB and the frontonasal angle. We also determined the ratio of the height of PA to the height of NB on median plane and the ratio of the height of PA to the width of PA. They were found less than 2.0 in 64.2% and 100% of the cases, respectively. The NB and PA were classified into 8 and 7 different types, respectively. Conclusions The knowledge of the morphometric data and different types of the NB and PA is essential for sex determination, all surgical procedures related to this area, and nasal reconstructions.

A complex variation of the parietal and visceral branches of the abdominal aorta

SUMMARY: Variations in the branches of the abdominal aorta were determined during a routine abdominal region dissection ofa 70-year-old male cadaver. Left gastric artery arose as the first root from antero-lateral of aorta. Coeliacomesenteric trunk occurred as athick root. After 29.9mm, coeliacomesenteric trunk bifurcated as coeliac trunk and superior mesenteric artery. Coeliac trunk bifurcatedas splenic artery and common hepatic artery. These multiple variations which change the normal anatomic structure of the abdominalaorta have to be kept in mind by surgeons, radiologists and anatomists. KEY WORDS: Abdominal aorta; Coeliacomesenteric trunk; Anatomical variation. INTRODUCTION Aorta, the main artery of circulation, is divided intothree according to its course; ascending aorta, arch of aortaand descending aorta. Passing through aortic hiatus undersidethe face of Th 12, aorta lies as abdominal aorta which is 13cm long and ends underside of L 4. The branches of theabdominal aorta can be classified as single-double orvisceral-parietal. Double visceral branches are (middlesuprarenal artery, renal artery, testicular artery (ovarianartery), single visceral branches are (coeliac trunk, superiormesenteric artery, inferior mesenteric artery), double parietalbranches are (inferior phrenic artery, lumbar arteries), andsingle parietal branch is median sacral artery (Standring,2005).Knowledge of such case has important clinicalsignificance in an abdominal operation or invasive arterialprocedure, that is by procedure and liver transplantation,laparoscopic surgery, and radiological procedures in theupper abdomen.

The evaluation of morphometry of the mastoid process using multidetector computed tomography in a living population.

AbstractThe aim of this study was to examine the relationships of the bony landmarks on the lateral surface of the mastoid process (MP). It was also the target of this study to reveal the importance of sexual dimorphism in terms of the mastoid triangle. Our study was performed on 140 (70 women, 70 men) multidetector computed tomography images obtained from patients who underwent radiologic examination at the Department of Radiology of Meram Medical Faculty, Necmettin Erbakan University. The height of the MP was measured using 2 different ways. The distance between the mastoid apex and the midpoint of the distance of the porion and the mastoid notch was measured (mastoid height 1). Then, the distance between the Frankfurt horizontal plane and the mastoid apex was measured (mastoid height 2). The distances between porion–mastoid notch, porion–mastoid apex, porion-asterion, asterion–mastoid apex, articular tubercle–asterion, articular tubercle–mastoid apex, as well as the right and the left MP were also measured. Finally, the angles between porion–mastoid apex–asterion, mastoid apex–asterion– porion, and asterion–porion–mastoid apex were measured. All data were analyzed statistically using the Student’s t-test. According to the results of the measurements, all right and left parameters of the men were higher than the women’s right and left sides except for the angle between asterion–porion–mastoid apex. In addition, all right and left parameters were almost the same in both sexes. Having the knowledge of measurements of the distances between the major landmarks of the temporal bone is essential to avoid possible complications during facial, mastoid, and especially sigmoid sinus surgeries.

Morphometric Analysis of Styloid Process Using Multidetector Computed Tomography.

AbstractStyloid process (SP) is a cylindrical anatomical structure located at the anterior side of stylomastoid foramen. Normally, it is 20 to 25 mm in length and can vary with ageand sex. An elongated SP is an unusual source of craniofacial and cervical pain. In this study, the clinical role of morphometric data of SP was discussed.In this study, 64-slice multidetector computed tomography images (Somatom Sensation 64, Siemens, Germany) from Radiology Departments archive of Necmettin Erbakan University were used. The examined images were collected from 100 patients (31 female and 69 male). Length of SP (SPL), SP width (SPW), distance between SP rooths (DBR), SPs angulation, and the distance between SP and internal carotid artery (SP-ICA) were measured.Statistical differences were found regarding to the data of SPL, SPW, DBR, and SP-ICA left between sexes. No statistical significance was detected between right and left side SPL (paired t test; P = 0.989, P > 0.05). SP was observed as mostly type A1 (right %55, left %52). These parameters were also compared with those of previous studies.The present study showed side and sex differences and types of SP. We believe that it was necessary to determine the normal range of values for different populations, and this knowledge will provide guidance to surgeons in the examination of this area.

The Morphometric Analysis of the Important Bone Structures on Skull Base in Living Individuals with Multidetector Computed Tomography

El objetivo de este estudio fue determinar datos morfometricos confiables de las estructuras oseas importantes de la base de craneo mediante tomografia computarizada multidetector (TCMD) y establecer las diferencias de estos datos en funcion del sexo y lateralizacion. Se realizo un estudio retrospectivo a partir de imagenes de TCMD obtenidas en el Departamento de Radiologia de la Facultad de Medicina Meram, Universidad de Necmettin Erbakan. Se evaluaron imagenes de 100 sujetos adultos (50 hombres y 50 mujeres), que no presentaban trauma craneal, cirugia o deformidad osea. Se midieron (i) altura y diametro anteroposterior de la fosa hipofisaria, (ii) longitud del condilo occipital y distancias intercondilares anterior y posterior, y (iii) el diametro sagital, transversal y el area del foramen magno. El resumen de los datos se expreso como Media±DE. La comparacion de los datos entre sexos y mediciones izquierda-derecha se realizo mediante la prueba t de Student, mientras que la relacion entre los distintos parametros mediante la prueba de correlacion de Pearson. Todos los parametros medidos, en el lado derecho e izquierdo, fueron mayores en hombres. Los valores mas altos se determinaron generalmente en el lado derecho en ambos sexos. Algunos parametros estuvieron altamente correlacionados en ambos sexos (P<0,001). Creemos que nuestros resultados pueden ser utiles al momento de realizar nuevos abordajes quirurgicos y en la evaluacion radiologica, relativas a la base de craneo.

Morphometric Analysis of the Inferior Vena Cava Related to Lumbar Vertebra and the Aortic Bifurcation on Multidetector Computed Tomography (MDCT)

Vascular structures are in greater danger during lumbar surgery. The purpose of this study is to describe the morphology of the inferior vena cava (IVC) related to the lumbar vertebra and aortic bifurcation (AB) and assessing the role of demographic values in these relations to decrease the risk of complications in the surgical interventions. The study was performed on Multidetector Computed Tomography (MDCT) images of 100 male and 100 female cases with an age range from 50 to 84 years. The morphometric values of the IVC obtained from the coronal, sagittal and the axial reformatted images were measured and compared with the demographic values. The distance from the IVC to the 1st lumbar vertebra (L1) and 2nd lumbar vertebra (L2) were measured as (26.5 mm and 18.1 mm) in males and (21.1 mm and 14.2 mm) in females with a high level of significance between genders; the distance from the IVC to the iliocaval confluence (IC), 3rd lumbar vertebra (L3) and 4rd lumbar vertebra (L4) were measured as (6.5 mm, 10.5 mm and 6.9 mm) in males and (4.9 mm, 9.1 mm and 5.5 mm) in females with significance between genders. The level of the IC was detected 46 % of males, 39 % of females at the level of lower third of L4. The vertical distance between the IC and the AB was measured and negative correlation between genders based on age was detected. Demographic values are important to consider the relationship of the IVC, the lumbar vertebra and the AB. The IVC was located further from the lumbar vertebra in males compared to females. Age increase played role in the approaching of the AB and the IC to each other in both gender and the IC to the promontory level in males.