Mete Erturk

The superior orbital fissure and its contents

Topographic landmarks for the superior orbital fissure are useful for general orientation and approach to the middle fossa, cavernous sinus and orbit. In this study, the microsurgical anatomy and morphometry of the superior orbital fissure and its related structures were examined in 57 disarticulated sphenoid bones, 102 skull bases and 58 adult cadaveric heads. The superior orbital fissure was observed in nine different shapes based on the classification of Sharma et al. (1988), and the most frequently observed was Type VI. The distance from the superomedial to the superolateral edge was measured as 17.3 ± 3.4 mm on the right side and 16.9 ± 2.9 mm on the left side, and from the superolateral to the inferior edge as 20.8 ± 3.9 mm on the right side and 20.1 ± 3.8 mm on the left side. The distance from the superomedial to the inferior edge of the fissure was measured as 9.5 ± 2.2 mm on the right side and 9 ± 2.4 mm on the left side. No right-left differences were observed for these measurements. Measurements regarding the relationship of the oculomotor, trochlear and abducent nerves, the ophthalmic branch of the trigeminal nerve and the superior orbital vein were performed and topographic aspects of the superior orbital fissure region were described.

The effect of hyperbaric oxygen on neuroregeneration following acute thoracic spinal cord injury

AIMS Although hyperbaric oxygen (HBO) treatment following spinal cord injury (SCI) have been studied in terms of neurological function and tissue histology, there is a limited number studies on spinal cord tissue enzyme levels. MAIN METHODS The effect of HBO treatment in SCI was investigated by measuring superoxide dismutase (SOD), catalase, glutathione peroxidase (GPx), nitric oxide synthase (NOS) and nitric oxide (NO) activity in the injured tissue. SCI was induced by applying an aneurysm clip extradurally at the level of T9-T11 vertebrae. Preoperative HBO (preopHBO) treatment was applied for 5days and postoperative HBO (postopHBO) for 7days. KEY FINDINGS In the preopHBO group, a significant decrease was observed in NOS and NO compared to the SCI group. There was a decrease in SOD, NOS and NO in the postopHBO group when compared to the SCI group. In the pre-postHBO group SOD, GPx, NOS and NO decreased significantly. There was a decrease in SOD in postopHBO compared to preopHBO. In the prepostopHBO, SOD decreased significantly compared to that in the preopHBO group. The prepostopHBO presented a significant decrease in GPx compared to postopHBO (p<0.05 for all parameters). No significant difference was observed for catalase for all groups. Significant improvement was found in BBB scores for both postopHBO and prepostHBO groups when compared to the SCI group (p<0.05). SIGNIFICANCE HBO treatment was found to be beneficial following SCI in terms of biochemical parameters and functional recovery in the postoperative period.

Neuro-arterial relations in the region of the optic canal.

In this paper, we present the results of our investigations on the neuro-arterial relations in the region of the optic canal. A thorough knowledge of the microanatomic features of the ophthalmic artery, optic canal and optic nerve is very important for surgeons approaching lesions of this area. We aimed to extend our present knowledge of the origin of the ophthalmic artery and microsurgical anatomy of the optic canal with exposure of the optic nerve. The optic canal walls and width and height of the orbital and cranial apertures, and thickness of the bony roof of the optic canal were measured on the right and left sides of 57 sphenoid bones, 102 skull bases and 58 fixed adult cadaver heads. The ophthalmic artery originated from the rostromedial circumference of the internal carotid artery in 51.8%, from the medial circumference in 26.2% and the laterobasal circumference in 22% of the specimens. The outer diameter of the ophthalmic artery at its origin was 1.81 ± 0.36 mm on the right and 1.75 ± 0.37 mm on the left side.

Comparative morphometry of the lower lumbar vertebrae: osteometry in dry bones and computed tomography images of patients with and without low back pain.

Various factors affect the development of the vertebral canal. The dimensions of the vertebral canal and the intervertebral foramen can be altered by these factors before or after birth. Sex differences in dimensions have also been reported. When there is a stenosis of the vertebral canal or the intervertebral foramen, neural structures confined within them can be affected easily, resulting in symptoms. Using computed tomography images, we compared vertebral canal dimensions in 100 patients with low back pain and/or radiculopathy with those in 40 healthy, non-symptomatic controls. We also measured the dimensions of 275 dry bones. We found significant correlations among the variables in the live subjects. We found significant differences between patients and controls in the variables that were measured. Stenoses were more prevalent in females. Dry bone measurements showed some sex differences, and stenosis mainly in vertebrae L4, L5 and S1.

Morphometry of the anterior third ventricle region as a guide for the subfrontal (translaminaterminalis) approach

The anterior third ventricle region acquires clinical significance in benign and malignant tumors and cyst formations, of which craniopharyngiomas and gliomas are the most common. The subfrontal approach is one of the most preferred approaches for removing these tumors. In this study, the microsurgical anatomy of 81 Turkish, adult cadaveric hemispheres was examined to provide morphometric data of the region. These measurements from the anterior third ventricle region serve as a guide for neurosurgeons during surgical approach for removing anterior third ventricle tumors.

Morphological analysis of occipital condyles and foramen magnum as a guide for lateral surgical approaches

Craniovertebral junction (CVJ) refers to an area that includes the foramen magnum (FM), occipital condyles (OCs) and the first two cervical vertebrae, namely atlas and axis [1]. FM is in the center of the skull base and has three parts: the dorsal part of the FM (the squamosal part), the ventral part of FM (the basal or clival part), and the condylar part connecting the squamosal and the clival parts. The condylar part includes the OC, posterior margin of the jugular foramen and the hypoglossal canal [2]. OC is the only articulation between the occiput and the atlas [3].