Browsing by Author "Aycan, A."

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Anterior Stabilization Application With Odontoid Screw in a Patient With Type 2 Odontoid Fracture a Case Report
(Yuzuncu Yil Universitesi Tip Fakultesi, 2022) Taş, A.; Aycan, A.; Arabaci, O.; Yokuş, A.; Arslan, H.
The treatment of type II odontoid fractures has been discussed for many years. Due to the complex anatomy of the craniocervical junction, many-questions are encountered in the diagnosis and treatment of such fractures. However, in centers without Neuro-navigation and O-arm, free hand technique still remains a viable option for the surgical treatment of such cases. Although there is no neuronavigation and O-arm in our center, we will present our case of type II odontoid screw placement with free hand technique that we successfully applied in our elderly patient with a Type II fracture. © 2022, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Colloid Cyst Presenting With Acute Hydrocephalus in an Adult Patient: Case Report and Review of Literature
(Yuzuncu Yil Universitesi Tip Fakultesi, 2018) Aycan, A.; Gülşen, İ.; Arslan, M.; Kuyumcu, F.; Akyol, M.E.; Arslan, H.
Colloid cysts (CC) are rare cystic lesions with a wide clinical spectrum including the asymptomatic cysts that are coincidentally diagnosed and the cysts leading to sudden death. The symptoms in CC are usually caused by obstructive hydrocephalus. The most common symptom for CC is headache. CC rarely cause intracranial herniation and death. In this study, we aimed to present our experience in the diagnostic and treatment process of a 57-year-old male patient with CC who presented to the emergency service with sudden severe headache, vomiting and confusion. © 2018, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
The Dynamics of Prehospital/Hospital Care and Modes of Transport During Civil Conflict and Terrorist Incidents
(W B Saunders Co Ltd, 2017) Celik, S.; Dursun, R.; Aycan, A.; Gonullu, H.; Adanas, C.; Eryilmaz, M.; Guloglu, C.
Objective: Prehospital and hospital care during incidents of mass violence and civil conflict involve a number of aspects that distinguish it from care during times of peace. We aimed to analyze the dynamics and outcomes of prehospital and hospital care during ongoing conflicts. Study design: Multicentric prospective observational study. Method: Patients enrolled in the study, which was conducted in Turkey, were all injured in armed conflict and taken to level 1 trauma centers. On admittance, patients were requested to complete a semistructured questionnaire containing questions on patient demographics, transport type, weapons used, injury severity score (ISS), and other incident-related factors. We analyzed patient outcomes (mortality, morbidity, complications, and length of hospital stay) and transfers of patients between hospitals. The present study evaluated the cases of 390 victims enrolled over a 9-month period and followed up for 6 months. Results: The majority of patients were transported by ambulances (n = 334, 85.6%); other transport modes were helicopters (n = 32, 8.2%) and private vehicles (n = 24, 6.2%). Nearly half of patients (48.7%) did not benefit by changing hospitals. During transport to hospitals, 4.1% of the vehicles in the study were involved in accidents. Using multiple regression analysis, only ISS (odds ratio [OR]: 1.098, 95% confidence interval [CI]: 1.044-1.156) and the Glasgow Coma Scale (OR: 0.744, 95% CI: 0.639-0.866) were found to affect mortality. In Receiver-operator characteristic analysis, a cutoff value of 22.5 for ISS had a sensitivity of 100% and a specificity of 89.6% for mortality. Conclusions: Despite lower ISS values, patient outcomes were worse in terror incidents/civil conflicts. Transport modes did not significantly affect outcomes, whereas hospital transport was found to be inefficiently used. (C) 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
Embolization After Internal Carotid Artery Injury Secondary To Transsphenoidal Pituitary Surgery and Delayed Intranasal Coil Protrusion: Illustrative Case
(American Association of Neurological Surgeons, 2022) Tas, A.; Bozan, N.; Akin, R.; Aycan, A.
BACKGROUND The authors presented a case of spontaneous nasopharyngeal coil migration that occurred 3 years after a patient had undergone transsphenoidal resection due to pituitary macroadenoma and was treated with coil application because of internal carotid artery injury secondary to transsphenoidal resection of the pituitary macroadenoma. OBSERVATIONS In the literature, eight cases of coil migration that occurred between 2 and 120 months after coil application have been reported, most of which were treated with surgical removal of the coil in a same-day surgery setting. LESSONS The case presented emphasized that coil protrusion and migration may lead to destruction in the skull base, thereby leading to serious consequences if left untreated, even in the absence of history of trauma. To the authors’ knowledge, this is the first case in the literature that required additional invasive procedures due to recurrent bleeding that occurred several months after surgical removal of coils. Also, this report underlinedthe need for careful and long-term follow-up of coil materials used for the treatment of pseudoaneurysms caused by vascular injuries secondary to skull base injury during surgery. © 2022 The authors.
Evaluation of Patients Operatively Treated With a Diagnosis of Lumbar Disc Hernia: an Epidemiological Investigation
(Yuzuncu Yil Universitesi Tip Fakultesi, 2017) Aycan, A.; Gülşen, İ.; Arslan, M.; Kuyumcu, F.; Akyol, M.E.
Lower back and leg pain is a common condition in the community which leads to loss of work and restricts daily life activities. About 2-3% of all painful lower back syndromes are caused by lumbar disc herniation (LDH). Surgery is performed in patients with sensory and motor deficits and the patients which are not responding to physical and medical treatment. In this study, we retrospectively evaluated the LDH patients that were operatively treated in our clinic through the review of the literature and the study was aimed to provide contribution to epidemiological studies. The retrospective study included 190 patients who were operatively treated between January 2013 and December 2015. Age, gender, level of herniation, neurological examination findings, presence of trauma, length of hospital stay, profession, recurrence, and surgical outcome were evaluated in all patients. The 190 patients included 108 (56.8%) males and 82 (43.2%) females with a mean age of 45 years. Mean length of hospital stay was 1.8 days. The level of herniation was L4-5 (51.6%), L5-S1 (32.1%) with a rate of 83.7%. Preoperative foot drop was found in 2.1% of the patients. Of these, 50% of them were improved and 50% of them sustained foot drop following the surgery. Lumbar disc herniation is one of the most common spine surgeries performed. Appropriate surgical procedure with an accurate diagnosis leads to good success rates and high patient satisfaction. Following the surgery, 122 patients were graded as “perfect”, 50 patients as “good”, 15 patients as “moderate”, and 3 patients as “poor”. These findings were consistent with the findings of the literature. © 2017, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Investigation of Bdnf, Apoptosis and Cholinergic System Enzymes in Glioblastoma Multiforme Patient Serum
(Medical Project Poland, 2024) El-Tekreti, S.A.A.; Yeltekin, A.Ç.; Aycan, A.; Tas, A.
Background: Glioblastoma Multiforme (GBM) is the most common type of brain tumor and it is an aggressive form of adult brain cancer that is globally fatal. Unfortunately, the poor prognosis of patients with glioblastoma and current treatments do not appear to be very effective against glioblastoma as the disease is still fatal. Our study aimed to explore new ways of diagnosing the disease to develop a treatment for this deadly disease. Method: This study included 40 individuals (20 glioblastoma multiforme 20 control groups). The blood samples were taken from the study groups, and biochemical analysis was performed. The groups were then compared for statistical significance. Results: Our study aimed to determine the relationship between enzymes, some parameters levels and glioblastoma multiforme. When compared to the control group, the levels of GSH-Px, SOD, CAT, AChE, and BChE were decreased in patients with GBM, and the levels of MDA caspase-3, BDNF, TNF alfa, and 8-OHdG were increased. Conclusion: The results noted here point out that Apoptosis, Cholinergic System Enzymes, and BDNF are good and accurate markers in Glioblastoma Multiforme to know of diagnosing the disease. Will make it possible to use characteristics seen in glioblastoma multiforme as indicators for assessing tumor aggressiveness, as well as to get a better understanding of Proteins that are involved in apoptosis as well as anti-apoptotic proteins, allowing for the creation of novel molecularly based treatments. © Oncology and Radiotherapy.
A New Alternative Flap in the Closure of Meningomyelocele Defects: Modified S Flaps
(Yuzuncu Yil Universitesi Tip Fakultesi, 2018) Koçak, Ö.F.; Demir, C.Y.; Ersöz, M.E.; Özsular, Y.; Sultanoğlu, Y.; Aycan, A.; Akyol, M.E.
Back defects may occur after several factors such as cancer, trauma and pressure sores. These conditions are more frequent in adult group, whereas the etiological factor in newborn infants is usually meningomyelocele defects. The aim of this study is to define more reliable and easily applicable surgical technique for the closure of meningomy elocele defects. This study included a total of 15 infants who underwent operation with the diagnosis of meningomyelocele and were treated with a modified S flap at our clinic between January 2016 and January 2017. During surgery, two flaps with a random pattern planned from the healthy skin on the right and left side of the meningomyelocele defect were transposed to close the defect. The flap donor sites were primarily sutured by elevating the surrounding skin. The left-sided flap was designed with superior pedicle and the right one with inferior pedicle. Of the participants, 13 were females and two were males with a mean age of 3.2 (min-max: 1 to 16) days. The mean follow-up was 11.5 (min-max: 5 to 17) months. The mean defect size was 6.5×5 (min-max: 5×4 to 7×6) cm. The mean flap size was 6.5×2.9 cm for the flap planned from the left side and right side of the defect. Complication was observed only in one patients including partial necrosis. Our study results suggest that modified S flap is an easily applicable flap. The greatest advantage of this flap is the shortening of the operation time. However, the major disadvantage of this flap is the random pattern flap (absence of a known blood vessel). © 2018, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Povidone-Iodine Antisepsis in Lumbar Disc Surgery
(Yuzuncu Yil Universitesi Tip Fakultesi, 2022) Taş, A.; Aycan, N.; Aycan, A.; Zengin, İ.; Akyol, M.E.
Postoperative surgical sit e infection still constitutes a major concern in spinal surgery and related with poor outcome. We aimed to investigate the effect of povidone-iodine (PVP-I) on skin colonization in lumbar disc herniation (LDH) surgery. Adult patients scheduled for LDH surgery were included in the study. Three skin swab cultures were taken when lying on the operating table (culture 1), after PVP-I application (culture 2), and at the end of the operation (culture 3). The effect of PVP-I and other independent predictors on ski n culture was analyzed. A total of 62 [28 (45%) female, mean age 47±13 years] patients were included. Only male sex and taking shower before the surgery have been found to be independent factors for affecting culture 1 growth while adjusted to age, body ma ss index, smoking, preoperative hospital stay, and surgery site shaving [OR (95% CI): 7.8 (1.4-41.9), p=0.016; OR (95% CI): 0.34 (0.003-0.35), p=0.005]. After PVP-I, the growth frequency of culture 2 decreased significantly compared to culture 1 [8 (13%) vs. 43 (70%), p<0.001]. However, culture 3 positivity rate was similar to culture 2 (p=0.219). In preoperative sterilization of lumbar disc surgery, PVP-I significantly reduces skin colonization both immediately after application and at the end of the operation. © 2022, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Short-Term Outcomes of Aneurysmatic/Non-aneurysmatic Patients Operated for Spontaneous Subarachnoid Hemorrhage: a Tertiary Referral Center
(Yuzuncu Yil Universitesi Tip Fakultesi, 2023) Aycan, A.; Taş, A.; Arslan, M.; Tufan, A.
We aimed to retrospectively analyze patients with aneurysmal dilatation and vascular malformation who presented with spontaneous SAH. Clinical data in patients files, Preoperative and postoperative neurological and radiological findings, age, gender, and treatment results were evaluated retrospectively. The same team performed surgery on 38 (47.5%) patients. Twenty (52.6%) of the patients included in the study were female, and 18 (47.3%) were male. There were 33 patients with detected bleeding aneurysms, three with bleeding AVMs, and two patients with non-bleeding aneurysms. It was determined that 5% of the patients had a Fisher score of 1, 34% had a Fis her score of 2, 24% had a Fisher score of 3, and 37% had a Fisher score of 4. Ten patients died. There were signs of vasospasm in 18 patients. Nine (50%) of 18 patients with vasospasm survived, and 9(50%) died. Eleven patients had hydrocephalus. EVD was in serted in 10 patients. Lamina terminalis was opened in 29 patients. The vessel with the most common aneurysm was the isolated AcomA aneurysm, with a rate of 31.5% (n=12). MCA aneurysm was found with the second frequency with a rate of 23.6% (n=9) Spontaneous subarachnoid hemorrhage is a disease with high mortality and morbidity in neurosurgery. Rebleeding, vasospasm, onset GCS, Fisher score, and experienced surgical equipment are among the factors affecting the treatment outcome. Multidisciplinary treatment in centers where diagnosis, treatment, and follow-up can be made by the same team will reduce mortality and morbidity rates. © 2023, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Treatment and Outcomes of Patients With Metastatic Spinal Cord Compression: a Double-Center Study
(NLM (Medline), 2023) Aycan, A.; Eren, B.; Tas, A.; Celik, S.; Karagoz Guzey, F.; Kuyumcu, F.; Aycan, N.
OBJECTIVE: Spinal metastases may only affect the bone tissue and result in spinal instability or may additionally result in epidural compression, leading to neurological deficits. Surgery has emerged as a popular method in treating metastatic epidural spinal cord compression (MESCC) due to the advances in surgical techniques and instrumentation. In this study, we evaluated patients with MESCC regarding neurological status, pain status, and survival rates, and presented our experience managing MESCC. PATIENTS AND METHODS: Clinical and radiographic records of 53 patients diagnosed with MESCC between January 2011 and March 2017 were retrospectively evaluated. The study included patients with a pathological diagnosis of primary cancer, those who complained of spinal metastasis, and those who had indications of MESCC on Magnetic Resonance Imaging (MRI). Bone structure and spinal stability were evaluated using assessed Computed Tomography (CT), and metastatic spread was considered using assessed Positron Emission Tomography (PET) in suitable cases. For each patient, the presence of a tumor compressing the spinal cord, age, gender, preoperative, and postoperative American Spinal Injury Association scores (ASIA), Tokuhashi prognostic score (TPS), affected spinal segment, pathological diagnosis, preoperative, and postoperative Visual Analog Scale (VAS), the status of spinal stability, follow-up period, and complications were evaluated. RESULTS: Forty-five patients (82.2% of them were women) underwent surgery with a mean age of 58.29 ± 15.14 years. The most frequent type of primary tumor was multiple myeloma (33.9%), followed by lung (24.6%), gastric (7.5%), and prostate (5.7%). The most common site of metastasis was the thoracic region (43.4%), followed by lumbar (24.5%), multiple (24.5%), and cervical (5.7%). The analysis indicated that a significant difference was found between the survival rates of the TPS categories. CONCLUSIONS: Common symptoms of MESCC include spinal pain and neurological deficit below the level of the injury. Prompt surgical treatment followed by oncological treatment leads to significant neurological recovery, more prolonged survival, pain relief, and improved quality of life in patients with a short survival time. Oncological treatments, including radiotherapy (RT), should be recommended after surgical treatment.