Browsing by Author "Beger, Burhan"

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Age-Dependent Changes in Diameters of Abdominal Visceral Arteries in Children
(Springer, 2024) Ten, Baris; Beger, Burhan
Purpose The diameters of the abdominal aorta and its branches are affected by demographic properties of patients like age, sex or body mass index. Some researchers use the body of the first lumbar vertebra (L1) as an anatomical indicator to create an exact standard for diagnosing arterial aneurysms or stenoses. In this regard, this work designed to uncover relations of abdominal visceral arteries with L1 in normal children using their abdominopelvic computed tomography images. Materials and methods The study population consisted of 180 subjects (age range 1-18 years) without any abdominopelvic disorders. The diameters of the abdominal visceral arteries were measured and the ratios of these arteries to L1 were calculated. Results The diameters of the abdominal visceral arteries increased from infancy period up to postpubescent period (p < 0.001), but L1's diameter did not change after late childhood period. Measurements in males were statistically similar to those in females, excepts from the transverse diameter of L1 (p = 0.001), the diameter of the common hepatic artery at the distal level (p = 0.002), and the diameter of the inferior mesenteric artery at the distal level (p = 0.019), which were greater in males than females. The ratios of diameters of the abdominal visceral arteries to L1 increased with advancing age (p < 0.001). Ratios in males were statistically similar to those in females (p > 0.05). Conclusion Our age-specific diameters and ratios regarding abdominal visceral arteries may facilitate the diagnosis of vascular disorders in children.
Age-Dependent Changes in the Hyoid Bone Morphology in Children
(Springer France, 2024) Beger, Burhan; Yalinkilic, Abdulaziz; Erdem, Mehmet Zeki; Akdemir, Zulkuf; Beger, Orhan
PurposeThis radiologic work aimed to display the alteration in the hyoid bone (HB) morphology in the pediatric population with advancing age. MethodsThis pediatric examination consisted of computed tomography images of 129 subjects (49 males / 80 females) aged 1-17 years. ResultsThe anterior-posterior length of HB, the lengths of right and left greater horns, the width and height of HB's body, and the distance between the midpoints of the posterior ends of the greater horns increased with advancing age (p < 0.001), but the angle of the right and left greater horns (p = 0.022) decreased. Four configurations regarding HB shape were observed: Type A (U-shaped HB) in 8.5% (11 HBs) out of 129 children, Type B (B-shaped HB) in 33.3% (43 HBs), Type C (D-shaped HB) in 45% (58 HBs), and Type D (V-shaped HB) in 13.2% (17 HBs). HB shape types correlated with the pediatric age (p < 0.001), but not gender (p = 0.153). ConclusionsMost of the parameters increased until the postpubescent period, but the angle of the right and left greater horns decreased after the late childhood. Our linear functions representing the growth pattern of HB in children may be useful to estimate HB size.
Atipik Yerle Tipik Yerleşimli Ciltalt Mli Ciltaltıkitle: Boyunda Hidatik Kist
(2018) Beger, Burhan; Tekin, Hakan; Şimşek, Metin
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Bir Periton Diyalizi Komplikasyonu Olarak Over Arteri Yaralanması: Olgu Sunumu
(2009) Beger, Burhan; Edirne, Yeşim; Çetin, Mecnun; Melek, Mehmet
Periton diyalizi tedavisindeki hastalar, başta peritonit olmak üzere, kateter çıkış yeri infeksiyonu, kateter disfonksiyonu, yetersiz klirens ve yetersiz ultrafiltrasyon gibi birçok komplikasyon ile karşı karşıyadırlar. Periton diyalizi yapılan hastalarda hemoperitoneum benign bir komplikasyon olarak tariflenmekle birlikte olguların % 20 gibi bir kısmında hayatı tehdit eden şiddette görülmesi nedeniyle dikkat edilmesi gereken önemli bir komplikasyondur. Çeşitli serilerde periton diyalizi sırasında oluşan intraperitoneal kanama komplikasyonu bildirilmekle birlikte kanamanın spesifik bir odağından bahsedilmemektedir. Bu çalışmada periton diyaliz kateterinin takılmasını takiben dördüncü günde gelişen over arteri yaralanmasına bağlı intraabdominal hemoraji sonucu exitus olan iki aylık kız bebek olgu sunulmaktadır. Özellikle sert malzemeden yapılmış periton diyaliz kateterlerinin kanama komplikasyonuna etkisi oldukça fazladır ve bu tür kateterlerin stabilizasyonu hayati önem taşır.
Çocuklarda Ovaryan Teratomlar: 7 Yıllık Deneyimimiz
(2020) Düz, Ebuzer; Beger, Burhan; Karaman, Erbil; Şimşek, Metin; Kızılyıldız, Baran Serdar
Amaç: Torsiyon ile ilişkili olarak kist içine kanama nedeniyle kitle görünümü oluşabilmektedir ve over dokusunun kanlanması radyolojik olarak net değerlendirilemeyebilir. Bu nedenle torsiyone ve torsiyone olmayan MKT’ lerin tanısı ciddi bir ikilem olmaya devam etmektedir. Gereç ve Yöntem: CRP yüksekliği torsiyonun eşlik etiği vakaların %40’ında anlamlı derecede yüksek(>5mg/l) bulundu. En sık yapılan cerrahi, 14 vakada uygulanan fertilite koruyucu kistektomi (%77) idi. Bulgular: Torsiyon olan ve olmayan ovaryan teratomların laboratuvar ve görüntüleme yöntemleri istatistiksel yöntemle karşılaştırıldı. Sonuçlar SPSS versiyon 24 kullanılarak istatistiksel olarak değerlendirildi. Normallik kontrolleri Shapiro-Wilk testi ile yapıldı. Gruplar bağımsız örneklem ttesti ile karşılaştırıldı. İstatistiksel anlamlılık p <0.05 idi. Sonuç: Prospektif ve çok sayıda hasta ile çalışmanın planlanması uygun olacaktır. Benign ovaryan kitlelerde ilk tercih fertilite koruyucu cerrahidir. CRP, WBC ve CA19-9 özellikle torsiyon vakalarında işaretleyici olabilir.
Çocukluk Çağında Nadir Bir Barsak Obstrüksiyonu Nedeni: Poliüretan Köpük Yutma
(2016) Kızılyıldız, Baran Serdar; Beger, Burhan; Karaman, Kamuran; Melek, Mehmet
Yabancı cisim yutulması çocukluk çağında morbidite ve mortaliteye neden olan önemli bir sorundur. Yutulan yabancı cisimlerin %60'ının midede, %20'sinin özefagusta, %11'inin barsaklarda, %9'unun orofarinkste olduğu bildirilmiştir. Yutulan bu cisimlerin çoğu gastrointestinal sistemi kesintisiz olarak geçmektedir. Olguların %10-20'si endoskopik olarak, %1-14'ü ise cerrahi olarak çıkarılmaktadır. Bu çalışmada poliüretan köpük yutma sonucu gelişen ve ileal obstrüksiyon nedeniyle laparotomi uygulanan 8 yaşındaki bir olgu sunuldu.
The Effect of Plasma Rich Platelet Graft on Post-Operative Complications in Mid-Penile Hypospadias
(Wiley, 2020) Eryilmaz, Recep; Simsek, Metin; Aslan, Rahmi; Beger, Burhan; Ertas, Kasim; Taken, Kerem
Hypospadias is one of the most common penile congenital anomalies, which often requires a surgical approach. After the hypospadias is repaired, urethral fistula can occur in around 20% of patients. In this study, we used platelet-rich plasma (PRP) to reduce the urethral fistula and other post-operative complications after hypospadias repair. Only patients with primary mid-penile hypospadias were included study. Patients with forms other than mid-penile hypospadias and cases with previous hypospadias surgery were excluded from the study. A total of 40 hypospadias patients were included in this study. These patients were divided into groups A and B with 20 patients in each group. Hypospadias repair was performed with the Snodgrass TIPU technique on both groups. PRP was used with group A, and PRP was not use with group B. These two groups were compared in terms of early and long-term post-operative complications. Both early and long-term post-operative UCF, urethral stenosis and post-operative infection rates were lower in the group using PRP, group A. PRP has the potential to prevent post-operative complications occurring after hypospadias repair, particularly post-operative infection.
Effective Diameter of the Abdominal Aorta in Children
(Springer France, 2024) Beger, Burhan; Ten, Baris
Purpose Measure out of the standard interval in the aorta diameter is a clue for aortic aneurysm or hypoplasia. Pediatric studies focusing specifically on the normal diameter of the abdominal aorta (AA) were limited in the literature. Therefore, the main goal of this work was to determine changes in the effective diameter of AA in healthy children aged 1-18 years for diagnosis of vascular diseases. Methods This retrospective work focused on abdominopelvic computed tomography views of 180 children (sex: 90 males / 90 females, average age: 9.50 +/- 5.20 years) without any abdominopelvic disease to measure diameters of AA, common iliac artery (CIA), external iliac artery (EIA), and first lumbar vertebra (L1). Results Vessel and vertebra diameters increased in pediatric subjects between 1 and 18 years (p < 0.001). Considering pediatric age periods, vessel diameters increased steadily, but L1 diameter showed an irregular growth pattern between age periods. All parameters were greater in males than females (p < 0.05), except from effective diameters of AA over the coeliac trunk (p = 0.084) and over the renal artery (p = 0.051). The ratios of diameters of vessels to L1 increased depending on ages between 1 and 18 years. Considering pediatric age periods, the ratios increased from infancy period to postpubescent period in irregular pattern; however, the ratios for right and left CIA, and AA over the aortic bifurcation did not alter after late childhood period. All ratios for males were similar to females (p > 0.05). Conclusion Our age-specific ratios may be beneficial for surgeons and radiologists for the diagnosis of vascular disorders such as aortic aneurysm.
Efficacy of Infliximab in Experimental Tracheal Stenosis
(Lippincott Williams & Wilkins, 2025) Yalinkilic, Abdulaziz; Yalinkilic, Fatma Ayaz; Beger, Burhan; Erdem, Mehmet Zeki; Ucar, Hadice; Beger, Orhan
Objective:This study aimed to investigate the efficacy of infliximab, a TNF-alpha inhibitor, on epithelial damage, inflammation, and fibrosis in experimental tracheal stenosis.Methods:Rats were divided into 3 groups. In group 1 (the control group), no procedure was applied. Tracheotomy was opened in the other groups. The laryngotracheal mucosa of the rats was traumatized with a brush through the tracheostoma to create a stenosis model. After surgery, group 2 (the infliximab group) received 5 mg/kg infliximab intraperitoneally. In group 3 (the sham group) only 0.5 ml of saline (0.9% NaCl) was administered intraperitoneally. After 14 days, the rats were sacrificed. Tracheal rings were excised, and epithelial damage, inflammation, and fibrosis were evaluated histopathologically.Results:Infliximab reduced the formation of epithelial damage (P=0.002), fibrosis (P=0.001), and inflammation (P=0.003) compared with the sham and control group.Conclusion:This was the first investigation displaying the effects of infliximab on tracheal stenosis. The authors' experimental results may offer guidance for further studies. Their experience presents novel sights into optimizing outcomes in tracheal stenosis surgery, and so paves the way for further clinical examinations.
Evaluation of Caustic Subtance Taking in Childhood
(2011) Beger, Burhan; Melek, Mehmet
Giriş ve Amaç: Koroziv madde alımına bağlı özofagus yanıkları yüksek morbidite ve mortalite oranları nedeniyle çocukluk çağının önemli bir sağlık problemidir. Koroziv özofajitin tedavisi yıllar içinde gelişme gösterse de üzerinde fikir birliği oluşmuş bir tedavi seçeneği yoktur. Bu çalışma ile çocukluk çağındaki koroziv madde alımlarına ait bilimsel verileri ortaya koymayı ve önlenebilir özellikte olduğuna vurgu yapılan bu tip kazalara karşı gerekli toplumsal duyarlılığın sağlanmasına katkı sunmayı amaçladık.Materyal-Metod: Biz bu çalışmada Yüzüncü Yıl Üniversitesi Tıp Fakültesi Çocuk Cerrahisi Kliniğimize Haziran 2005 - Aralık 2010 tarihleri arasında koroziv madde alımı nedeni ile başvuran ve yatarak takip ve tedavisi yapılan 0-15 yaş aralığındaki 158 çocuk hastayı yaş, cinsiyet, sosyal ve demografik açıdan gözden geçirdik.Bulgular: Hastaların 97'si erkek (%61,4) ve 61'i kız (%38,6) idi. Olguların yaş ortalaması 4,07±2,7 olarak saptandı. Koroziv madde alımı en fazla (%58) 0-3 yaş gurubunda ve ikinci sıklıkta (%26) 3-6 yaş gurubunda görüldü. Her yaşta en sık içilen koroziv madde çamaşır suyu olarak saptandı. Olguların %36,1'inde içilen koroziv madde miktarı bilinmemekteydi. Koroziv maddenin içildiği kap sorgulandığında (%47.5) ile en kalabalık grubu koroziv maddeyi çay bardağından içen olguların oluşturduğu tespit edildi. %39,2' sinin koroziv maddeyi kendi kabından içtiği tespit edildi. Bu tip kazaların %89'unun ev içinde gerçekleştiği saptandı. Olguların %52,7'sinin koroziv maddeyi susuzluğunu gidermek için; %1' inin intihar amaçlı içtiği tespit edildi. Olguların %96,1'i koroziv maddeyi kendi içtiği saptandı. Olguların %73,2'si hasta yakının şüphesi ile hastaneye getirildiler. Olguların %89,8'ine hastaneye getilmeden önce bir ilk müdahale yapıldığı saptandı. Olguların %86,7 sinin ilk 24 saatte hastaneye başvurdukları tespit edildi. %72'sinde ilk fizik muayene normal olarak saptandı. Akut dönem olarak değerlendirdiğimiz ilk 3 gün boyunca oral alımını kestiğimiz olgulara intravenöz mayi verildi. Olgularımızın tümüne proflaktik amaçla antibiyotik tedavisi başlandı. Belirgin semptomları olan ve özofagoskobide pozitif bulgular saptanan 26 olguda tedaviye steroid de eklendi. 26 hastaya özofagoskopi yapıldı. Yedi hastada mukozal ödem ve hiperemi 1 hastada yüzeyel ülserler saptandı. Ortalama hastanede kalış süresi 73,82 ± 25,77 saat olarak gerçekleşti. Olguların %82,3'ü (n:130) semptomlarının gerileyip kaybolmasını takiben poliklinik kontrolümüze devam etmek üzere ve 21. günde de özofagografi çekilmesi planlanarak şifa ile taburcu edildi. 28 olgu ise hastanede tedavinin herhangi bir aşamasında tedaviyi reddederek kliniği terk etmek suretiyle takipten çıktı. Özofagografi sonucu ile polikliniğimize başvuran 61 olgunun 3'ünde değişik derecelerde striktür tespit edildi. Olguların %83,5'inin (n:132) il merkezinde yaşadığı saptandı. %76'sının kendine ait bir evde oturduğu saptandı. Olguların %83'ünün aynı hanede 5 kişiden fazla insanın barındığı kalabalık ailelerden geldiği tespit edildi. %35 (n:54) olguda anne-baba akrabalığı olduğu tespit edildi. Annelerin % 45,6'sı babaların %14'ü okur yazar değildi. Annelerin %95'i babaların %8,9'u çalışmamaktadır. Ailelerin %87,5'inin 1000 Tl' nin altında bir gelirle yaşadığı saptandı.
Ganglioneuroma in a Child With Chronic Constipation and Abdominal Pain
(2018) Guven, Burcu; Avci, Veli; Beger, Burhan; Yaşar, Akkız Şahin
Ganglioneuromas are rare, benign, slow-growing tumors arising from the neural crest. They are most commonly in posterior mediastinum, retroperitoneum, adrenal medulla and neck. They are very rare in presacral region. A 15 year old girl presented with abdominal pain and chronic constipation. A mass was seen between the uterus and sacrococcygeal bone in abdominal CT. It is resected totally and evaluated as ganglioneuroma. Conclusion: Presacral ganglioneuroma is a benign tumor which is rarely encountered. Patients might present with abdominal pain and constipation complaints as seen in our patient. Therefore, imaging methods should certainly be used for patients with chronic constipation which is resistance to treatment.
Gastric Volvulus: a Rare Cause of Gastric Outlet Obstruction in Pediatric Age
(2019) Beger, Burhan; Uslu, Enver; Hekimoğlu, Ebuzer Can; Güven, Burcu
Gastric volvulus is a rare disease in the pediatric population. Symptoms may change depending on the type ofthe disease, rotation degree, and the etiology. Early diagnosis and treatment are important especially in theacute type of the gastric volvulus. Here, it was presented a 10-month-old girl with non-bilious vomiting andabdominal distention in last 2 days, diagnosed gastric volvulus.
Hirschsprung Hastalığı: Duhamel-martin Deneyimlerimiz
(2018) Beger, Burhan; Avci, Veli
Amaç: Kliniğimizde Hirschsprung Hastalığı tedavisindeuygulanan Duhamel ameliyatının Martin modifikasyonuile ilgili deneyimlerimizi sunmak.Gereç ve Yöntem: Ocak 2012 ile Ekim 2017 tarihleriarasında Hirschsprung Hastalığı tanısı alan hastaların yaş,cinsiyet, başvuru zamanı, semptom-bulgular, konjenitalanomaliler, tedavi metodları, rezeke edilen barsakuzunluğu, ameliyat sonrası ilk defekasyona kadar geçensüre, nazogastrik dekompresyon süresi, oral beslenmeyegeçiş zamanı, ameliyat sonrası komplikasyonlar,hastanede yatış günü ile morbidite-mortalite açısındangeriye dönük değerlendirildi.Bulgular: Çalışmadaki 53 hastanın 38’i erkek, 15’i kız idi.En sık başvuru nedeni kronik kabızlıktı (%81). Hastaların%15’inde ek konjenital anomali v ardı. Tanı konulanhastaların %24’ünün yaşı bir aydan küçüktü. Tümhastalara Duhamel-Martin yöntemi ile definitif cerrahigerçekleştirildi. Ortalama 21 cm barsak rezeksiyonuyapıldı. Gaita çıkışları ameliyattan ortalama üç gün sonragözlendi. Nazogastrik sonda ile takip süresi ortalama dörtgündü.Aganglionik barsak segmenti en sık rekto-sigmoid (%71)bölgede görüldü. Ameliyat sonrası en sık gelişenkomplikasyon anal bölge enfeksiyonları (%25) idi. Birhasta sepsis nedeni ile kaybedildi. Hastanede toplam yatışsüresi ortalama 17 gündü.Sonuç: Hirschsprung Hastalığının tedavisinde uygulananDuhamel-Martin tekniğinde morbidite ve mortaliteoranlarının düşük olması nedeni ile kliniğimizde yıllarcagüvenle uygulanan cerrahi bir yöntem olmuştur.
Ileocecal Stenosis With Agenesis of Vermiform Appendix: a Rare Cause of Congenital Bowel Obstruction
(Elsevier Science Bv, 2018) Beger, Burhan; Kizilyildiz, Baran Serdar; Beger, Orhan
A 3-month old male patient, with chronic constipation and abdominal distension complaints, was intraoperatively diagnosed with ileocecal stenosis with agenesis of the vermiform appendix. Agenesis of the vermiform appendix is a very rare anatomical finding with an incidence rate about 0.001% in patients who receive laparotomy due to suspected acute appendicitis. No previous cases of ileocecal stenosis with agenesis of the vermiform appendix were reported in the literature. Ileocecal stenosis with agenesis of the vermiform appendix, which present with more shallow symptoms as opposed to ileocecal atresia, can be a cause of congenital bowel obstruction during neonatal period. Stenotic segment was resected without ileocecal valve reconstruction and then ileocolic anastomosis was performed. Development of the baby was normal during post-op 6-month follow-up period. The main objective of this case report is to attract the attention of pediatric surgeons in differential diagnosis of ileus and treatment strategies during laparotomy. (C) 2018 Anatomical Society of India. Published by Elsevier, a division of RELX India, Pvt. Ltd. All rights reserved.
Ischiofemoral Space Dimensions for Ischiofemoral Impingement: Is It Different in Children
(Springer, 2022) Ten, Baris; Beger, Orhan; Balci, Yuksel; Duce, Meltem Nass; Beger, Burhan
Objective This study intended to analyze alterations in ischiofemoral space (IFS) dimensions in normal children between the ages of 1 and 18 years for the ischiofemoral impingement. Materials and methods This study retrospectively focused on computed tomography images of 360 hips of 180 (90 boys and 90 girls) pediatric subjects (mean age: 9.50 +/- 5.20 years, range: 1-18 years) without any hip disorders to measure IFS, femoral neck angle (FNA), and ischial angle (IA). Results Mean IFS, FNA, and IA were measured as 14.64 +/- 7.24 mm, 34.61 +/- 11.47 degrees, and 131.52 +/- 4.22 degrees, respectively. IFS increased in children aged between 1 and 18 years, whereas FNA and IA decreased. IFS was similar in infancy and early childhood periods but then increased up to postpubescent period. FNA decreased proportionally from birth, whereas IA decreased in an irregular pattern. Linear functions were detected as y = 3.451 + 1.178 x years for IFS, as y = 48.555 - 1.468 x years for FNA, and as y = 132.535 - 0.107 x years for IA. Conclusion Our findings indicate that IFS tends to increase in size with age during childhood but decreases with further aging. Therefore, age-specific values for IFS, FNA, and IA may be beneficial for clinicians and radiologists for the diagnosis of ischiofemoral impingement.
Megacystis-Microcolon Hypoperistalsis Syndrome: a Case Report
(Hindawi Ltd, 2009) Melek, Mehmet; Edirne, Yesim; Beger, Burhan; Cetin, Mecnun
Megacystis Microcolon Intestinal Hypoperistalsis Syndrom (MMIHS) is a quite rare congenital and fatal disease which was firstly defined by Berdon and his colleagues. It appears through a widely enlarged bladder and microcolon and its cause is unknown (Berdon et al., 1976; Carmelo et al., 2005; Makhija et al., 1999; Loening-Baucke and Kimura 1999; Redman et al., 1984; Hsu et al., 2003; Yigit et al., 1996; Srikanth et al., 1993). The disease is found in females three or four times more than in males (Srikanth et al., 1993; Sen et al., 1993; Hirato et al., 2003). Most of the cases die within the early months of their lives (Yigit et al., 1996; Srikanth et al., 1993; Sen et al., 1993; Hirato et al., 2003). We present the case of a female newborn with antenatal ultrasound revealing intestinal mass and bilateral hydroureteronephrosis. The case was admitted for intestinal obstruction after birth. Copyright (C) 2009 Mehmet Melek et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Morphologic Evaluation of the Coccyx in the Pediatric Population
(Springer France, 2025) Meylani, Nevzat; Ten, Baris; Temel, Gulhan; Yuksek, Hasan Husnu; Comert, Ali Danyal; Beger, Burhan; Beger, Orhan
Purpose This computed tomography study aimed to display the alteration in the coccyx morphology (its ossification process, dimension and angulation) in children with advancing age. Methods Pelvic radiologic scans of 180 children aged 1-18 years were retrospectively evaluated to observe changes in the coccyx morphology with age, and to measure the linear length (LL), curvilinear length (CLL), sacrococcygeal angle (SCA), and intercoccygeal angle (ICA). Results The present study divides the postnatal evolution of the coccyx into three phases as follows: (a) in the first stage when the coccyx is of the shortest, it is completely cartilage until the age of 2 (infancy period) and its first segment begins to ossify by the age of 3 (early childhood period), (b) in the second stage when the coccyx is of medium size, its first segment is completely ossified by the age of 6 (late childhood period) and the ossification of its all segments is completed from the age of 11 (prepubescent period), and (c) in the third stage when the coccyx is of the longest, it reaches to adult size (postpubescent period). Linear functions were calculated as y = 15.647 + 1.145 x age (p < 0.001, R-2 = 0.561) for LL, and as y = 16.829 + 1.243 x age (p < 0.001, R2 = 0.559) for CLL. Conclusion Considering that morphological features of the coccyx, such as ICA, can be used in the diagnosis of coccydynia, our dataset may facilitate the identification of children with suspected coccydynia.
Morphometric Features of the Latissimus Dorsi Muscle in Fetal Cadavers With Meningomyelocele for Prenatal Surgery
(Lippincott Williams & Wilkins, 2019) Beger, Orhan; Beger, Burhan; Dinc, Ugur; Hamzaoglu, Vural; Erdemoglu, Ece; Ozalp, Hakan
Purpose: Latissimus dorsi (LD) flaps are frequently used in the prenatal meningomyelocele (MMC) repairs; on that basis, this study aims to reveal the morphometric features of LD, thoracodorsal artery (TDA) and nerve (TDN) in fetal cadavers with MMC defects, with an anatomical perspective. Methods: The study was conducted on 7 formalin-fixed human fetal cadavers (4 males and 3 females) with MMC defects, aged from 18 to 27 weeks of gestation. The size of LD, TDA, and TDN including their area, length, and width were measured by a digital caliper and digital image analysis software. Our direct measurements were compared with the corresponding estimations of a previous study in the literature which provides regression formulae based on gestational age. Results: The fetal cadavers with MMC had bilateral LD. No significant differences were found in the numerical data of anatomical structures between the sides or the sexes. LD size (ie, area, length and width) was approximately 3% to 10% smaller in the fetuses with MMC defects than that of the normal fetuses. Unilateral LD flap in a 22-week-old fetus with a large MMC was evaluated as insufficient to close the defects. Conclusion: Ten percent shrinkage in the area of LD might be too critical to be disregarded by surgeons during the closure of MMC defects. The dimensional findings about LD (area, length, and width) may be helpful in planning of LD flap harvesting for the repairs of MMC.
Morphometric Properties of the Latissimus Dorsi Muscle in Human Fetuses for Flap Surgery
(Springer France, 2018) Beger, Orhan; Beger, Burhan; Uzmansel, Deniz; Erdogan, Semra; Kurtoglu, Zeliha
Although latissimus dorsi (LD) flaps are extensively used in a wide range of interventions, fetus studies on this subject are quite limited. This study aims to obtain detailed information about the morphometric features of LD, thoracodorsal artery (TDA) and nerve (TDN). The study was carried out on both sides of 50 formalin-fixed human fetuses (22 male/28 female) with a mean gestational age of 24.5 +/- 4.7 (range 18-36) weeks, which were in the inventory of Anatomy Department of Mersin University Faculty of Medicine. Dimensions of LD, lengths and width of TDA and TDN were measured. Surface area of LD was calculated using digital image analysis software. All samples had LD muscle. Neither gender nor side-significant differences were observed in relation with the numerical data of LD, TDN and TDA. Linear function of surface area was calculated as "y = - 1767.532 + 114.582 x Age (weeks)". LD was attached directly to the posterior part of iliac crest in 59 of 100 sides meanwhile in the rest 41, it was attached by the thoracolumbar fascia. TDA gave a branch to serratus anterior in 96 cases and 2 branches in 4 cases. TDN passed superficial to TDA in 84 and deep to TDA in 16 samples. TDN had bifurcation in 93, trifurcation in 6 and tetrafurcation in 1 side. Data obtained from this study can be useful for estimating the sizes of LD and related neurovascular structures, especially in neonate surgeries. Linear function of LD surface area can be helpful to design the flap dimensions in newborn surgeries. A throughout knowledge about the branching pattern of TDN and its location-wise relation with TDA should be kept in mind to prevent possible complications during harvesting LD flaps and TDN grafts.
Morphometric Properties of the Levator Scapulae, Rhomboid Major, and Rhomboid Minor in Human Fetuses
(Springer France, 2018) Beger, Orhan; Dinc, Ugur; Beger, Burhan; Uzmansel, Deniz; Kurtoglu, Zeliha
The main objective of this study is to showcase the growth dynamics of levator scapulae, rhomboid major, and rhomboid minor algebraically, to help plan surgeries on newborns and young infants. Twenty-five formalin-fixed fetuses (11 male-14 female) with a mean gestational age of 21.80 +/- 2.61 (range 18-27) weeks present in the inventory of Mersin University Faculty of Medicine Anatomy Department were dissected. Surface area of levator scapulae, rhomboid major, and rhomboid minor was calculated using digital image analysis software; width and length parameters were measured using digital calipers. Neither sex nor side significant differences were observed in relation with the numerical data of levator scapulae, rhomboid major, and rhomboid minor (p > 0.05). Algebraic parameters such as surface area, width and length were detected to exhibit a linear growth from 18th to 27th week. Linear functions for levator scapulae, rhomboid major and rhomboid minor surface areas were obtained as y = - 136.871 + 10.598 x age (weeks), y = - 480.567 + 33.147 x age (weeks) and y = - 128.090 + 8.843 x age (weeks), respectively. The results and data of this study can potentially be beneficial in planning of surgeries for many infancy diseases such as trapezius paralysis, obstetrical brachial plexus palsy, Sprengel's disease, or winged scapula. Linear functions calculated in this study are expected to provide a better understanding of the growth dynamics of levator scapulae, rhomboid major, and rhomboid minor in fetal term and more precise estimation of muscle sizes.