Browsing by Author "Beger, Orhan"

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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.
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.
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.
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.
Multiple Muscular Abnormalities in a Fetal Cadaver With Charge Syndrome
(Springer France, 2019) Beger, Orhan; Koc, Turan; Beger, Burhan; Ozalp, Hakan; Hamzaoglu, Vural; Vayisoglu, Yusuf; Olgunus, Zeliha Kurtoglu
The CHARGE syndrome characterized by coloboma, heart defects, atresia of the choanae, retarded growth, genitourinary hypoplasia, and ear anomalies is one of the rare syndromes. Although certain clinical issues (scapular winging, sloping shoulder, Sprengel's deformity, kyphosis and scoliosis) which could be related to abnormalities in musculoskeletal structures of the neck and shoulder have been identified in CHARGE syndrome, data on details of muscle anomalies seem to be quite limited in the literature. In this case report, bilateral multiple muscular abnormalities (agenesis of the trapezius, presence of the rhombo-atloid muscle, and presence of the bipartite rhomboid minor with superficial and deep parts) was presented in a fetus cadaver with atypical CHARGE syndrome to attract the attention of clinicians for definitive diagnoses and surgical reconstruction of the shoulders deformity such as scapular winging and Sprengel's deformity. By considering the previous studies, we propose that the absence of the trapezius, as well as the other muscle abnormalities around the neck and shoulder, should be revised as being a component of CHARGE syndrome.
A New Esophageal Elongation Technique for Long-Gap Esophageal Atresia: in Vitro Comparison of Myotomy Techniques
(Springer Japan Kk, 2019) Beger, Burhan; Beger, Orhan
Background: Complications such as stricture, leakage, recurrent tracheoesophageal fistula and mucosal pouch are commonly seen in myotomy techniques used for long-gap esophageal atresia (LGEA) treatments. Therefore, we think that there is a clear need for other techniques which would enable us to create more robust and longer esophagus in such cases. In this study, we reviewed multiple V-myotomy (VM) technique and the differences of the said technique with Livaditis circular myotomy (LM) and Kimura spiral myotomy (KM) techniques using literature as an aid.Methods21 esophagus samples from 21 male lambs aged 12months were used in vitro for the study. All esophageal samples were matched to have a length of 120mm. Samples were divided into 3 groups of 7 and VM, LM and KM techniques were used in each group, respectively. Post-op esophagus lengths, elongation amount with each incision and perforation pressures were measured.ResultsPost-op esophageal lengths were measured as 227, 210 and 200mm for VM, LM and KM, respectively. Elongation amount per incision was measured as 5.1, 4 and 3.34mm, again in previous order of VM, LM, and KM. Finally, perforation pressure following VM, LM, and KM was measured as 460, 400, and 410mmHg.ConclusionVM was found to significantly increase total esophagus length and elongation per incision over LM and KM. In addition, VM was also shown to have a higher perforation pressure. Although in vivo live animal studies are required, we can say that VM can be used to create longer and robust esophagus.
Pediatric Anatomy of the Sternocleidomastoid Muscle on Magnetic Resonance Imaging Views
(Lippincott Williams & Wilkins, 2025) Beger, Burhan; Yalinkilic, Abdulaziz; Erdem, Mehmet Zeki; Mengi, Sevinc; Beger, Orhan
Objective: This study aimed to investigate morphologic features of the sternocleidomastoid muscle (SCM) in children for pediatric head-neck surgeries. Methods: Magnetic resonance imaging images of 84 (46 males/38 females) pediatric patients aged ages 1 to 18 years (mean age: 9.38 +/- 4.46 y) constituted the study universe. The size of SCM (including its height, width, and angulation) was measured, and the origin types of SCM were noted. Results: All patients had SCM bilaterally. The origin variation of SCM was observed in 22 sides (13.10%). The authors observed type 1 in 146 sides (86.90%), type 2a in 15 sides (8.90%), type 3 in 2 sides (1.20%), type 4 in 1 side (0.60%), and type 5 in 4 sides (2.40%). The absence and presence of SCM variation were not affected by sex (P = 0.370) and side (P = 0.360). All measured parameters were similar in right and left sides, and also in males and females, except from the angle between the junction of the sternal and clavicular heads of SCM. The angle was greater in males than females (P = 0.004). All measured parameters increased with advancing age (between 1 and 18 y; P < 0.05). Conclusion: The authors' SCM-related data may be useful for clinicians to estimate the size origin variations of SCM in children.
Quantitative and Neurovascular Anatomy of the Growing Gracilis Muscle in the Human Fetuses
(Lippincott Williams & Wilkins, 2018) Beger, Burhan; Beger, Orhan; Koc, Turan; Dinc, Ugur; Hamzaoglu, Vural; Kayan, Gulden; Olgunus, Zeliha Kurtoglu
This study is intended to obtain the algebraic growth dynamics of the gracilis in fetuses and determine the variations of neurovascular pedicle(s) of the gracilis, to aid infant surgeries. Forty fetuses (19 males and 21 females) were included in the study. Gestational mean age of the fetuses was 22.40 +/- 2.67 (range, 18-28) weeks. Numerical values were obtained using a digital caliper and a digital image analysis software. Linear functions for the surface area, width, anterior, and posterior margin lengths of the gracilis were calculated, respectively, as: y = -289.307+20.501 x age (weeks), y = -7.113 + 0.622 x age (weeks), y = -24.421 + 3.434 x age (weeks), and y = -24.397 + 3.314 x age (weeks). In addition, length and width of the gracilis tendon were calculated as y = -6.676 + 0.934 -age (weeks) and y = -0.732 + 0.074 -age (weeks), respectively. Parameters of the gracilis had no statistically significant difference regarding side and sex (P > 0.05). In all the specimens, the gracilis was innervated by the anterior branch of the obturator nerve. Blood supply of the gracilis was identified to be derived from 1 single artery in 38 sides of total 80 (47.5%), from 2 arteries in 36 (45%) and from 3 arteries in 6 (7.5%). In 74 sides (92.5%), the nerve was superficial to the main artery, whereas in 6 sides (7.5%), it was deeper. The data of the present study could be beneficial for surgeons in infant surgeries to treat conditions such as obstetrical brachial plexus paralysis, facial palsy, or anal incontinence. Linear functions can be utilized to better evaluate the growth course of the gracilis in fetuses and to predict the dimensions thereof. Additionally, comprehending the structure and recognizing the variations of the gracilis nerves and arteries can help to protect the neurovascular pedicle(s) of the gracilis during the operations.
Quantitative Assessment of the Growth Dynamics of the Teres Major in Human Fetuses
(Springer France, 2018) Beger, Orhan; Koc, Turan; Beger, Burhan; Kayan, Gulden; Uzmansel, Deniz; Olgunus, Zeliha Kurtoglu
PurposeThe main objective of the study was to examine the use of teres major (TM) as a flap in the pediatric surgeries from an anatomical perspective by: (1) revealing the growth dynamics of the developing TM; (2) assessing the possible interconnecting structures between TM and latissimus dorsi (LD); (3) exposing the innervation patterns of TM in human fetuses.MethodsStudy was conducted on 50 fetuses (26 females and 24 males), on a mean gestational age of 22.863.21 (range 18-30) weeks. All the measurements were collected with a digital caliper and a digital image analysis software. Additionally, structural relations between TM and LD were examined in detail and further classified.ResultsNo significant difference of side and sex was detected on TM measurements (p>0.05). Linear functions for the surface area, width, length of the superior and inferior margins of TM were detected as follows: y=-257.142+18.334xage (weeks), y=-5.497+0.545xage (weeks), y=-1.621+1.068xage (weeks), and y=-2.147+1.284xage (weeks), respectively. As classified in five types, a number of 33 muscular or tendinous connections between TM and LD were detected. Musculo-tendinous slips from TM to triceps brachii (TB) were evident in four sides. Innervation of TM was observed to be providing by the lower subscapular nerve in all the cases.Conclusion p id=Par4 First, linear functions, representing the developing fetal morphometry obtained by our study can be adapted for estimating the morphometric of this muscle in early childhood. Besides, acknowledging the diverse appointments of TM with the surrounding muscles such as LD and TB may facilitate the prevention of neurovascular structures and the application of surgical procedures during tendon transfers. In brief, our findings are highly potent to bring the attention of pediatric surgeons.