Browsing by Author "Hamzaoglu, Vural"

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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.
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.
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.