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Amaç: Bu radioanatomik çalışmada, optik sinir cerrahisi açısından önemli bir referans noktası olması nedeni ile optik strut’ın morfometrik özellikleri ile ilgili veri elde edilmesi amaçlanmıştır. Materyal-Metot: Tıp Fakültesi Anatomi Anabilim Dalı envanterinde bulunan 7 adet erişkin insan kuru kafatası bu çalışmaya dahil edildi. Direkt anatomik ölçümler dijital kumpas ve radyolojik ölçümler bilgisayarlı tomografi yardımı ile elde edildi. Prekiyazmatik sulkusa göre optik strut’ın konumu değerlendirildi. Bulgular: Direkt anatomik ölçümlerde optik strut’ın uzunluğu ve genişliği 4.53±0.74 mm ve 4.83±1.34 mm olarak bulundu. Bilgisayarlı tomografide ise optik strut’ın uzunluk ve genişliği 4.13±1.27 mm ve 4.31±0.82 mm olarak tespit edildi. Direkt anatomik ölçüm ve bilgisayarlı tomografide iki strut arası mesafe 16.83±2.56 mm ve 15.91±1.81 mm olarak bulundu. Bilgisayarlı tomografi ve direkt anatomik değerlendirmede optik strut’ın 4 kuru kafada sulkal, 2 kuru kafada postsulkal ve 1 kuru kafada asimetrik olduğu belirlendi. Sonuç: Optik strut’ın cerrahlar açısından bir referans noktası olması ve anteriyor klinoid proses rezeksiyonu sırasında hasarlanabileceği dikkate alındığında, sayısal verilerimiz optik sinir çevresinde yapılan cerrahi müdahaleler sırasında faydalı olabilir.

Objectives Skull base is an important and a challenging area for surgeons. Success in skull base surgery depends on various factors such as pre-operative evaluation, appropriate surgical technique, anesthesia duration, intraoperative neuromonitorization and wound care. Materials and methods This study was performed in the Anatomy dissection laboratory of M.U. Medical Faculty (Ethical committee approval number 2010-103). Twelve fetuses between 17-33 gestational weeks fixed with formaldehyde were enrolled to the study. Results This study was planned to investigate the cross sectional areas of the sigmoid sinus in three levels to compare the right-left sides and the probable relationship among the levels in fetuses to further delineate the developmental factors on jugular foramen asymmetry. The cross-sectional measurements of sigmoid sinus lumen were done on 3 levels which are described as A1 level; sinodural angle, A2 level; the midpoint between the sinodural angle and endocranial orifice and A3 level as the entrance (endo-cranial orifice) of the jugular foramen. There is a strong positive correlation between left (L) A1 and L A2 and also the same for L A1 and right (R) A2. These strong and positive correlations are all valid between L A2-L A3, L A2-R A2, L A2-R A3, L A3-R A3, R A1-R A2. Conclusion Multicenter studies would be beneficial to investigate the topic with greater number of fetuses also on the different regions for genetic differences.

WOS:000497661000015 Toxic effects of silica nanoparticle of rats exposed intratympanically for 7 days were investigated using brainstem auditory evoked potential and distortion product otoacoustic emission techniques. The histopathological changes were evaluated with light microscopy and field emission-scanning electron microscopy were demonstrated in cochleas using based energy-dispersive X-ray spectroscopy. The reduction in the amplitude and prolongation at the peak latency and interpeak latencies of brainstem auditory evoked potential were observed. Silica nanoparticles significantly reduced distortion product otoacoustic emission amplitude in the 2, 3 and 4 kHz frequencies. In the light microscopic evaluation, the samples obtained from the experimental group showed a significant loss of hair cells. Field emission scanning electron microscope analysis of experimental group showed considerable hair cell damage compared to control group. The findings of this study show that intratympanic administration of silica nanoparticles may lead to hearing impairment by causing structural changes in cochlear hair cells. Research Fund of Mersin University in TurkeyMersin University [BAP- 2017-1-TP2-2143] This study was supported by the Research Fund of Mersin University in Turkey with Project Number: BAP- 2017-1-TP2-2143.

Amaç: Bu çalışmanın amacı, insan fetüslerinde septum veya çift hipoglossal kanal insidansını tespit etmektir. Yöntem: Tıp Fakültesi Anatomi Anabilim Dalı envanterinde bulunan ortalama 23.36±2.63 haftalık 25 fetüs (14 erkek, 11 kız) çalışmaya dahil edildi. Bulgular: Fetüslerin 9’unda (%36) septum vardı. Fetüslerin 2’sinde (%8) bilateral, 3’ünde (%12) sağ ve 4’ünde (%16) sol tarafta çift hipoglossal kanal tespit edildi. Gestasyonal yaş, cinsiyet ve taraflar ile septum varlığı arasında bir ilişki görülmedi. Sonuç: Hipoglossal kanalın bölümlenme paterni özellikle hipoglossal kanal schwannoma’ları gibi posterior kraniyal fossa operasyonları açısından önem taşıdığından nörocerrahlar ve radyololar için büyük önem taşımaktadır. Ayrıca çalışmamızdaki veriler, kafa tabanının gelişiminin anlaşılması açısından anatomistler ve antropologlar için kıymetli olabilir.

Objectives:This study aims to reveal morphometric properties of the clivus including length, width and angle to the base of the skull from the perspective of skull base procedures.Materials and Methods:Twenty-four human dry skulls were included in the inventory of Mersin University Medical Faculty Anatomy Department. Direct anatomic measurements (DAM) were performed using digital caliper and digital image analysis software. Radiological analysis was performed using computed tomography (CT).Results:The length and inner surface area of the clivus for DAM and CT were 25.17±3.98/24.83±3.91 mm and 546.51±66.44/523.37±87.48 mm2, respectively. Clival angle (Welcher angle) for DAM and CT was 126.12±9.51°/124.37±10.86°. No statistically significant difference was found between the numerical data obtained by DAM and CT (p>0.05).Conclusion:Considering that clivus anomalies are associated with diseases such as platybasia, basilar invagination, CHARGE syndrome or Chiari type I, the data of the present study can be used for the detection of clivus anomalies as well as choosing the type of approach to the skull base.

Introduction: A cadaveric experimental investigation aimed to show the rupture pressure of the tympanic membrane (TM) for otologists to evaluate its tensile strength. Methods: Twenty adult ears in 10 fresh frozen whole cadaveric heads (four males, six females) mean age 72.8 (SD 13.8) years (range 40–86) were studied. The tensile strength of the TM was evaluated with bursting pressure of the membrane. The dimensions of the membranes and perforations were measured with digital imaging software. Results: The mean bursting pressure of the TM was 97.71 (SD 36.20) kPa. The mean area, vertical and horizontal diameters of the TM were 57.46 (16.23) mm2, 9.54 (1.27) mm, 7.99 (1.08) mm respectively. The mean area, length and width of the perforations were 0.55 (0.25) mm2, 1.37 (0.50) mm, and 0.52 (0.22) mm, respectively. Comparisons of TM dimension, bursting pressure, and perforation size by laterality and gender showed no significant differences. The bursting pressure did not correlate (positively or negatively) with the TM or perforation sizes. Conclusions: The TM can rupture during activities such as freediving or scuba diving, potentially leading to serious problems including brain injuries. Studying such events via cadaveric studies and data from case studies is of fundamental importance. The minimum experimental bursting pressures might better be taken into consideration rather than average values as the danger threshold for prevention of TM damage (and complications thereof) by barotrauma.

BACKGROUND Evaluation of cranial nerve morphology through measuring cross-sectional area (CSA) on magnetic resonance imaging (MRI) is increasing day-by-day in clinical diseases. In Bell's palsy (BP), the manifestation of the enlarged CSA of the facial nerve (FN) may be used for diagnosis. This study aims to evaluate whether there is an enlargement of the cisternal FN in BP. METHODS This retrospective study included 43 patients diagnosed with BP. In the reconstructed MRI, the long (LD) and short (SD) diameters of the paralytic and normal sides of the FNs located in the cerebellopontine angle were measured, and the CSA was calculated using the Radinsky formula. Before the radiologic measurement, a preliminary experiment was carried out on the rat sciatic nerve to be able to determine the actual nerve boundary on MRI. FINDINGS There was a statistically significant relationship between paralytic and normal sides in the measurements of LD, SD, and CSA. The paralytic side was larger than the normal side in the cisternal FN. According to the Receiver Operating Characteristic (ROC) curve, BP can be estimated with 60% sensitivity and 70% specificity by the CSA of the FN more than 1.04 mm2 . As a result of the preliminary experiment, it was found that the actual nerve boundary was at approximately 50% intensity between the minimum and maximum values. CONCLUSION Although entrapment of FN in the labyrinthine segment in BP was known, this study showed that the cisternal FN, which could be evaluated more conveniently, enlarged in the paralytic side compared with the normal side, and revealed the necessity of performing the comparison amongst the MRI studies on BP patients by a standardised measurement method. This study will also help clinicians to make a decision in the diagnosis of BP by giving a cut-off value for the CSA.

To present the quantitative development of the geniculate ganglion (GG) in foetal cadavers.This study focused on 60 temporal bones of 30 (15 female and 15 male) foetuses aged 18?30 weeks of gestation (mean age, 22.83 ± 3.49 weeks) to measure the length, width and area of the GG.According to gestational weeks and months, the ganglion length (1.21 ± 0.41 mm), width (1.03 ± 0.28 mm) and area (1.24 ± 0.61 mmsup2/sup) did not change. In terms of sexes or sides, ganglion dimensions were not significantly different. Positive correlation was found between the length and width (p=0.033, r=0.276), between the length and area (p0.001, r=0.762) and between the width and area (p0.001, r=0.622). Linear functions were calculated for the ganglion area (y=0.355 + 0.039 × weeks), length (y=0.636 + 0.025 × weeks) and width (y=0.634 + 0.017 × weeks).The ganglion size did not change in foetal cadavers aged 18?30 weeks of gestation. This finding may be important for anatomists and embryologists in performing morphometric studies and understanding the development of the GG and for neurootologists and neurosurgeons in achieving greater success in skull base surgeries.

To compare the right and left sides and the endo?exocranial orifices of the jugular foramen (JF) considering the vascular compartment (VC) and the neural compartment (NC).A total of 20 human dry skulls belonging to the inventory of Medical Faculty, Department of Anatomy, were included in this study. Numerical values were obtained using direct anatomical and also computed tomography measurements.The endocranial and exocranial VC occupied wider areas on the right side than on the left side (p0.05). However, there was no statistically significant difference between the surface area of the endocranial and exocranial NC in terms of the sides (p0.05). The length of the endocranial VC was greater on the right than on the left side. The right exocranial VC was wider than the left exocranial VC. However, the widths and lengths of the endocranial and exocranial NC showed no statistically significant difference between the sides (p0.05).The right-sided dominance of JF observed in this study was attributed to the length of endocranial VC and the width of exocranial VC.

This study assessed the adequacy of patient data entry in the context of International Statistical Classification of Diseases and Related Health Problems (ICD-10) in the Hospital Information Administration System. It was also aimed to study the adequacy and functionality of the ICD-10 coding in the current Turkish Otorhinolaryngology (ORL) practice in detail. The medical records of 1216 patients who presented to the ORL outpatient clinic between 2012 and 2013 were reviewed. Eight diagnostic codes used by the ORL department were selected from the patient diagnoses report to form patient lists. The accessibility of the ICD-10 codes was analyzed. The data was transferred into the MEdCalc 12.0 software package in a digital medium. The study data was analyzed using frequency tables, Chi-square test, and the two sided likelihood ratio test. Among the ICD-10 codes included in the study, the larynx malignant neoplasm diagnosis (C32.9) was recorded at a rate of 60% and had the greatest ratio of recorded medical history, followed by malignant disorders (C32.3) of the laryngeal cartilage, vertigo (R42) (12.4%) whereas facial asymmetry (Q67.0) (10.5%) had the lowest recorded medical history ratios. There was a significant difference between the recorded and unrecorded patient groups (p [Med-Science 2018; 7(4.000): 873-7]

Objective There is still ongoing research on the relationship of arcuate eminence (AE) and superior semicircular canal (SSC). We aimed to evaluate the precision of predictability of SSC through the morphology of AE via radiological means. Materials and methods This investigation is performed on 12 dry skulls belonging to Mersin University Medical Faculty department of anatomy. Computed tomography (CT) assessment is performed with 0.5-mm-thin sections temporal bone algorithm on dry skulls which were marked with fixated copper wire by scotch tapes on the most prominent part of the middle fossa floor assuming the location of AE. The data are reformatted on the workstation with vitrea 2.0. The distances of the determined three points including lateral (A), apical (B), and medial (C) of the SSC and the copper wire are measured radiologically. Also, the height between the most apical part of the SSC to the floor of the skullbase (H) is measured. The angles between the placed copper wires and the SSC (E) are calculated. The angle between SSC and the midpoint of the IAC (F) and SSC to the sulcus of the greater GSPN (G) were measured. The nearest distance was measured between the most posterior part of the SSC and the point marked by the perpendicular line drawn from the medial border of the petrous bone to the most posterior part of the internal auditory canal (IAC) (D). Results The right and left A, B, and C distances are 2.54+/- 2.75, 3.67+/-3.16, 5.85+/-3.77; 2.92+/-2.24, 3.68+/-2.93, 6.09+/-3.40, respectively. We could not find any statistical significance when the right A, B, and C distances were compared with the left values. Examination of the values revealed that C distance is greater than the A distance of the same side both for right (p=0.040) and left (p=0.022) measurements. The calculated left and right E angles are 30.313+/-12.838, and 35.558+/-18.437 degrees, respectively. Statistical significance was not found between the right and left angles. The right and left F, G angles were 53.17, 47.25; 93.58, 100.92 degrees; and D distances are 8.01, 8.13 millimeters, respectively. Statistical significance was not found when right and left E, F, G angles and D distances were compared. Among 12 left and 12 right sides, the copper wire was found to be nearly overlapping to SSC in two in the right and only one in the left. Conclusion This study reveals that there is a great variability predicting the exact location of SSC through the prominence of AE. Complementary studies are needed with greater number of dry skulls and cadavers. Comparison of different hypothesis including the effect of temporal lobe sulcus is to be discussed to better enlighten the exact relationship of the aforementioned anatomical structures.

This study aims to evaluate the antimicrobial effects of Ecballium Elaterium (E.E) that is topically applied for treatment of rhinosinusitis as a traditional medicine. Pure and extract forms of E.E are applied to the nasal cavity of rats for rhinosinusitis. Nasal mucosa, soft palate and trachea of rats were harvested in the first hour, 3rd day and 3rd week for histopathological evaluation. This experimental study revealed antiinflammatory effects of E.E. It has also been shown that E.E reduced fibrosis. The antiinflammatory effect of all forms of E.E has been found to be at their maximum level in the 3rd day with a decreasing manner to 3rd week. Additionally, pure form of E.E caused severe epithelial loss in hyperacute stage. E.E also reduced fibrosis besides its antiinflammatory effect. The action mechanism of antiinflammatory effect of different levels of extract forms need to be further analysed through related enzymatic pathways by different dose and time studies.

This study aimed to evaluate the antimicrobial effects of the medicinal plant Ecballium elaterium, which is topically applied as a traditional medicine for the treatment of rhinosinusitis. Pure and extract forms of E elaterium were applied to the nasal cavity of rats for the treatment of Streptococcus-pneumoniae -induced rhinosinusitis. The nasal mucosa, soft palate, and trachea of the rats were harvested in the first hour, third day, and third week for histopathologic evaluation. This experiment revealed the anti-inflammatory effects of E elaterium and showed that it reduced fibrosis. The anti-inflammatory effect of all forms of E elaterium was found to reach its maximum level on the third day, decreasing by the third week. We also observed that the pure form of E elaterium caused severe epithelium loss in the first hour after application. The mechanism of the anti-inflammatory effect of different levels of extract forms needs to be further analyzed with different doses and duration of treatment.

The aim of this study was to investigate the probable effects of Hypericum perforatum (HP) on wound healing in diabetic rats.Thirty-five male Wistar rats were divided evenly into 5 groups. Diabetes formation was induced by intraperitoneal streptozotocin (60 mg/kg) administration for groups 1 (HP extract in olive oil), 2 (HP extract in ethanol), 3 (povidone-iodine application), and 4 (diabetic rats without any applied medication); group 5 was the control. Dorsal dermoepidermal incision was performed on each rat after 48 hours. The aforementioned solutions were applied only to groups 1, 2, and 3; groups 4 and 5 did not receive solution applications. At the end of the 7-day period, the cutaneous tissue was resected from the center of the incised and sutured region and divided into 3 pieces for biomechanical, biochemical, and histopathological assessments.Ultimate stress and toughness significantly decreased in groups 3, 4, and 5 compared to group 1. There was a significant difference between groups 2 and 3 for the same parameters (P.05). Compared with group 4, tissue malondialdehyde levels were found to be lower in the HP groups (P.05). Histopathological evaluation revealed the fibroblast count was reduced considerably in the HP-applied rats compared with other groups (P.05).Application of HP may be recommended as effective on wound healing in diabetic rats, but further investigation is needed to adapt the findings for clinical use.

Summary Deep lobe of the parotid gland is a rare localisation of head and neck tumors and most of them are pleomorphic adenoma. We encountered a 76-year-old woman with deep lobe parotid gland oncocytic neoplasms (synchronous oncocytoma and multifocal nodular oncocytic hyperplasia), but without any complaints. The patient was operated for larynx carcinoma four years ago. A deep lobe parotid gland lesion was detected during radiological evaluation of her middle ear cholesteatoma. A near total parotidectomy was performed. Oncocytoma is an uncommon salivary gland tumor and generally occurs in the superficial lobe of parotid gland of older patients. Multifocal nodular oncocytic hyperplasia is an unusual parotid gland lesion that accounts for 0.1% of parotid tumors. Computed tomography, magnetic resonance imaging, FNA and sialoscintigraphy may be helpful for evaluating parotid gland oncocytomas. Acinic cell carcinoma and clear cell carcinoma were the main differential diagnosis of oncocytoma. Surgical removal is the treatment of choice and total parotidectomy is suggested for deep lobe parotid gland oncocytomas. Recurrences are unusual for oncocytoma. Long-term follow up is necessary for multinodular cases. Parotid gland space occupying lesions may necessitate further emphasis regarding the fact that either second primary or a metastatic lesion may be found in especially a previously noted head and neck carcinoma patient.

Background Although bevacizumab has deleterious effects on the healing of colonic anastomoses, trapidil improves wound healing of colonic and tracheal anastomoses. Objective We aimed to assess the effects of bevacizumab and trapidil on wound healing after tracheal transection. Materials and methods We evaluated 35 rats divided in 5 groups: bevacizumab (Group I, n = 7), trapidil (Group II, n = 7), trapidil + bevacizumab (Group III, n = 7), controls (Group IV, n = 7), and sham (Group V, n = 7). Anastomotic healing was assessed by measurement of bursting pressure and inflammation score at the anastomotic region on the seventh day. Results The bursting pressures of Group II, Group III, and Group V were significantly higher than controls (P = 0.001, P = 0.033, and P = 0.035, respectively). Fibrosis was significantly high in the sham group when compared with the other four groups (P = 0.047). Conclusions Although bevacizumab seems to impair anastomotic healing, trapidil can be suggested to improve tracheal anastomoses.

Bronchoscopy has the potential to propagate infections. Bacterial translocation was hypothesised to be the cause of infections observed following bronchoscopy and this study was designed to assess the risk of bacterial translocation following rigid bronchoscopy in rats. A total of 30 rats were evaluated. The study group (n=15) underwent rigid bronchoscopy. Arterial blood gas analysis was performed in all rats. Blood and tissue cultures from the ileum, caecum, mesenteric lymph nodes, liver, spleen, mediastinal lymph nodes and lung were obtained 24 h following bronchoscopy. Bacterial translocation to the mesenteric lymph nodes was found in seven of 15 rats (46.7%) that underwent bronchoscopy, compared with none of the controls. Of the seven positives, three rats (42.8%) also demonstrated other organ involvement, such as the liver and spleen. Escherichia coli, Salmonella typhymirium, S. enteritidis and Pseudomonas spp. were found as translocating bacteria. In the study group, pH and arterial oxygen tension were significantly lower and arterial carbon dioxide tension was higher, compared with controls. This study shows that rigid bronchoscopy may induce bacterial translocation in rats. Further investigations aimed at understanding the clinical consequences of this phenomenon are warranted.

This study was designed to investigate the effects of bipolar and mononopolar electrocauterization on peripheral nerve tissue. The comparison on the deleterious effects of the different cautery modalities and the importance of probe tip placement are evaluated using electrophysiological, electron microscopic and biochemical assessment parameters. Ninety-eight male Wistar albino rats, each weighing 250–275 g, were randomly divided into 14 groups. Each group consisted of seven animals. Monopolar and bipolar electrocautery were performed at 15 watts. The application was performed either directly on the nerve or 1 mm lateral to the longitudinal axis of the nerve for ‘near the nerve groups’, respectively. The electrophysiological findings showed that the mean amplitudes were at the lowest value in the first day for all the groups. At the end of the 3rd week, we recognised that the electrophysiological recovery continued. Electron microscopic evaluation showed myelin disruption in all groups. Myelin disruption of healthy neurons was at the highest level in the 1st day of application in accordance with the electrophysiological findings. Biochemical evaluation revealed statistical significance between the control and the two of the ‘near the nerve groups’ (GIII and GV) for NO (nitrite and nitrate) serum level. The data of the present study might suggest that electrocautery, independent of the type and form of application, may result in significant damage in histological and electrophysological basis. Although the relative proportions cannot be ascertained, the time course of recovery suggests that both axon and myelin damage have occurred. The probable electrocautery damage may be of substantial importance for the situation that the nerves are displaced by tumor masses or atypical neural traces.