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Öğe An evaluation using colored doppler ultrasonography of central retinal artery hemodynamics in the healthy eye in individuals with late monocular blindness(Lippincott Williams & Wilkins, 2020) Özen, Özkan; Aslan, FatihStructural and functional changes occur in the brain after vision losses. The purpose of the present study was to investigate central retinal artery (CRA) hemodynamics in the healthy eye of individuals developing late monocular blindness (LMB) using colored Doppler ultrasonography. The CRAs of 13 healthy eyes of 13 patients with LMB and of 13 healthy individuals as a control group were evaluated in this prospective study. Peak systolic velocity, end-diastolic velocity, mean flow velocity, systolic/diastolic velocity ratio, and resistivity and pulsatility index (RI, PI) values in the CRAs were determined using colored Doppler ultrasonography in both groups. The mean age of all the individuals examined was 39.3 +/- 12.3 years, and loss of vision in the LMB patients had been present for a mean 22 +/- 13.2 years. The PSH, DHS, and mean flow velocity values in the LMB group were 13.3 +/- 2.5 cm/s, 3.1 +/- 0.8 cm/s, and 6.5 +/- 1.6 cm/s, respectively, significantly lower than in the control group at 18.6 +/- 5 cm/s, 5.5 +/- 2.8 cm/s, and 10 +/- 3.2 cm/s (P< 0.05). The PI, RI, and systolic/diastolic velocity ratio values differences in the both group were not statistically significant (P> 0.05). In conclusion, the absence of a significant difference in RI and PI values between the 2 groups revealed that vascular resistance did not develop in the CRA hemodynamics of healthy eyes of individuals with LMB, although the low velocity values showed an increase in CRA width.Öğe Analysis of cerebellum with magnetic resonance 3D T1 sequence in individuals with chronic subjective tinnitus(Springer Heidelberg, 2020) Şahin, Caner; Avnoğlu, Seda; Özen, Özkan; Candan, BelceTinnitus is a symptom in which the patient can hear ringing, buzzing and similar sounds in the ear for 3 months longer. In our study, we aimed to analyse the cerebellum volume and cerebellum connections in patients with chronic tinnitus using VolBrain program. A total number of 10 patients and 10 otherwise healthy peoples records were then enrolled. Volumetric analysis was performed with automated segmentation of the cerebellum and its lobules, using magnetic resonance imaging (MRI). The mean volumes of 10 cerebellar volume were compared between the tinnitus and control groups. Quadrangular lobular portion of the cerebellum, the flocculonodular part and the volume of the central cerebellar lobule were decreased in the tinnitus group. White and grey matter decreased and the amygdala size was increased. We found statistically important volumetric changes in our study. VolBrain can be used in the future for analysing, diagnosis and treatment tinnitus patients. We recommend to use this practical, free of charge and easy programme to analyse for tinnitus patients. This may provide us with practical and useful information about the disease. In patients with tinnitus, the volume loss was 17.48% in the quadrangular lobe, 21% in the central lobule, and 9.33% in the total cerebellum volume.Öğe Assessment rate of true dorsogluteal intramuscular drug injection using ultrasonography(Professional Medical Publications, 2019) Özen, Özkan; Günaydin, Mücahit; Tosun, Alptekin; Coşkun, Zafer Ünsal; Aytekin, Kürşad; Takır, SelçukObjective: Medications are generally administered by either the enteric or parenteral route. With parenteral administration, intramuscular (IM) is the preferred approach because it increases the bioavailability of the drug, acts more quickly than the enteric route. The aim of this study was to determine the rate of true dorsogluteal intramuscular drug injection and to determine the causes for application failures in practice by ultrasonography (US). Methods: The study was conducted from May 1 to May 30, 2017 in Giresun University Education and Research Hospital, Giresun, Turkey. We examined 60 patients who were administered dorsogluteal IM injection with a 38.1mm length needle. After the injection, localization of medications (whether intramuscular or subcutaneous adipose tissue [SAT]) was evaluated by Ultrasound. Results: Female/male ratio of the patients was 27/33, with a mean age of 39.78 +/- 2.16 years. Obese/ normal weight ratio was 20/40. The mean dorsogluteal area SAT thickness of obese and normal weight patients were 32.34 +/- 2.17 mm and 20.85 +/- 1.20 mm, respectively. In 23 of the patients, IM injected drug was observed in the SAT, while it was observed in the IM area in 37 patients. Medication was observed in IM area in 37 of 50 patients who dorsogluteal region SAT thickness was appropriate (SAT thickness lower than 33.1mm) for IM injection while it was seen in SAT area in 13 patients. Conclusions: SAT thickness values are important if IM drug injection is to be administered correctly. Unsuccessful IM injections may be seen even in patients with appropriate SAT thicknesses.Öğe Bilateral Alt Ekstremite Ameli: Olgu Sunumu(2021) Akdeniz, Hüseyin; Arslan, Harun; Özen, Özkan; Akdemir, ZülküfAmeli bir ekstremitenin tamamen olmaması anlamına gelir. Bu anomali izole olabileceği gibi multipl konjenital anomalilerin bir parçası olarak da bulunabilir. Ender görülen ve genellikle etyolojisi saptanamayan bir durumdur. Antenatal dönemde 24. gebelik haftasında bilateral alt ekstremite amelisi tespit edilen bir vakanın sunulması amaçlanmıştır.Öğe Bilateral post-traumatic facial paralysis that contains longitudinal and transverse temporal fracture(Lippincott Williams & Wilkins, 2018) Şahin, Caner; Özen, ÖzkanAcute bilateral post-traumatic facial paralysis is rare in the literature. Post-traumatic facial paralysis is frequently accompanied transverse fractures of temporal more. The incidence of acute bilateral post-traumatic facial paralysis has been reported as 1 to 5 per million in the literature. Trauma and concurrent facial paralysis are usually in the same subsite (right temporal bone fracture and right facial paralysis). There is one pathophysiological pattern for a single temporal bone fracture in a subsite. The authors present a bilateral isolated different pathophysiological pattern sudden onset facial paralysis in a patient herein.Öğe Common carotid artery bifurcation aneurysm mimicking glomus caroticum(2019) Etli, Mustafa; Şahin, Caner; Özen, ÖzkanPatients with extracranial carotid aneurysms may apply to Ear, Nose and Throat clinics with complaints of pulsatile mass in the neck, neurological symptoms or tinnitus. Glomus caroticum is one of the most common diagnoses of patients with a large mass of pulsatile neck. Herein, we present a case of common carotid artery aneurysm at the level of common carotid artery mimicking glomus caroticum. Glomus may coexist with an aneurysm in the carotid artery. Risk of complications during lesion excision may increase the presence of aneurysm. In patients admitted with a pulsatile mass lesion in the carotid bifurcation region, the diagnosis and treatment of aneurysm with glomus caroticum should be kept in mind.Öğe Correlation of clinical findings with computed tomography in orbital traumas(Lippincott Williams and Wilkins, 2019) Aslan, Fatih; Özen, ÖzkanBackground: Although the eye is a well-protected organ, it is frequently affected by trauma. The timely detection of ocular injuries is extremely important. In this study, the authors evaluated the consistency between findings in computed tomography (CT) examination for orbital fractures and globe integrity and clinical findings in patients presenting to the emergency department due to orbital trauma. Methods: The authors retrospectively reviewed the files of patients presenting with orbital trauma between January 2015 and January 2018 from emergency department records. Ophthalmology consultation and follow-up notes, radiology reports, and the emergency physician's notes were reviewed. Results: During the study period, 286 patients presented to the emergency department with orbital trauma. A total of 119 eyes of 83 patients who underwent orbital CT were included in the study. Orbital bone fracture was detected in 54.6% (n = 65) of the eyes. Of these, 73.8% (n = 48) involved multiple fractures. Among all eyes, the distribution of fractures in the orbital walls was lateral wall in 41.2% (n = 49), floor in 32.8% (n = 39), medial wall in 31.1% (n = 37), and roof in 10.9% (n = 13). Multiple wall fractures were detected in 36.9% (n = 44) of the eyes. At least 1 clinical finding such as diplopia, laceration, abnormal pupillary response, hypoesthesia, and exophthalmos was observed in 47.1% (n = 56) of the eyes. This rate was 56.8% among eyes with orbital fractures and 35.2% in those without fracture. There was a statistically significant relationship between floor fractures and diplopia (P = 0.002). No significant correlations were found between the other radiological and clinical findings. Conclusion: Our study revealed a relationship between the presence of orbital fracture and eye damage. In particular, the authors found that the frequency of diplopia was significantly higher in eyes with maxillary bone fracture in the orbital floor. However, orbital CT findings other than bone fracture were not consistent with clinical findings. Copyright © 2019 Mutaz B. Habal, MD.Öğe Ectopic partial intrahepatic gallbladder: Magnetic resonance imaging and clinical findings(Medical Sciences University of Teheran, 2019) Özen, Özkan; Habibi, Mani; Yüksel YavuzEctopic gallbladder (GB) is a very rare anomaly. Ectopic GB can be found in intrahepatic, suprahepatic, retrohepatic, retroperitoneal sites as well as in falciform ligament, intra-abdominal wall, left abdominal quadrant and intrathoracic localizations. A 43-year-old male patient presented with a right upper quadrant pain in the abdomen. Upon detection of a cystic lesion with lobulated contour associated with GB in the liver in ultrasound examination, dynamic magnetic resonance imaging (MRI), MRI cholangiopancreatography, and contrast-enhanced MRI cholangiography were performed on the patient. MRI revealed that the lesion was a partial ectopic intrahepatic GB. In this article, we presented an ectopic partial intrahepatic gall bladder anomaly, which is very uncommon and has been previously described by surgical operations and cadaver studies, according to our literature review. © 2019 Tehran University of Medical Sciences.Öğe Evaluation of the mastoid missary canals with computerized tomography in patients with chronic otitis media(Thieme Medical Publ Inc, 2020) Özen, Özkan; Şahin, CanerBackground The mastoid emissary veins (MEVs) pass through the mastoid emissary canal-mastoid foramen (MEC-MF) in the mastoid region of the skull. MEVs can give rise to complications during surgical procedures. The purpose of our study was to investigate the morphological and morphometric characteristics of MECs of patients with clinical chronic otitis media (COM) using high-resolution computed tomography (HRCT). Methods Patients diagnosed with COM and undergoing temporal HRCT were identified by retrospectively scanning our hospital's automation system. Patients undergoing temporal HRCT for reasons other than COM, infection or tinnitus were identified for the control group by scanning the PACS archive. Sixty-two mastoid regions were examined in 38 unilateral and 12 bilateral COM patients, and 100 mastoid regions in the 50 patients in the control group. The presence of an accessory MEC-MF and MEC-MF diameters was evaluated in both groups. Results Main MEC diameters on the side of the ear with COM were 1.6mm, and total accessory and main MEC diameters were 1.8mm, both values being significantly higher than in the control group. Presence of accessory MEC on the side of the ear with COM was determined at 61.8%, significantly higher than in the control group. Conclusion Preoperative awareness of cranial venous drainage abnormalities is important to reduce surgical complications. Our study shows that MECs may be wider in diameter in patients with COM. MECs in COM patients must be identified before surgery to the mastoid region.Öğe Exposure to live in geographically steep terrain decreases patella height and increases the incidence of patella baja(2020) Aytekin, Kürşad; Özen, Özkan; Özen, Natalya; Akdeniz, Esra; Esenyel, Cem ZekiObjectives: This study aims to investigate the effect of the geographical conditions on patellar height. Methods: Two different groups of the same society were created according to the geographical structures that people live in (fully rugged mountainous terrain Giresun and flat terrain Alanya). But the daily activities such as kneeling, praying, squatting or sitting with crossed legs were same culturally. The study included patients living and working in these areas, as their parents, throughout their lives. Knee MRI of patients who did not suffer anterior knee pain were retrospectively evaluated. The Insall-Salvati index (ISI) was calculated and the patella baja incidence rates were compared between regions using the Fisher’s exact test. Results: A total of 885 knee MRIs were evaluated. The mean ISI for all individuals was found significantly different with a mean of 0.946±0.141 in Giresun and 1.014±0.13 in Alanya (p<0.001). The incidence of patella baja for all individuals was 5% in Giresun and 2% in Alanya (p=0.01). Conclusion: Our findings suggested that as the inclination of the region gets steeper; the patella height decreases and the patella baja incidence rate increases. Living in steep sloped geographical structures may be relevant in the etiology of patella baja.Öğe Frontal Recess Morphology and Frontal Sinus Cell Pneumatization Variations on Chronic Frontal Sinusitis(2023) Orhan Kubat, Gözde; Özen, ÖzkanObjective: The morphology and anatomical structure of the frontal sinus and recess are quite complex. The assessment of sinus ventilation is important in understanding the pathophysiology of chronic frontal sinusitis. The present study investigates the effects of frontal recess morphology, frontal beak thickness, and frontal sinus cell pneumatization variations on chronic frontal rhinosinusitis and examines the role of frontal beak thickness in frontal sinusitis. Methods: Frontal recess morphology, frontal sinus anatomy and pneumatization variations, and frontal beak thickness were analyzed with paranasal sinus-computed tomography scans, and the findings of the participants with and without frontal sinusitis were examined through logistic regression analysis. Results: Frontal beak thickness was greater in the chronic frontal rhinosinusitis group, while the frontal sinus ostium width and frontal recess width were greater in the control group (P < .001). The incidence of frontal air cells was statistically significantly higher in the chronic frontal rhinosinusitis group than in the control group (P < .05). Conclusion: The findings of our study reveal the narrowing of the frontal recess is an important factor in the development of chronic frontal sinusitis. Accordingly, frontal recess and frontal sinus anatomical structures should be assessed in detail in cases of chronic frontal sinusitis, and changes in these structures should be taken into consideration for treatment. The lack of any significant correlation between bone density and sinusitis suggests that chronic frontal sinusitis does not cause histopathological changes in the bony structure of the frontal beak.Öğe Gergin Omurilik Sendromu ve Tip I Ayrık Omurilik Malformasyonu Birlikteliği(2021) Akdeniz, Hüseyin; Özen, Özkan; Arslan, Harun; Akdemir, Zülküf; Yokuş, AdemGergin omurilik sendromu; doğumsal veya edinsel nedenlerle omuriliğin gerilmesi sonucu ortaya çıkan ilerleyici nörolojik, ürolojik ve ortopedik fonksiyon kayıplarıyla karakterize bir hastalık grubudur. Nadiren, başlangıçta asemptomatik olup ciddi nörolojik sekel ilerleyen dönemlerde ortaya çıkabilir. Lumbosakral hipertrikoz ve kapiller hemanjiyomlar, dermal sinüs traktları, orta hatta cilt altı lipomları, lumbosakral cilt ekleri gibi cilt bulgularının dikkate alınması, belirtilerin olmadığı dönemde gergin omurilik sendromunun tanınmasını sağlayan ipuçları olabilir. Ayrık omurilik malformasyonları; çocukluk çağında görülen okkült spinal disrafizmin ender bir formudur. Ayrık omurilik malformasyonları tek veya çift dural kılıf içerisinde, omuriliğin iki ayrı yarıdan oluştuğu konjenital anomaliyi tanımlar. Asemptomatik kalabileceği gibi nörolojik, ürolojik ve ortopedik yakınmalara neden olabilir. Bu problemlerin gelişmesinin önlenebilmesi malformasyonun erken teşhis ve tedavisine bağlıdır. Bu çalışmada, hastanemize lumbosakral bölgede aşırı kıllanma şikayeti ile başvuran 3 yaşındaki kız çocukta saptadığımız Gergin omurilik sendromu ve Tip 1 Ayrık omurilik malformasyonunun Manyetik Rezonans Görüntüleme bulgularını sunmayı amaçladık.Öğe Giant colonic lipoma causing intussusception: CT scan and clinical findings(African Field Epidemiology Network-Afenet, 2019) Özen, Özkan; Güler, Yılmaz; Yüksel, YavuzColonic lipomas are uncommon and usually asymptomatic tumors. A 30-year-old woman with abdominal pain lasting 10 days was admitted to the surgical clinic. Her physical examination revealed sensitivity on the right upper quadrant and her bowel sounds were normal. A lesion and invagination findings in the colon were found in the ultrasound examination and CT was performed. CT scan revealed a lipoma and invagination in the colon and the patient has undergone surgery. Pathological diagnosis of the lesion was reported as submucosallipoma. In this case report, we present clinical and radiological findings of a submucosal colonic lipoma causing intussusception.Öğe Hypovolemic shock due to giant ovarian tumor rupture after minor trauma: A case report(2021) Güler, Yılmaz; Çalış, Hasan; Şengül, Serkan; Özen, Özkan; Karabulut, ZülfikarRupture of gynecologic tumors secondary to trauma rarely occurs. Rupture can lead to acute abdominal pain due to hemorrhage from the ruptured area and organs; rupture can also lead to peritonitis, depending on the size of the tumor. We describe the case of giant epithelial ovarian tumor rupture exhibiting due to minor trauma and the development of hypovolemic shock. A 69-year-old female patient was admitted to the emergency room with complaints of acute abdominal pain and subsequent clouding of consciousness after falling down while walking. Emergency abdominal computed tomography scan revealed widespread hemorrhagic free fluid in the abdominal cavity and a mass measuring 27.5 cm × 21 cm × 15 cm, extending from the right quadrant of the abdomen to the left. The patient underwent an emergency operation due to hypovolemic shock. During surgery, a totally ruptured mass lesion arising from the right ovary was seen; the mass contained cystic components and measured approximately 30 cm × 20 cm × 15 cm. Hemostasis was achieved in the bleeding areas, and the right ovarian mass was totally resected. The patient was discharged as cured on the 6th post-operative day. Gynecologic tumor rupture due to trauma is a rare event. However, it is a clinical condition that should be kept in mind regardless of the type of trauma. This is especially true in patients who experienced trauma and were radiologically found to have intra-abdominal hemorrhage with normal-appearing solid organs, such as liver and spleen, that frequently cause bleedingÖğe Maksiller sinüste osteom: Olgu sunumu(2018) Kubat, Gözde Orhan; Şahin, Caner; Özen, ÖzkanMaksiller sinüste osteom, literatürde nadiren izlenen osteoblastik benign kemik lezyondur. Osteom büyük boyutlar ulaştığı zaman maksiller sinüs ostiumunda tıkanmaya, çevre yapılarda basıya neden olabilir; küçük boyutlarda ise asemptomik seyredebilir. Lezyon asemptomatik ise belirli aralıklarla takip edilebilir, eğer semptomatik ise veya komplikasyon gelişmiş ise cerrahi tedavi uygulanır. Olgu sunumumuzda maksiler sinüs içerisinde lokalize olan osteom literatür eşliğinde sunulmuştur.Öğe Maksillofasiyal bölgede ateşli silah yaralanması(2018) Şahin, Caner; Özen, ÖzkanBaş boyun bölgesi birçok önemli anatomik yapılar içermesi nedeniyle özellik arz etmektedir. Karotis arterleri, juguler ven, kafa sinirleri, intrakraniyal yapılar travmalara karşı tehdit altındadır. Maksillofasiyal bölge ateşli silah yaralanmaları kanama, kozmetik deformite, infraorbital sinir yaralanması ve hava yolu güvenliği problemleri yaratabilmektedir. Bu makalede maksillofasial bölgeye isabet eden ve maksilla ön duvarına saplanıp kalan bir baş boyun kurşunlanma vakası sunulmuştur.Öğe Morphometric evaluation of cerebellar structures in late monocular blindness(Springer, 2020) Özen, Özkan; Aslan, FatihBackground Only a few studies have investigated structural and functional changes in monocular blind individuals. Our aim in this study was to segmentally investigate the cerebellar structures of subjects with late-onset monocular blindness (LMB) using a Voxel-based volumetric analysis system. Methods The segmental volumetric values, cortical thickness, gray matter volumes and percentage ratios of the cerebellar lobules of individuals with LMB due to trauma and in healthy individuals with bilateral sight as the control group were calculated at the volBrain CERES 1.0 website () by using brain 3D fast spoiled gradient recall acquisition in steady-state (3D T1 FSPGR) MRI sequence images in our prospective study. Results We studied 11 subjects with LMB (8 males/3 females) and 11 healthy control subjects (8 males/3 females). The mean age was 41.45 +/- 14.15 and 40 +/- 11.11 years, respectively (p > 0.05). The mean duration of the LMB status was 20.8 +/- 11.2 years. Cerebellar lobule crus II volume and cerebellar lobule VIIB/VIIIA volume/percentage were higher in the LMB group, and mean cerebellar cortical thickness, cerebellar lobule VI-cerebellar lobule crus I-II cortical thickness, and cerebellar lobule VI gray matter volume values were lower in the LMB group (p < 0.05). Conclusion In this study, cerebellar lobule VIIB/VIIIA volume/total percent ratio, cerebellar cortical thickness and cerebellar gray matter volume in the LMB group were found to be different from the control group. To our knowledge, this is the first study to report cerebellar anatomical changes in patients with LMB.Öğe Nazal Septal Deviasyon ve Fasiyal Asimetri Arasındaki İlişkinin Tomografi Analizi(2022) Kubat, Gözde Orhan; Özen, ÖzkanAmaç: Fasiyal asimetri hem işlevsel hem de estetik sorunlara neden olmaktadır. Nazal septal deviasyon derecesinin dikkate alındığı az sayıda çalışma bulunmaktadır. Bu çalışmadaki amacımız, nazal septal deviasyon ile fasiyal asimetri arasındaki bütüncül ilişkiyi 3 boyutlu analiz etmektir. Gereç ve Yöntemler: Hastaların tomografi görüntüleri 3 boyutlu ve multiplanar reformat yapılarak aksiyal, koronal ve sagittal kesitler ile birlikte değerlendirilmiştir. Çalışmamıza vertikal ve aksiyal plandaki septal deviasyon açısı 5 derece ve üzeri olan hastalar seçilmiştir. Yüz hasta randomize seçilerek incelenmiş, fasial genişlik (maxillo-zigion arası), sağ/sol lateral projeksiyon (porion-maxillozigion arası), sağ/sol uzunluk (zygomatikofrontal sutur- gonion arası) milimetre (mm) cinsinden, vertikal ve aksiyal plandaki septal deviasyon açısı derece cinsinden ölçülmüştür. Bulgular: Morfolojik analizlere göre; septum deviasyonu ile fasiyal asimteri arasında istatistiksel olarak anlamlı bir ilişki gösterilmiştir (p<0.05). Hem vertikal deviasyon açısı hem aksiyal deviasyon açısı ile fasiyal genişlik ve projeksiyon arasında pozitif yönlü bir korelasyon bulunmuştur (p<0.05). Deviasyonun olduğu tarafta karşı tarafa göre fasiyal genişlik fazla, uzunluk daha kısa tespit edilmiştir (p<0.05). Sonuç: Çalışmamızda nazal septal deviasyon ile fasiyal asimetri arasında bir ilişki olduğu gösterilmiştir. Fasiyal asimetri değerlendirilirken 3 boyutlu değerlendirme yapılması gerektiğini önermekteyiz. Yüz asimetrisi olan hastaları ameliyat öncesi doğru bir şekilde değerlendirmek, beklentileri daha gerçekçi hale getirmek ve olası sonuçları öngörebilmek açısından önemlidir.Öğe Perforation of terminal ileum by a toothpick(Ma Healthcare Ltd, 2020) Özen, Özkan; Torun, Ebru; Yüksel, Yavuz; Ergün, Tarkan; Başaran, Ismail[No abstract available]Öğe Perinephric abscess as a rare cause of acute abdomen: A case report(Selçuk BAŞAK, 2020) Güler, Yilmaz; Şengül, Serkan; Çalış, Hasan; Uçar, Murat; Özen, ÖzkanRenal and perinephric abscesses are usually confined within the Gerota's fascia and treated with conservatively. We herein present a case with peritonitis caused by the spillage of perinephritic abscess into the abdomen through the Gerota’s fascia, which is clinical outcome. A 41-year-old female patient was admitted to emergency room with complaints of abdominal pain, bloating, fever, and fatigue. During the operation, an abscess of approximately 20x15cm in size was observed to extend into the abdominal cavity through the Gerota's fascia, causing secondary peritonitis. On the 20th postoperative day, the patient was uneventfully discharged. Delay in diagnosis of renal and perinephric abscesses can lead to fatal complications. Laparotomy is a life-saving approach in cases that cannot be treated with percutaneous drainage, when the abscess is large and causes complications such as strictures, fistulas, or secondary peritonitis, by extension through the Gerota's fascia, as in our case.
