Yazar "Akyoldas, Goktug" seçeneğine göre listele

Listeleniyor 1 - 2 / 2
  • Küçük Resim Yok
    Öğe
    Gamma knife radiosurgery for pituitary spindle cell oncocytomas
    (Elsevier, 2019) Akyoldas, Goktug; Hergunsel, Omer Batu; Ozdemir, Inan Erdem; Sengoz, Meric; Peker, Selcuk
    Objectives: Spindle cell oncocytomas (SCOs) are benign lesions of the posterior portion of the pituitary gland that typically come to neurosurgical attention due to compression of the sellar or parasellar structures, and headaches. Initial treatment options for SCOs include surgical resection, particularly via the transsphenoidal approach. However, given that initial resection tends to be insufficient and subsequent revision surgery carries high complication risk, adjuvant treatment modalities may appear to offer promising solutions for controlling tumor progression. This report focuses on a potential new therapeutic option for SCOs, gamma knife radiosurgery (GKRS). Patients and methods: The authors identified all patients at one center who had a pituitary lesion treated with GKRS between 2005 and 2016. Five patients with histopathologically confirmed SCO who underwent GKRS were retrospectively identified and included in the present study Results: The mean patient age was 52 years (range, 41-61 years). The most common presenting symptom was visual disturbance. All five patients had a history of transsphenoidal surgical resection prior to GKRS therapy. The mean tumor volume was 2.25 cm(3) (range 0.7-5.38 cm(3)). The median tumor margin dose was 12 Gy (range, 12-14 Gy), and the median maximal dose was 24 Gy (range, 24-35 Gy). The median isodose was 50 (range, 40-50). No tumor volume progression was observed during radiological follow-up after GKRS (mean, 52 months; range, 36-84 months). At last follow-up, no neurological, endocrinological, or visual complications had been observed. Conclusion: Given their highly vascular and adherent nature, SCOs can be challenging tumors to treat, in particular when they recur. In our five cases, GKRS provided excellent tumor volume control for approximately 4.3 years on average. These results suggest that GKRS is a safe and effective treatment modality for histopatholo-gically confirmed residual SCO.
  • Küçük Resim Yok
    Öğe
    Preoperative Magnetic Resonance Imaging Abnormalities Predictive of Lumbar Herniation Recurrence After Surgical Repair
    (Elsevier Science Inc, 2022) Karadag, Mehmet Kursat; Akinci, Ahmet Tolgay; Basak, Ahmet Tulgar; Hekimoglu, Mehdi; Yildirim, Hakan; Akyoldas, Goktug; Aydin, Ahmet Levent
    OBJECTIVE: There are currently no standard criteria for evaluating the risk of recurrent disk herniation after surgical repair. This study investigated the predictive values of 5 presurgical imaging parameters: paraspinal muscle quality, annular tear size, Modic changes, modified Phirrmann disk degeneration grade, and presence of sacralization or fusion. METHODS: Between 2015 and 2018, 188 patients (89 female, 99 male, median age 50) receiving first corrective surgery for lumbar disk herniation were enrolled. Micro-diskectomy was performed in 161 of these patients, and endoscopic translaminar diskectomy approach was performed in 27 patients. Clinical status was evaluated before surgery and 4, 12, and 24 months post surgery using a visual analog scale, Oswestry Disability Index, and Short Form 36. RESULTS: Recurrent disk herniation was observed in 21 of 188 patients. Seventeen of the recurrent disk herniations were seen in those who underwent microdiskectomy and 4 in those who underwent endoscopic translaminar diskectomy. There were significant differences in visual analog scale, Oswestry Disability Index, and Short Form 36 scores at 4, 12, and 24 months between patients with recurrence and the 167 no-recurrence patients. The median annular tear length was significantly greater in patients with recurrence than without recurrence. In addition, there were significant differences in recurrence rate according to Modic change type distribution, sacralization or fusion presence, Pfirmann disk; degeneration grade distribution, dichotomized annular tear size, dichotomized Modic change; and type and simplified 3-tier muscle degeneration classification distribution. CONCLUSIONS: Patients with poor clinical scores and recurrence exhibited additional radiologic abnormalities before surgery, such as poor paraspinal muscle quality, longer annular tears, higher Modic change type, higher modified Phirrmann disk degeneration grade, and sacralization or fusion. This risk evaluation protocol may prove valuable for patient selection, surgical planning, and choice of postoperative recovery regimen.