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Öğe Assessment of visualization of structures in the middle ear via Tos modified canal wall-up mastoidectomy versus classic canal wall-up and canal wall-down mastoidectomies(Elsevier Ireland Ltd, 2007) Uzun, Cem; Kutoglu, TuncObjective: The aim of this prospective study is to evaluate the differences in the ability to view structures in the middle ear between Tos modified canal watt-up mastoidectomy and classic canal wall-up (CWU) and canal wall-down (CWD) mastoidectomies. Methods: Eighteen temporal bones of 10 cadaver heads were used. Six bones were randomly selected for each surgicat technique (Tos' technique, CWU and CWD mastoidectomies) and fixed on an operating table. In the Tos' technique: (1) transmeatal posterior tympanotomy with drilling of the supero-posterior bony annulus, (2) transmeatal atticotomy with preservation of the bony bridge and (3) cortical mastoidectomy were performed. In the classic CWU mastoidectomy, cortical mastoidectomy and posterior atticotympanotomy (faciat recess approach) were performed. Incus and posterior half of the tympanic membrane were removed from all temporal bones. An independent specialist performing otologic surgery evaluated all of the temporal bones and approved the proper extent of dissections. Two another independent observers blinded to the purpose of the study were asked to point five anatomic structures and locations (sinus tympani, anterior attic, posterior crus, lateral attic and the Eustachian tube orifice) in two different sessions. Observers were allowed to rotate the operating table as it has been done during otologic surgery, and the line of view for the observers was both transmastoid and transcanal. The ability to view these structures was recorded as correct /visible or incorrect/invisible. These records were also verified after removing the posterior and superior walls of the outer ear canal in temporal bones of the Tos and CWU groups at the end of the study. Results: Significant differences were found in the ability to view middle ear structures between the Tos' technique and CWU mastoidectomy as well as between CWU and CWD mastoidectomies, with the Tos' and CWD techniques almost equally showing superiority to CWU (p < .0001). Of the five locations, sinus tympani and anterior attic were observed more frequently with the Tos' technique versus CWU (p = .001). Sinus tympani (p < .005), anterior attic (p = .001) and posterior crus (p < .05) were observed more frequently with CWD versus CWU. There was no significant difference in the ability to observe Lateral attic and the Eustachian tube orifice among the three techniques. In addition, there was no significant difference in the ability to visualize all the five locations between the Tos' and CWD technique. Conclusions: Statistical analysis showed good reproducibility of this randomised, blinded study. Tos' modified CWU mastoidectomy, in which most part of the canal wall is intact, showed similar advantage of the CWD in viewing structures in the middle ear. The Tos' technique and CWD mastoidectomy provided better visualization of sinus tympani and anterior attic that are the most frequent places of residual cholesteatoma in the classic CWU mastoidectomy. (C) 2007 Elsevier Ireland Ltd. All rights reserved.Öğe Effect of formaldehyde inhalation on rat livers: A light and electron microscopic study(Sage Publications Inc, 2010) Cikmaz, Selman; Kutoglu, Tunc; Kanter, Mehmet; Mesut, RecepIt is well known that formaldehyde (FA) is cytotoxic and potentially carcinogenic. Although the individual effects of this reactant on cells has been investigated, the cytotoxicity exerted by the coexistence of FA is poorly understood. The aim of this study was to investigate the effects of FA on the liver in rats, by light and electron microscopic level. We used 18 Wistar albino rats divided into three groups, exposed to 0 (control), 19.7 ppm FA gas for a total of 4 weeks, 8 h/day, 5 days a week (subacute) and 20.3 parts per million (ppm) FA gas for a total of 13 weeks, 8 h/day, 5 days a week (subchronic). After the completion of the exposure period, they were sacrificed by decapitation and their liver tissue samples were taken in order to be processed for light and electron microscopic studies. Light microscopic evaluation of liver tissue samples of FA-exposed rats revealed enlarged sinusoids filled with blood and mononuclear cell infiltration in the portal areas and around the central veins. In addition, some of the hepatocytes showed loss of cytoplasm, and some had a hyperchromatic nucleus. The cells of FA-exposed livers, on the other hand, showed an electron-lucent ground-cytoplasm and a hypertrophy of the smooth-surfaced endoplasmic reticulum. In conclusion, we observed that exposure FA caused diverse histopathological changes indicating the destruction in the liver tissue and this destruction has direct relationship with the length of the exposure period.Öğe Insertions of the lateral pterygoid muscle to the disc-capsule complex of the temporomandibular joint and condyle(Tubitak Scientific & Technological Research Council Turkey, 2010) Kilic, Cenk; Dergin, Guhan; Yazar, Fatih; Kurt, Bulent; Kutoglu, Tunc; Ozan, Hasan; Balcioglu, Huseyin AvniAim: To investigate the disc-capsule complex and condyle attachments of the lateral pterygoid muscle and its variations Materials and methods: Forty-nine temporomandibular Joint (TMJ) specimens were used, obtained from 26 human cadavers The insertion point of each muscle head was determined The widths and lengths of the heads were measured Results: In 32 specimens, 2-headed muscles were present, while 3 heads were observed in 17 specimens We defined 4 different types of attachments of muscle heads In the most common type of attachment, the upper head inserted into the disc-capsule complex and condyle, and the lower head Inserted Into the condyle (36 7%). In the second type, the upper head Inserted into the disc-capsule complex and the lower head inserted into the condyle In the third type, both heads inserted into the condyle In the fourth type, the upper head inserted into the disc-capsule complex and the lower head Inserted into the complex and condyle Conclusion: Detailed knowledge of the morphology of the lateral pterygoid muscle will provide great benefit in addressing temporomandibular Joint problems. The results of the present study will be helpful for further clinical, radiological, and anatomical researchÖğe The synovial plicae in the knee joint(Saudi Med J, 2006) Gurbuz, Hulya; Capur, Osman U.; Ozcan, Mert; Kutoglu, Tunc; Mesut, RecepObjectives: To investigate and evaluate the prevalence of 4 kinds of synovial plicae named according to patella, which are inferior, medial, lateral and superior. Methods: We evaluated plicae in 318 knee arthroscopies through video records. obtained from January 1994 to December 2002 in the Arthroscopy Unit, Department of Orthopedic Surgery, Faculty of Medicine, Trakya University, Edirne, Turkey. In addition, we also investigated plicae in 7 bilateral knee cadavers. Results: In the arthroscopic evaluation, the prevalence of infrapatellar synovial plica was 194 (61%), mediopatellar plica was 302 (95%), lateral patellar plica was 66 (20.7%) and suprapatellar plica was 184 (57.8%). We found that there were 8 (57%) infrapatellar synovial plicae, 13 (92%) mediopatellar plicae, 7 (50%) lateral patellar plicae and 6 (42%) suprapatellar plicae in 14 cadaveric knees. Conclusions: We observed a high prevalence of lateral plicae and mediopatellar plicae on the cadavers and the people with arthroscopic diagnosis, and believe our results can contribute to knee anatomy and surgery.
