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Öğe A case series of deep subgluteal block: a new block targeting the missed portion of the hip for analgesia after total hip replacement(2024) Atalay, Yunus Oktay; Çiftçi, Bahadır; Tekin, Bahar; Ansen, Gamze; Şakul, Bayram Ufuk; Çaçan, Mehmet Akif; Azboy, İbrahim; Yılmaz, Bilge; Alıcı, Haci AhmetThe study aimed to evaluate the effectiveness of deep subgluteal block (DSGB) for pain relief after posterolateral-approached total hip replacement. The cadaver study and observational case series assessed the spread and outcomes of ultrasound-guided DSGB. Results showed low postoperative pain scores, minimal opioid requirements, and no complications related to DSGB. Anatomical dissection revealed effective spread of the injected substance. These findings suggest that DSGB could be a promising regional analgesic technique for postoperative pain management after posterolateral-approached total hip replacement.Öğe A possible mechanism of motor blockade of high volume pericapsular nerve group (PENG) block: A cadaveric study(Elsevier Inc., 2021) Çiftçi, Bahadır; Ahıskalıoğlu, Ali; Altıntaş, Hilal Melis; Tekin, Bahar; Şakul, Bayram Ufuk; Alıcı, Hacı AhmetTo the Editor, Pericapsular nerve group (PENG) block is an interfascial plane block that provides analgesia for the hip. PENG block targets the hip capsule by blocking the articular branches of the femoral nerve (FN) and the accessory obturator nerve (AON). The local anesthetic is administrated below the psoas muscle-tendon between the anterior inferior iliac spine (AIIS) and iliopubic eminence (IPE) [1]. After its first description for hip fracture analgesia, PENG block has been reported to provide analgesia for several indications such as varicose vein surgery, intertrochanteric femur fracture, prevention of adductor muscle spasm, and mass excision of the medial thigh [2–6]. Giron-Arango et al. emphasized that the main advantage of the PENG block is the motor-sparing effect because of blocking only the articular branches of FN and AON that have only sensory fibers [1,6]. There are clinical reports about motor weakness after PENG block in the literature. Yu et al. performed PENG block and reported inadvertent quadriceps weakness after the block with 20 ml [7]. Ahiskalioglu et al. performed PENG block with 30 ml LA in two patients and reported quadriceps weakness in one of them [3]. There-fore, the mechanism of motor weakness and spread of LA during PENG is still unclear. Several questions come to mind: can the high volume PENG block cause motor weakness, and can the high volume PENG block act like a lumbar plexus block? In light of these points, in this cadaveric study, we aimed to evaluate the spread of LA following PENG block with 20 ml or 30 of dye.Öğe Anatomical spread of local anesthetic in circumpsoas block: a cadaveric study(2025) Atalay, Yunus Oktay; Sözcü, Semih Burak; Tekin, Bahar; Ansen, Gamze; Cingöz, Gözde; Şakul, Bayram Ufuk; Alıcı, Haci Ahmet...Öğe Cadaveric investigation about the spread of peritibial fascial infiltration block(NLM (Medline), 2022) Çiftçi, Bahadır; Ekinci, Mürsel; Tekin, Bahar; Pençe, Kadriye B.; Alver, Selçuk; Sakul, Bayram Ufuk; Alıcı, Haci AhmetRecently, Ekinci et al. defined a novel lower extremity fascial plane block named peritibial fascial infiltration block (PFIB). They performed PFIB for analgesia management after tibia fracture surgery and reported successful pain control during the postoperative period.1 Following the description of PFIB by Ekinci et al., Altiparmak et al. performed PFIB with a saphenous nerve block (SNB) for a patient who underwent a bimalleolar fracture of the ankle.2 They combined two techniques for the reason that SN is responsible for the sensorial innervation of the lower leg. Due to fascial plane blocks being volume-related applications,3 we decided to investigate the spread of PFIB with different volumes in this cadaveric study. This study was approved by the Istanbul Medipol University Ethics and Research Committee (Decision no. 35; 06.01.2022).Öğe Comparison of conventional MRI, MR arthrography, MR arthrography with traction, MR arthrography with pressure in the evaluation of articular distension(Reed Elsevier India Pvt. Ltd., 2022) Örmeci, Tuğrul; Tekin, Bahar; Altıntaş, Hilal Melis; Durur Subaşı, Irmak; Çaçan, Mehmet AkifObjective: To evaluate the performance of conventional MRI, standard MR arthrography, MR arthrography with traction and MR arthrography with pressure in articular distension in patients with ACL injury. Design and patients: The consecutive patients (7 female, 21 male) with acute ACL injured conventional MRI, MR arthrography, MR arthrography with traction and MR arthrography with pressure were evaluated. Results: The amount of distension in the joint was evaluated in the posterior, femorotibial and anterior com- partments. Medially, between the meniscus posterior horn and the tibial corner, MRA with pressure was found to be more effective in showing this distance than MRA with traction (p < 0,05). Laterally, in measurements made between the posterior horn of the meniscus and the capsule, MRA with traction and MRA with pressure are more effective showing this distance than conventional MRI and standard MRA (p < 0,05). In measurements made medially, between the posterior horn of the meniscus and the capsule, MRA with traction is more effective in showing this distance than standard MRA (p < 0,05). In all three different MRA modalities, the lateral femo- rotibial joint distance was found to be statistically higher than conventional MRI (p < 0,05). Medial femorotibial joint distance was found to be statistically higher in MRA with pressure than in conventional MRI and standard MRA (p < 0,05). The medial infrapatellar distance was found to be statistically higher in MRA with pressure than standard MRA and MRA with traction (p < 0,05). The lateral infrapatellar distance is higher in MRA with pressure than in MRA with traction, and this height is statistically significant (p < 0,05). Conclusion: Traction and pressure applications added to MRA will increase the effectiveness of the method by increasing the distension in the knee joint. Although both seem to be effective in creating distension in posterior compartment and femorotibial joint distance, MRA with pressure is more effective especially in anterior compartment.Öğe Does ESPB performed at the level of T4 cover axillary area? A cadaveric study(Elsevier Inc., 2021) Çiftçi, Bahadır; Altıparmak, Başak; Tekin, Bahar; Şakul, Bayram Ufuk; Alıcı, Hacı AhmetErector spinae plane block (ESPB) has rapidly become popular following its first description by Forero et al. in 2016 [1,2]. Previous randomized controlled trials demonstrated the efficacy of ESPB for breast cancer surgery [3,4], however, still some issues such as the exact mechanism of action and spread of local anesthetic (LA) remain unclear [2]. In addition, none of the previous cadaveric studies have evaluated the axillary spread following.Öğe Evaluation of the distribution of mechanoreceptors in the hip joint with severe coxarthrosis in 9 patients: A histologic and stereological study(Elsevier Masson s.r.l., 2022) Tekin, Bahar; Bilgili, Mustafa Gökhan; Edipoğlu, Erdem; Şentürk, G. E.; Kolbaşı, Bircan; Shojaolsadati, Paria; Atasever, AlperDue to its high mobility, hip joint plays a crucial role in executing many movements such as standing, sitting, running, crouching. The distribution of mechanoreceptors and neural elements in anatomical structures that provide stabilization of the hip joint is important in determining the optimal surgical incision site for the hip joint stabilizers in patients with coxarthrosis. Various studies have been conducted about the mechanoreceptors and distribution of neural elements in structures such as the transvers acetabular ligament, teres (round) ligament of femur, acetabular labrum and hip joint capsule with using various staining methods. To our knowledge, there is insufficient information about the mechanoreceptor distribution within the anatomic structures that participate in stabilization of the hip joint. This study is planned to examine the distribution of mechanoreceptors in the transverse acetabular ligament, teres ligament, acetabular labrum and joint capsule in samples obtained during the surgery who are operated for hip replacement surgery due to severe coxarthrosis. Each specimen was stained with silver impregnation technique and density of mechanoreceptors were estimated by stereological method. Teres ligament has the highest number of mechanoreceptors among all other specimens. Within the joint capsule, mechanoreceptors were most abundant at its antero-inferior part, whereas its anterior part contained the lowest number of mechanoreceptors. These results suggest that, as the anterior part of hip capsule bears the lowest number of mechanoreceptors, it might be safer for incision during total hip arthroplasty surgery.Öğe Is the deep supraspinatus muscle plane block and suprascapular nerve block the same approach? A cadaveric nomenclature study(Korean Society of Anesthesiologists, 2022) Altıparmak, Başak; Çiftçi, Bahadır; Tekin, Bahar; Şakul, Bayram Ufuk; Alıcı, Hacı AhmetInterfascial plane blocks have become popular in daily anesthesia practice in the field of acute and chronic pain management [1]. Owing to the use of ultrasound (US), novel plane blocks are increasingly being developed. To reduce controversy regarding the names and properties of these novel blocks, American Society of Regional Anesthesia and Pain Medicine (ASRA)-European Society of Regional Anaesthesia and Pain Therapy (ESRA) consensus published a nomenclature study [2]. Despite this, new descriptions of novel techniques continue to be defined. Kose et al. [3] has proposed that the deep supraspinatus muscle plane block (DSMPB), which involves the administration of local anesthetic (LA) into the plane between the supraspinatus muscles (SMs) and the posterior scapula, is a safer and easier novel technique. Recently, Teles et al. [4] called the DSMPB, a “new old technique” since the block is basically an indirect anatomical landmark-guided suprascapular nerve block (SNB) verified by US. In contrast, Ciftci et al. [5] emphasized the different injection points used for the two blocks, namely, the needle is inserted approximately 2.5 cm away from the suprascapular notch for an SNB, while the insertion point for a DSMPB is 4 cm away and therefore likely to act under the principles of interfacial plane blocks. Given this controversy, we performed a cadaveric study to directly test whether the US-guided DSMPB and landmark-guided (US-verified) SNB would result in a similar anatomical area of coverage.Öğe Is the femoral nerve affected by iliopsoas block? A cadaveric volume study(2025) Atalay, Yunus Oktay; Tekin, Bahar; Ansen, Gamze; Koç, Elif; Uludağ Yanaral, Tümay; Şakul, Bayram Ufuk; Alıcı, Haci Ahmet...Öğe Kalça eklemi stabilizasyonunda görevli anatomik yapılarda, mekanoreseptörlerin ve nöral yapıların gümüşleme yöntemi ile dağılımının gösterilmesi(İstanbul Medipol Üniversitesi Sağlık Bilimleri Enstitüsü, 2017) Tekin, Bahar; Atasever, AlperKalça eklemi sahip olduğu yüksek hareket yeteneği sayesinde ayakta durma, oturma, koşma, çömelme gibi pek çok hareketin gerçekleştirilmesinde önemli rol oynayan bir eklemdir. Kalça ekleminin stabilizasyonunu sağlayan anatomik yapılardaki mekanoreseptör ve nöral yapıların dağılımı, cerrahi girişim planlanan koksartrozlu hastalarda eklem kapsülü üzerindeki uygun cerrahi insizyon yerinin belirlenmesinde oldukça önemlidir. Literatürde bu eklemin stabilizasyonunda görevli olan anatomik yapılar ( ligamentum transversum acetabuli, ligamentum capitis femoris (ligamentum teres), labrum acetabulare, kalça eklem kapsülü) ile ilgili farklı metotlarla boyamalar yapılarak mekanoreseptörlerin ve nöral yapıların dağılımına ilişkin çeşitli çalışma yapılmıştır. Yapılan çalışmalar koksartrozlu hasta kalçada, kalça eklemi stabilizasyonuna katılan bütün anatomik yapıların mekanoreseptör dağılımı hakkında detaylı bilgi verememektedir. Bu çalışma, kalça ekleminin stabilizasyonunu sağlayan anatomik yapıların canlı dokudan alınan örneklerindeki mekanoreseptörlerin ve nöral yapıların dağılımını detaylı olarak ortaya koymayı amaçlamaktadır. Hastaların ameliyatları esnasında çıkartılan ligamentum transversum acetabulare, ligamentum capitis femoris, labrum acetabulare dokusu ve kalça eklem kapsülün'den yapılan örneklemeler gümüş çöktürme yöntemi ile boyanarak bu yapılardaki mekanoreseptör ve nöral yapıların dağılımları incelenmiştir. Bu çalışmada bahsi geçen anatomik yapılar içerisinde koksartroz durumunda mekonoreseptör sayısının ligamentum transversum acetabulide en fazla olduğu, ligamentum tereste koksartroz durumunda mekanoreseptör dağılımında diğer bölgelere göre daha az olduğu, yapılan diğer çalışmalar ile mukayese edildiğinde eklem kapsülündeki mekanoreseptör sayısında ciddi bir azalış olduğu, ligamentum tereste ise mekanoreseptör varlığı tespit edilmiştir. Serbest sinir sonlanmaları en fazla labrumda tespit edilmiş olup, ligamentum tereste istatistiksel olarak anlamlı bir şekilde mekanoreseptör sayısının serbest sinir sonlanmalarna göre daha fazla olduğu gösterilmiştir.Öğe Para-sartorial compartments block: A cadaveric study of dye spreading(NLM (Medline), 2023) Atalay, Yunus Oktay; Tekin, Bahar; Ansen, Gamze; Güngör, Hande; Şakul, Bayram Ufuk; Alıcı, Hacı Ahmet[Abstract Not Available]Öğe Re-evaluation of the symptoms of Hirayama disease through anatomical perspective(International Advancement Center for Medicine and Health Research Co., Ltd., 2023) Tekin, Bahar; Ansen, Gamze; Örmeci, Tuğrul; Helvacı Yılmaz, Nesrin; Şakul, Bayram UfukHirayama disease is a rare disease of the anterior horn motor neuron caused by compression of the cervical spinal cord when the neck is flexed. Cervical myelopathy may accompany the disease. It is characterized by symmetrical or asymmetrical muscle weakness and atrophy of muscles innervated by lower cervical and upper thoracic motor neurons. We recorded two male cases of Hirayama disease between the ages of 15 and 21 based on magnetic resonance imaging (MRI) features obtained from the cervical neutral state and from the flexion position which appeared in the right upper extremity. Loss of strength and atrophy in the right upper extremities was existent in clinical findings of these patients. When MRI was taken in the flexion position, there were dilated veins as hypointense signal void on T2 weighted series in posterior epidural area. The contrast enhancement was seen on these veins. It was observed that the posterior dura was displaced anteriorly and the anterior subarachnoid space was narrow. In cases which show clinical findings such as atrophy and loss of strength, having normal MRI results obtained in the neutral position makes it difficult to diagnose Hirayama Disease. In case of a suspicion of Hirayama disease the diagnosis can be made more easily by MRI taken in the flexion position. These case reports aim to bring Hirayama disease to mind and optimize the management of affected individuals.Öğe Single-shot sacral erector spinae block: a cadaveric study of dye spreading(2024) Atalay, Yunus Oktay; Tekin, Bahar; Ansen, Gamze; Uzunoğlu, Emine; Koç, Elif Kübra; Şakul, Bayram Ufuk; Alıcı, Haci Ahmet...Öğe Three-dimensional semi-autotamatic segmentation of nasolacrimal duct morphometry on computed tomography images(2025) Pençe, Kadriye Betül; Nalçacı Bozkurt, Nureda; Tekin, Bahar; Şen, Selva; Ansen, Gamze; Örmeci, Tuğrul; Yüzbaşıoğlu, NeslihanPurpose: Given the potential role of nasolacrimal duct (NLD) morphometry in the aetiology of primary acquired obstructions, it is imperative that clinicians have access to detailed anatomical information. The aim of this study was to determine normative data on nasolacrimal duct morphometry in the Turkish population sample and to provide guidelines for clinicians. Methods: The study included retrospectively computed tomography images of a healthy Turkish population sample of 151 individuals, 79 of whom were female and 72 of whom were male. Images were modeled and analyzed using 3D Slicer version 5.2.2. Results: The total volume and area of the NLD were smaller in females than in males. The right- and left-sided volume of the NLD were smaller in females than in males (In male, right side 219.28 ± 77.53 mm3 and left side 213.14 ± 73.82 mm3; in female, right side 193.82 ± 75.71 mm3, left side, 190.34 ± 82.54 mm3). Although the anteroposterior and transverse diameters of the right-sided NLD were not statistically different between the genders, the anteroposterior and transverse diameters of the left-sided NLD and distance between right and left NLD were smaller in female than in males. The volume and surface area of the right-sided NLD and the distance between the right and left NLD were larger with increasing age. The anteroposterior diameter was observed to be larger on the right side than on the left in both sexes, whereas the transverse diameter was larger on the right side than on the left side exclusively in females. Conclusion: The results of this study may assist clinicians in the surgical approaches.
