Browsing by Author "Civi, Soner"

Now showing 1 - 14 of 14

Bone Cement Leakage in Transpedicular Percutaneous Vertebroplasty: Analysis of 20 Patients
(2018) Civi, Soner; Durdag, Emre; Suner, Halil Ibrahim; Kardes, Ozgur; Tufan, Kadir; 0000-0002-1055-5152; 0000-0003-2854-941X; 0000-0001-6939-5491; 0000-0002-5957-8611; 0000-0003-1509-4575; U-2400-2018; P-5895-2018; AAK-1734-2021; AAJ-5381-2021; AAK-1686-2021
Objective: Percutaneous vertebroplasty (PVP) is one of the frequently preferred interventional methods in spinal surgery. Although it is classified as minimally invasive, the most common complication of this procedure is bone cement leakage. Leakage of bone cement is often asymptomatic, but can lead to serious complications such as paraplegia and pulmonary embolism. In this study, we aimed to investigate the complications and consequences of cement leakage in the percutaneous vertebroplasty procedure. Methods: Between 2009 and 2015, 20 (14 female and 6 male, mean age 69.7) patients who underwent percutaneous vertebroplasty to 26 vertebrae were included in the study. 17 vertebrae were treated for osteoporotic compression (65.3%), 4 vertebrae for pathologic compression fractures (15.3%), 4 vertebrae for traumatic compression fractures (15.3%) and 1 vertebrae for painful hemangioma (3.8%). Leakage localizations of bone cement were classified as venous plexus, paravertebral soft tissue, spinal canal, intervertebral foramen, into the niddle channel and intervertebral disc space. Results: Twelve vertebrae showed no leakage (46.1%). 5 vertebrae had leakage into the niddle channel (19.2%), and 3 had leakage to vertebra disc space leakage (11.5%) and 2 vertebrae had to venous plexus and paravertebral tissue leakage (7.6%) Foraminal and spinal canal leakage (3.8%) was observed in one patient on single level. Radicular pain was seen in one patient. Partial pain control was observed in 20% of the patients while 80% of the patients had complete pain control on follow ups. Conclusion: Major complications following percutaneous vertebroplasty are mostly due to bone cement leaks. In order to prevent major complications, it is necessary to determine the possible causes of leakage. Performing the application with the correct technique with properly prepared bone cement is essential. Also usage of contast dye may be useful for pre-injection risk of leakage complications.
Brain Metastasis of Penile Angiosarcoma
(2018) Kardes, Ozgur; Aydemir, Fatih; Suner, Halil Ibrahim; Durdag, Emre; Civi, Soner; Tufan, Kadir; Kayaselcuk, Fazilet; https://orcid.org/0000-0003-2854-941X; https://orcid.org/0000-0002-5957-8611; https://orcid.org/0000-0001-6939-5491; https://orcid.org/0000-0002-1055-5152; https://orcid.org/0000-0003-1509-4575; https://orcid.org/0000-0002-1180-3840; 29150829; P-5895-2018; AAJ-5381-2021; AAK-1734-2021; U-2400-2018; AAK-1686-2021; AAE-2550-2021
Angiosarcoma is a rare malignancy originating from vascular endothelial cells. Brain metastasis of aniosarcomas are uncommon up to the literature. Penile angiosarcomas are also seldom among all anjiosarcomas. A case with penile angiosarcoma with confirmed brain metastasis is aimed to be reported and contribute to the literature for similar cases.
Does The Dominant Hand Factor Have an Effect on Postoperative Recovery in The Surgical Treatment of Carpal Tunnel Syndrome?
(2018) Civi, Soner; Tanburoglu, Anil; Suner, Halil Ibrahim; Kardes, Ozgur; Durdag, Emre; Tufan, Kadir; https://orcid.org/0000-0002-1055-5152; https://orcid.org/0000-0001-9627-3502; https://orcid.org/0000-0002-5957-8611; https://orcid.org/0000-0003-2854-941X; https://orcid.org/0000-0001-6939-5491; https://orcid.org/0000-0003-1509-4575; U-2400-2018; AAK-1876-2021; AAJ-5381-2021; P-5895-2018; AAK-1734-2021; AAK-1686-2021
Objective: Carpal Tunnel Syndrome (CTS) is the most frequently encountered entrapment neuropathy. Surgical treatment is usually suggested to patients with severe symptoms. In this study, we aimed to examine the effect of the dominant hand on the clinical results of CTS decompression surgery. Methods: Fifty (5M, 45F) patients were included in the study. The Edinburgh Handedness Inventory was used to identify the dominant hand of patients included in the study. Visual analogue scale (VAS) values were evaluated pre- and postoperatively. Results: Twenty-eight patients underwent surgery on the dominant hand and 22 patients had surgery to their non-dominant hand. The VAS values of patients who underwent non-dominant hand surgery were lower than those who underwent surgery on the dominant hand. Conclusion: In our study, it was determined that patient complacency after surgical procedures performed on dominant hands was less when compared with the non-dominant side. We believe that suitable exercise and protection programs for dominant hands in the postoperative period of carpal tunnel surgery, in addition to a good and careful surgical technique, positively affects the results of surgical treatment.
Effect of decompressive hemicraniectomy in patients with acute middle cerebral artery infarction 2050
(2021) Suner, Halil İbrahim; Tanburoglu, Anil; Durdag, Emre; Civi, Soner; Gunesli Yetisken, Aylin; Kardes, Ozgur; Andic, Cagatay; Tufan, Kadir; 0000-0002-5957-8611; 0000-0003-2854-941X; 0000-0001-9627-3502; 0000-0001-8581-8685; 33890450; AAJ-5381-2021; P-5895-2018; AAK-1876-2021; AAM-1671-2021
Background/aim: We aimed to determine in which cases this procedure may be more effective based on the data of patients who underwent decompressive hemicraniectomy (DHC). Material and methods: Overall, 47 patients who underwent DHC due to acute middle cerebral artery (MCA) infarction between January 2014 and january 2019 were retrospectively investigated. These patients were divided into two groups: those who died after DHC (Group A) and those who survived DHC (Group B). The groups were compared in terms of various parameters. We investigated whether the patient's modified Rankin scale (mRS) status changed depending on age (> 60 and < 60 years). Results: The median age of all patients was 65 (37-80) years; groups A and B had median ages of 66.5 (37-80) and 61 (44-79) years (p = 0.111), respectively; 55.3% patients were male. The elapsed times until hospitalization after the onset of symptoms were 4.5 and 3 h in groups A and B, respectively (p = 0.014). The median GCS score at the time of admission was 7 (5-12) and 10 (8-14) in groups A and B, respectively (p = 0.0001). At the time of admission, 63.3% patients in group A had anisocoria, whereas no patient in group B had anisocoria (p = 0.0001). In postoperative period, 40% patients in group A and all patients in group B received AC/AA treatment. The survival of patients aged < 60 and > 60 years who underwent DHC for MCA infraction was 61.5% and 26.5%, respectively (p = 0,041). The median mRS of patients < 60 and > 60 years were 4 (1-6) and 6 (1-6), respectively (p = 0.018). Conclusion: Age, DHC timing, and elapsed time until hospitalization or access to treatment directly affect the functional outcome and survival in MCA-infarcted patients who underwent DHC. In patients in whom the medical treatment fails, early DHC administration will increase survival without waiting for neurological worsening once herniation is detected radiologically.
Effect of gabapentin on primary surgical treatment of experimental sciatic nerve injury in rats
(2018) Kardes, Ozgur; Civi, Soner; Bulduk, Erkut Baha; Selcuk, Fazilet Kaya; Suner, Halil İbrahim; Durdag, Emre; Tufan, Kadir; 30394505
BACKGROUND: The aim of our study is to minimize the morbidity related to nerve injury by determining the protective effects of gabapentin in experimental sciatic nerve injury and end-to-end anastomosis model in rats and to guide clinical studies on this subject. METHOD: In our study, 40 adult male Sprague-Dawley rats were randomly divided into the following five groups: I: Only surgical intervention was applied; II: The sciatic nerve was cut properly and was repaired by end-to-end anastomosis. No additional procedure was performed; III: A single dose of gabapentin at 30 mg/kg was given after anastomosis; IV: 30 mg/kg gabapentin was given for 3 days after anastomosis; and V: 30 mg/kg gabapentin was given for 7 days after anastomosis. The experiment was terminated with high-dose thiopental (50 mg/kg) 60 days after the surgical intervention. The right sciatic nerve was taken from all animals. The obtained sections were examined immunohistopathologically. RESULT: Immunohistochemical properties and Schwann cell proliferation were found to be statistically significantly lower in the control group than in the other groups. Schwann cell proliferation was higher in Group 3 than in Group 5. Immunohistochemical changes were significantly lower in Group 4 than in Group 3. Axonal degeneration was also higher in Group 4 than in Group 3. CONCLUSION: Gabapentin promotes neurological recovery histopathologically in peripheral nerve injury due to its neuroprotective properties. Our study results show that gabapentin can be used as an adjunctive therapy to primary surgical treatment after peripheral nerve injury.
Effects of Atorvastatin on Experimental Spinal Cord lschemia-Reperfusion Injury in Rabbits
(2017) Kardes, Ozgur; Civi, Soner; Tufan, Kadir; Oz Oyar, Eser; Omeroglu, Suna; Aykol, Sukru; 0000-0003-2854-941X; 27593815; P-5895-2018
AIM: Extent of secondary injury is the determinant of tissue destruction and functional worsening after primary spinal cord injury (SCI). Data have accumulated on alleviation of secondary injury in SCI from many studies on the subject. Besides its cholesterol lowering effects, statins are known to have anti-inflammatory and anti-oxidant effects which are the main targets of spinal cord research. This study aims to evaluate the effects of atorvastatin on experimental spinal cord ischemia-reperfusion injury. MATERIAL and METHODS: Thirty adult male New Zealand rabbits were allocated into control, ischemia-reperfusion (I/R) and treatment groups. Treatment group received 5 mg/kg of atorvastatin via lavage for the preceding 14 days. Other groups received placebo during the same time period. After two weeks, animals in the I/R and treatment groups underwent abdominal temporary aorta occlusion for 30 minutes. Neurological condition of the animals was recorded during the 48 hours of observation. Afterwards, animals were sacrificed and levels of malondialdehyde, glutathione and nitric oxide in spinal cord tissue and plasma and the histopathological tissue changes were determined. RESULTS: Animals in the treatment groups demonstrated significantly better results than the I/R group regarding biochemical markers. Neurological evaluation using the Tarlov scale demonstrated significantly better results at the 48th hour in treatment group. Histopathological results were also better in the treatment groups. CONCLUSION: Results of this study demonstrate the neuroprotective effects of atorvastatin. Atorvastatin has favorable effects on biochemical markers of oxidative stress in SCI. Further studies with larger cohorts and different time periods are also needed.
The Effects of Infusion of Perineural Pregabalin in the Experimentally Created Sciatic Nerve Anastomosis in Rats
(2018) Civi, Soner; Bulduk, Erkut Baha; Kocer, Nazim Emrah; Kardes, Ozgur; Suner, Halil Ibrahim; Durdag, Emre; Tufan, Kadir; 0000-0002-5943-9283; 0000-0003-2854-941X; 0000-0002-5957-8611; 0000-0001-6939-5491; 0000-0003-1509-4575; 30569903; AAM-5436-2021; P-5895-2018; AAJ-5381-2021; AAK-1734-2021; AAK-1686-2021
INTRODUCTION AND OBJECT: The aim of our study was to assess the effect of perineural pregabalin administration on the success of coaptation in experimental rat sciatic nerve anastomosis by measuring the expression of anti-inflammatory cytokine TGF-beta. It is thus to provide alternative solutions to this problem which we often see in clinical practice and whose results are not satisfactory. METHODS: In our study, 40 adult, male, Sprague-Dawley rats; 5 groups were randomly assigned Group 1: This group's sciatic nerves were dissected and the surgical site was sutured. Group 2: Rats whose sciatic nerves are sectioned transversely through the fill-thickness and end-to-end anastomosis is performed and no additional procedure is performed. Group 3: Intraperitoneal administration of 30 mg / kg pregabalin for 7 days with anastomosis. Group 4: 30 mg/kg pregabalin given orally for 7 days with anastomosis. Group 5: Given 10 microliters / h pregabalin subcutaneous perineural infusion for 7 days with anastomosis. After 60 days of surgery, the experiment was terminated with high dose thiopental (50 mg/kg). The right sciatic nerves of all animals were taken and sections obtained were examined immunohistopathologically. RESULTS: Inflammation was significantly less in the 5th group than in the other groups. TGF-beta expression in Groups 3, 4, and 5 is significantly higher than Groups 1 and 2, which also supports this situation. Although the expression in group 5 was not statistically significant, the number of TGF-beta expression was higher than Groups 3 and 4. In terms of immunohistochemical properties; 1 to 3, 1 to 4, 1 to 5, 2 to 5 groups were statistically significant (p<0,05). CONCLUSIONS: In conclusion, perinural infusion of pregabalin into the anastomotic region has not been previously tried in the literature and it has been found that immunohistochemistry provides positive contributions to healing of anastomosis. More research is needed to demonstrate that this effect is superior to other methods of administration of the drug.
Effects of Quercetin on Chronic Constriction Nerve Injury in an Experimental Rat Model
(2016) Civi, Soner; Emmez, Gokcen; Dere, Umit Akin; Borcek, Alp Ozgun; Emmez, Hakan; https://orcid.org/0000-0002-1055-5152; 26960544; U-2400-2018
Flavonoids are popular substances in the literature, with proven effects on cardiovascular, neoplastic and neurodegenerative diseases. Antioxidant effect is the most pronounced and studied one. Among thousands of flavonoids, quercetin (QUE) is a prototype with significant antioxidant effects. This study aims to demonstrate the effects of QUE in an experimental rat model of chronic constriction injury (CCI). A two-level study was designed with 42 adult Wistar rats that were randomly assigned to different groups. In the first part, animals in sham, control, quercetin, morphine and gabapentine groups received chronic constriction injury to their sciatic nerves and received a single dose of QUE, morphine and gabapentine. In the second part, different dose regimens of QUE were administered to different groups of animals. Pre-injury and post-injury assessments for mechanical hypersensitivity, thermal sensitivity, locomotor activity and anxiety were recorded and statistical comparisons were performed between different groups. Comparison of QUE with morphine and gabapentine has revealed significant effects of this agent in the current chronic constriction injury model. QUE was significantly superior to Gabapentine and morphine in terms of alleviating mechanical and thermal hypersensitivity. Additionally, pre-injury administration of QUE for 4 days demonstrated long-term effectiveness on mechanical hypersensitivity. This preliminary report the on effects of QUE in a chronic constriction injury model proved significant effects of the agent, which should be supplemented with different studies using different dose regimens.
Magnetic Resonance Guided Stereotactic Biopsy of Intracranial Lesions: Analysis of 310 Cases
(2018) Kardes, Ozgur; Durdag, Emre; Civi, Soner; Suner, Halil Ibrahim; Tufan, Kadir
Objective: Stereotaxic biopsy is an important surgical procedure that provides definite diagnosis in brain lesions. It is possible to obtain diagnosis with minimal invasive manner in deeply located and critical localized lesions. There are large case series in the literature. We aimed to present our experience of magnetic resonance (MR) guided 310 stereotaxic biopsies in this study. Method:We retrospectively evaluated age and gender distribution, locations of the lesions, histopathologic results, and complications of 310 cases which MR guided stereotactic biopsied was performed in our clinic between 2012 and 2018. In addition, technical information was also provided. Results:Stereotactic frame application was performed with local anesthesia and surgical procedure was performed by under general anesthesia. Of 310 patients 169 were male (55%) and were 141 female (45%). Mean age was 57.28 (3-87). 184 of the lesions were hemispheric (59%), and the most common diagnosis was glioblastoma multiforme (34.19%). 8 patients were not diagnosed (2%). Complications developed in 13 cases (4%) and 2 of cases were died in the early phase due to the procedure (0.6%). Histopathological diagnostic success was 99% Conclusion:The results of our study show that the stereotactic biopsy procedure applied in the MRI guideline is reliable and feasible with low complication rate and high effectiveness in cases where definitive histopathologic results are required for treatment planning.
Reversal of Rocuronium Induced Neuromuscular Block with Sugammadex in Patients Under 2 Years of Age. A Series of 280 Cases
(2023) Ozmete, Ozlem; Dardag, Emre; Civi, Soner; 38131376
AIM: Neuromuscular muscle relaxants are still indispensable for surgical procedures requiring general anesthesia, and the use of these agents may result in postoperative residual curarization. Sugammadex may offer a distinct advantage to pediatric patients where residual neuromuscular blockade may be poorly tolerated. Sugammadex is approved for use in adults and children over two years. This is the main reason why large-scale studies could not be conducted in the group of patients younger than two years old. This study aimed to evaluate the efficacy and safety of sugammadex for reversing deep rocuronium-induced neuromuscular blockade in children under two years of age. METHODS: Pediatric patients younger than two years of age who underwent neurosurgery under sevoflurane anesthesia were included in the study. Neuromuscular block was achieved by the administration of rocuronium. It was antagonized by the administration of 5 mg/kg sugammadex and evaluated using train-of-four (TOF). Primary outcome measure was the time from sugammadex administration to return of the TOF ratio to 0,9. Postoperative adverse events were also recorded. RESULTS: Two hundred eighty patients (10 day-24 months of age; 3-18 kg) were included in this study. Reversal of deep rocuronium-induced neuromuscular block with sugammadex was rapid in all patients. No residual curarization or recurarization was observed. No adverse events or hypersensitivity reactions were observed after administration of sugammadex. CONCLUSION: Reversal of rocuronium-induced deep neuromuscular block in infants was rapid and safe. Sugammadex provided safe extubation in patients younger than two years of age who had undergone neurosurgery. Research Fund.
Safety and Efficacy of Ventriculostomy Procedures under Dual Antiplatelet Therapy in Patients Treated with Stent Assisted Coiling in Subarachnoid Hemorrhage
(2018) Kardes, Ozgur; Civi, Soner; Suner, Halil Ibrahim; Durdag, Emre; Tufan, Kadir; Andic, Cagatay; Ozmete, Ozlem; 28944945
AIM: Stent assisted coiling (SAC) is an alternative in the treatment of ruptured aneurysms. Stenting requires the use of dual antiplatelet agents. Hydrocephalus is a complication of subarachnoid hemorrhage (SAH) and may require ventriculostomy. Antiplatelet treatment carries a risk of hemorrhage in ventriculostomy. The anti-aggregant effect starts at least four hours after the initial doses of treatment. However, in many studies, ventriculostomy was performed before antiplatelet treatment and hemorrhagic complications were related to the procedure. The aim of this study was to determine the risk of ventriculostomy related hemorrhage in patients with impaired thrombocyte function and to contribute to the literature. MATERIAL and METHODS: Between 2011 and 2016, 53 patients treated with SAC due to SAH in our clinic were retrospectively evaluated. Hemorrhagic complication risks due to antiplatelet therapy related to ventriculostomy were also evaluated. RESULTS: All of the ventricular catheter procedures were performed at least 1 day after the dual therapy (in average 4.3 days after SAC). In 5 patients 1 ventriculostomy was performed, in 2 patients 2, and in 1 patient 6 ventriculostomies were performed. Although radiological hemorrhage was present on the catheter tract in 4 patients, no temporary or permanent neurological deficit was observed. CONCLUSION: Impaired thrombocyte functions pose a risk in ventriculostomy. Also, evaluating the risk of hemorrhage before the antiplatelet treatment reaches its full effect may lead to false results. Studies with small patient groups with anti-aggregant therapy and impaired thrombocyte functions also contribute to the literature. Larger studies regarding this subject are needed.
Spine Tango in Turkish: Development of a Local Registry System
(2017) Civi, Soner; Borcek, Alp Ozgun; Bulduk, Erkut B.; Emmez, Hakan; Kaymaz, Memduh; 0000-0002-1055-5152; 27593753; U-2400-2018
AIM: Successfully established registry systems, rather than personal efforts to collect data, are required to record, analyze, compare and secure patient related data. Unfortunately, our country does not have such patient registry systems for spinal pathologies and surgeries at this time. In order to fill this gap in patient management in Turkey, the authors adopted already established Spine Tango registry system in a unique way answering the requirements of our health system. This article aims to present the adaptation process of Spine Tango forms for use in Turkish and describe the first implementation with 50 patients treated for spinal pathologies in a tertiary referral center. MATERIAL and METHODS: In 2011, an effort was initiated by the first author to translate the original Spine Tango forms into Turkish. Funding for this project was provided by authors themselves. With the assistance of a Spine Tango team, the translation process was completed. The Turkish forms were then used in an academic institution with a high spinal workload. A local solution was developed by the authors using commercially available software and mobile instruments. This system was tested with 50 spine patients from June 2012 to January 2013. RESULTS: The analysis of the data gathered using the new Turkey Spine Tango registry system was successful. CONCLUSION: In an environment of exponentially increasing medical data, successfully established registry systems have the potential to facilitate patient management. The authors recommend the use of Turkish Spine Tango forms for clinics performing spinal interventions.
Sugammadex Given for Rocuronium-Induced Neuromuscular Blockade in Infants: A Retrospective Study
(2016) Ozmete, Ozlem; Bali, Cagla; Cok, Oya Yalcin; Turk, Hatice Evren Eker; Ozyilkan, Nesrin Bozdogan; Civi, Soner; Aribogan, Anis; 0000-0002-1055-5152; 0000-0003-3004-2626; 0000-0002-7901-0185; 0000-0002-4973-8132; 0000-0003-2615-1918; 0000-0002-4419-5693; 0000-0001-5845-699X; 27871583; AAI-7779-2021; U-2400-2018; AAI-7998-2021; AAI-8790-2021; AAI-8769-2021; S-8336-2019; AAI-7880-2021
Study Objective: To evaluate the efficacy and safety of sugammadex in reversing profound neuromuscular block induced by rocuronium in infant patients. Design: Retrospective observational study. Setting: University teaching hospital. Patients: Twenty-six infants (2-12 months of age; 3-11 kg) with an American Society of Anesthesiologists classification I, II, or III who were scheduled to undergo neurosurgical procedures were included in the study. Interventions: Anesthesia was induced with 5 mg/kg thiopental, 1 mu g/kg fentanyl and 0.6 mg/kg rocuronium. Sevoflurane was administered to all patients after intubation. Methods: The neuromuscular block was monitored with acceleromyography using train-of-four (TOF) stimuli. Patients received additional doses of rocuronium to maintain a deep block during surgery. If profound neuromuscular block (TOF, 0) persisted at the end of the surgery, 3 mg/kg sugammadex was administered. Measurements: The demographic data, surgeries, and anesthetic agents were recorded. The time from sugammadex administration to recovery of neuromuscular function (TOF ratio, >0.9) and complications during and after extubation were also recorded. Main results: Twenty-six infants who had a deep neuromuscular block (TOF, 0) at the end of surgery received 3 mg/kg sugammadex. The mean recovery time of the T4/T1 ratio of 0.9 was 112 seconds. No clinical evidence of recurarization or residual curarization was observed. Conclusions: The efficacy and safety of sugammadex were confirmed in infant surgical patients for reversal of deep neuromuscular block induced by rocuronium. (C) 2016 Elsevier Inc. All rights reserved.
Usefulness of End-to-Side Bridging Anastomosis of Sural Nerve to Tibial Nerve : An Experimental Research
(2017) Civi, Soner; Durdag, Emre; Aytar, Murat Hamit; Kardes, Ozgur; Kaymaz, Figen; Aykol, Sukru; 0000-0003-2854-941X; 0000-0001-6939-5491; 0000-0002-1055-5152; 28689390; P-5895-2018; AAK-1734-2021; U-2400-2018
Objective : Repair of sensorial nerve defect is an important issue on peripheric nerve surgery. The aim of the present study was to determine the effects of sensory-motor nerve bridging on the denervated dermatomal area, in rats with sensory nerve defects, using a neural cell adhesion molecule (NCAM). Methods : We compared the efficacy of end-to-side (ETS) coaptation of the tibial nerve for sural nerve defect repair, in 32 Sprague-Dawley rats. Rats were assigned to 1 of 4 groups : group A was the sham operated group, group B rats had sural nerves sectioned and buried in neighboring muscles, group C experienced nerve sectioning and end-to-end (ETE) anastomosis, and group D had sural nerves sectioned and ETS anastomosis was performed using atibial nerve bridge. Neurological evaluation included the skin pinch test and histological evaluation was performed by assessing NCAM expression in nerve terminals. Results : Rats in the denervated group yielded negative results for the skin pinch tests, while animals in the surgical intervention groups (group C and D) demonstrated positive results. As predicted, there were no positively stained skin specimens in the denervated group (group B); however, the surgery groups demonstrated significant staining. NCAM expression was also significantly higher in the surgery groups. However, the mean NCAM values were not significantly different between group C and group D. Conclusion : Previous research indicates that ETE nerve repair is the gold standard for peripheral nerve defect repair. However, ETS repair is an effective alternative method in cases of sensorial nerve defect when ETE repair is not possible.