Browsing by Author "Isik, Semra"

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ABO and Rh Blood Groups and Risk of Myelomeningocele
(2020) Isik, Semra; Cevik, Serdar; Turhan, Ali Haydar; Baygul, Arzu; Hanimoglu, Hakan; 32239487
AIM: To investigate the relationship between the distribution of ABO or Rhesus (Rh) blood group antigens and the incidence of myelomeningocele. MATERIAL and METHODS: A retrospective data was reviewed for all myelomeningocele patients operated at a tertiary academic hospital between years 2014 and 2019. Age, sex, delivery method, physical and neurological examination findings, and radiological findings alongside with blood type of each patient were recorded. The data of blood group distribution among the study patients was compared to the data of healthy individuals in the same region. RESULTS: Patients with group B and AB showed a higher chance of developing myelomeningocele. Rh-positive blood group was associated with high incidence of myelomeningocele (93.5%), whereas Rh-negative blood group showed least association (6.5%). Rh-positive blood group was also found to be more frequent in patients with myelomeningocele with hydrocephalus and Chiari malformation. CONCLUSION: The findings of this study show that ABO and Rh blood groups have an effect on the development of myelomeningocele under the influence of environmental or genetic factors.
Effect of Antithrombotic Therapy on Development of Acute Subdural Hematoma After Burr Hole Drainage of Chronic Subdural Hematoma
(2020) Yuksel, Mehmet Onur; Cevik, Serdar; Erdogan, Baris; Tunckale, Tamer; Katar, Salim; Isik, Semra; Caliskan, Tezcan; Evran, Sevket; 32996579
AIM: To evaluate the relationship between the time from cessation of anticoagulant/antiplatelet medication to surgery and risk of postoperative acute subdural hematoma (ASDH) after burr hole drainage of chronic subdural hematoma (CSDH). MATERIAL and METHODS: A retrospective study of patients who underwent burr hole drainage of CSDH between December 2014 and December 2019 was performed. Demographic and clinical data regarding age, gender, medication (antithrombotic therapy), smoking, daily alcohol consumption, history of head trauma, presenting symptoms, and neurological examination were collected from the medical records. Patients were divided into 3 groups based on time from referral to surgery: <24 hours, 24-72 hours, and >72 hours. RESULTS: One hundred seventeen patients underwent burr hole drainage of CSDH during the 5-year study period. Seventy-two patients were male (61.5%) and 45 were female (38.5%). Mean age was 70.5 +/- 7.2 years. Postoperative ASDH occurred in 2 of the 32 patients (6.3%) who were not taking antithrombotic medication and 6 of the 85 patients (7.1%) who were taking antithrombotic medication. The difference was not significant (p=0.797). CONCLUSION: The risk of ASDH after burr hole drainage of CSDH was not affected by antithrombotic medication. Although the literature suggests that antiplatelet and anticoagulant drugs to be discontinued between 5 and 7 days before surgery, our results showed that acute hemorrhage was not detected in any patient who underwent surgery more than 72 hours after referral.
Lateral transorbital approach: an alternative microsurgical route for supratentorial cerebral aneurysms
(2021) Ulutas, Murat; Cinar, Kadir; Dogan, Ihsan; Secer, Mehmet; Isik, Semra; Aksoy, Kaya; 0000-0002-6929-7135; 31783357; K-6580-2015
OBJECTIVE Transorbital approaches for neurosurgery have recently attracted attention and several anatomical studies have aimed to improve these techniques, but significant deficiencies in clinical practice remain, especially for aneurysm surgery. The authors present an alternative microsurgical route and the results of an analysis of patients with intracranial aneurysms who underwent a lateral transorbital approach (LTOA) using lateral orbito-zygoma-sphenotomy (LOZYGS). METHODS The clinical and surgical results of a series of 54 consecutive patients with 1 or more aneurysms who underwent surgery via LTOA are reported. A lateral orbitotomy was performed after making a 3-cm skin incision parallel to the lateral orbital rim. A second bone flap, which included the zygoma and sphenoid bones that form the lateral orbital wall, was removed. The lesser sphenoid wing, including the anterior clinoid process, was fully drilled, except in cases of middle cerebral artery (MCA) aneurysms. Cisternal dissection was performed using the classic microsurgical technique starting from the proximal Sylvian fissure and carotid cistern. After the aneurysm was clipped following microsurgical principles, the dura mater was closed in a watertight fashion and 2-piece bone reconstruction was achieved. RESULTS Sixty aneurysms in 54 patients were clipped using the LOZYGS route. Twenty-one aneurysms were located on the MCA, 30 on the anterior communicating artery, 8 on the internal carotid artery, and 1 at the apex of the basilar artery. The unruptured-to-ruptured aneurysm ratio was 17:43. The operative field was moved to the orbit using the LTOA to avoid interference by bone and muscle tissues. Early proximal control was achieved using a short working distance and direct exposure of the base of the cerebrum, without any requirement for retraction. Because different view angles and surgical corridors were used, no segment of the aneurysm or the parent artery remained unexposed. Therefore, the introduction of additional tools was not required. CONCLUSIONS The LTOA allowed enhanced broad-perspective exposure of the operative field, early proximal control, and satisfactory surgical freedom. This alternative surgical approach safely exposed the target area and the operative field. The LOZYGS route is safe and effective for the LTOA and microsurgical clipping of anterior circulation aneurysms. According to the authors' surgical experience and clinical experience, the LTOA can be considered an alternative surgical route to supratentorial aneurysm surgery.
Radiofrequency Thermocoagulation of the Ganglion Impar for Coccydynia Management: Long-Term Effects
(2019) Kircelli, Atilla; Demircay, Emre; Ozel, Omer; Coven, Ilker; Isik, Semra; Civelek, Erdinc; Kabatas, Serdar; 0000-0003-2109-1274; 29617062
Objective To investigate the short- and long-term effects of ganglion impar radiofrequency thermocoagulation (RFT) treatment in patients with chronic coccydynia. Methods We retrospectively analyzed the medical records of patients who underwent RFT of the ganglion impar between 2009 and 2011. Pain intensity visual numeric scale (VNS) scores and Euroqol 5D (EQ-5D) index scores were recorded pre-intervention and post-intervention at the first, sixth, and twelfth months. The differences between pre-procedural VNS scores and post-procedural VNS scores at the first, sixth, and twelfth months were evaluated. The success of the intervention was recorded as the percentage difference between the pre-intervention VNS scores and post-intervention VNS scores at the first, sixth, and twelfth months. Results The mean age of the patients, including 11 females (55%) and 8 males (45%), was 48.7 +/- 14.3 years. The average follow-up duration was 17.3 +/- 2.9 months. Statistically significant differences were observed between the pre- and post-procedure VNS scores (P < 0.0001). Improvements in VNS scores were correlated with improvements in EQ-5D index scores. Mid-term (sixth month) and long-term (twelfth month) evaluations after the intervention revealed that 67.4% and 61.1% of the patients had successful outcomes, respectively. Conclusion Our data suggested that RFT of the ganglion impar in patients with chronic coccydynia resulted in effective outcomes, and patients who responded to RFT had significantly lower post-RFT pain scores.
The Role of Age on Effectiveness of Active Repositioning Therapy in Positional Skull Deformities
(2020) Ozkilic, Alper; Cevik, Serdar; Isik, Semra
Purpose: Non-synostotic positional deformities are currently diagnosed in nearly half of the newborns, however not any evidence-based guidelines are available for management. The aim of this study is to assess the effect of active repositioning treatment at infants with positional skull deformities. Method: A retrospective data of 158 infants treated with active repositioning as a conservative treatment for at least 2 months were analyzed in this study. Anthropometric 3D scanner measurements of pre-and post-treatment diagonal difference, cranial vault asymmetry index, cranial ratio were evaluated for each patient. Infants were separated to 4 different groups according to their morphologic deformation types as plagiocephaly, brachycephaly, scaphocephaly and combined (brachycephaly+plagiocephaly), and 2 groups according to age at onset of treatment. Results: In combined group, pre-treatment mean diagonal difference and cranial vault asymmetry index values decreased from 9.38 mm and 6.9% to 6.94 mm and 4.9% respectively. In plagiocephaly group, mean pre-treatment results changed from 10.32 mm and 7.5% to 7.83 mm and 5.5% respectively after treatment. All these changes were statistically significant. Effectiveness of timing of repositioning treatment on different positional skull deformities was analyzed and outcome was found significantly improved when the active repositioning treatment was started before 4 months of age. Conclusion: Improvement rates of the asymmetry decrease with age due to decreasing skull enlargement rate. Early diagnosis, especially before 4 months of age, more parental education, and close follow-up are important for babies with this condition who may benefit just from repositioning treatment.
The role of age on helmet therapy in deformational plagiocephaly and asymmetric brachycephaly
(2020) Cevik, Serdar; Isik, Semra; Ozkilic, Alper; 0000-0002-6929-7135; 31482314; K-6580-2015
Purpose This study aimed to investigate the effect of age at helmet therapy onset on treatment efficacy in moderate-to-severe deformational plagiocephaly (DP) and combined DP and asymmetrical brachycephaly (AB) in infants. Methods Ninety-eight infants who were referred to our institution and who underwent helmet therapy between 2014 and 2018 were retrospectively reviewed. Patients with DP [cranial vault asymmetry index (CVAI) > 7% and DD > 10 mm] and AB [CVAI > 7% and cephalic ratio (CR) >= 94] were included. Pre- and post-treatment calvarial asymmetries (difference among DD, CVAI, and CR) were measured using 3D screening systems (SmartSoc and Omega Scanner 3D). Infants were classified according to age at treatment onset: group 1 (age, < 6 months) and group 2 (age, >= 6 months). Results CVAI was statistically different between treatment onset and end in subgroups. Moreover, the regression of CVAI between groups DP1 (- 7.5% +/- 1.2%) versus DP2 (- 5.4% +/- 1.5%; p = 0.001) and groups AB1 (- 6.6% +/- 1.4%) versus AB2 (- 4.4 +/- 2.5; p = 0.0013) was statistically significant. CVAI was < 3.5% and CR was <= 89 (assumed as normal cranial shape) after treatment in 48%, 40%, 32%, and 6% of infants in groups DP1, DP2, AB1, and AB2, respectively. Conclusion These findings emphasize the efficacy of helmet therapy for DP and AB. Helmet is an appropriate treatment option particularly for infants with severe DP and AB, and early onset of helmet therapy before the age of 6 months is advised.
Spinal anesthesia in surgical treatment of lumbar spine tumors
(2020) Ogrenc, Ahmet; Akar, Ezgi; Koban, Orkun; Isik, Semra; Sener, Mesut; Yilmaz, Mesut; Dalbayrak, Sedat; 32619901
Objective: This study aims to show the feasibility of spinal anesthesia in lumbar spinal tumor surgery; share our data and experience. Patients and methods: : A retrospective review of 14 patients with high risk for general anesthesia due to severe comorbidities was carried out. Patients who underwent surgeries under spinal anesthesia for lumbar vertebral column or spinal cord tumors at a single center between 2007-2019 were evaluated. The final pathological diagnosis, operation time, and surgical procedures were analyzed. Also, preoperative and postoperative ad-vantages and disadvantages were determined. A comparison was performed with other 184 patients who were operated for spinal tumors in the same period under general anesthesia. Results: Maximum operation time was found 220 min, and the average operation time was 166 min. The most primary diagnosis was vertebral column metastasis. The mean age was 65.5 years. None of the patients required general anesthesia during surgery; however, two patients needed additional spinal anesthesia preoperatively, which was performed by the surgeon. Lumbar decompression and fusion were the most performed procedures. Conclusion: Spinal anesthesia is a feasible and useful method of anesthesia in lumbar spinal tumor surgery for especially elderly patients with American Society of Anesthesiologists (ASA) 3 or 4 score and high risk of general anesthesia.