Fakülteler / Faculties
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Item 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-1686-2021Objective: 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.Item Prevalence of Persistent Median Artery in Carpal Tunnel Syndrome: Sonographic Assessment(2016) Altinkaya, Naime; Leblebici, Berrin; https://orcid.org/0000-0003-1348-8167; https://orcid.org/0000-0002-6241-268X; 26324380; AAM-5169-2021; AAM-3220-2021This study investigated the frequency of persistent median artery (PMA) in patients with carpal tunnel syndrome (CTS) and controls. A total of 84 CTS patient wrists, and 136 wrists of control subjects without CTS, were examined on ultrasonography (US) and color Doppler US (CDUS), and by electrophysiological evaluations. The frequency of PMA in CTS was evaluated. Of 84 CTS patient wrists, 2 (2.4 %) had a PMA (both on the right side). Of 136 control wrists, 12 (9 %) had a PMA, which was unilateral in eight (three right and five left), and bilateral in two, cases. There was no significant difference between the CTS patient and control groups with respect to the frequency of PMA (P > 0.05). There was no significant difference between the CTS patient and control groups in the frequency of PMA. We suggest that an ipsilateral PMA does not increase the risk of CTS.Item Ultrasonographic and Electrophysiological Evaluation of the Ulnar Nerve in Patients Diagnosed With Carpal Tunnel Syndrome(2016) Ozlece, Hatice Kose; Huseyinoglu, Nergiz; Gok, Mustafa; Ilik, Faik; 27760070Purpose: In this study, we evaluated the ulnar nerve of patients diagnosed with carpal tunnel syndrome (CTS) using electrophysiology and ultrasonography. Methods: The study included 86 patients (136 hands) and 39 controls (78 hands) with normal electrophysiological assessment. According to Bland's classification, patients were divided into group 1 (grades 1-3 CTS) or group 2 (grades 4-6 CTS). The ulnar nerve was evaluated at the wrist using nerve conduction studies and ultrasonography. Results: The sensory velocity was slower in group 2 than in group 1 (P < 0.001), slower in group 2 than in controls (P < 0.001), and slower in group 1 than in controls (P < 0.005). Although the ultrasonography results showed a reduction in the ulnar nerve cross-sectional area in group 1 compared with controls, the difference was not statistically significant. However, the reduction was significant in group 2 compared with group 1 and controls (P < 0.001). Conclusions: Based on our study results, the ulnar nerve is affected electrophysiologically and morphologically in patients with CTS, especially those with advanced-stage CTS.Item Physical therapy versus radial extracorporeal shock wave therapy in the treatment of carpal tunnel syndrome: A randomized-controlled study(2022) Saglam, Gonca; Alisar, Dilek Cetinkaya; Ozen, Selin; 35949973Objectives: This study aims to compare the efficacy of physical therapy (PT) and radial extracorporeal shock wave therapy (rESWT) in the treatment of carpal tunnel syndrome (CTS). Patients and methods: Between May 2020 and July 2020, a total of 125 wrists of 95 patients (22 males, 73 females; mean age: 54.3 +/- 11.3 years; range, 19 to 69 years) with mild-to-moderate CTS were allocated into three groups. The control group (Group 1, n=42) was treated with splinting and an exercise program. Group 2 (n=42) was treated with a total of three sessions of rESWT, splinting and an exercise program. Group 3 (n=41) was treated with a total of 15 sessions of PT modalities, splinting, and an exercise program. Each patient was evaluated before, three weeks and 12 weeks after treatment using a Visual Analog Scale (VAS), the Boston Carpal Tunnel Questionnaire (BCTQ), the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) Pain Scale, and electrodiagnostic testing. Results: The reduction in VAS, BCTQ, LANSS, and improvement in sensory nerve conduction velocity were significantly greater at three and 12 weeks of follow-up in Groups 2 and 3, compared to Group 1 (p<0.001). A greater improvement was observed in all clinical parameters in Group 2, compared to Group 3 (p<0.001). Conclusion: This is the first study to compare the treatment outcomes of PT and rESWT in the treatment of CTS. The results of this study show that both PT and rESWT are effective in the treatment of CTS; however, rESWT yields superior treatment effects compared to conventional PT. The practicalities of administering rESWT and its efficacy in the treatment of CTS may make it the treatment of choice.Item Ultrasonographic And Electrophysiological Outcomes Of Carpal Tunnel Syndrome Treated With Low-Level Laser Therapy: A Double-Blind, Prospective, Randomized, Sham-Controlled Study(2022) Nalbant, Merve; Yemisci, Oya Umit; Ozen, Selin; Tezcan, Sehnaz; https://orcid.org/0000-0002-0501-5127; 35949869; AAJ-8820-2021Objectives: The aim of this study was to investigate the therapeutic effects of low-level laser therapy (LLLT) on clinical, ultrasonographic (US), and electrophysiological findings in carpal tunnel syndrome (CTS). Patients and methods: Between January 2015 and August 2015, 42 patients (7 males, 35 females; mean age: 50.4 +/- 8.7 years; range, 32 to 65 years) with mild-to-moderate CTS were randomly assigned to one of two groups: active LLLT (therapy group, n=22) 0.8 J/painful point and sham LLLT groups (n=20). Both groups wore neutral wrist orthoses. The patients were evaluated before and after 15 sessions of therapy (670 nm, 4 J/session over the carpal tunnel). Follow-up parameters included the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) Symptom Severity Scale (SSS), Functional Status Scale (FSS), nerve conduction studies and US evaluation of the median nerve cross-sectional area (CSA), vascularization (via power Doppler), flattening ratio (FR), and palmar bowing of the flexor retinaculum. Results: Nocturnal paresthesia improved in both groups; however, pain and patients with a positive Phalen's test reduced only in the therapy group (p=0.031). The FSS and SSS scores also improved only in the therapy group (p<0.001). Electrophysiologically, median sensory nerve conduction velocities showed a significant improvement only in the therapy group (p=0.002). The CSA, FR, and vascularization of the median nerve showed a significant improvement in the therapy group alone (p<0.001, p=0.048, and p=0.021, respectively). Conclusion: Improvements in the signs and symptoms of CTS and hand function, the improvements in sensory nerve conduction studies, and reduction in median nerve CSA, FR and vascularity in the LLLT group can be attributed to the anti-inflammatory and analgesic effects of LLLT. This study provides new US data demonstrating efficacy of LLLT along with a clinical and electrophysiological improvement. The LLLT seems to be an easily applied, non-invasive treatment option.Item Intraneural Vascular Resistive Index of the Median Nerve as a Predictor of Severity of Carpal Tunnel Syndrome(2020) Pekoz, Burcak Cakir; Pekoz, Mehmet Taylan; Analan, Pinar Doruk; 0000-0002-3528-3712; AAA-8043-2021Objective: There is a limited data about resistive index (RI) of median nerve (MN) in patients with carpal tunnel syndrome (CTS). In our study, we aimed to evaluate the relationship between CTS severity and MN-RI. Methods: A total of 115 CTS patient wrists, and 49 wrists of control subjects without CTS, were examined on ultrasonography (US) and color Doppler US (CDUS), pulsed Doppler ultrasonography (PDUS), and by electrophysiological evaluations. MN peak-systolic velocity (MN-PSV), MN end-diastolic velocity, MN-RI and MN pulsatility index (MN-PI) were measured by PDUS. Patients were divided into 3 groups according to electrophysiological examinations severity findings of CTS as mild (Group-I), moderate (Group-II), and severe (Group-III). Results: MN-PSV, MN-PI and MN-RI increased significantly from Group-I to Group-III and these parameters were significantly higher in Group-III than other two groups. MN-RI independently determines the patients to have severe CTS. Increased MN-RI (per-0.1) was found to increase the risk of having severe CTS by 3.45-times. In the ROC analysis, the area under the curve was 0.846 for MN-RI. When the MN-RI cut-off value was taken as 0.80, it determines patients to be severe CTS with 85.2% sensitivity and 78.2% specificity. Conclusion: The increase in MN-RI in CTS patients is independently associated with disease severity and may be used in the clinical follow-up of these patients.Item Gray Scale Histogram Analysis of Carpal Tunnel Syndrome with Ultrasonography(2019) Umay, Sermin Tok; Analan, Pinar Doruk; 0000-0002-3528-3712; 31989885; AAA-8043-2021Purpose: In this study, we aim to evaluate the diagnostic value of echogenicity ratio with histogram analyses. Materials & Methods: This retrospective study was performed on 22 patients with 44 hands. The patients had clinical presentations consistent with CTS, in at one hand. Quantitative ultrasound scanning and image capture were completed using a diagnostic sonography machine. For gray scale histogram analysis, image J software was used. Results: Mean flexor tendons histogram analysis echogenicity/Mean median nerve histogram analysis echogenicity was significantly high for 1,7 cutoff value. Conclusion: Mean FTE/MNE ratio may be a useful sonographic parameter for CTS.Item Parvovirus B19-induced acute bilateral carpal tunnel syndrome in twin girls(2015) Sakalli, Hale; Baskin, Esra; Dener, Sefik; 26422355We describe 2 cases of 6-year-old twin girls presenting with acute carpal tunnel syndrome (CTS) associated with human parvovirus B19 (HPV-B19) infection, as evidenced by serological data and detection of HPV-B19 DNA in blood with use of polymerase chain reaction (PCR). To our knowledge, this is the first time that HPV-B19 infection has been suggested as the causal agent of simultaneous acute bilateral CTS in twins, thus presenting the possibility that similar immunologic responses can be observed in twins during viral infections.Item The effect of smartphone usage on the median nerve(2018) Ilik, Faik; Buyukgol, Huseyin; Eren, Fatma A.; Ilik, Mustafa K.; Kayhan, Fatih; Kose, HaticePurpose: The aim of this study was to examine the effects of smartphone use on the median nerve. Materials and Methods: Participants were classified into three groups according to their smartphone use frequencies; high smartphone users (with Smartphone addiction scale (SAS) score of higher than 71), low smartphone users (SAS score less than 71) and classical type mobile phones users. The Visual analogue scale (VAS), quick-disabilities of arm, shoulder, hand (qDASH) and median nerve conductions of the participants were assessed. Groups were compared to each other as well as dominant and non-dominant hand nerve measurements of participants were also compared. Results: VAS and qDASH values were not significantly different between groups. It was observed that the rare use of smartphones affected the median nerve conductions in a lesser manner compared to the classical mobile phone use. However, using smart phone in an increasing rate influenced the median nerves adversely. Conclusion: Excessive use of smartphone can lead to carpal tunnel syndrome via affecting the median nerve. In recent decades, there has been a widespread use of smartphones even at the level of addiction. This should be noted while designing the smartphones and voice applications should be used more often. Furthermore, it can be beneficial to follow up the median nerve conductions of patients who are addicted to smartphones with the help of electrophysiological studies.