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    The Effectiveness of Asymmetric Dorsal Preservation for Correction of I-Shaped Crooked Nose Deformity in Comparison to Conventional Technique
    (2020) Ozucer, Berke; Cam, Osman Halit; 0000-0002-2785-4474; 32392429; AAP-1533-2020
    Importance: Using asymmetric dorsal preservation (ADP) (pushdown technique for deviated side and letdown technique to the contralateral nondeviated side) is an alternative surgical method to correct osseocartilaginous deviation in crooked nose deformity. Objective: Aim of this study was to evaluate whether ADP rhinoplasty is a good method to address I-shaped crookedness in comparison with conventional midvault deconstructing/reconstructing rhinoplasty. Design, Setting, and Participants: This study was conducted between June 2017 and August 2019. Twenty-two consecutive patients' I-shaped crookedness was addressed with either ADP (n = 10) or conventional midvault techniques (n = 12). Patients were followed up at least for 6 months. Main Outcomes and Measures: Pre- and postoperative frontal photographs and digital screen protractor was utilized for measurement of crookedness in a single-blinded manner. Surgical success were calculated and compared. Results: In ADP group, mean angle of deviation was 10.2 +/- 3.7 degrees and 0.5 +/- 1.0 degrees pre- and postoperatively, respectively. In control group, mean angle of deviation was 9.5 +/- 1.8 degrees and 0.3 +/- 0.9 degrees pre- and postoperatively, respectively. Change in angle was statistically significant for both groups. Postoperative calculated mean success rate was 96.3 +/- 7.9% and 97.5 +/- 8.5% for dorsal preservation and control group, respectively. Eight out of 10 patients in dorsal preservation group and 11 out of 12 patients in the control group achieved the ideal angle of 0 degrees, hence had 100% postoperative surgical success. Conclusions and Relevance: Utilization of dorsal preservation principles for correction of I-shaped crookedness presents as a promising and practical surgical alternative approach that should be in every rhinoplasty surgeon's armamentarium.
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    The role of delineation education programs for improving interobserver variability in target volume delineation in gastric cancer
    (2017) Onal, Cem; Cengiz, Mustafa; Guler, Ozan C.; Dolek, Yemliha; Ozkok, Serdar; 0000-0002-2742-9021; 0000-0001-6908-3412; 28339289; D-5195-2014; AAC-5654-2020
    Objective: To assess whether delineation courses for radiation oncologists improve interobserver variability in target volume delineation for post-operative gastric cancer radiotherapy planning. Methods: 29 radiation oncologists delineated target volumes in a gastric cancer patient. An experienced radiation oncologist lectured about delineation based on contouring atlas and delineation recommendations. After the course, the radiation oncologists, blinded to the previous delineation, provided delineation for the same patient. Results: The difference between delineated volumes and reference volumes for pre-and post-course clinical target volume (CTV) were 19.8% (-42.4 to 70.6%) and 12.3% (-12.0 to 27.3%) (p = 0.26), respectively. The planning target volume (PTV) differences pre-and post-course according to the reference volume were 20.5% (-40.7 to 93.7%) and 13.1% (-10.6 to 29.5%) (p = 0.30), respectively. The concordance volumes between the pre-and post-course CTVs and PTVs were 467.1 +/- 89.2 vs 597.7 +/- 54.6cm(3) (p < 0.001) and 738.6 +/- 135.1 vs 893.2 +/- 144.6 cm(3) (p < 0.001), respectively. Minimum and maximum observer variations were seen at the cranial part and splenic hilus and at the caudal part of the CTV. The kappa indices compared with the reference contouring at pre- and post-course delineations were 0.68 and 0.82, respectively. Conclusion: The delineation course improved interobserver variability for gastric cancer. However, impact of target volume changes on toxicity and local control should be evaluated for further studies. Advances in knowledge: This study demonstrated that a delineation course based on current recommendations helped physicians delineate smaller and more homogeneous target volumes. Better target volume delineation allows proper target volume irradiation and preventing unnecessary normal tissue irradiation.