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1. Gross Total Resection of a Grade IV Astrocytoma Adjacent to the Precentral Gyrus With Nonawake Motor Mapping and Motor-Evoked Potential Monitoring: 3-Dimensional Operative Video
(2020) Operative neurosurgery (Hagerstown, Md.), 18 (4), pp. E127-E128. Cited 1 time.
B Ozaydin, I Dogan, BJ Wheeler, MK Baskaya
DOI: 10.1093/ons/opz185
Abstract
Surgical treatment of the gliomas located in or adjacent to the eloquent areas poses significant challenge to neurosurgeons. The main goal of the surgery is to achieve maximal safe resection while preserving the neurological function. This might be possible with utilizing pre- and intraoperative adjuncts such as functional magnetic resonance imaging (MRI), image guidance, mapping of the function of interest, intraoperative MRI, and neurophysiological monitoring. In this video, we demonstrate the utilization of nonawake mapping and motor-evoked potential (MEP) monitoring for the resection of a right-sided posterior superior frontal gyrus grade IV astrocytoma adjacent to the primary motor cortex. The patient is a 69-yr-old woman presented with multiple episodes of simple partial seizures involving her left leg and spreading to the left arm. MRI and functional MRI examinations showed a heterogeneously enhancing mass with peritumoral edema adjacent to the primary motor cortex. Because the patient did not want to undergo an awake craniotomy, a decision was made to perform the resection of the tumor with nonawake motor mapping and continuous MEP monitoring. Nonawake motor mapping and MEP monitoring enabled us to perform gross total resection. Because it has been shown that supratotal resection may provide improved survival outcome,1,2 we extended the white matter resection beyond the contrast enhancing area in noneloquent parts of the tumor. Surgical steps in dealing with vascular anatomy as well as utilizing intraoperative adjuncts such as motor mapping and MEP monitoring to enhance the extent of resection while preserving the function are demonstrated in this 3-dimensional surgical video. The patient consented to publication of her operative video. Copyright © 2019 by the Congress of Neurological Surgeons.
ISSN: 23324260
PubMed ID: 31301145
Document Type: Article
Publication Stage: Final
Source: Scopus
2. Diagnosis of Shunt Failure in the Lack of Hydrocephalus: a Case Report
(2020) Indian Journal of Surgery. O Mammadkhanli, I Dogan, H Tuna
DOI: 10.1007/s12262-020-02209-8
ISSN: 09722068
CODEN: IJSUA
Document Type: Letter
Publication Stage: Article in Press
Source: Scopus
3. Timing of shunt insertion in children with neural tube defects and hydrocephalus: A clinical study
(2020) Turkish Neurosurgery, 30 (2), pp. 194-198. O Ozgural, G Kahilogullari, I Dogan, U Eroglu, F Yakar, MC Kilinc
DOI: 10.5137/1019-5149.JTN.26588-19.1
Abstract
AIM: To define the optimal time of shunt insertion in patients with neural tube defects and hydrocephalus. MATERIAL and METHODS: In total, 71 patients who underwent operation for neural tube defects and hydrocephalus were retrospectively evaluated between 2012 and 2018. The first group comprised 43 patients who underwent operation at different times (in 10 days after the repair of defect), and the second group comprised 28 patients who underwent operation at the same time. Ruptured and unruptured sacs were immediately considered and operated within 72 hours. RESULTS: In the first group, 43 patients underwent operation for neural tube defect after birth. Ventriculoperitoneal shunt insertion was performed 10 days after wound healing. Five (11.6%) patients were diagnosed with meningitis on follow-up. Shunt infection or meningitis was not observed on follow-up in the second group, which comprised patients who underwent operation at the same time. CONCLUSION: The lowest complication rate existed in hydrocephalus management when shunt insertion and myelomeningocele repair procedures were performed at the same time. © 2019, Turkish Neurosurgical Society.
ISSN: 10195149
CODEN: TUNEE
PubMed ID: 32153000
Document Type: Article
Publication Stage: Final
Source: Scopus
4. Marking basilar artery using neuronavigation during endoscopic third ventriculostomy: A clinical study
(2020) Turkish Neurosurgery, 30 (1), pp. 23-29.
O Ozgural, G Kahilogullari, G Cinalli, U Eroglu, I Dogan, ESM Al-Beyati
DOI: 10.5137/1019-5149.JTN.25698-19.1
Abstract
AIM: To evaluate the efficacy of using a neuronavigation system for demonstrating the relationship between the basilar artery (BA) and ventricular floor during endoscopic third ventriculostomy (ETV). MATERIAL and METHODS: Records of 28 patients (16 females and 12 males) diagnosed with obstructive hydrocephalus who had undergone a neuroendoscopic procedure were retrospectively examined. Patient age ranged from 1 to 76 years (median 24.46 years). The BA was marked with using the neuronavigation system in all cases to visualise its relationship to the floor of the third ventricle in real time. RESULTS: ETV was successfully performed in 28 patients with obstructive hydrocephalus. Of these, 13 (46.4%) patients had a thickened tuber cinereum (TC) membrane and 3 (10.7%) showed lateralization of the BA under the ventricular floor. No contact with the BA or related complications (e.g., major bleeding) was encountered with BA marking by using neuronavigation. CONCLUSION: Even though thickening of the TC membrane and/or displacement of the BA might be seen otherwise, we describe a new method that combines marking the BA and using neuronavigation to provide greater safety in the area where the ventriculostomy will be performed. This permits clearer orientation for the surgeon which significantly contributes to minimizing surgical morbidity. © 2020, Turkish Neurosurgical Society.
ISSN: 10195149
CODEN: TUNEE
PubMed ID: 30875080
Document Type: Article
Publication Stage: Final
Source: Scopus
5. Low-Cost Stereoscopic Recordings of Neurologic Surgery Operative Microscopy for Anatomic Laboratory Training (2019) World Neurosurgery, 125, pp. 240-244. Cited 1 time.
I Dogan, OS Sahin, B Ozaydin, MK Baskaya
DOI: 10.1016/j.wneu.2019.01.237
Abstract
Objective: Stereoscopic video recordings of operative microscopy during neuroanatomic dissections are an important component of surgical training and research in well-financed medical schools and teaching hospitals. However, the high cost of the latest operative microscopes with integrated video recording equipment can be a limiting factor in their worldwide use. The aim of the present work is to provide a simple low-cost 3-dimensional (3D) stereoscopic operative microscope recording system that can be used even in economically and resource-limited locations. This is achieved by using readily available smartphones, smartphone accessories, and computer software. Methods: Stereoscopic recording is accomplished by attaching and aligning matched or similar smartphones to the eyepieces of an operative microscope using readily available smartphone mounting connectors. Video recordings from the smartphones are then transferred to a personal computer and processed with a video-editing software to generate stereoscopic movies that are viewed on a smartphone using virtual-reality glasses. Results: The setup time to mount and align the smartphone cameras typically requires 15–30 minutes. Video image quality and 3D depth presentation is more than sufficient for surgical training and research purposes. The implementation cost ranges from $1,315–$7,066, or much less if smartphones and a computer are already available. Conclusions: The 3D video system demonstrated herein can be implemented on any type of operative microscope, including older units for which commercial stereo recording systems are not available. The system and method presented herein can be readily and affordably implemented in low-budget environments for clinical training and research. © 2019 Elsevier Inc.
Index Keywords
Article, cost benefit analysis, human, image quality, neurosurgery, stereoscopic vision, surgical anatomy, surgical training, three dimensional imaging, videorecording, virtual reality, devices, economics, education, microsurgery, neuroanatomy, neurosurgery, procedure,smartphone, three dimensional imaging, video microscopy; Humans, Imaging, Three-Dimensional, Microscopy
Video, Microsurgery, Neuroanatomy, Neurosurgery, Smartphone, Video Recording
ISSN: 18788750
PubMed ID: 30776517
Document Type: Article
Publication Stage: Final
Source: Scopus
6. Collagen Peptide Presenting Nanofibrous Scaffold for Intervertebral Disc Regeneration (2019) ACS Applied Bio Materials, 2 (4), pp. 1686-1695. Cited 2 times.
ABT Ozge Uysal, Elif Arslan, Gulcihan Gulseren, Mustafa Cemil Kilinc, ihsan Dogan
DOI: 10.1021/acsabm.9b00062
Abstract
Lower back pain (LBP) is a prevalent spinal symptom at the lumbar region of the spine, which severely effects quality of life and constitutes the number one cause of occupational disability. Degeneration of the intervertebral disc (IVD) is one of the well-known causes contributing to the LBP. Therapeutic biomaterials inducing IVD regeneration are promising candidates for IVD degeneration treatments. Here, we demonstrate a collagen peptide presenting nanofiber scaffold to mimic the structure and function of the natural extracellular matrix of the tissue for IVD regeneration. The collagen peptide presenting nanofiber was designed by using a Pro-Hyp-Gly (POG) peptide sequence on a self-assembling peptide amphiphile molecule, which assembled into nanofibers forming scaffolds. Injection of collagen peptide presenting peptide nanofiber scaffold into the degenerated rabbit IVDs induced more glycosaminoglycan and collagen deposition compared to controls. Functional recovery of the tissue was evaluated by degeneration index score, where the bioactive scaffold was shown to provide functional recovery of the IVD degeneration. These results showed that the collagen peptide presenting nanofiber scaffold can prevent the progression of IVD degeneration and provide further functional recovery of the tissue. Copyright © 2019 American Chemical Society.
Index Keywords
Collagen, Nanofibers, Peptides, Recovery, Scaffolds (biology), Tissue; Extracellular matrices, Functional recovery, Inter-vertebral disc degeneration, Intervertebral discs, Nanofibrous scaffolds, Needle puncture, regeneration, Self-assembling peptides; Tissue regeneration
ISSN: 25766422
Document Type: Article
Publication Stage: Final
Source: Scopus
7. Supraorbital Keyhole Approach: Lessons Learned from 106 Operative Cases
(2019) World Neurosurgery, 124, pp. e667-e674. Cited 4 times.
U Eroglu, K Shah, M Bozkurt, G Kahilogullari, F Yakar, İ Dogan, O Ozgural
DOI: 10.1016/j.wneu.2018.12.188
Abstract
Objective: The supraorbital keyhole approach through an eyebrow incision has been a potentially less invasive approach as an alternative to the standard pterional craniotomy. We aimed to review procedures for anterior and middle cranial fossa lesions and identify lessons learned from addressing various pathologies through this approach. Methods: We retrospectively reviewed 106 consecutive patients who underwent this approach. We documented patients’ age, sex, pathology, clinical results, extent of tumor resection, complications, use of endoscope, and cosmetic results. Results: Our series addressed a variety of pathologies. Male patients accounted for 55% of the cohort and mean age was 51.7 (2–79) years. Notably, 52% of patients underwent resection of extra-axial masses. Gross total resection was achieved in 74.4% of intra-axial lesions according to postoperative imaging. Two (1.9%) patients developed transient ptosis. One (0.9%) patient developed an allergic reaction to titanium. No cerebrospinal fluid fistula or rhinorrhea occurred. Three patients developed temporary diabetes insipidus after resection of parasellar lesions (2 craniopharyngiomas and 1 pituitary adenoma). In 14 patients with olfactory groove meningiomas, 6 (42.8%) suffered from absence or diminished olfaction postoperatively, and 2 (14.2%) developed postoperative anosmia. Five (38.5%) patients underwent a subsequent resection of recurrent glial tumors. Four weeks postoperatively, 95% of patients demonstrated acceptable cosmetic results. Cosmetic results for 6 (5%) patients were unavailable. Conclusions: The supraorbital keyhole approach may be safely used for various lesions within the anterior and middle cranial fossa. The effectiveness and limitations of this approach and possible complications are discussed. This is a valuable approach for selected patients. © 2019 Elsevier Inc.
Index Keywords
abdominal bleeding, adult, anosmia, anterior communicating artery aneurysm, anterior cranial fossa, Article, brain tumor, cancer surgery, cohort analysis, craniopharyngioma, craniotomy, diabetes insipidus, epidermoid tumor, Ewing sarcoma, eyebrow supraorbital keyhole craniotomy, female, glioblastoma, glioma, human, hypophysis adenoma, hypothalamus tumor, incision site drainage, major clinical study, male, medical record review, meningioma, middle aged, middle cranial fossa, olfactory groove meningioma, oligodendroglioma, pilocytic astrocytoma, postoperative complication, ptosis (eyelid), recurrent disease, retrospective study, supraorbital hypesthesia, surgical patient, teratoma, tumor recurrence, vasospasm
ISSN: 18788750
Document Type: Article
Publication Stage: Final
Source: Scopus
8. Spinal hydatid cyst disease: Challenging surgery - An institutional experience
(2019) Journal of Korean Neurosurgical Society, 62 (2), pp. 209-216.
YS Caglar, O Ozgural, M Zaimoglu, C Kilinc, U Eroglu, I Dogan
DOI: 10.3340/jkns.2017.0245
Abstract
Objective: Hydatid cyst disease is caused by the parasite Echinococcus granulosus. It is rarely seen in the vertebral system, occurring at a rate of 0.2-1%. The aim of this study is to present 12 spinal hydatid cyst cases, and propose a new type of drainage of the cyst. Methods: Twelve cases of spinal hydatid cysts, surgical operations, multiple operations, chronic recurrences, and spinal hydatic cyst excision methods are discussed in the context of the literature. Patients are operated between 2005 and 2016. All the patients are kept under routine follow up. Patient demographic data and clinicopathologic characteristics are examined. Results: Six male and six female patients with a median age of 38.6 at the time of surgery were included in the study. Spinal cyst hydatid infection sites were one odontoid, one cervical, five thoracic, two lumbar, and three sacral. In all cases, surgery was performed, with the aim of total excision of the cyst, decompression of the spinal cord, and if necessary, stabilization of the spinal column. Mean follow up was 61.3 months (10-156). All the patients were prescribed Albendazole. Three patients had secondary hydatid cyst infection (one lung and two hepatic). Conclusion: The two-way drainage catheter placed inside a cyst provides post-operative chlorhexidine washing inside the cavity. Although a spinal hydatid cyst is a benign pathology and seen rarely, it is extremely difficult to achieve a real cure for patients with this disease. Treatment modalities should be aggressive and include total excision of cyst without rupture, decompression of spinal cord, flushing of the area with scolicidal drugs, and ensuring spinal stabilization. After the operation the patients should be kept under routine follow up. Radiological and clinical examinations are useful in spotting a recurrence. © 2019 The Korean Neurosurgical Society.
Index Keywords
albendazole, chlorhexidine; adolescent, adult, Article, bone hydatidosis, case report, child, clinical article, computer assisted tomography, contrast enhancement, curettage, cyst rupture, diffusion weighted imaging, distant metastasis, Echinococcus granulosus, female, flushing, follow up, human, laminectomy, male, middle aged, motor dysfunction, nuclear magnetic resonance imaging, paraplegia, postoperative care, recurrent disease, school child, sensory dysfunction, spinal cord cyst, spinal cord decompression, spine stabilization, spine surgery, wound healing impairment
ISSN: 20053711
Document Type: Article
Publication Stage: Final
Source: Scopus
Access Type: Open Access
9. Surgical Management of Spinal Arachnoid Cysts in Adults
(2019) World Neurosurgery, 122, pp. e1146-e1152. Cited 4 times.
U Eroglu, M Bozkurt, G Kahilogullari, I Dogan, O Ozgural, KJ Shah
DOI: 10.1016/j.wneu.2018.11.005
Abstract
Background: Spinal arachnoid cysts (SACs) are uncommon lesions in the spinal canal. They are usually asymptomatic, but can occasionally cause mass effect leading to neurologic symptoms. They can be congenital or secondary to a variety of causes. They can produce a variety of neurologic symptoms including pain, weakness, sensory changes, incontinence, and more. Surgical intervention may be necessary when SACs cause symptomatic mass effect. Methods: Thirteen consecutive patients who underwent surgical intervention for an SAC were retrospectively reviewed. The data included presenting symptoms, imaging findings, neurologic status, and follow-up. Results: Of the 13 patients, the majority of cases were located in the thoracic spine (54%) and all but one case were located dorsally or dorsolaterally. Furthermore, 38% were located extradurally and 54% were located intradurally. Pain (80%) was the most common presenting symptom. Most patients had improvement or complete resolution of their symptoms after intervention. Extradural SACs and their capsules were completely resected, whereas intradural SACs underwent fenestration. No complications occurred in this series. Conclusions: SACs are usually asymptomatic, but rarely cause mass effect and neurologic deficits requiring surgical intervention. Surgical intervention is tailored to the position of the cysts’ dorsal or ventral locations. Pain and weakness are the most likely symptoms to improve, whereas sensory symptoms are least likely to improve. © 2018 Elsevier Inc.
Index Keywords
adult, arachnoid cyst, Article, backache, case report, clinical article, conus medullaris, female, fenestration, follow up, human, hypesthesia, laminoplasty, latent period, leg pain, liquorrhea, male, medical record review, middle aged, nerve compression, neurologic examination, neurosurgery, nuclear magnetic resonance imaging, retrospective study, sensory evoked potential, spinal arachnoid, spinal pain, spine radiography, tendon reflex, thoracic spine, urine incontinence, urine retention, arachnoid cyst, diagnostic imaging, disease management, laminectomy, procedures, spinal cord disease; Adult, Arachnoid Cysts, Disease Management, Female, Follow-Up Studies, Humans, Laminectomy, Male, Middle Aged, Spinal Cord Diseases
ISSN: 18788750
PubMed ID: 30447456
Document Type: Article
Publication Stage: Final
Source: Scopus
10. Aggressive, Multidisciplinary Staged Microsurgical Resection of a Giant Cervicomedullary Junction Chordoma
(2019) Journal of Neurological Surgery, Part B: Skull Base, 80, pp. S378-S379.
S Sayyahmelli, I Dogan, AM Wieland, M Pyle, MK Başkaya
DOI: 10.1055/s-0039-1695062
Abstract
Chordomas of the cranial base are locally destructive tumors since they are surrounded by significant complex neurovascular structures. Thus, their surgical removal is challenging, recurrence rates are high, and their therapeutic strategies remain controversial. In this video, we present a 47-year-old man with a recent onset of swallowing difficulties, hoarseness, and weight loss for several weeks. In the neurological examination, he had complete paralysis of the 9th, 10th, 11th, and 12th cranial nerves. Magnetic resonance imaging (MRI) showed a heterogeneously enhancing expansile invasive mass lesion centered within the clivus and involving the C1, the occipitocervical junction, the retropharynx, and the hypoglossal canal. The decision was made to proceed with multiple staged surgeries. In the first surgical stage, we performed a mastoidectomy with the infralabyrinthine approach to perform a test clip ligation of the sigmoid sinus and to resect the tumor component that extended into the infralabyrinthine space. In the second stage, we performed a far-lateral transcondylar approach for tumor resection and occipitocervical fusion. In the third stage, we used a transoral approach with endoscopic assistance to complete the excision of the remaining tumor in the retropharyngeal space and anterior aspect of C1 and C2 bodies that were not accessible in the first two stages. The surgeries and postoperative course were uneventful. Postoperative MRI showed a gross total resection of the tumor. Histopathology indicated a chordoma. The patient subsequently received proton radiotherapy and has continued to do well without recurrence at 14 months' follow-up. © 2019 Georg Thieme Verlag KG Stuttgart • New York.
Index Keywords
adult, Article, atlantooccipital joint, body weight loss, cancer surgery, case report, chordoma, clinical article, clivus, dysphagia, giant cervicomedullary junction chordoma, histopathology, hoarseness, human, human tissue, hypoglossal canal, male, mastoidectomy, microsurgery, middle aged, neuroimaging, nuclear magnetic resonance imaging, occipitocervical fusion, paralysis, posterior inferior cerebellar artery, priority journal, proton therapy, retropharynx, sigmoid sinus, spine fusion, vertebral artery
ISSN: 2193634X
Document Type: Article
Publication Stage: Final
Source: Scopus
Access Type: Open Access
11. The effect of phenyramidol on neural development in early chicken embryo model
(2019) Turkish Neurosurgery, 29 (6), pp. 851-855.
O Ozgural, B Bahadir, I Dogan, U Eroglu, S Aktan, I Kar, G Cakici
DOI: 10.5137/1019-5149.JTN.26158-19.1
Abstract
AIM: To investigate the effects of Phenyramidol (Phe) on neural development in an early chicken embryo model. MATERIAL and METHODS: Sixty fertile non-pathogenic Super Nick eggs were incubated for 24 hours (h) and divided into four groups of 15 eggs each. Phe was administrated through the sub-blastoderm, and the eggs were incubated for another 24 h. All eggs were opened after 48 h of incubation, and the embryos were evaluated morphologically and histopathologically. RESULTS: In Group 1 (control group), none exhibited neural tube defects (NTDs) (0%), 1 (6.6%) was undeveloped; in Group 2 (low dosages), 1 did not develop (6.6%); in Group 3 (normal dosages), 2 (13.4%) had NTDs, 1 (6.6%) was undeveloped; in Group 4 (high dosages), 5 (33.3%) had NTDs, 2 (13.3%) were undeveloped. CONCLUSION: In light of the results, it was determined that the use of increasing doses of Phe led to defects in midline closure in early chicken embryos. This is the first report in the literature on Phe used in an early chicken embryo model. © 2019, Turkish Neurosurgical Society.
ISSN: 10195149
CODEN: TUNEE
PubMed ID: 31192442
Document Type: Article
Publication Stage: Final
Source: Scopus
Access Type: Open Access
12. Microsurgical Resection of Posterior Third Ventricular/Pineal Region Papillary Tumor Via Supracerebellar Infratentorial Approach: 3-Dimensional Operative Video
(2018) Operative Neurosurgery, 15 (6), p. E87.
S Sayyahmelli, I Dogan, MK Başkaya
DOI: 10.1093/ons/opy133
Index Keywords
adult, case report, clinical article, female, follow up, human, hydrocephalus, microsurgery, Note, papilloma, posterior pineal region papillary tumor, posterior third ventricular papillary tumor, postoperative period, priority journal, supracerebellar infratentorial approach, surgical approach, third ventriculostomy, three dimensional imaging
ISSN: 23324252
PubMed ID: 29788336
Document Type: Note
Publication Stage: Final
Source: Scopus
13. Surgical outcomes of decompressive laminectomy by transspinous approach for degenerative lumbar spinal stenosis
M Ücer, I Aydin, AE Tacyildiz, I Dogan, E Emel
(2018) Journal of the Pakistan Medical Association, 68 (11), pp. 1618-1624.
Abstract
Objectives: To assess clinical and radiographical outcomes of transspinous decompression technique for the treatment of degenerative central lumbar spinal stenosis. Methods: The single-centre, non-randomised interventional, prospective, observational study was conducted Neurosurgery Clinic of Mazhar Osman Research and Training Hospital for Psychiatry and Neurology, Istanbul, Turkey from May 2013 and May 2016 and comprised adult patients with refractory symptoms from degenerative central lumbar spinal stenosis who underwent lumbar spinous process-splitting laminectomy. Pre-and post-operative Oswestry Disability Index score, visual analogue scale for overall pain, maximum walking distance and anteroposterior diameter of the spinal canal on magnetic resonance imaging were assessed on follow-up examination. SPSS 22 was used for data analysis. Results: Of the 89 patients, 7(7.86%) were lost to follow-up, while 82(92.14%) completed the study. Of them, 42(51%) were women and 40(49%) were men. Overall mean age was 63.86±10.02 years (range: 40-85 years). A total of 95 transspinous decompressive laminectomies were performed. Mean number of decompressed spinal segments was 1.16. Median duration of surgical procedure was 45 min, while mean length of hospital stay was 1.22±0.47 days. Mean decrease in pre-operative Oswestry Disability Index scoreat 1-year was 56.4% and overall visual analogue scale was 55.9%.Mean increase of 155.2% was documented over pre-operative maximum walking distance. Radiological assessment revealed a 40.7% increase in the mean and anteroposteriordiameter of the spinal canal at the level of the target lesion. The improvement in various parameters was statistically significant (p<0.001). Conclusion: Lumbar spinous process-splitting laminectomy led to significant improvement with respect to patient-reported perceived recovery, functional disability and radiological evidence of effective surgical decompression in patients with lumbar spinal stenosis. © 2018, Pakistan Medical Association. All rights reserved.
Index Keywords
adult, anterior posterior axis, Article, backache, bleeding, computer assisted tomography, female, follow up, hospitalization, human, intermittent claudication, laminectomy, leg pain, length of stay, lumbar spinal stenosis, major clinical study, male, maximum walking distance, middle aged, nuclear magnetic resonance imaging, observational study, Oswestry Disability Index, pain, prospective study, radiodiagnosis, scoliosis, urine incontinence, vertebral canal, visual analog scale, aged, decompression surgery, diagnostic imaging, laminectomy, lumbar vertebra, procedures, radiography, treatment outcome, vertebral canal stenosis, very elderly; Adult, Aged, Aged, 80 and over, Decompression, Surgical, Female, Follow-Up Studies, Humans, Laminectomy, Lumbar Vertebrae, Magnetic Resonance Imaging, Male, Middle Aged, Prospective Studies, Radiography, Spinal Stenosis, Treatment Outcome
ISSN: 00309982
CODEN: JPKMA
PubMed ID: 30410142
Document Type: Article
Publication Stage: Final
Source: Scopus
14. Is a Unilateral Surgical Approach Effective in Patients with Bilateral Leg Pain with Unilateral Lumbar Disc Herniation? A Prospective Nonrandomized Clinical and Surgical Study
(2018) World Neurosurgery, 117, pp. e316-e322. Cited 1 time.
I Dogan, M Bozkurt, G Kahilogullari, F Yakar, M Zaimoglu, B Bakirarar
DOI: 10.1016/j.wneu.2018.06.022
Abstract
Objective: To examine the surgical results of unilateral lumbar discectomy in patients with bilateral leg pain and discuss short- and long-term outcomes within the limits of lumbar decompression. Methods: We analyzed 60 patients with unilateral disc herniation who underwent unilateral lumbar discectomy and hemipartial laminectomy between 2014 and 2017. Group 1 (30 patients) had bilateral leg pain and unilateral lumbar disc herniation. Pain lateralization was determined radiologically. Group 2 (30 patients) had unilateral leg pain and unilateral lumbar disc herniation. Pain scores were preoperatively evaluated with visual analog scale (VAS) for both legs and Oswestry Disability Index (ODI) for overall life quality. In both groups, surgery was performed on the ipsilateral side of the herniated disc. Scores were repeated on postoperative day 1 and 1, 3, 6, 12, and 24 months later. VAS score differences for pain lateralization and disc levels were compared in group 1. ODI score differences were compared between both groups. Results were statistically analyzed. Results: VAS score differences were statistically significant at all follow-up time points in patients with ipsilateral and contralateral pain. VAS score differences between L4–L5 and L5–S1 level discopathies were statistically insignificant for all time points in both groups. All postoperative ODI score decreases for all time points were statistically significant (P < 0.001) for both groups, whereas the differences between groups 1 and 2 were statistically insignificant. Conclusions: Conventional lumbar disc surgery alone is sufficient for the ipsilateral side of radiologically demonstrated disc herniation in patients with bilateral leg pain. © 2018 Elsevier Inc.
Index Keywords
antibiotic agent; adult, Article, clinical effectiveness, clinical evaluation, controlled study, dermatome, discectomy, female, follow up, foraminotomy, hospital admission, human, hypesthesia, intervertebral disk degeneration, laminectomy, leg pain, long term care, lumbar disk hernia, major clinical study, male, medical history, neurologic examination, Oswestry Disability Index, outcome assessment, pain assessment, postoperative care, preoperative care, prospective study, quality of life, radicular pain, short course therapy, surgical approach, time to treatment, unilateral lumbar discectomy, visual analog scale, aged, case report, discectomy, intervertebral disk hernia, lumbar vertebra, middle aged, musculoskeletal pain, procedures, treatment outcome; Adult, Aged, Diskectomy, Female, Humans, Intervertebral Disc Displacement, Laminectomy, Lumbar Vertebrae, Male, Middle Aged, Musculoskeletal Pain, Prospective Studies, Treatment Outcome
ISSN: 18788750
PubMed ID: 29906582
Document Type: Article
Publication Stage: Final
Source: Scopus
15. Surgical Management of Supratentorial Intracerebral Hemorrhages: Endoscopic Versus Open Surgery
(2018) World Neurosurgery, 114, pp. e60-e65. Cited 12 times.
U Eroglu, G Kahilogullari, I Dogan, F Yakar, ESM Al-Beyati, O Ozgural,
DOI: 10.1016/j.wneu.2018.02.056
Abstract
Objective: Intracerebral hemorrhage continues to be a major global problem. No standard treatment or surgical procedure has been identified for intracerebral hemorrhages. High morbidity and mortality rates caused by conventional approaches and the disease itself have necessitated more-invasive treatment methods. The endoscopic approach is a more minimally invasive method than craniotomy, which is another alternative surgical treatment. Methods: We compared intracerebral hematoma drainage in 2 groups of 17 patients each, treated with minimally invasive endoscopic method versus craniotomy. All the patients were treated for supratentorial spontaneous hemorrhage between December 2013 and February 2017 at the Neurosurgery Clinic of Ankara University Faculty of Medicine. Results: We retrospectively evaluated 34 patients surgically treated between December 2013 and February 2017. All patients underwent surgery within the first 24 hours. Patients in the early surgery group had better surgical outcomes. In the neuroendoscopic group, Glasgow Coma Scale increased from 6 to 11 at 1 week postoperatively compared with 5 to 9 in the craniotomy group. Conclusions: Minimally invasive endoscopic hematoma evacuation may be a good alternative surgical method for treating supratentorial spontaneous cerebral hematomas. © 2018 Elsevier Inc.
Index Keywords
adult, Article, brain hemorrhage, clinical article, clinical outcome, craniotomy, endoscopic surgery, female, Glasgow coma scale, human, intermethod comparison, male, medical record review, middle aged, open surgery, postoperative period, retrospective study, aged, brain hemorrhage, craniotomy, hematoma, neuroendoscopy, procedures, treatment outcome; Adult, Aged, Cerebral Hemorrhage, Craniotomy, Drainage, Female, Glasgow Coma Scale, Hematoma, Humans, Male, Middle Aged, Neuroendoscopy, Retrospective Studies, Treatment Outcome
ISSN: 18788750
PubMed ID: 29567287
Document Type: Article
Publication Stage: Final
Source: Scopus
16. Effect of Riluzole on Spinal Cord Regeneration with Hemisection Method Before Injury
(2018) World Neurosurgery, 114, pp. e247-e253. Cited 3 times.
YS Caglar, A Demirel, I Dogan, R Huseynov, U Eroglu, O Ozgural
DOI: 10.1016/j.wneu.2018.02.171
Abstract
Objective: The pathophysiology of spinal cord injury (SCI) with the information obtained to date has not been elucidated fully. A safe drug or treatment protocol that results in cell regeneration for SCI remains unknown. Neuroprotective and neuroregenerative effects of riluzole, administered after a SCI, have been shown in experimental studies. This study aimed to investigate the effect of riluzole on neural regeneration in a rat SCI model. Methods: Thirty-two rats were divided into 8 groups, with 4 rats in each group. Hemisection method was performed after T7–T9 laminectomy. Rats were intraperitoneally aministered with riluzole (6 mg/kg). Locomotor recovery of the rats was assessed at 1 day, and 1, 2, 3, and 4 weeks after the 21-point Basso, Beattie, and Bresnahan test. Subsequently, the spinal cords of the rats were scored according to a semiquantitative grading system using a light microscope, and the numbers of myelinated axons, neurons, and glial cells were calculated. Results: Basso, Beattie, and Bresnahan test changes were statistically significant when groups 4–6 and 8 were compared with the other groups (P < 0.05, P < 0.00625). The results of the numbers of neurons, glial cells, and myelinated axons were statistically significant. Especially group 8, in which riluzole was administered 5 days before injury, more positive clinical and histopathologic results were obtained. Conclusions: Riluzole treatment is more effective when provided before injury. Riluzole may contribute to functional recovery when used in the preoperative period in patients who are at a high risk for permanent neurologic deficit. © 2018 Elsevier Inc.
Index Keywords
riluzole, neuroprotective agent, riluzole; adult, animal cell, animal experiment, animal model, animal tissue, Article, axon, blood brain barrier, comparative study, controlled study, glia cell, histopathology, laminectomy, male, myelinated nerve, nerve regeneration, neuroprotection, nonhuman, preoperative period, rat, spinal cord hemisection, spinal cord injury, spinal cord regeneration, surgical patient, treatment duration, animal, convalescence, disease model, dose response, drug administration, drug effect, locomotion, myelin sheath, physiology, severity of illness index, spinal cord injury, Wistar rat; Animals, Disease Models, Animal, Dose-Response Relationship, Drug, Drug Administration Schedule, Laminectomy, Locomotion, Male, Myelin Sheath, Nerve Regeneration, Neuroprotective Agents, Rats, Rats, Wistar, Recovery of Function, Riluzole, Severity of Illness Index, Spinal Cord Injuries
ISSN: 18788750
PubMed ID: 29530700
Document Type: Article
Publication Stage: Final
Source: Scopus
17. Gross Total Resection of Chordoid Glioma of the Third Ventricle via Anterior Interhemispheric Transcallosal Transforaminal Approach at Two Stages
(2018) Journal of Neurological Surgery, Part B: Skull Base, 79, . Cited 2 times.
I Dogan, M Ucer, MK Başkaya
DOI: 10.1055/s-0038-1625967
Abstract
Suprasellar tumors in particular tumors located in the retrochiasmatic area and anterior third ventricle are challenging cases in terms of optimal surgical exposure. Several approaches have been described including transsylvian, translamina terminalis, endoscopic endonasal, and anterior interhemispheric. Each approach has advantages and disadvantages. In this video, we present a case of retrochiasmatic anterior third ventricular tumor that was operated via anterior interhemispheric transcallosal transforaminal approach. The patient is a 42-year-old female who presented with sudden onset of severe headache and depressed level of consciousness. Computed tomography (CT) scan of the head showed a hemorrhage in the third ventricle and suprasellar cisterns. CT angiogram and magnetic resonance imaging (MRI) confirmed diagnosis of hemorrhagic mass lesion in the third ventricle. Upon further questioning of her family, we found out that she was having excessive urination and short-term memory problems for last 2 weeks. First, ventriculostomy was placed for obstructive hydrocephalus. She then underwent surgical resection via anterior interhemispheric transcallosal transforaminal approach. Foramen of Monro was enlarged by performing transchoroidal dissection. Using transforaminal route, tumor was resected. Due to the narrow surgical corridor and high vascularity of the tumor, decision was made to come back at a second stage. Using same surgical approach, in the second stage, gross total resection was performed. Postoperative MRI confirmed gross total resection. Histopathology was chordoid glioma of the third ventricle. She made excellent recovery with persistent diabetes insipidus. Currently, she is completing radiation therapy. In this video, we demonstrate techniques and pitfalls of anterior interhemispheric transcallosal approach to anterior third ventricular tumor. The link to the video can be found at: https://youtu.be/CI5c6Zup8sY . Copyright © 2017, Georg Thieme Verlag KG. All rights reserved.
ISSN: 2193634X
Document Type: Article
Publication Stage: Article in Press
Source: Scopus
Access Type: Open Access
18. Facial nerve outcome and extent of resection in cystic versus solid vestibular schwannomas in radiosurgery era
(2018) Neurosurgical Focus, 44 (3), art. no. E3, . Cited 5 times.
PE Ocak, I Dogan, U Ocak, C Dinc, S Gubbels, M Pyle, MK Baskaya
DOI: 10.3171/2017.12.FOCUS17667
Abstract
OBJECTIVE Cystic vestibular schwannomas (CVSs) are a subgroup of vestibular schwannomas (VSs) that are reported to be associated with unpredictable clinical behavior and unfavorable postoperative outcomes. The authors aimed to review their experience with microsurgical treatment of CVSs in terms of extent of resection and postoperative facial nerve (FN) function and compare these outcomes with those of their solid counterparts. METHODS Two hundred-eleven VS patients were treated surgically between 2006 and 2017. Tumors were defined as cystic when preoperative neuroimaging demonstrated cyst formation that was confirmed by intraoperative findings. Solid VS (SVSs) with similar classes were used for comparison. Clinical data of the patients were reviewed retrospectively, including clinical notes and images, as well as operative, pathology, and neuroradiology reports. RESULTS Thirty-two patients (20 males and 12 females) with a mean age of 52.2 years (range 17-77 years) underwent microsurgical resection of 33 CVSs (mean size 3.6 cm, range 1.5-5 cm). Forty-nine patients (26 males and 23 females) with a mean age of 49.9 years (range 21-75 years) underwent microsurgical resection of 49 SVSs (mean size 3 cm, range 2-4.5 cm). All operations were performed via either a retrosigmoid or a translabyrinthine approach. Gross-total resection was achieved in 30 cases in the CVS group (90.9%) and 37 in the SVS group (75.5%). The main reason for subtotal and near-total resection was adherence of the tumor to the brainstem and/or FN in both groups. None of the patients with subtotal or near-total resection in the CVS group demonstrated symptomatic regrowth of the tumor during the mean follow-up period of 41.6 months (range 18-82 months). The FN was anatomically preserved in all patients in both groups. Good FN outcomes were achieved in 15 of CVS (grade I-II; 45.5%) and 35 of SVS (71.4%) surgeries at discharge. Good and fair FN functions were noted in 22 (grade I-II; 81.5%) and 5 (grade III only; 18.5%) of the CVS patients, respectively, at the 1-year follow-up; none of the patients showed poor FN function. CONCLUSIONS Surgery of CVSs does not necessarily result in poor outcomes in terms of the extent of resection and FN function. Special care should be exercised to preserve anatomical continuity of the FN during surgery, since longterm FN function outcomes are much more satisfactory than short-term results. High rates of gross-total resection and good FN outcomes in our study may also suggest that microsurgery stands as the treatment of choice in select cases of large CVSs and SVSs in the era of radiosurgery. © AANS 2018.
Index Keywords
acoustic neuroma, adolescent, adult, aged, comparative study, cyst, diagnostic imaging, facial nerve, female, human, male, microsurgery, middle aged, neurosurgery, procedures, radiosurgery, retrospective study, treatment outcome, tumor volume, young adult; Adolescent, Adult, Aged, Cysts, Facial Nerve, Female, Humans, Male, Microsurgery, Middle Aged, Neuroma, Acoustic, Neurosurgical Procedures, Radiosurgery, Retrospective Studies, Treatment Outcome, Tumor Burden, Young Adult
ISSN: 10920684
PubMed ID: 29490554
Document Type: Article
Publication Stage: Final
Source: Scopus
Access Type: Open Access
19. Microsurgical Resection of Tuberculum Sellae Meningioma via Pterional Craniotomy with Extradural Anterior Clinoidectomy and Optic Unroofing
(2018) Journal of Neurological Surgery, Part B: Skull Base, 79 (2), . Cited 3 times.
I Dogan, M Ucer, MK Başkaya
DOI: 10.1055/s-0037-1620254
Abstract
Microsurgical treatment of suprasellar tumors, in particular tuberculum sellae meningiomas, poses significant challenge. These tumors are surrounded by vital neurovascular structures, such as optic apparatus, pituitary stalk, internal carotid artery and its branches, and anterior cerebral arteries. In large and complex cases, early identification and decompression of these structures may facilitate safer dissection and resection. Therefore, extradural anterior clinoidectomy with optic unroofing facilitates the internal carotid artery exposure and optic nerve decompression. In this video, we describe a 37-year-old female patient who presented with new onset of severe headaches. On visual examination, she was found to have bitemporal visual defects. MRI scan of the head showed a large, approximately 3 cm suprasellar tumor consistent with tuberculum sellae meningioma. She underwent surgical resection via pterional craniotomy with extradural anterior clinoidectomy and optic unroofing. Microsurgical gross total resection was achieved and histopathology was WHO grade II meningioma. She had an uneventful postoperative course and visual field examination improved significantly. In this video, surgical technique in performing extradural anterior clinoidectomy and optic unroofing and steps of microsurgical resection are demonstrated. The link to the video can be found at: https://youtu.be/oPZ8NTyvxJc . Copyright © 2017, Georg Thieme Verlag KG. All rights reserved.
ISSN: 2193634X
Document Type: Article
Publication Stage: Article in Press
Source: Scopus
Access Type: Open Access
20. Usefulness and radiological evaluation of accuracy of the innovative "smart" hand technique for pedicle screw placement: An anatomical study
(2018) Turkish Neurosurgery, 28 (6), pp. 866-876.
A COMERT, I DOGAN, YS CAGLAR
DOI: 10.5137/1019-5149.JTN.21391-17.1
Abstract
AIM: To use a smartphone application (app) during pedicle screw placement navigation and examine the accuracy of this application on an anatomical dry vertebrae model. MATERIAL and METHODS: Seventy-six dry vertebrae were used for this study, and pedicle entry points and projections of pedicle screw trajectory lines in the lateral and superior aspects of the vertebral body were identified and drawn for each vertebra bilaterally. In each position, all angulations were measured directly before the procedure manually. One hundred and fifty two pedicle screws were inserted as a simulation of screw placement with the guidance of the angle-meter smart app. Accuracy of the method was tested according to the occurrence of bone penetration while the angular deviation of the inserted screws was evaluated in computed tomography images. RESULTS: The mean deviation for 76 pedicle screws on the right side was 2.30 ° ± 1.78° in the horizontal plane and 2.17 ° ± 1.57° in the sagittal plane; and on the left side, 3.01 ° ± 1.83° in the horizontal plane and 2.38 ° ± 1.68° in the sagittal plane. No bone penetration occurred during 152 pedicle screw placements. According to the t-test results, there were significant differences between the two groups in the craniocaudal direction of the right side pedicle screws and in the craniocaudal direction of left sided pedicle screws. CONCLUSION: The free smartphone app presented here as an angle-meter is a safe digital device for spinal instrumentation procedures. As a prototype of future pedicle screw fixation systems, it should be improved in terms of its feasibility and compatibility with screw probes. This may lead to a useful mobile digital angle-meter for spinal procedures. © 2018 Turkish Neurosurgical Society.
Index Keywords
anatomic model, cervical vertebra, human, mobile application, pedicle screw, procedures, spine fusion, surgery; Cervical Vertebrae, Humans, Mobile Applications, Models, Anatomic, Pedicle Screws, Spinal Fusion
ISSN: 10195149
CODEN: TUNEE
PubMed ID: 29204980
Document Type: Article
Publication Stage: Final
Source: Scopus
Access Type: Open Access
21. Fatal rupture of dissecting anterior inferior cerebellar artery aneurysm as an unexpected complication after anterior skull base surgery: A case report
(2018) Turkish Neurosurgery, 28 (4), pp. 675-677.
ESM Al-Beyati, I Dogan, A Unlu, M Bozkurt
DOI: 10.5137/1019-5149.JTN.18758-16.0
Abstract
Aneurysm of the anterior inferior cerebellar artery (AICA) is a very rare entity, and the manifestation and manipulation of such aneurysms remain contentious. In this paper, we report a case where a successful surgery for an olfactory groove meningioma was performed and the patient discharged, but re-admitted to hospital with loss of consciousness and subsequently passed away three hours after re-admission. The patient was diagnosed with subarachnoid hemorrhage. The cause of the fatal subarachnoid hemorrhage was rupture of a new onset AICA dissecting aneurysm which had provided neither clinical nor radiological signs before the operation. We discuss the possible causes of the formation of such aneurysm. © 2018 Turkish Neurosurgical Society.
ISSN: 10195149
CODEN: TUNEE
PubMed ID: 27858381
Document Type: Article
Publication Stage: Final
Source: Scopus
Access Type: Open Access
22. Transcranial endoscopic treatment of thalamic neuroepithelial cyst: case report and review of the literature
(2018) British Journal of Neurosurgery, . Article in Press.
O Ozgural, I Dogan, S Solmaz, T Morali Guler, G Kahilogullari
DOI: 10.1080/02688697.2018.1552753
Abstract
Thalamic neuroepithelial cysts are rare, benign lesions. Thirteen cases have been published in eight articles. The most frequent symptoms are headache, hemiparesis, tremor and related signs of hydrocephalus such as gait disturbance, confusion, and Paranaud’s syndrome. Surgical interventions include endoscopic fenestration, open surgery and stereotaxic biopsy or aspiration. We report a case of a 63-year-old woman who had headache and right hemiparesis for 1 week, but no hydrocephalus. We treated her with transcranial neuronavigation-guided endoscopic complete resection. The patient recovered completely after cyst removal. © 2019, © 2019 The Neurosurgical Foundation.
ISSN: 02688697
CODEN: BJNEE
Document Type: Article in Press
Publication Stage: Article in Press
Source: Scopus
23. Assessing aneurysm obliteration and neck remnants in 225 clipped aneurysms using indocyanine green video angiography, micro-doppler ultrasonography and postoperative digital subtraction angiography
(2018) Turkish Neurosurgery, 28 (6), pp. 970-978. Cited 2 times.
M Bozkurt, O Ozgural, G Kahilogullari, U Eroglu, I Dogan, H Sekmen
DOI: 10.5137/1019-5149.JTN.21878-17.2
Abstract
AIM: To present our experience of 225 clipped aneurysms in 196 patients to compare indocyanine green video angiography (ICGVA), micro-Doppler ultrasonography (MDUSG), and postoperative digital subtraction angiography (DSA) in terms of determining aneurysm obliteration, neck remnants, and parent artery patency. MATERIAL and METHODS: This retrospective study included 196 patients (108 female and 88 male patients) treated between 2013 and 2016. In all cases, aneurysm neck remnants and vessel patency were assessed using ICG-VA and 16-Hz MDUSG. DSA was performed in every case postoperatively within the first 5 days. RESULTS: The mean patient age was 55.8 years (range, 31-80 years), and the mean follow-up duration was 25 months (range, 2-48 months). Of the 225 clipped aneurysms, 86 were located in the anterior cerebral artery and its branches, 103 in the bifurcation of the middle cerebral artery (MCA) and the branches of the MCA, 34 in the internal cerebral artery and its branches, 1 in the posterior inferior cerebellar artery, and 1 at the basilar apex. We observed 2 neck remnants (0.8%), 2 parent/perforating artery occlusions (0.8%), and 2 residual aneurysm fillings (0.8%). There were no striking differences among the assessed methods. CONCLUSION: ICG-VA, MDUSG, and dome puncturing are all useful techniques in aneurysm surgery for assessing complete obliteration of the aneurysm. In our experience, all the 3 tools are complementary to each other, and none of them is superior to the others. We recommend the use of all 3 tools to obtain a favorable outcome. © 2018 Turkish Neurosurgical Society.
Index Keywords
indocyanine green; adult, aged, brain angiography, devices, diagnostic imaging, digital subtraction angiography, Doppler ultrasonography, female, human, intracranial aneurysm, male, middle aged, postoperative period, procedures, retrospective study, surgical equipment, vascular surgery, very elderly; Adult, Aged, Aged, 80 and over, Angiography, Digital Subtraction, Cerebral Angiography, Female, Humans, Indocyanine Green, Intracranial Aneurysm, Male, Middle Aged, Postoperative Period, Retrospective Studies, Surgical Instruments, Ultrasonography, Doppler, Vascular Surgical Procedures
ISSN: 10195149
CODEN: TUNEE
PubMed ID: 29634081
Document Type: Article
Publication Stage: Final
Source: Scopus
Access Type: Open Access
24. Visualization of superficial cerebral lesions using a smartphone application
(2018) Turkish Neurosurgery, 28 (3), pp. 349-355. Cited 1 time.
I Dogan, U Eroglu, O Ozgural, ESM Al-Beyati, MC Kilinc, A Comert
DOI: 10.5137/1019-5149.JTN.20509-17.1
Abstract
AIM: Accurate localizations of cerebral lesions ensure good surgical outcomes and minimize intraoperative complications. Currently, microscope-integrated neuronavigation systems compensate these requirements. Since these units are expensive and large, the need to create more practical and portable systems in this "smart" century has become apparent. MATERIAL and METHODS: The See-Through Camera smartphone application (app) is a photography app that penetrates the existing background picture and merges this with a camera image on the smartphone display. This app was applied to neurosurgery for visualization of the projection of the tumors over head in 20 patients. App accuracy was tested according to neuronavigation system. RESULTS: Precision of the app was evaluated according to the superposition ratio of the tumor image drawn by the navigation system with the tumor picture on the smartphone display. This ratio was 40%-100% in 16 (80%) patients and below 40% as an unfavorable result in the rest of the patients. CONCLUSION: Basic rationality of this app can provide the basis of future pocket navigation systems in terms of its design and principles. © 2017, Turkish Neurosurgical Society.
Index Keywords
adult, brain tumor, child, computer assisted diagnosis, female, human, male, middle aged, mobile application, neuronavigation, neurosurgery, preschool child, procedures, smartphone, young adult; Adult, Brain Neoplasms, Child, Child, Preschool, Female, Humans, Image Interpretation, Computer-Assisted, Male, Middle Aged, Mobile Applications, Neuronavigation, Neurosurgical Procedures, Smartphone, Young Adult
ISSN: 10195149
CODEN: TUNEE
PubMed ID: 29105725
Document Type: Article
Publication Stage: Final
Source: Scopus
Access Type: Open Access
25. Preoperative Exposure of Sigmoid Sinus Trajectory in Posterolateral Cranial Base Approaches Using a New Landmark Through a Neurosurgical Perspective
(2018) Journal of Craniofacial Surgery, 29 (1), pp. 220-225. Cited 2 times.
I Dogan, O Özgüral, Ü Eroglu, ESM Al-Beyati, CM Kilinç, A Cömert
DOI: 10.1097/SCS.0000000000004182
Abstract
The location of burr holes in posterolateral cranial base approaches should be appropriate to provide an adequate operative field, and surgical freedom is crucial for bone window opening. The aim of this study was to search for more convenient and easily detectable landmarks in comparison with current landmarks in posterolateral cranial base surgery. Twenty 3-dimensional reconstructed head and neck computed tomography angiography images (group 1) and 20 cadaver heads (group 2) were evaluated. An imaginary line connecting the angle of the mandible and the mastoid tip was extended upward. A second line passing through the lateral edge of the zygomatic arch was also extended posteriorly. The authors examined if the first line met with the sigmoid sinus throughout its course and determined the location of the intersection point of these 2 lines relative to the sigmoid-transverse sinus junction. The intersection point did not correspond to the sinus region in 3 images from group 1 and 4 specimens from group 2. The matching of the mandibula-mastoid line trajectory with the sigmoid sinus course was unacceptable in 4 images and 5 cadavers. For venous anatomy preservation and anatomic skull base fossa orientation during posterolateral cranial base approaches, upward extension of the mandibula-mastoid line can be a proper landmark for surgical planning in this region. The authors' proposed superficial anatomical line and intersection point over the skull could be used as a reliable indicator for the external projection of the sigmoid sinus and an appropriate initial burr-hole location. © Copyright 2017 by Mutaz B. Habal, MD.
Index Keywords
anatomic landmark, anatomy and histology, cadaver, computed tomographic angiography, cranial sinus, craniotomy, diagnostic imaging, human, mandible, mastoid, neurosurgery, skull base, surgery, three dimensional imaging, transverse sinus, zygoma; Anatomic Landmarks, Cadaver, Computed Tomography Angiography, Cranial Sinuses, Craniotomy, Humans, Imaging, Three-Dimensional, Mandible, Mastoid, Neurosur
(2018) Journal of Craniofacial Surgery, 29 (6), pp. e572-e578. Cited 3 times.
O Ozgural, G Kahilogullari, I Dogan, ESM Al-Beyati, M Bozkurt, B Tetik
DOI: 10.1097/SCS.0000000000004592
Abstract
This study aimed to report the authors’ single-center clinical experience about craniopharyngiomas and discuss surgical outcomes of these patients according to the type of surgical approach (endoscopic endonasal or open microscopic transcranial approach). Twenty-four patients diagnosed with craniopharyngiomas between May 2013 and April 2017 were considered for inclusion. The patients were divided into 2 groups according to the surgical approach (open transcranial microscopic approach [group A] and endoscopic endonasal approach [group B]). These groups were compared in terms of postoperative surgical outcome scores (extent of tumor removal, visual deficit, hydrocephalus, metabolic disorders, and Glasgow coma scale) and hospitalization interval. There was no patient of mortality in both groups. In this study, 4 of the 13 patients in group A and 9 of the 11 patients in group B underwent gross total resection. However, 1 patient in group B underwent repair because of cerebrospinal fluid leakage postoperatively. In addition, 1 patient in group A had a wound healing problem postoperatively. The postoperative outcome scores were 9.5 in group A and 11.5 in group B. The hospitalization interval in group A (range, 7 – 9 days) was longer than that in group B (range, 5 – 7 days). The endoscopic endonasal approach should be considered the first-line surgical treatment modality in patients with a preliminary diagnosis of craniopharyngioma in terms of low complication risk, minimal invasiveness, and better outcome scores. Open microscopic transcranial procedures may be combined with this approach in a single session for challenging cases. Copyright © 2018 by Mutaz B. Habal, MD.
Index Keywords
adolescent, adult, aged, child, craniopharyngioma, craniotomy, female, human, hypophysis tumor, male, microsurgery, middle aged, natural orifice transluminal endoscopic surgery, neurosurgery, nose, postoperative period, procedures, treatment outcome, x-ray computed tomography, young adult; Adolescent, Adult, Aged, Child, Craniopharyngioma, Craniotomy, Female, Humans, Male, Microsurgery, Middle Aged, Natural Orifice Endoscopic Surgery, Neurosurgical Procedures, Nose, Pituitary Neoplasms, Postoperative Period, Tomography, X-Ray Computed, Treatment Outcome, Young Adult
ISSN: 10492275
CODEN: JSURE
PubMed ID: 29863551
Document Type: Article
Publication Stage: Final
Source: Scopus
(2017) Neurosurgical focus, 43 (Video), p. V12. Cited 1 time.
I Dogan, PE Ocak, GM Pyle, MK Başkaya
DOI: 10.3171/2017.10.FocusVid.17379
Abstract
Surgical access to the petroclival region poses a challenge to neurosurgeons. A wide range of approaches has been demonstrated in the past. In this video, the authors present a 69-year-old male patient who presented with 3-month history of worsening left-sided numbness. The tumor was totally removed in 2 sessions via anterior transpetrosal and retrosigmoid approaches, respectively. The authors demonstrate 2 separate skull base approaches to resect a petroclival meningioma and discuss pitfalls and problems of management for challenging meningiomas. The authors suggest that surgical approaches to petroclival meningiomas should be selected based on an individual case. A skull base team should be versatile in performing all these approaches. The video can be found here: https://youtu.be/BCVrn3TeNvE .
Index Keywords
aged, case report, diagnostic imaging, human, male, meningioma, neurosurgery, nuclear magnetic resonance imaging, posterior fossa, procedures, skull base, skull base tumor, treatment outcome; Aged, Cranial Fossa, Posterior, Humans, Magnetic Resonance Imaging, Male, Meningeal Neoplasms, Meningioma, Neurosurgical Procedures, Skull Base, Skull Base Neoplasms, Treatment Outcome
ISSN: 10920684
PubMed ID: 28967312
Document Type: Article
Publication Stage: Final
Source: Scopus
Access Type: Open Access
28. Minimally invasive synchronous dual intervention in a penetrating spinal trauma
(2017) Turkish Journal of Thoracic and Cardiovascular Surgery, 25 (2), pp. 301-303.
M Özkan, İ Dogan, SMAB Eyyub, E Hamzayev, A Kayı Canbır
DOI: 10.5606/tgkdc.dergisi.2017.13400
Abstract
Penetrating spinal cord injuries towards the thoracic region may carry a high risk of additional vascular or organ injuries. In this article, we present a case of stab injury in the back, which was successfully treated via open laminectomy under thoracoscopy guidance by performing a minimally invasive method with a multidisciplinary approach. © 2017. Turkish Society of Cardiovascular Surgery.
ISSN: 13015680
Document Type: Article
Publication Stage: Final
Source: Scopus
Access Type: Open Access
(2017) Turkish Neurosurgery, 27 (4), pp. 573-584. Cited 2 times.
I DOGAN, G KAHILOGULLARI, H SEKMEN, U EROGLU, O OZGURAL
DOI: 10.5137/1019-5149.JTN.17229-16.0
Abstract
Aim: To report our clinical experience, surgical treatment algorithm and technique in the reconstruction of uncomplicated and small-size calvarial defects by performing autologous split-bone grafting technique on anatomical findings and patients' outcome. Material and Methods: We covered the defective calvarial zone without bone (area, 3.8 to 7.5 centimetersquare; median area 4.2 centimetersquare) following the resection of pathological skull region with an inner table of horizontally split adjacent skull site in thirty-six patients (aged between 28 and 125 months; median age, 68.75 months, minimum follow-up 14 months). The donor site, the characteristics of skin incision such as length, shape, location and bone splitting technique were determined based on our treatment algorithm for "8 cranioplasty". Pre- and postoperative clinical outcomes and courses as well as radiological results are documented. Results: Mean follow-up period for all children was 25 months. There was no mortality and 5.55% morbidity (n=2: 1 sterile wound dehiscence and 1 sterile wound discharge). No infected flap was seen and none of the patients required a second surgery. No graft failure, tumor recurrence or residue occurred. Conclusion: Almost all of our patients reported good surgical and clinical outcomes with this presented management and surgical algorithm. Autologous split bone grafting technique in small-size skull defects, with its proposed name "8 cranioplasty" is a safe and effective reconstructive procedure due to its short-term surgery, small-size surgical zone, low complication rate, good cosmetic results and cost effectiveness. In addition, our algorithm specified for this procedure is purposive and also saves the surgeon time in the surgical planning stage.
Index Keywords
algorithm, autotransplantation, bone transplantation, child, female, human, male, preschool child, procedures, reconstructive surgery, retrospective study, skull, surgery, surgical flaps; Algorithms, Bone Transplantation, Child, Child, Preschool, Female, Humans, Male, Reconstructive Surgical Procedures, Retrospective Studies, Skull, Surgical Flaps, Transplantation, Autologous
ISSN: 10195149
CODEN: TUNEE
PubMed ID: 27509459
Document Type: Article
Publication Stage: Final
Source: Scopus
Access Type: Open Access
(2015) Child's Nervous System, 31 (8), pp. 1407-1411. Cited 5 times.
Dogan I1, Kahilogullari G, Guner E
DOI: 10.1007/s00381-015-2728-0
Abstract
Background: Involvement of spine in patients with hydatid disease (HD) is less than 1 % and primary intra-spinal extradural HD is extremely rare. Although this disease is introduced as benign pathology according to its clinical presentation and biological behavior, intraoperative rupture of the cyst may aggravate the patients’ outcome in the long-term especially in pediatric patient population. Case presentation: We report a 9-year-old girl who presented a progressive neurological deterioration due to an enlargement of a ventrally located extradural hydatid cyst within the thoracic spinal canal. Total removal of the cyst was achieved by preserving the capsule integrity for preventing potential seeding. Our preoperative initial diagnosis based on the radiological findings was confirmed as cyst hydatid histopathologically. Conclusion: Cyst hydatid should be considered in the differential diagnosis of the presence of homogenous cystic lesions with regular shape inside the spinal canal especially in patients from endemic region. To our knowledge, this pediatric patient is the first case of cyst hydatid located ventral side of the spinal cord extradurally located inside the spinal canal showing no extension. © 2015, Springer-Verlag Berlin Heidelberg.
Index Keywords
albendazole; Article, backache, case report, cerebrospinal fluid, child, childhood disease, computer assisted tomography, differential diagnosis, disease duration, echinococcosis, emergency surgery, falling, feces incontinence, female, follow up, histopathology, human, laminectomy, limb weakness, medical history, mental deterioration, muscle strength, nuclear magnetic resonance imaging, paraplegia, paresthesia, physical disability, priority journal, school child, spinal cord compression, spinal cord cyst, spine radiography, thoracic spine, tumor volume, urine incontinence, vertebra body, walking, walking difficulty, echinococcosis, parasitology, procedures, Spinal Diseases; Child, Echinococcosis, Female, Humans, Laminectomy, Magnetic Resonance Imaging, Spinal Diseases
ISSN: 02567040
CODEN: CNSYE
PubMed ID: 25930726
Document Type: Article
Publication Stage: Final
Source: Scopus
(2013) Journal of Craniofacial Surgery, 24 (5), pp. 1815-1818. Cited 7 times.
HC Ugur, I Dogan, G Kahilogullari, ESM Al-Beyati, M Ozdemir, S Kayaci
DOI: 10.1097/SCS.0b013e3182997ff8
Abstract
Literature defines the landmarks to identify the courses and locations of the transverse and sigmoid sinuses on the outer surface of the skull and inner surface of the scalp. These natural landmarks may only be helpful after skin incision and are inadequate to determine the length and size of the skin incision. Still, there is a need to identify palpable landmarks easily to determine the ideal location to open the initial burr hole before an operation. Twenty-eight dried adult human skulls and 2 cadavers were evaluated. The zygomatic root, the inion, and the mastoid process were identified on the external, and the grooves for sigmoid and transverse sinuses, on the internal surfaces. The distances between the 3 landmarks and the midpoints, and the shortest distances of the midpoints to the border of the groove for sigmoid sinus and groove for transverse sinus were measured. Statistically significant differences were evaluated for both sides. Based on the measurements, the defined "artificial landmarks" can be considered safe points that involve no vascular structures and may be used to perform the initial burr hole during posterolateral approaches. Identification of the midpoints and palpation of the defined landmarks easily before the operation render the study feasible and practical unlike with natural landmarks. To avoid venous injury, the midpoints of mastoid-inion line and zygomatic root-inion line can be used safely in skin incision during posterior fossa approaches and craniotomy. Copyright © 2013 by Mutaz B. Habal, MD.
Index Keywords
adult, anatomic landmark, article, cadaver, cranial sinus, craniotomy, histology, human, in vitro study; Adult, Anatomic Landmarks, Cadaver, Cranial Sinuses, Craniotomy, Humans
ISSN: 10492275
CODEN: JSURE
PubMed ID: 24036786
Document Type: Article
Publication Stage: Final
Source: Scopus
(2020) World Neurosurgery
E Arık, H Dolgun, S Hanalioglu, OS Sahin, F Ucar, D Yazicioglu, I Dogan
Objective: Sleep disorders in intensive care units (ICU) after a craniotomy can decrease melatonin secretion and increase the inflammatory stress response. The aim of this study was to investigate the influence of improving sleep quality via eye patches and earplugs on melatonin secretion and inflammatory mediator release.Methods: The study enrolled 41 patients who underwent craniotomy. Patients were randomized into two groups. Group Intervention received a sleep-promoting intervention with eye patches and earplugs to provide light and noise isolation, while Group Control received standard care. Blood levels of C reactive protein (CRP) and interleukin 1(IL-1) and 6 (IL-6) along with urine levels of 6-sulphatoxymelatonin (aMT6) were measured preoperatively (baseline) and on postoperative days1 and 3. Sleep quality was assessed with the Richards-Campbell Sleep Questionnaire. Results: Sleep quality was higher in the intervention group (Richards-Campbell score:80.61±11.96 vs.33.50±16.32; p<0.001). Urine aMT6 levels increased significantly in the intervention group in spot urine samples from 10.15 (5.38-14.40) ng/ml at baseline to 14.52 (6.24-29.11) and 11.51 (7.88-29.05) ng/ml on postoperative days 1 and 3. They also increased in 24-hour urine samples from 25.73 (8.24-52.73) ng/ml at baseline to 35.38 (11.48-95.65) and 39.18 (2.36-125.23) ng/ml on postoperative days 1 and 3 (p=0.001 and p=0.005, respectively). The aMT6 concentration did not change significantly in the control group. The CRP concentrations increased postoperatively compared to baseline concentrations in both groups (p=0.001 and p<0.001). Conclusions: Melatonin secretion significantly increased as a result of improving postoperative sleep quality by noise and light isolation in neurosurgical ICU patients after craniotomy.
Key words:Melatonin, Interleukin, Cranial surgery, Intensive care
M Ulutas, K Çinar, I Dogan, M Secer, S Isik, K Aksoy
Journal of Neurosurgery 1 (aop), 1-12
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.
34. Subcutaneous schwannoma in the head region
U Eroglu, F Yakar, M Zaimoglu, E Sayaci, O Ozgural, İ Dogan, HC Ugur
Asian journal of neurosurgery 13 (1), 96
Schwannoma is a benign neural tumor derived from Schwann cells surrounding the nerves. It occurs primarily in subcutaneous tissues and muscles with a tendency for distal extremities, head, and neck area. Treatment of schwannoma is surgical excision. Lipomas are the most common soft-tissue lesions. A case is presented to increase awareness on differential diagnosis of head and neck subcutaneous masses.
Keywords: Head and neck tumor; schwannoma; subcutaneous mass.
35. Pure spinal extradural arteriovenous malformation in the thoracolombar region: a case report
F Yakar, Ü Eroğlu, İ Doğan, HÇ Uğur
The European Research Journal 5 (1), 213-216
Pure extradural spinal arteriovenous malformations (AVMs) are formed with an epidural artery, a nidus and an arterialized intradural vein in the absence of vertebral cavernous hemangioma and uncommon lesions. The most common extradural tumors are metastasis, lymphomas , benign tumors and malignant bony tumors. Herein, w e present a -29-year-old Turkish woman with pure extradural mass that histopathologically diagnosed as AVM . When an extradural spinal compressive mass is detected, neurosurgeons should consider on AVM in differential diagnosis and requirement of selective spinal angiography.
36. Trigeminal Schwannomas: Part II—Classification, Pathology, and Treatment
PE Ocak, U Ocak, I Dogan, MK Baskaya
Contemporary Neurosurgery 40 (2), 1-7
Learning Objectives:After participating in this CME activity, the neurosurgeon should be able to:
Describe the various types of trigeminal schwannomas.
Explain the treatment options for patients with trigeminal schwannomas.
Describe various surgical approaches for resection of trigeminal schwannomas with pros and cons of each procedure.
37. Sellar embryonal tumor: A case report and review of the literature
F Yakar, İ Doğan, C Meco, AO Heper, G Kahilogullari
Asian journal of neurosurgery 13 (4), 1197
Primitive neuroectodermal tumors (PNETs) are aggressive, poorly differentiated tumors in children and young adults. However, the embryonal tumor group did not include the central nervous system (CNS) PNET title and ependymoblastoma subtitle in the 2016 World Health Organization CNS tumor classification. Here, we report the case of a 6-year-old boy with a sellar embryonal tumor and present a review of the related literature. To the best of our knowledge, this is the first case of an endoscopically operated sellar embryonal tumor in the pediatric age group.
Uluslararası Dergilerde Yayınlanan (Diğer İndeksler) Bilimsel Makalelerim
1. Papillary tumor of the pineal region
M Zaimoglu, F Yakar, I Dogan, YS Caglar
International Surgery Journal 4 (12), 4076-4078
I Dogan, A Erdem, ESM Al-Beyati, O Ozgural
International Surgery Journal 4 (11), 3760-3764
F Yakar, I Dogan, O Ozgural, U Eroglu, S Beton, A Unlu
International Surgery Journal 4 (10), 3519-3522
F Yakar, I Dogan, E Ozyurek, O Ozgural, U Eroglu, M Bozkurt
International Surgery Journal 4 (10), 3507-3510
5. Epidural hematoma: postoperative complication
F Yakar, I Dogan, B Bahadır, MO Ozates, O Ozgural, A Attar, YS Caglar
International Surgery Journal 4 (6), 2058-2062
Ulusal Dergilerde Yayınlanan Makalelerim
İ Doğan, G Kahiloğulları, MA Ünlü
Van Medical Journal 23 (3), 263-268
O Özgüral, ESM Al-Beyati, B Shukuruyev, F Yakar, İ Doğan, Ü Eroğlu
Ankara Universites Tip Fakultesi Mecmuasi
3. Kraniovertebral Bileşkeye Transoral Yaklaşımlar
YŞ ÇAĞLAR, A DEMİREL, İ DOĞAN
Turkiye Klinikleri Neurosurgery-Special Topics 9 (3), 83-87
O Özgüral, O Mammadkhanli, İ Doğan, Ü Eroğlu, F Yakar, EY Sayacı
Ankara Universites Tip Fakultesi Mecmuası
5. Three Rare Localizations of Intracranial Dermoid Tumors
O Özgüral, O Mammadkhanlı, İ Doğan, Ü Eroğlu, AHOA Ünlü
Journal of Ankara University Faculty of Medicine 71 (2), 192-196
6. Perkütanöz Lomber Pediküler Vida Yerleştirilmesi
İ DOĞAN, A ATTAR
Turkiye Klinikleri Neurosurgery-Special Topics 7 (2), 205-208
7. Lomber Dejeneratif Disk Hastalıklarında İnstabilite
İ DOĞAN, A ATTAR
Turkiye Klinikleri Neurosurgery-Special Topics 5 (3), 56-62
8. Pineal Bölgeye Yaklaşımda Anatomik Temeller
M BÜYÜKTEPE, I DOĞAN Türk Nöroşirürji Dergisi
9. Suboksipital Orta Hat ve Retrosigmoid Yaklaşımda Anatomik Temeller
Murat BÜYÜKTEPE, İhsan DOĞAN
Ankara Üniversitesi Tıp Fakültesi, Nöroşirürji Anabilim Dalı, Ankara, Türkiye
Türk Nöroşirürji Dergisi
10. Nöroşirürji’de Yapay Zeka ve İnsan Zekası
ÖS ŞAHIN, M ÜÇER, B ÖZAYDIN, I DOĞAN
Türk Nöroşirürji Dergisi
11. Kalvaryal Kavernöz Hemanjiom: nadir görülen bir olgu
O Özgüral, ESM Al-Beyati, İ Doğan, Ü Eroğlu, S KUŞ, H Tuna
Ankara Universitesi Tip Fakultesi Mecmuası
12. Posterior fossa dura onarımında “iç kapak” yöntemi: Cerrahi teknik ve tek merkezli klinik tecrübemiz
İ Doğan
Ankara Universites Tip Fakultesi Mecmuası
13. Epilepsi Cerrahisinde Temporal Lobektomi ve Amigdalohipokampektomi Tekniği
B KAZANCI, YC ERBAŞ, RH NURHAT, İ DOĞAN, A ERDEM Türk Nöroşirürji Dergisi
H Özalp, O Özgüral, İ Doğan, M Bozkurt Ankara Tıp Fakültesi Mecmuası
15. Selective Amygdalohippocampectomy
İhsan Doğan, Atilla Erdem,Burak Kazancı Türk Nöroşirürji Dergisi
16. A Tuberous Sclerosis Case with Intractable Seizures: Case Report and Literature Review
YAKAR, F., EROĞLU, Ü., ÖZGÜRAL, O., DOĞAN, İ., UĞUR, H. and ÇAĞLAR, Ş., A Tuberous Sclerosis Case with Intractable Seizures: Case Report and Literature Review. Türk Nöroşirürji Dergisi
İ Doğan, M Bozkurt
Pamukkale Tıp Dergisi, 188-195
18. Ailesel Hiperlipidemi ve Aort Kapak Darlığı Nedenli Ameliyat Edilen, Ameliyat Sonrası Dönemde Ekstrakorporeal Membran Oksijenizasyon (Ecmo) Desteği Verilen Hastada Non-Travmatik Subdural Hematom Olgusu
Türk Nöroşirürji Dergisi
Yakar Fatih,BAHADIR BURAK,DOĞAN İHSAN, Kahiloğulları Gökmen
19. İntraserebral Hematomun Kanamış Distal Anterior Serebral Anevrizmalı Hastalardaki Prognostik Önemi
İhsan Doğan, Türk Nöroşirürji Dergisi