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    Computed Tomography Based Evaluation of the Anterior Group of the Paranasal Sinuses
    (2023) Yaprak, Fulya; Çoban, İstemihan; Sarıoğlu, Orkun; Özer, Mehmet Asim; Govsa, Figen
    Objective: The study aims to ascertain the prevalence of paranasal sinus variations among healthy adults in the Turkish population, as well as to analyze the symmetry of these variations. Methods: The CTIs of 200 adult patients who did not have any trauma, carcinoma, tumor, surgery, or a condition that could affect the paranasal anatomy, such as chronic rhinosinusitis, were included. The prevalences of the Agger nasi cell (ANC), supraorbital ethmoid cell (SOEC), Haller’s cell (HC), middle turbinate pneumatization, and frontal sinus (FS) agenesis variations in the adult Turkish population were revealed. Results: Bilateral SOECs were found 38.5% of 200 patients, and at least 53% of patients had SOECs on one side. In 21.5% of instances, LCs were observed on both sides; in 35% of instances, they were observed on at least one side. ANCs were observed bilaterally in 68.5% of the total, the rate of patients with ANC on at least one side was 84.5%. The rate of bilaterality of the HC was 24%, it was observed at least one side in 43% of the cases. Bilateral concha bullosa (CB) were observed in 19% while CB variation on at least one side was 42%. Bilateral absence of the FS was found to be 8.5%, and unilateral absence was 2.5%. Conclusion: The most common paranasal sinus variation was ANC, while the least was FS agenesis. Bilateral inheritance was found to be most prevalent in SOEC. The findings of our study hold significance for interventional procedures involving the paranasal region. Keywords: Paranasal sinuses; Anatomic variations; Paranasal sinus diseases; Conchae nasales; Frontal sinuses
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    Prespecialist perceptions of three-dimensional heart models in anatomical education
    (Springer France, 2023) Yaprak, Fulya; Özer, Mehmet Asim; Govsa, Figen; Cinkooğlu, Akın; Pınar, Yelda; Gökmen, Gökhan
    PurposeThis article aims to discuss the use of three-dimensional (3D) printed models of vascular variation cases as an educational tool for undergraduate and postgraduate anatomy students.MethodsThis advanced study involved ten anatomy assistants who were provided with five distinct cases of congenital cardiovascular variations, each accompanied by a computed tomography angiography (CT-A) and 1:1 solid model format. The residents were asked to generate perceptions for both formats and then compare these perceptions based on identifying the variation, defining the structural features, and evaluating relevant educational perspectives.ResultsThe vascular origin measurement values compared to the statistically evaluated real values of the related cases showed that models were 1:1 identical copies. Qualitative assessment feedback from five stations supported the usefulness of 3D models as educational tools for organ anatomy, simulation of variational structures, and overall medical education and anatomy training. Models showcasing different anatomical variations such as aortic arch with Type 2 pattern, a right-sided aortic arch with Type 2 pattern, an aberrant right subclavian artery, arteria lusoria in thorax, and a left coronary artery originating from pulmonary trunk in an Alcapa type pattern allow for better analysis due to their complex anatomies, thus optimizing the study of variation-specific anatomy. The perception level in the 3D model contained higher points in all of the nine parameters, namely identification of cardiovascular variations, defining the vessel with anomaly, aortic arch branch count and appearance order, feasibility of using it in peers and student education. 3D models received a score 9.1 points, while CT-A images were rated at 4.8 out of 10.Conclusion3D printed anatomical models of variational cardiovascular anatomy serve as essential components of anatomy training and postgraduate clinical perception by granting demonstrative feedback and a superior comprehension of the visuospatial relationship between the anatomical structures.
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    The Upper Attachment of the Uncinate Process and Anterior Ethmoidal Artery
    (Sage Publications Inc, 2023) Yaprak, Fulya; Çoban, İstemihan; Özer, Mehmet Asim; Eraslan, Cenk; Govsa, Figen
    Objective: Variations in the upper attachment of the uncinate process (UP) are important because they can affect frontal sinus drainage and change the morphology. Functional endoscopic sinus surgery (FESS) is the primary technique used to treat chronic medically refractory rhinosinusitis. Uncinectomy is the basis of FESS technique to obtain the best possible result from surgery. The anterior ethmoidal artery (AEA) enters the nasal cavity through the orbital medial wall (lamina papyracea) may also be affected by the upper attachment of the UP. The aim of this study was to investigate a possible link between UP variations and the course of the AEA. Materials and Methods: This retrospective, computed tomography (CT)-based, anatomic study was conducted on 200 healthy adults (100 females and 100 males) by screening bilateral paranasal sinus images. The upper attachment of the UP was classified in 6 types (1-6) based on the Liu classification. The AEA was divided into 4 types (A-D) based on location: anterior to the frontal sinus (A), between the frontal sinus and the middle nasal turbinate (B), and anterior to the posterior ethmoidal cells (C and D). All the CT images were evaluated simultaneously by 2 anatomists and 1 radiologist. Results: Of the total cases (200 right and 200 left side), 48.8% were type 1 UP attachment, 11.0% type 2, 12% type 3, 9% type 4, 18% type 5, and 1.2% type 6. The AEAs were classified as 12.2% type A, 71.8% type B, 15.2% type C, and 0.8% type D. Conclusion: The course of the AEA through the nasal cavity was observed to shift anteriorly from the ethmoidal bulla to the frontal sinus in patients with UP attached to the lamina papyracea and middle turbinate. Remarkably, the AEA always coursed anterior from the middle nasal turbinate line.