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    ANALYSIS OF SPINE ALIGNMENT IN PATIENTS WITH LUMBAR POSTURAL ASYMMETRY USING PATIENT-FRIENDLY DIGITAL ANTHROPOMETRIC METHOD
    (Nobelmedicus, 2024) Duygu, Özden Bedre; Hepgüler, Simin; Govsa, Figen; Öztürk, Anıl Murat; Süer, Onur; Tamsel, İpek
    Objective: The frequent use of intense X-rays in the diagnosis and follow-up of adolescent scoliosis patients results in radiation exposure. This study aims to explore the viability of a patient-friendly digital anthropometry method as an auxiliary tool. It also evaluates the correlation between this digital method and the Cobb method in assessing lumbar scoliosis values. Material and Method: 100 scoliosis patients were examined using the digital anthropometric method with 17 anatomical parameters defined. Lumbar scoliosis degrees were also measured using the Cobb method based on radiological images. Result: The patients had a female to male ratio of 3:1, and 49% were diagnosed with lumbar scoliosis. The patient with the highest lumbar scoliosis displayed a 13.8 degree cervical lordosis angle, a 50.1 degree thoracic kyphosis angle, and a 26.4 degree lumbar lordosis angle. This lumbar lordosis angle was above the mean value. Conversely, the patient with the lowest lumbar scoliosis had a 12.9 degree cervical lordosis angle, a 53.81 degree thoracic kyphosis angle, and a 21.8 degree lumbar lordosis angle, with the latter being below the mean value. A significant positive correlation was observed between the lumbar lordosis angle obtained from the photoanthropometric analysis and the lumbar scoliosis degree measured using the Cobb method (r=0.902, p<0.001). Conclusion: Patient follow-up can be enhanced through the photo-anthropometric method, and due to its patientfriendly nature, it can be more integrally included in treatment programs. © 2024, Nobelmedicus. All rights reserved.
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    Exploring the lacrimal sac fossa: anatomical insights for optimizing external dacryocystorhinostomy
    (Springer France, 2025) Duygu, Ozden Bedre; Govsa, Figen; Pinar, Yelda; Oner, Zulal
    BackgroundExternal dacryocystorhinostomy is considered the gold standard for treating epiphora resulting from nasolacrimal duct obstruction. Despite the success of the procedure, a visible facial skin scar often undermines the surgical outcome. The aim of this study is to prevent visible facial scarring following oculoplastic interventions by improving the insight into the anatomical details of the lacrimal sac fossa (LSF), lacrimo-maxillary suture (LMS), periosteum, and lacrimal diaphragm.MethodsThe study examined the medial canthal region of eighty adult male sspecimens to investigate the landmarks associated with the LSF. The periorbital area was dissected to reveal the skin, subcutaneous tissues, orbicularis oculi muscles, and the lacrimal drainage system, all of which were detached from their bony attachments. The lengths of the lacrimal crests, midline length, midline width, dorsolateral angle, composition of the LMS, and area of the LSF were evaluated using the ImageJ program. The LSF was categorized into six distinct shapes: ellipsoid, oval, inverted pear, straight pear, oblique hammer, and quadrangular.ResultsThe measurements of the anterior lacrimal crest averaged 2.2 +/- 0.4 cm, the posterior edge 2.0 +/- 0.4 cm, and the midline 1.9 +/- 0.3 cm. The area of the LSF was found to be 1.4 +/- 0.5 cm(2). The analysis reveals that about half of the LSF consists of equal parts maxillary and lacrimal bones. The dorsolateral angle values where the maxilla and os lacrimale equally contributed to the structure of the LSF were higher than those completely formed by the maxilla. The shapes of the LSF were classified as ellipsoid (35%), oblique hammer (21.3%), oval (13.7%), inverted pear (15%), with the ellipsoid type being the most frequent. The anterior lacrimal crest length of the oval-shaped LSF was shorter than that of the oblique hammer-shaped LSF. Similarly, the posterior lacrimal crest of the oval-shaped LSF was shorter than that of the oblique hammer-shaped LSF. The midline length of ellipsoid, oval, and inverted pear-shaped LSFs was shorter than that of oblique hammer-shaped LSFs.ConclusionThe length of anterior lacrimal crest and LMS are suggested as the most reliable navigational references for locating the type of LSF. Mastery of the transversal and vertical orientation of the LSF is essential for surgeons performing oculoplastic surgeries tailored to individual anatomical variations. This study is clinically valuable as it underscores the necessity for oculoplastic surgeons to adapt surgical techniques in response to anatomical differences encountered during surgery.
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    Using Photogrammetry to Analyze Anatomical Changes in the Nipple in Juvenile and Adolescent Scoliosis Patients
    (Springer, 2024) Duygu, Ozden Bedre; Govsa, Figen; Bicer, Ahmet
    BackgroundThe need for an objective set of anterior trunk measurements, such as nipple and clavicular shoulder joints, is essential to quantify the anterior asymmetry present in scoliosis. This study aims to characterize breast asymmetry (BA) in young individuals with scoliosis using photogrammetry.MethodsDigital photographs of the anterior trunk of the 51 scoliosis patients aged 4-20 years were taken from an anterior perspective. These images were then transferred to a computer. Ten parameters were measured using the ImageJ software. The positions of patients' nipples were classified into 6 types based on ratios on the x-axis.ResultsThe majority of patients had a right breast that was larger, intensifying the apparent BA due to trunk rotation. The apical vertebra level in patients was found at T8 in 23.6% and T9 in 45.1%. In 92.5% of the patients, the right breast was consistently larger. The lengths between the lateral boundaries and nipples of the right and left breasts and between the medial boundary and nipple of the right breast were statistically significantly higher in males than in females (p<0.05). Significant differences were found when comparing the values of the lengths between the medial boundaries and nipples of the right and left breasts, the difference in length between the right and left acromioclavicular joint lines, and the angles of the nipple and acromioclavicular joint with the degrees of scoliosis in juvenile and adolescents (p<0.05). Pearson regression analysis revealed a significant correlation between BA differences and the Cobb angle with a correlation coefficient of 0.901. Factors related to breast aesthetics, like differences in the height of nipples and the distance from the sternal notch to the nipple, represent 30% of the overall score.ConclusionThe study concluded that there is a significant correlation between the severity of scoliosis and BA differences. Augmentation mammaplasty for BA not only decreased the breast difference but also leveled the nipple disparities. Photogrammetry is considered to be an alternative to other methods and is believed to contribute to the follow-up of BA.Level of Evidence IVThis journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.