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    Angles of needle insertion for true vocal fold access via the thyrohyoid and cricothyroid membranes of the larynx
    (Elsevier, 2023) Sarı, Elif; Nteli Chatzioglou, Gkionoul; Temirbekov, Dastan; Aliyeva, Aynur; Gürses, İlke Ali
    Objective This study aims to provide an analysis of the cricothyroid and thyrohyoid membrane approaches for laryngeal injections in cadaveric vocal cords. The primary objective is to determine the optimal techniques, needle trajectories, and anatomical landmarks for accessing different regions of the vocal cords percutaneously. Materials and methods The study was conducted on 23 adult cadavers, consisting of 8 females and 15 males. The cadaveric larynges were mounted vertically to ensure proper anatomical positioning. Both the cricothyroid and thyrohyoid membrane approaches were utilized for reaching the vocal cords. Measurements were taken for needle trajectories, angles, and distances to determine the optimal approach for accessing the anterior, middle, and posterior thirds of the vocal cord. Results Through the thyrohyoid membrane approach, the anterior, middle, and posterior thirds of the vocal cords can be accessed with the optimal needle insertion coronal angles of 15.46 ± 7.86°, 16.52 ± 7.15° and 18.29 ± 14.46°, and sagittal angles of 126.01 ± 9.65°, 116.67 ± 8.04° and 111.02 ± 8.86° respectively at a lateral distance of 1.92 ± 1.62 mm from the midline and 8.48 ± 2.73 mm below the vertical line. From the cricothyroid membrane approach, optimal coronal and sagittal insertion angles of the anterior, middle, and posterior thirds of the vocal cord were respectively: 158.95 ± 9.3°, 156.09 ± 11.59°, 152.4 ± 14.46°, 11.5 ± 7.77°, 21.83 ± 12.47° and 32.91 ± 12.59°. Conclusion This analysis of the cricothyroid and thyrohyoid membrane approaches in cadaveric larynges provides valuable insights for clinicians and researchers in the field of laryngology. The findings serve as a reference for optimizing laryngeal injection techniques, enhancing patient outcomes, and minimizing complications.
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    The variations of osseous structure of the internal acoustic canal: an anatomical study
    (Brazilian Association of Otorhinolaryngology and Cervicofacial Surgery, 2024) Sarı, Elif; Nteli Chatzioglou, Gkionoul; Temirbekov, Dastan; Aliyeva, Aynur; Öztürk, Adnan; Gürses, İlke Ali
    Objectives: The internal acoustic meatus is an osseous canal that connects the inner ear to the posterior cranial fossa. It is located in the petrous portion of the temporal bone. A thin cribriform osseous plate known as the fundus is situated at the lateral end of the canal. This study assesses the structural and numerical variations of the fundus formations. Methods: Fifty-four temporal bones of unknown gender and age were examined with the surgical microscope. Results: The temporal bones analyzed were 46.2% right-sided and 53.7% left-sided. Only one temporal bone had two parallel transverse crests, while three had a single anterior crest that split into two branches posteriorly. The number of foramina at the transverse crest varied, with 29.6% having none, 48.1% having a single foramen, and 22.2% having several foramina. An anterior crest structure was seen in 53.7% of the temporal bones, with 5% having a slightly constricted entry to the facial canal. In cases with a single nerve foramen, 48.1% had one, while 51.8% had more than one, including examples with three or four foramina. A crest was found between the foramina of the single nerve in 7% of patients. Furthermore, a crest between the saccular nerve foramen and the high fiber foramina was seen in 25.9% of cases, and 5% had two saccular nerve foramina. Conclusion: We think that revealing the anatomical, structural and numerical variations in the fundus will be useful in explaining the disease-symptom relationship.