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    Duplication of the abducens nerve at the petroclival region: An anatomic study
    (Oxford Univ Press Inc, 2003) Ozveren, MF; Sam, B; Akdemir, I; Alkan, A; Tekdemir, I; Deda, H
    OBJECTIVE: During its course between the brainstem and the lateral rectus muscle, the abducens nerve usually travels forward as a single trunk, but it is not uncommon for the nerve to split into two branches. The objective of this study was to establish the incidence and the clinical importance of the duplication of the nerve. METHODS: The study was performed on 100 sides of 50 autopsy materials. In 10 of 11 cases of duplicated abducens nerve, colored latex was injected into the common carotid arteries and the internal jugular veins. The remaining case was used for histological examination. RESULTS: Four of 50 cases had duplicated abducens nerve bilaterally. In seven cases, the duplicated abducens nerve was unilateral. In 9 of these 15 specimens, the abducens nerve emerged from the brainstem as a single trunk, entered the subarachnoid space, split into two branches, merged again in the cavernous sinus, and innervated the lateral rectus muscle as a single trunk. In six specimens, conversely, the abducens nerve exited the pontomedullary sulcus as two separate radices but joined in the cavernous sinus to innervate the lateral rectus muscle. In 13 specimens, both branches of the nerve passed beneath the petrosphenoidal ligament. In two specimens, one of the branches passed under the ligament and the other passed over it. In one of these last two specimens, one branch passed over the petrosphenoidal ligament and the other through a bony canal formed by the petrous apex and the superolateral border of the clivus. in all of the specimens, both branches were wrapped by two layers: an inner layer made up of the arachnoid membrane and an outer layer composed of the dura during its course between their dural openings and the lateral wall of the cavernous segment of the internal carotid artery. This finding was also confirmed by histological examination in one specimen. CONCLUSION: Double abducens nerve is not a rare variation. Keeping,such variations in mind could spare us from injuring the Vlth cranial nerve during cranial base operations and transvenous endovascular interventions.
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    Examination of the skin perforators of the posterior tibial artery on the leg and the ankle region and their clinical use
    (Lippincott Williams & Wilkins, 2006) Ozdemir, R; Kocer, U; Sahin, B; Oruc, M; Kilinc, H; Tekdemir, I
    Background: There are many treatment alternatives for reconstruction of leg and foot defects. One of these treatment alternatives includes local flaps. A detailed understanding of the blood flow of the leg region is essential for producing new alternatives for the reconstruction of defects of this region. Methods: The leg and foot region blood flow was examined oil 11 fresh cadavers, and perforators of this region were examined in three zones. Perforator numbers and their diameters were defined at this region. It was determined in cadaver studies that especially zones I and II were more suitable for the planned flaps based oil perforators of the posterior tibial artery. In a clinical study that accompanies this anatomical study, eight patients underwent reconstruction by flaps based on the perforators of the posterior tibial artery. Results: Patients were followed for 3 to 14 months. In three patients, venous drainage problems had developed, and in one of them, partial flap loss had developed. This partially necrosed region was left to heal by secondary intention. Venous drainage problems resolved in 5 to 7 days in the two remaining patients. No other complications were seen. Conclusion: Regarding the results of the clinical study, the authors observed that this flap call provide the desired soft-tissue support for defects that expose the bones, tell dons, and neural and vascular bull dies.