{"id":7232,"date":"2026-05-05T13:28:05","date_gmt":"2026-05-05T13:28:05","guid":{"rendered":"https:\/\/kamranaghayev.com\/?p=7232"},"modified":"2026-11-03T16:10:39","modified_gmt":"2026-11-03T16:10:39","slug":"eagle-sendromu-torasik-outlet-sendromu","status":"publish","type":"post","link":"https:\/\/kamranaghayev.com\/tr\/eagle-sendromu-torasik-outlet-sendromu\/","title":{"rendered":"Eagle Sendromu Torasik Outlet Sendromuna Nas\u0131l Yol A\u00e7ar? 11. Kraniyal Sinir \u00dczerinden"},"content":{"rendered":"<p><strong>Eagle Sendromu<\/strong> en \u00e7ok bo\u011faz a\u011fr\u0131s\u0131yla bilinir. <a href=\"https:\/\/kamranaghayev.com\/tr\/juguler-ven-kompresyonu\/\"><strong>Stiloid kaynakl\u0131 juguler ven kompresyonu<\/strong><\/a> ise giderek daha fazla ba\u015f a\u011fr\u0131s\u0131, beyin sisi ve kafa i\u00e7i bas\u0131n\u00e7 art\u0131\u015f\u0131n\u0131n bir nedeni olarak tan\u0131n\u0131yor. G\u00f6zden ka\u00e7mas\u0131 kolay, daha nadir bir olas\u0131l\u0131k daha var: <strong>spinal aksesuar sinirin<\/strong> s\u0131k\u0131\u015fmas\u0131. Bu, omzu yukar\u0131da tutan b\u00fcy\u00fck kas olan trapeziusu zay\u0131flatabilir. Zay\u0131f, d\u00fc\u015f\u00fck omzu olan baz\u0131 hastalarda <strong><a href=\"https:\/\/kamranaghayev.com\/tr\/torasik-outlet-sendromu-nedir\/\">Torasik Outlet Sendromu<\/a> (TOS)<\/strong> belirtilerine benzeyen kol \u015fik\u00e2yetleri de geli\u015fir. \u0130kisinin belirli bir hastada ba\u011flant\u0131l\u0131 olup olmad\u0131\u011f\u0131 ancak de\u011ferlendirmeyle anla\u015f\u0131labilir.<\/p>\n<p>Spinal aksesuar sinire <strong>11. kraniyal sinir<\/strong> ya da <strong>CN XI<\/strong> da denir. Trapeziusu ve sternokleidomastoid kas\u0131 (boynun \u00f6n\u00fcndeki kay\u0131\u015f bi\u00e7imli kas) y\u00f6netir. Kafatas\u0131 taban\u0131ndan <strong>internal juguler venin<\/strong> yak\u0131n\u0131ndan iner ve nadir durumlarda stiloid \u00e7\u0131k\u0131nt\u0131 ile birinci omur aras\u0131ndaki dar alanda s\u0131k\u0131\u015fabilir.<\/p>\n<p>Trapezius zay\u0131flad\u0131\u011f\u0131nda omuz d\u00fc\u015febilir ve k\u00fcrek kemi\u011fi g\u00f6\u011f\u00fcs kafesinden ayr\u0131larak <strong>kanatlanabilir<\/strong>. D\u00fc\u015f\u00fck bir omzun, boyundan kola giden sinirler olan <strong>brakiyal pleksusu<\/strong> birinci kaburgan\u0131n \u00fczerinde gererek <strong>n\u00f6rojenik Torasik Outlet Sendromunun<\/strong> kar\u0131ncalanma, uyu\u015fma ve kol a\u011fr\u0131s\u0131na yol a\u00e7abilece\u011fi \u00f6ne s\u00fcr\u00fclm\u00fc\u015ft\u00fcr. Bu, birka\u00e7 hastada belgelenmi\u015f olas\u0131 bir mekanizmad\u0131r; herkeste izlenen bir s\u00fcre\u00e7 de\u011fildir.<\/p>\n<p>Kafatas\u0131 taban\u0131ndaki bir anatomik sorun \u2014 \u00f6rne\u011fin i\u00e7e do\u011fru e\u011fik bir <strong>stiloid \u00e7\u0131k\u0131nt\u0131<\/strong> (kafatas\u0131ndan, \u00e7enenin arkas\u0131ndan a\u015fa\u011f\u0131 sarkan ince, parmak bi\u00e7imli bir kemik), en \u00fcstteki omurun kal\u0131nla\u015fm\u0131\u015f kemik kanad\u0131 (<strong>C1 transvers \u00e7\u0131k\u0131nt\u0131s\u0131<\/strong>) ya da ikisi birden \u2014 daha s\u0131k nedenler d\u0131\u015fland\u0131ktan sonra akla getirilecek, aksesuar sinir g\u00fc\u00e7s\u00fczl\u00fc\u011f\u00fcn\u00fcn nadir nedenlerinden biridir.<\/p>\n<h2><strong>Eagle Sendromunun \u00dc\u00e7\u00fcnc\u00fc Y\u00fcz\u00fc<\/strong><\/h2>\n<p><strong>Eagle Sendromu<\/strong> anlat\u0131mlar\u0131n\u0131n \u00e7o\u011fu iki klinik tablodan s\u00f6z eder:<\/p>\n<ol>\n<li><strong>Klasik Eagle Sendromu<\/strong>: glossofaringeal sinirin ve bo\u011fazdaki di\u011fer sinirlerin tahri\u015fine ba\u011fl\u0131 bo\u011faz a\u011fr\u0131s\u0131, kulak a\u011fr\u0131s\u0131 ve yutma g\u00fc\u00e7l\u00fc\u011f\u00fc.<\/li>\n<li><strong>Vask\u00fcler Eagle Sendromu \/ <a href=\"https:\/\/kamranaghayev.com\/tr\/juguler-ven-kompresyonu\/\">stiloid kaynakl\u0131 juguler ven kompresyonu<\/a><\/strong>: internal juguler venin s\u0131k\u0131\u015fmas\u0131na ba\u011fl\u0131 ba\u015fta bas\u0131n\u00e7 hissi, ba\u015f a\u011fr\u0131s\u0131, pulsatil kulak \u00e7\u0131nlamas\u0131 ve beyin sisi.<\/li>\n<\/ol>\n<p>\u00dc\u00e7\u00fcnc\u00fc ve nadir tablo <strong>spinal aksesuar sinir (CN XI) felcidir<\/strong>. 2023&#8217;te Mitchell ve arkada\u015flar\u0131 bu sorunu olan iki hastay\u0131 tan\u0131mlad\u0131 ve trapezius erirken k\u00fcrek kemi\u011finin kanatlanmas\u0131ndan dolay\u0131 buna <strong>&#8220;kanatl\u0131&#8221; Eagle Sendromu<\/strong> ad\u0131n\u0131 verdi. <sup><a href=\"#footnote_1_7232\" id=\"identifier_1_7232\" class=\"footnote-link footnote-identifier-link\" title=\"Mitchell EC, Wu K, Yoo J, Ross DC, Miller TA, Siddiqi F (2023). &ldquo;Winged&rdquo; Eagle&rsquo;s syndrome: neurophysiological findings in a rare cause of spinal accessory nerve palsy. Illustrative cases. J Neurosurg Case Lessons, 6(24):CASE23358. PMID: 38079628\">1<\/a><\/sup> Raporlar\u0131ndaki iki hastada ilerleyici omuz g\u00fc\u00e7s\u00fczl\u00fc\u011f\u00fc, <strong>lateral skapular kanatlanma<\/strong> ve trapezius atrofisi vard\u0131; g\u00f6r\u00fcnt\u00fcleme, kafatas\u0131 taban\u0131nda <strong>atlanto-stiloid aral\u0131kta<\/strong> spinal aksesuar sinir s\u0131k\u0131\u015fmas\u0131n\u0131 g\u00f6sterdi. \u0130kisi de <strong>sinir dekompresyonuyla birlikte stiloidektomi<\/strong> \u2014 stiloid \u00e7\u0131k\u0131nt\u0131n\u0131n cerrahi olarak al\u0131nmas\u0131 ve s\u0131k\u0131\u015fan sinirin serbestle\u015ftirilmesi \u2014 sonras\u0131nda d\u00fczeldi. Rapor sinir felcini ve tedavisini anlat\u0131yor. Bu hastalarda torasik outlet sendromu ya da standart bir ameliyat s\u0131ralamas\u0131 bildirmiyor.<\/p>\n<h2><strong>Eagle Sendromunun N\u00f6rolojik Belirtileri: Genel Bak\u0131\u015f<\/strong><\/h2>\n<p>Eagle Sendromu kafatas\u0131 taban\u0131nda birka\u00e7 farkl\u0131 siniri s\u0131k\u0131\u015ft\u0131rabilir ya da tahri\u015f edebilir ve her biri kendine \u00f6zg\u00fc belirtiler verir:<\/p>\n<ul>\n<li><strong>Glossofaringeal sinir (CN IX)<\/strong>: bo\u011faz a\u011fr\u0131s\u0131, kulak a\u011fr\u0131s\u0131, yutma g\u00fc\u00e7l\u00fc\u011f\u00fc.<\/li>\n<li><strong>Vagus siniri (CN X)<\/strong>: belirsiz g\u00f6\u011f\u00fcs rahats\u0131zl\u0131\u011f\u0131, \u00e7arp\u0131nt\u0131, kar\u0131n belirtileri.<\/li>\n<li><strong>Sempatik zincir<\/strong>: y\u00fcz a\u011fr\u0131s\u0131, g\u00f6z a\u011fr\u0131s\u0131, yans\u0131yan a\u011fr\u0131.<\/li>\n<li><strong>Spinal aksesuar sinir (CN XI)<\/strong>: bu yaz\u0131n\u0131n konusu. Trapezius g\u00fc\u00e7s\u00fczl\u00fc\u011f\u00fc, omuz d\u00fc\u015f\u00fckl\u00fc\u011f\u00fc, skapular kanatlanma ve bunlar\u0131n ard\u0131ndan gelen Torasik Outlet Sendromu.<\/li>\n<\/ul>\n<p>Eagle Sendromunun t\u00fcm bu tablolarda sinirleri ve belirtileri nas\u0131l etkiledi\u011fine dair geni\u015f resim i\u00e7in <a href=\"https:\/\/kamranaghayev.com\/tr\/eagle-sendromu\/\"><strong>Eagle Sendromu: Ayr\u0131nt\u0131l\u0131 \u0130nceleme<\/strong><\/a> sayfas\u0131na bak\u0131n. Bu yaz\u0131 \u00f6zellikle CN XI s\u0131k\u0131\u015fmas\u0131n\u0131n ba\u015flatt\u0131\u011f\u0131 zincire odaklan\u0131yor, \u00e7\u00fcnk\u00fc en az tan\u0131nan ve hastay\u0131 en s\u0131k yanl\u0131\u015f tetkik yoluna sokan tablo bu.<\/p>\n<h2><strong>Spinal Aksesuar Sinir Neden Kafatas\u0131 Taban\u0131nda S\u0131k\u0131\u015f\u0131r?<\/strong><\/h2>\n<p><strong>Atlanto-stiloid aral\u0131k<\/strong>, stiloid \u00e7\u0131k\u0131nt\u0131 ile birinci boyun omurunun (C1, atlas) transvers \u00e7\u0131k\u0131nt\u0131s\u0131 aras\u0131ndaki dar koridordur. Stiloid i\u00e7e do\u011fru C1&#8217;e yasland\u0131\u011f\u0131nda bu koridor kemikten bir f\u0131nd\u0131kk\u0131raca\u011fa d\u00f6n\u00fc\u015f\u00fcr.<\/p>\n<p>Beyinden kan\u0131 bo\u015faltan ana damar olan internal juguler ven bu koridordan ge\u00e7er. Spinal aksesuar sinir de buradan ge\u00e7er ve ikisi kafatas\u0131 taban\u0131ndaki juguler delikten a\u015fa\u011f\u0131 inerken venin etraf\u0131n\u0131 dolan\u0131r.<\/p>\n<p>Roberts ve Cardozo&#8217;nun 2024&#8217;te yapt\u0131\u011f\u0131 ayr\u0131nt\u0131l\u0131 kadavra \u00e7al\u0131\u015fmas\u0131 \u00e7arp\u0131c\u0131 bir \u015fey g\u00f6sterdi: insanlar\u0131n <strong>%56\u201396&#8217;s\u0131nda<\/strong> CN XI, kafatas\u0131ndan a\u015fa\u011f\u0131 inerken internal juguler venin <em>\u00f6n\u00fcnden<\/em> \u00e7aprazlan\u0131r. \u0130nsanlar\u0131n yakla\u015f\u0131k <strong>%2,8&#8217;inde<\/strong> sinir, <em>venin duvar\u0131ndaki bir delikten<\/em> (fenestrasyon) ge\u00e7er. Nadir vakalarda (yakla\u015f\u0131k %0,4) ven iki dala ayr\u0131l\u0131r ve sinir bu dallar\u0131n aras\u0131ndan ge\u00e7er <sup><a href=\"#footnote_2_7232\" id=\"identifier_2_7232\" class=\"footnote-link footnote-identifier-link\" title=\"Roberts SO, Cardozo A (2024). A detailed review of the spinal accessory nerve and its anatomical variations with cadaveric illustration. Anat Sci Int, 99(3):239&ndash;253. doi:10.1007\/s12565-024-00770-w. PMID: 38696101\">2<\/a><\/sup>.<\/p>\n<p>Bu d\u00fczenlemeler, sinir ile veni C1 d\u00fczeyinde birbirine yak\u0131n konumland\u0131r\u0131r ve sinirin seyri ki\u015fiden ki\u015fiye de\u011fi\u015fir. <strong>Yak\u0131n olmalar\u0131, birinin s\u0131k\u0131\u015fmas\u0131n\u0131n her zaman di\u011ferini de s\u0131k\u0131\u015ft\u0131raca\u011f\u0131 anlam\u0131na gelmez.<\/strong> Her birinin ayr\u0131 de\u011ferlendirilmesi gerekir.<\/p>\n<p>Bu b\u00f6lgeden ge\u00e7en di\u011fer alt kraniyal sinirler, yani glossofaringeal (CN IX), vagus (CN X) ve hipoglossal (CN XII) sinirler, venle bu kadar yak\u0131n bir ili\u015fki kurmaz ve genellikle etkilenmez. \u0130nternal karotis arter ise <strong>stiloidin i\u00e7 taraf\u0131nda<\/strong>, ayr\u0131 bir b\u00f6lmede durur ve bu mekanizmadan da etkilenmez.<\/p>\n<p>Baz\u0131 anatomistler, sinirin ven duvar\u0131ndaki bir a\u00e7\u0131kl\u0131ktan ge\u00e7ti\u011fi nadir d\u00fczenlemelerin, siniri kafatas\u0131 taban\u0131ndaki daralmaya kar\u015f\u0131 daha a\u00e7\u0131k b\u0131rakabilece\u011fini \u00f6ne s\u00fcrm\u00fc\u015ft\u00fcr. Bu, hastalarda \u00f6l\u00e7\u00fclm\u00fc\u015f de\u011fildir.<\/p>\n<h2><strong>&#8220;Normal&#8221; Bir Stiloid Neden Yine de Siniri S\u0131k\u0131\u015ft\u0131rabilir?<\/strong><\/h2>\n<figure><img fetchpriority=\"high\" decoding=\"async\" width=\"800\" height=\"450\" src=\"https:\/\/kamranaghayev.com\/wp-content\/uploads\/2026\/05\/styloid-process.webp\" alt=\"Kafatas\u0131 taban\u0131ndan inen stiloid \u00e7\u0131k\u0131nt\u0131 ve C1 omuru\" \/><figcaption><em>Stiloid \u00e7\u0131k\u0131nt\u0131: kafatas\u0131 taban\u0131ndan, \u00e7enenin hemen arkas\u0131ndan a\u015fa\u011f\u0131 inen ince bir kemik. C1 omuruyla olan <strong>ili\u015fkisinin<\/strong>, yaln\u0131zca uzunlu\u011fundan daha \u00f6nemli oldu\u011fu d\u00fc\u015f\u00fcn\u00fclmektedir.<\/em><\/figcaption><\/figure>\n<p>Bu, <a href=\"https:\/\/kamranaghayev.com\/tr\/juguler-ven-kompresyonu\/\">Juguler Ven Kompresyonu<\/a> yaz\u0131s\u0131ndaki kritik bak\u0131\u015f de\u011fi\u015fikli\u011finin ayn\u0131s\u0131: <strong>bunlar\u0131n olmas\u0131 i\u00e7in stiloidin uzun olmas\u0131 gerekmez.<\/strong><\/p>\n<p>Mitchell&#8217;in ilk vaka raporlar\u0131ndan birinde stiloid yaln\u0131zca 2,2 cm&#8217;ydi, yani normal s\u0131n\u0131rlar i\u00e7indeydi. Ama <strong>koronal d\u00fczlemde<\/strong> 31 derece a\u00e7\u0131l\u0131yd\u0131 (i\u00e7e do\u011fru, C1&#8217;e e\u011fikti) ve atlanto-stiloid koridor yaln\u0131zca <strong>1,5 mm&#8217;ye<\/strong> kadar daralm\u0131\u015ft\u0131 <sup><a href=\"#footnote_1_7232\" id=\"identifier_3_7232\" class=\"footnote-link footnote-identifier-link\" title=\"Mitchell EC, Wu K, Yoo J, Ross DC, Miller TA, Siddiqi F (2023). &ldquo;Winged&rdquo; Eagle&rsquo;s syndrome: neurophysiological findings in a rare cause of spinal accessory nerve palsy. Illustrative cases. J Neurosurg Case Lessons, 6(24):CASE23358. PMID: 38079628\">1<\/a><\/sup>.<\/p>\n<p>\u00d6nemli olan stiloid uzunlu\u011fu de\u011fil, <strong>stiloid ile C1 transvers \u00e7\u0131k\u0131nt\u0131s\u0131 aras\u0131ndaki ili\u015fkidir<\/strong>. <strong>Bu hasta grubu i\u00e7in stilo-atlantal sendrom, klasik Eagle Sendromundan daha do\u011fru bir terimdir.<\/strong> \u00d6ne s\u00fcr\u00fclen mekanizma, <a href=\"https:\/\/kamranaghayev.com\/tr\/juguler-ven-kompresyonu\/\">stiloid kaynakl\u0131 juguler ven kompresyonuna<\/a> yol a\u00e7abilen daralman\u0131n ayn\u0131s\u0131d\u0131r. \u0130kisi birlikte g\u00f6r\u00fclebilir, ama biri di\u011ferinin varl\u0131\u011f\u0131n\u0131 kan\u0131tlamaz.<\/p>\n<p>Bu sorundan \u015f\u00fcphelenildi\u011fi i\u00e7in kafatas\u0131 taban\u0131 BT&#8217;si \u00e7ekildi\u011finde, stiloidin uzunlu\u011funun yan\u0131 s\u0131ra a\u00e7\u0131s\u0131n\u0131n ve C1&#8217;e olan mesafesinin de raporlanmas\u0131 faydal\u0131d\u0131r. Sinir s\u0131k\u0131\u015fmas\u0131n\u0131 do\u011frulayan ya da d\u0131\u015flayan, \u00fczerinde uzla\u015f\u0131lm\u0131\u015f bir mesafe yoktur.<\/p>\n<h2><strong>Spinal Aksesuar Sinir Felci: CN XI Ne Yapar ve Bozuldu\u011funu Neden Fark Etmeyebilirsiniz?<\/strong><\/h2>\n<p>11. kraniyal sinir <strong>esas olarak bir motor sinirdir<\/strong>. \u0130ki kas\u0131 y\u00f6netir:<\/p>\n<ul>\n<li><strong>Trapeziusu<\/strong> y\u00f6netir. Trapezius, kafatas\u0131n\u0131n arkas\u0131ndan ba\u015flay\u0131p omzun \u00fcst\u00fcnden ge\u00e7erek s\u0131rt\u0131n \u00fcst k\u0131sm\u0131na inen b\u00fcy\u00fck, u\u00e7urtma bi\u00e7imli kast\u0131r. K\u00fcrek kemi\u011fini yer \u00e7ekimine kar\u015f\u0131 yukar\u0131da tutar, omuz silkti\u011finizde omzu kald\u0131r\u0131r ve kolunuzu kald\u0131r\u0131rken k\u00fcrek kemi\u011fini sabitler.<\/li>\n<li><strong>Sternokleidomastoid kas\u0131 (SKM)<\/strong> y\u00f6netir. Bu, boynun \u00f6n\u00fcndeki ve ba\u015f\u0131 kar\u015f\u0131 tarafa \u00e7eviren kay\u0131\u015f bi\u00e7imli kast\u0131r.<\/li>\n<\/ul>\n<p>Aksesuar sinir sorunlar\u0131 \u00e7o\u011fu zaman a\u011fr\u0131l\u0131d\u0131r: geni\u015f bir cerrahi seride hastalar\u0131n \u00e7o\u011fu a\u011fr\u0131l\u0131 omuz i\u015flev kayb\u0131 nedeniyle sevk edilmi\u015fti. <sup><a href=\"#footnote_3_7232\" id=\"identifier_4_7232\" class=\"footnote-link footnote-identifier-link\" title=\"Camp SJ, Birch R (2011). Injuries to the spinal accessory nerve: a lesson to surgeons. J Bone Joint Surg Br, 93(1):62&ndash;67. PMID: 21196545\">3<\/a><\/sup> Anatomik \u00e7al\u0131\u015fmalar da sinirde a\u011fr\u0131 ileten lifler tan\u0131mlar. <sup><a href=\"#footnote_2_7232\" id=\"identifier_5_7232\" class=\"footnote-link footnote-identifier-link\" title=\"Roberts SO, Cardozo A (2024). A detailed review of the spinal accessory nerve and its anatomical variations with cadaveric illustration. Anat Sci Int, 99(3):239&ndash;253. doi:10.1007\/s12565-024-00770-w. PMID: 38696101\">2<\/a><\/sup> Yine de g\u00fc\u00e7s\u00fczl\u00fck, kas sinir deste\u011fini kaybettik\u00e7e \u2014 doktorlar\u0131n <strong>denervasyon<\/strong> dedi\u011fi s\u00fcre\u00e7 \u2014 yava\u015f yava\u015f ve az a\u011fr\u0131yla da geli\u015febilir. Omuz yava\u015f yava\u015f d\u00fc\u015fer. Bir\u00e7ok hasta bunu ilk kez eski foto\u011fraflarda fark eder: y\u0131llara yay\u0131lan aile foto\u011fraflar\u0131nda bir omuz di\u011ferinden a\u015fa\u011f\u0131dad\u0131r ve bu fark zamanla belirginle\u015fir.<\/p>\n<p>Spinal aksesuar sinir felcini sinsi yapan da budur. Eagle Sendromunun klasik bo\u011faz a\u011fr\u0131s\u0131 kendini y\u00fcksek sesle belli eder. Juguler ven kompresyonu ba\u015f bas\u0131nc\u0131yla kendini g\u00f6sterir. Aksesuar sinir g\u00fc\u00e7s\u00fczl\u00fc\u011f\u00fc ise fark edilmeden ilerleyebilir.<\/p>\n<h2><strong>Zincirleme S\u00fcre\u00e7: Kafatas\u0131 Taban\u0131ndan Parmaklara<\/strong><\/h2>\n<p><strong>\u00d6ne s\u00fcr\u00fclen mekanizma, tek c\u00fcmleyle:<\/strong> kafatas\u0131 taban\u0131ndaki bir sorun omzu yukar\u0131da tutan kas\u0131 zay\u0131flat\u0131r; omuz sarkar; ve ele giden sinirler birinci kaburgan\u0131n \u00fczerinde gerilebilir.<\/p>\n<p>Spinal aksesuar sinir atlanto-stiloid aral\u0131kta s\u0131k\u0131\u015ft\u0131\u011f\u0131nda ayn\u0131 s\u00fcre\u00e7 ad\u0131m ad\u0131m \u015f\u00f6yle i\u015fler:<\/p>\n<ol>\n<li><strong>Stilo-atlantal s\u0131k\u0131\u015fma.<\/strong> Stiloid \u00e7\u0131k\u0131nt\u0131 C1&#8217;e bask\u0131 yapar ve atlanto-stiloid koridoru daralt\u0131r.<\/li>\n<li><strong>CN XI s\u0131k\u0131\u015f\u0131r<\/strong>; kemikten f\u0131nd\u0131kk\u0131racak ile internal juguler venin aras\u0131nda kal\u0131r.<\/li>\n<li><strong>Trapezius ve SKM sinir deste\u011fini kaybeder (denervasyon).<\/strong> Kaslar zay\u0131flamaya ve k\u00fc\u00e7\u00fclmeye ba\u015flar.<\/li>\n<li><strong>Omuz deste\u011fini kaybeder<\/strong>; doktorlar buna <strong>omuz ku\u015fa\u011f\u0131 ask\u0131s\u0131n\u0131n kayb\u0131<\/strong> der. Trapezius art\u0131k k\u00f6pr\u00fcc\u00fck kemi\u011fini ve k\u00fcrek kemi\u011fini yer \u00e7ekimine kar\u015f\u0131 yukar\u0131da tutamaz.<\/li>\n<li><strong>Omuz d\u00fc\u015f\u00fckl\u00fc\u011f\u00fc geli\u015fir.<\/strong> K\u00f6pr\u00fcc\u00fck kemi\u011finin \u00fcst\u00fcndeki \u00e7ukur (<strong>supraklavik\u00fcler fossa<\/strong>) g\u00f6zle g\u00f6r\u00fcl\u00fcr bi\u00e7imde derinle\u015fir. K\u00fcrek kemi\u011fi d\u0131\u015fa do\u011fru e\u011filir; doktorlar buna <strong>lateral skapular kanatlanma<\/strong> der.<\/li>\n<li><strong>K\u00f6pr\u00fcc\u00fck kemi\u011fi ile birinci kaburga aras\u0131ndaki aral\u0131k, yani kostoklavik\u00fcler aral\u0131k daral\u0131r<\/strong>, \u00e7\u00fcnk\u00fc k\u00f6pr\u00fcc\u00fck kemi\u011fi a\u015fa\u011f\u0131 iner.<\/li>\n<li><strong>Brakiyal pleksus gerilir<\/strong>; doktorlar buna <strong>brakiyal pleksus traksiyonu<\/strong> der. Bu sinirlerin en alttaki dallar\u0131, yani ser\u00e7e parma\u011fa, y\u00fcz\u00fck parma\u011f\u0131na ve \u00f6nkolun i\u00e7 y\u00fcz\u00fcne giden <strong>alt trunkus<\/strong> (C8\u2013T1), bir kenar\u0131n \u00fczerinde gerilen bir halat gibi birinci kaburgan\u0131n \u00fczerinden a\u015fa\u011f\u0131 \u00e7ekilir.<\/li>\n<li><strong>\u0130kincil Torasik Outlet Sendromu.<\/strong> Kolun i\u00e7 y\u00fcz\u00fc boyunca ve elin ser\u00e7e parma\u011f\u0131-y\u00fcz\u00fck parma\u011f\u0131 taraf\u0131nda a\u011fr\u0131, kar\u0131ncalanma ve uyu\u015fma (t\u0131bbi ad\u0131yla <strong>parestezi<\/strong>); doktorlar bu b\u00f6lgeye <strong>medial kol ve ulnar parmaklar<\/strong> der. Belirtiler kol ba\u015f \u00fcst\u00fcne kald\u0131r\u0131ld\u0131\u011f\u0131nda artar.<\/li>\n<\/ol>\n<p>Tek tek ad\u0131mlar farkl\u0131 hastalarda ve farkl\u0131 \u00e7al\u0131\u015fmalarda bildirilmi\u015ftir. <strong>Hi\u00e7bir \u00e7al\u0131\u015fma, kafatas\u0131 taban\u0131ndan ele kadar t\u00fcm zinciri tek bir hasta grubunda izlememi\u015ftir<\/strong>; bu nedenle bu, kan\u0131tlanm\u0131\u015f bir yol de\u011fil, her ki\u015fide s\u0131nanmas\u0131 gereken bir hipotezdir. \u00d6zellikle k\u00fcrek kemi\u011fi kanatlanmas\u0131n\u0131n, en s\u0131k uzun torasik sinir sorunu olmak \u00fczere ba\u015fka nedenleri de vard\u0131r ve kendi ba\u015f\u0131na de\u011ferlendirilmelidir.<\/p>\n<h2><strong>Trapezius G\u00fc\u00e7s\u00fczl\u00fc\u011f\u00fc, Skapular Kanatlanma ve Omuz D\u00fc\u015f\u00fckl\u00fc\u011f\u00fc: G\u00f6r\u00fcnen Belirtiler<\/strong><\/h2>\n<p>Bunlar, doktoru kol belirtilerini tek ba\u015f\u0131na tedavi etmek yerine yukar\u0131ya, kafatas\u0131 taban\u0131na bakmaya y\u00f6neltmesi gereken belirtilerdir.<\/p>\n<h3><strong>Trapezius G\u00fc\u00e7s\u00fczl\u00fc\u011f\u00fc ve Atrofisi<\/strong><\/h3>\n<p>Trapezius yava\u015f ve asimetrik bi\u00e7imde erir. Etkilenen tarafta k\u00f6pr\u00fcc\u00fck kemi\u011finin \u00fcst\u00fcndeki kas kitlesi di\u011fer taraftan g\u00f6zle g\u00f6r\u00fcl\u00fcr bi\u00e7imde daha k\u00fc\u00e7\u00fck ya da daha d\u00fcz g\u00f6r\u00fcn\u00fcr. K\u00f6pr\u00fcc\u00fck kemi\u011finin \u00fcst\u00fcndeki \u00e7ukur (supraklavik\u00fcler fossa) daha derindir. Dirence kar\u015f\u0131 iki omzunuzu birden silkti\u011finizde \u00f6nce etkilenen taraf g\u00fc\u00e7ten d\u00fc\u015fer.<\/p>\n<p>Bir\u00e7ok hasta bunu aylar ya da y\u0131llar i\u00e7inde aynada fark etti\u011fini anlat\u0131r. Baz\u0131lar\u0131na fizyoterapistleri ya da masaj terapistleri &#8220;bir taraftaki trapezin farkl\u0131&#8221; oldu\u011funu s\u00f6yler. Birka\u00e7\u0131 ancak bir arkada\u015f\u0131 ya da aile \u00fcyesi eski bir foto\u011fraf\u0131 g\u00f6sterdikten sonra tan\u0131 al\u0131r.<\/p>\n<h3><strong>Skapular Kanatlanma<\/strong><\/h3>\n<p><strong>Skapular kanatlanma<\/strong>, k\u00fcrek kemi\u011finin g\u00f6\u011f\u00fcs kafesinin arkas\u0131nda d\u00fcz kaymak yerine kafesten kalkmas\u0131 demektir. Birka\u00e7 kanatlanma tipi vard\u0131r ve tan\u0131 i\u00e7in hangi tip oldu\u011fu \u00f6nemlidir.<\/p>\n<p>CN XI felcinin yol a\u00e7t\u0131\u011f\u0131 tipe <strong>lateral skapular kanatlanma<\/strong> denir: k\u00fcrek kemi\u011fi <em>d\u0131\u015fa ve a\u015fa\u011f\u0131<\/em> do\u011fru e\u011filir ve bu en \u00e7ok kolunuzu \u00f6ne ya da yana kald\u0131rd\u0131\u011f\u0131n\u0131zda g\u00f6r\u00fcl\u00fcr. (Bu, uzun torasik sinir hasar\u0131n\u0131n yol a\u00e7t\u0131\u011f\u0131 ve duvara yaslan\u0131p itti\u011finizde k\u00fcrek kemi\u011finin omurgaya do\u011fru \u00e7\u0131kt\u0131\u011f\u0131 daha tan\u0131d\u0131k <em>medial<\/em> kanatlanmadan farkl\u0131d\u0131r.)<\/p>\n<p>Skapular kanatlanma fark edilmi\u015f ama nedeni bulunamam\u0131\u015fsa, muayene ve sinir testleri hangi kas\u0131n zay\u0131f oldu\u011funu g\u00f6sterebilir. D\u00fc\u015f\u00fck omuzla birlikte lateral kanatlanma trapeziusu ve sinirini d\u00fc\u015f\u00fcnd\u00fcr\u00fcr. Bu durumda bile boyun ameliyat\u0131 ya da yaralanma, kafatas\u0131 taban\u0131ndaki s\u0131k\u0131\u015fmadan \u00e7ok daha s\u0131k bir nedendir. <a href=\"https:\/\/kamranaghayev.com\/tr\/kanatli-skapula\/\">Kanatl\u0131 skapula rehberimiz<\/a> nedenlerin ve tedavilerin geni\u015f yelpazesini anlat\u0131yor.<\/p>\n<h3><strong>Omuz D\u00fc\u015f\u00fckl\u00fc\u011f\u00fc ve Sark\u0131k Omuz Sendromu<\/strong><\/h3>\n<p>Trapezius omuz ku\u015fa\u011f\u0131n\u0131 art\u0131k yukar\u0131da tutamad\u0131\u011f\u0131nda omuz yava\u015f yava\u015f a\u015fa\u011f\u0131 iner. Bir omuz di\u011ferinden g\u00f6zle g\u00f6r\u00fcl\u00fcr bi\u00e7imde a\u015fa\u011f\u0131da durur. A\u011f\u0131r vakalarda k\u00f6pr\u00fcc\u00fck kemi\u011fi al\u0131\u015f\u0131lmad\u0131k bir a\u00e7\u0131yla birinci kaburgaya do\u011fru e\u011fimlenir.<\/p>\n<p>1984&#8217;te Swift ve Nichols bu tabloyu <strong>Sark\u0131k Omuz Sendromu<\/strong> olarak tan\u0131mlad\u0131: servikal kaburga, skalen anomalisi ya da ba\u015fka belirgin bir mekanik neden olmadan, yaln\u0131zca kronik omuz d\u00fc\u015f\u00fckl\u00fc\u011f\u00fcnden kaynaklanan bir Torasik Outlet Sendromu bi\u00e7imi. <sup><a href=\"#footnote_4_7232\" id=\"identifier_6_7232\" class=\"footnote-link footnote-identifier-link\" title=\"Swift TR, Nichols FT (1984). The droopy shoulder syndrome. Neurology, 34(2):212&ndash;215. PMID: 6538012\">4<\/a><\/sup> 2024 tarihli bir olgu sunumu, sark\u0131k omzu torasik outlet sendromuna a\u00e7\u0131lan olas\u0131 bir <strong>kap\u0131<\/strong> olarak tan\u0131mlad\u0131; omzun erken tedavisi kol belirtilerini hafifletebilir. <sup><a href=\"#footnote_5_7232\" id=\"identifier_7_7232\" class=\"footnote-link footnote-identifier-link\" title=\"Lokman B, Aymane A, Yachaoui S, El Oumri AA (2024). Droopy shoulder syndrome: a gateway to thoracic outlet syndrome. Cureus, 16(6):e62213. doi:10.7759\/cureus.62213. PMID: 39006624\">5<\/a><\/sup> Bu tek bir hastan\u0131n raporudur; erken tedavinin TOS&#8217;u \u00f6nledi\u011finin kan\u0131t\u0131 de\u011fildir.<\/p>\n<p>D\u00fc\u015f\u00fckl\u00fck <strong>kafatas\u0131 taban\u0131ndaki spinal aksesuar sinir g\u00fc\u00e7s\u00fczl\u00fc\u011f\u00fcnden<\/strong> kaynaklan\u0131yorsa, ayn\u0131 zincir ilke olarak ge\u00e7erli olabilir. Bu, bir hasta serisinde g\u00f6sterilmi\u015f de\u011fildir.<\/p>\n<h2><strong>Omuz D\u00fc\u015f\u00fckl\u00fc\u011f\u00fcnden TOS&#8217;a: Neler Bildirildi<\/strong><\/h2>\n<p>Aksesuar sinir yaralanmas\u0131 ile Torasik Outlet Sendromu aras\u0131ndaki ba\u011flant\u0131 onlarca y\u0131ll\u0131k bir konudur. Bilinenlerin \u00e7o\u011fu farkl\u0131 bir durumdan gelir: boyun ameliyat\u0131 s\u0131ras\u0131nda CN XI&#8217;nin istemeden yaralanmas\u0131. <strong>Kafatas\u0131 taban\u0131ndaki kronik s\u0131k\u0131\u015fman\u0131n ayn\u0131 sonu\u00e7lara yol a\u00e7\u0131p a\u00e7mad\u0131\u011f\u0131 do\u011frudan incelenmemi\u015ftir.<\/strong><\/p>\n<p>2003&#8217;te Al-Shekhlee ve Katirji, rutin bir boyun lenf bezi biyopsisi s\u0131ras\u0131nda CN XI&#8217;nin <strong>iyatrojenik yaralanmas\u0131ndan<\/strong> (istemeden olu\u015fan hasar) sonra torasik outlet bulgular\u0131 geli\u015fen iki hastay\u0131 tan\u0131mlad\u0131. <sup><a href=\"#footnote_6_7232\" id=\"identifier_8_7232\" class=\"footnote-link footnote-identifier-link\" title=\"Al-Shekhlee A, Katirji B (2003). Spinal accessory neuropathy, droopy shoulder, and thoracic outlet syndrome. Muscle Nerve, 28(3):383&ndash;385. PMID: 12929202\">6<\/a><\/sup> Birinde kol 90 derece yana kald\u0131r\u0131ld\u0131\u011f\u0131nda <strong>aksiller arterin<\/strong> (kola giden ana atardamar) tamamen t\u0131kand\u0131\u011f\u0131 g\u00f6r\u00fcld\u00fc; bu, TOS&#8217;un vask\u00fcler bir bi\u00e7imidir. <strong>Di\u011ferinde sinir iletim \u00e7al\u0131\u015fmalar\u0131yla \u00f6l\u00e7\u00fclen, brakiyal pleksusun alt trunkusunda hasar bulgusu vard\u0131; bu, n\u00f6rojenik tablodur.<\/strong> Bir hastaya sinir grefti uyguland\u0131; ikisi de omuz g\u00fc\u00e7lendirme egzersizleri yapt\u0131 ve ikisi de iki y\u0131l i\u00e7inde yava\u015f yava\u015f d\u00fczeldi.<\/p>\n<p>Bu iki hastada, sinir yaralanmas\u0131ndan sonra geli\u015fen omuz d\u00fc\u015f\u00fckl\u00fc\u011f\u00fc hem vask\u00fcler hem n\u00f6rojenik torasik outlet bulgular\u0131yla birlikte g\u00f6r\u00fcld\u00fc.<\/p>\n<p>Bunu 2023&#8217;teki kafatas\u0131 taban\u0131 raporlar\u0131yla birlikte d\u00fc\u015f\u00fcnmek bir olas\u0131l\u0131\u011fa i\u015faret eder: kafatas\u0131 taban\u0131ndaki s\u0131k\u0131\u015fma baz\u0131 hastalarda ayn\u0131 zinciri ba\u015flatabilir. Her iki sorunu olan bir hastada sorulmas\u0131 makul bir sorudur; TOS&#8217;un kan\u0131tlanm\u0131\u015f bir nedeni de\u011fildir.<\/p>\n<h2><strong>Ne Zaman Yukar\u0131ya, Kafatas\u0131 Taban\u0131na Bakmal\u0131?<\/strong><\/h2>\n<figure><img decoding=\"async\" width=\"800\" height=\"450\" src=\"https:\/\/kamranaghayev.com\/wp-content\/uploads\/2026\/05\/tos-tests.webp\" alt=\"Torasik outlet sendromu belirtilerini ortaya \u00e7\u0131karmak i\u00e7in kullan\u0131lan Wright ve Roos testleri\" \/><figcaption><em>Wright testi (solda) ve Roos testi (sa\u011fda): <a href=\"https:\/\/kamranaghayev.com\/tr\/torasik-outlet-sendromu-belirtiler-riskleri\/\">torasik outlet sendromu belirtilerini<\/a> ortaya \u00e7\u0131karmak i\u00e7in kullan\u0131lan iki kol kald\u0131rma manevras\u0131. Bu testler bir\u00e7ok nedenle pozitif olabilir; boyun g\u00f6r\u00fcnt\u00fclemesi normalken pozitif bir test, ba\u015fka nedenlere dikkatle bakmay\u0131 gerektirir ve kafatas\u0131 taban\u0131 bunlardan yaln\u0131zca nadir bir olas\u0131l\u0131kt\u0131r.<\/em><\/figcaption><\/figure>\n<p>Standart TOS tetkiklerinden zaten ge\u00e7mi\u015f olabilirsiniz: <strong>Roos testi<\/strong> (kollar ba\u015f \u00fcst\u00fcnde, \u00fc\u00e7 dakika boyunca ellerinizi a\u00e7\u0131p kapat\u0131rs\u0131n\u0131z), <strong>Wright testi<\/strong> (kol d\u0131\u015fa ve geriye \u00e7evrilir) ve boyun g\u00f6r\u00fcnt\u00fclemesi. Bu testler belirtileri ortaya \u00e7\u0131kar\u0131yor ama g\u00f6r\u00fcnt\u00fclemede servikal kaburga, belirgin bir kemik anomalisi yoksa ve servikal MR normalse, TOS&#8217;un yukar\u0131daki nedeni a\u00e7\u0131klanmam\u0131\u015f demektir.<\/p>\n<p>B\u00f6yle bir durumda \u015fu belirtiler CN XI tutulumu sorusunu g\u00fcndeme getirir:<\/p>\n<ul>\n<li><strong>Asimetrik trapezius kitlesi.<\/strong> Omzun \u00fcst k\u0131sm\u0131n\u0131n bir taraf\u0131 di\u011ferinden g\u00f6zle g\u00f6r\u00fcl\u00fcr bi\u00e7imde daha k\u00fc\u00e7\u00fck ya da daha d\u00fcz.<\/li>\n<li><strong>Omuz d\u00fc\u015f\u00fckl\u00fc\u011f\u00fc.<\/strong> Bir omuz di\u011ferinden a\u015fa\u011f\u0131da. \u00c7o\u011fu zaman eski foto\u011fraflarda aynadakinden daha kolay g\u00f6r\u00fcl\u00fcr.<\/li>\n<li><strong>Lateral skapular kanatlanma.<\/strong> Kolunuzu kald\u0131rd\u0131\u011f\u0131n\u0131zda k\u00fcrek kemi\u011finiz g\u00f6\u011f\u00fcs kafesinden kalkar.<\/li>\n<li><strong>Omuz silkme g\u00fcc\u00fcnde azalma.<\/strong> Dirence kar\u015f\u0131 iki omzunuzu birden silkti\u011finizde bir taraf \u00f6nce g\u00fc\u00e7ten d\u00fc\u015fer.<\/li>\n<li>Etkilenen omzun kar\u015f\u0131 taraf\u0131na do\u011fru ba\u015f \u00e7evirmede <strong>hafif g\u00fc\u00e7s\u00fczl\u00fck<\/strong>. (Bu, CN XI g\u00fc\u00e7s\u00fczl\u00fc\u011f\u00fcn\u00fcn SKM bile\u015fenidir; \u00e7o\u011fu hasta test edilene kadar fark etmez.)<\/li>\n<\/ul>\n<p>TOS belirtilerinin yan\u0131nda bunlardan herhangi biri varsa soru <em>&#8220;torasik \u00e7\u0131k\u0131\u015f\u0131 nas\u0131l tedavi ederiz?&#8221;<\/em> olmaktan \u00e7\u0131kar ve <em>&#8220;trapezius neden zay\u0131f ve nedeni kafatas\u0131 taban\u0131nda m\u0131?&#8221;<\/em> sorusuna d\u00f6n\u00fc\u015f\u00fcr.<\/p>\n<p>Trapezius g\u00fc\u00e7s\u00fczl\u00fc\u011f\u00fc do\u011frulan\u0131rsa, nedeni tedavi plan\u0131 i\u00e7in \u00f6nemlidir. S\u00fcren bir omuz d\u00fc\u015f\u00fckl\u00fc\u011f\u00fc brakiyal pleksusu gergin tutabilir; bu y\u00fczden plan her iki soruna da y\u00f6nelmelidir.<\/p>\n<p>Bunun <a href=\"https:\/\/kamranaghayev.com\/tr\/tekrarlayan-torasik-outlet-sendromu\/\">tekrarlayan ve kal\u0131c\u0131 Torasik Outlet Sendromuna<\/a> ne kadar katk\u0131da bulundu\u011fu \u00f6l\u00e7\u00fclm\u00fc\u015f de\u011fildir.<\/p>\n<h2><strong>CN XI S\u0131k\u0131\u015fmas\u0131 Nas\u0131l Te\u015fhis Edilir?<\/strong><\/h2>\n<p>\u00d6nce muayene gelir: hangi kaslar\u0131n zay\u0131f oldu\u011funu ve tablonun aksesuar siniri mi, uzun torasik siniri mi, yoksa ba\u015fka bir omuz ya da n\u00f6rolojik sorunu mu d\u00fc\u015f\u00fcnd\u00fcrd\u00fc\u011f\u00fcn\u00fc g\u00f6sterir. Tetkikler ard\u0131ndan belirli sorulara yan\u0131t verir:<\/p>\n<ol>\n<li><strong>Kafatas\u0131 taban\u0131 ve \u00fcst boyun omurgas\u0131n\u0131n BT&#8217;si.<\/strong> Stiloid uzunlu\u011funu, stiloidin C1&#8217;e do\u011fru y\u00f6nelme a\u00e7\u0131s\u0131n\u0131 ve iki taraftaki <strong>atlanto-stiloid mesafeyi<\/strong> \u00f6l\u00e7er. Bulgular kafatas\u0131na yak\u0131n bir aksesuar sinir lezyonunu ya da kafatas\u0131 taban\u0131nda yap\u0131sal bir nedeni d\u00fc\u015f\u00fcnd\u00fcrd\u00fc\u011f\u00fcnde de\u011ferlendirilir. Tek ba\u015f\u0131na g\u00f6r\u00fcn\u00fcr bir kanatl\u0131 skapula ya da normal bir boyun MR&#8217;\u0131 bunun i\u00e7in bir gerek\u00e7e de\u011fildir.<\/li>\n<li><strong>BT venografi.<\/strong> Juguler veni g\u00f6steren \u00f6zel bir BT taramas\u0131; e\u015flik eden juguler ven kompresyonundan \u015f\u00fcphelenildi\u011finde kullan\u0131l\u0131r.<\/li>\n<li><strong>Brakiyal pleksus MR&#8217;\u0131.<\/strong> Servikal kaburga, fibr\u00f6z bant, kitle ya da skalen anomalisi gibi di\u011fer TOS nedenlerini d\u0131\u015flamak i\u00e7in.<\/li>\n<li><strong>Trapezius ve SKM&#8217;nin EMG&#8217;si.<\/strong> Elektromiyografi, ince bir i\u011fneyle kaslar\u0131n elektriksel etkinli\u011fini kaydederek onlar\u0131 besleyen sinirin \u00e7al\u0131\u015f\u0131p \u00e7al\u0131\u015fmad\u0131\u011f\u0131n\u0131 g\u00f6steren bir testtir. EMG, CN XI tutulumunu do\u011frular ve a\u011f\u0131rl\u0131\u011f\u0131n\u0131 derecelendirir.<\/li>\n<li><strong>Brakiyal pleksus sinir iletim \u00e7al\u0131\u015fmalar\u0131.<\/strong> Kola giden duyu sinirlerinin \u00f6zel elektriksel testleri; \u00f6zellikle <strong>ulnar SNAP<\/strong> (ser\u00e7e parmak taraf\u0131ndaki duyu sinirinin duyusal sinir aksiyon potansiyeli) ve <strong>medial antebrakiyal kutan\u00f6z SNAP<\/strong> (\u00f6nkolun i\u00e7 y\u00fcz\u00fcndeki duyu sinirinden). N\u00f6rojenik TOS&#8217;ta oldu\u011fu gibi brakiyal pleksusun alt trunkusu kronik traksiyon alt\u0131ndayken ikisi de tipik olarak d\u00fc\u015fer ve d\u00fc\u015f\u00fc\u015f\u00fcn bi\u00e7imi bu nedeni di\u011ferlerinden ay\u0131r\u0131r.<\/li>\n<\/ol>\n<h2><strong>Tedavi<\/strong><\/h2>\n<p>Tedavi, ger\u00e7ekten saptanan sorunlara y\u00f6nelir. Tan\u0131ya, s\u00fcrecin ne kadar s\u00fcrd\u00fc\u011f\u00fcne ve sinirin ne kadar toparland\u0131\u011f\u0131na g\u00f6re bu; rehabilitasyon, bir g\u00f6zlem d\u00f6nemi, sinire y\u00f6nelik bir ameliyat ya da ba\u015fka bir ameliyat olabilir.<\/p>\n<p><strong>Kafatas\u0131 taban\u0131nda dekompresyon.<\/strong> Orada s\u0131k\u0131\u015fma do\u011frulanm\u0131\u015f ve belirgin g\u00fc\u00e7s\u00fczl\u00fc\u011fe yol a\u00e7\u0131yorsa, se\u00e7eneklerden biri <a href=\"https:\/\/kamranaghayev.com\/tr\/eagle-sendromu-tedavisi\/\">transservikal stiloidektomi<\/a> \u2014 stiloid \u00e7\u0131k\u0131nt\u0131n\u0131n cerrahi olarak al\u0131nmas\u0131 \u2014, C1 transvers \u00e7\u0131k\u0131nt\u0131s\u0131n\u0131n k\u0131smen al\u0131nmas\u0131 ya da ikisidir; 2023&#8217;teki iki hastada oldu\u011fu gibi. Se\u00e7im, s\u0131k\u0131\u015fmaya hangi yap\u0131n\u0131n daha \u00e7ok katk\u0131da bulundu\u011funa ba\u011fl\u0131d\u0131r.<\/p>\n<p><strong>Omuz ku\u015fa\u011f\u0131 rehabilitasyonu.<\/strong> Sinir toparland\u0131k\u00e7a trapezius, duru\u015f d\u00fczeltmesi ve hedefe y\u00f6nelik g\u00fc\u00e7lendirme ile yeniden g\u00fc\u00e7lendirilebilir.<\/p>\n<p><strong>Torasik outlet dekompresyonu.<\/strong> Torasik outlet belirtileri s\u00fcrerse, torasik outlet dekompresyonu kendi gerek\u00e7eleriyle de\u011ferlendirilebilir; <a href=\"https:\/\/kamranaghayev.com\/tr\/torasik-outlet-sendromu-pure-teknigi\/\">PURED prosed\u00fcr\u00fc<\/a> bu yakla\u015f\u0131mlardan biridir.<\/p>\n<p>Birden fazla sorundan \u015f\u00fcphelenildi\u011finde, bunlar\u0131 tedavi etmenin gerek\u00e7eleri ve s\u0131ras\u0131 her hasta i\u00e7in ayr\u0131ca a\u00e7\u0131klanmal\u0131d\u0131r.<\/p>\n<p>Yay\u0131mlanm\u0131\u015f raporlar farkl\u0131 ameliyat s\u0131ralamalar\u0131n\u0131 kar\u015f\u0131la\u015ft\u0131rm\u0131yor ve kafatas\u0131 taban\u0131 \u00f6nce tedavi edilmezse torasik outlet cerrahisinin ba\u015far\u0131s\u0131z olaca\u011f\u0131n\u0131 g\u00f6stermiyor.<\/p>\n<h2><strong>Sonu\u00e7<\/strong><\/h2>\n<p><strong>Eagle Sendromunun<\/strong> standart tan\u0131m\u0131, \u00e7ok daha geni\u015f bir anatomik sorunun yaln\u0131zca bir y\u00fcz\u00fcn\u00fc yakalar. Kafatas\u0131 taban\u0131nda klasik olarak bo\u011faz sinirlerini etkileyen ayn\u0131 s\u0131k\u0131\u015fma, ayn\u0131 dar koridorda internal juguler venin etraf\u0131n\u0131 dolanan spinal aksesuar siniri de s\u0131k\u0131\u015ft\u0131rabilir.<\/p>\n<p>CN XI i\u015flevini yitirdi\u011finde trapezius zay\u0131flar, k\u00fcrek kemi\u011fi kanatlanabilir ve omuz d\u00fc\u015febilir; bu da brakiyal pleksusu gerebilir. Nadir durumlarda kafatas\u0131 taban\u0131ndaki bir sorun eldeki belirtilere katk\u0131da bulunabilir.<\/p>\n<p>Kol \u015fik\u00e2yetlerinizle birlikte <strong>d\u00fc\u015f\u00fck bir omuz, g\u00f6r\u00fcn\u00fcr trapezius g\u00fc\u00e7s\u00fczl\u00fc\u011f\u00fc ya da skapular kanatlanma<\/strong> varsa, tedavi se\u00e7ilmeden \u00f6nce hangi kaslar\u0131n ve sinirlerin etkilendi\u011fini belirleyen bir de\u011ferlendirme isteyin. Kafatas\u0131 taban\u0131 g\u00f6r\u00fcnt\u00fclemesi her hasta i\u00e7in de\u011fil, muayene ve tetkiklerin ortaya koydu\u011fu belirli bir soru i\u00e7in yap\u0131l\u0131r. <a href=\"https:\/\/kamranaghayev.com\/tr\/kanatli-skapula\/\">Kanatl\u0131 skapula rehberimiz<\/a> nedenlerin geni\u015f yelpazesini anlat\u0131yor.<\/p>\n<h2><strong>Sonraki Yaz\u0131<\/strong><\/h2>\n<p><a href=\"https:\/\/kamranaghayev.com\/tr\/torasik-outlet-sendromu-pure-teknigi\/\"><strong>Torasik Outlet Sendromu i\u00e7in PURED Prosed\u00fcr\u00fc<\/strong><\/a><\/p>\n<p><em>Torasik outlet dekompresyonu gereken hastalar i\u00e7in cerrahi yakla\u015f\u0131mlardan biri.<\/em><\/p>\n<h2><strong>Ayr\u0131ca Bak\u0131n\u0131z<\/strong><\/h2>\n<ul>\n<li><a href=\"https:\/\/kamranaghayev.com\/tr\/eagle-sendromu\/\"><strong>Eagle Sendromu: Ayr\u0131nt\u0131l\u0131 \u0130nceleme<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/kamranaghayev.com\/tr\/juguler-ven-kompresyonu\/\"><strong>\u0130nternal Juguler Ven Kompresyonu: Ayr\u0131nt\u0131l\u0131 \u0130nceleme<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/kamranaghayev.com\/tr\/torasik-outlet-sendromu-nedir\/\"><strong>Torasik Outlet Sendromu Nedir?<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/kamranaghayev.com\/tr\/tekrarlayan-torasik-outlet-sendromu\/\"><strong>Kal\u0131c\u0131 ve Tekrarlayan Torasik Outlet Sendromu<\/strong><\/a><\/li>\n<\/ul>\n<h2>Referanslar<\/h2>\n<ol class=\"footnotes\"><li id=\"footnote_1_7232\" class=\"footnote\">Mitchell EC, Wu K, Yoo J, Ross DC, Miller TA, Siddiqi F (2023). &#8220;Winged&#8221; Eagle&#8217;s syndrome: neurophysiological findings in a rare cause of spinal accessory nerve palsy. Illustrative cases. J Neurosurg Case Lessons, 6(24):CASE23358. PMID: 38079628<span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_1_7232\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_3_7232\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_2_7232\" class=\"footnote\">Roberts SO, Cardozo A (2024). A detailed review of the spinal accessory nerve and its anatomical variations with cadaveric illustration. Anat Sci Int, 99(3):239\u2013253. doi:10.1007\/s12565-024-00770-w. PMID: 38696101<span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_2_7232\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_5_7232\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_3_7232\" class=\"footnote\">Camp SJ, Birch R (2011). Injuries to the spinal accessory nerve: a lesson to surgeons. J Bone Joint Surg Br, 93(1):62\u201367. PMID: 21196545<span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_4_7232\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_4_7232\" class=\"footnote\">Swift TR, Nichols FT (1984). The droopy shoulder syndrome. Neurology, 34(2):212\u2013215. PMID: 6538012<span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_6_7232\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_5_7232\" class=\"footnote\">Lokman B, Aymane A, Yachaoui S, El Oumri AA (2024). Droopy shoulder syndrome: a gateway to thoracic outlet syndrome. Cureus, 16(6):e62213. doi:10.7759\/cureus.62213. PMID: 39006624<span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_7_7232\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_6_7232\" class=\"footnote\">Al-Shekhlee A, Katirji B (2003). Spinal accessory neuropathy, droopy shoulder, and thoracic outlet syndrome. Muscle Nerve, 28(3):383\u2013385. PMID: 12929202<span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_8_7232\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><\/ol>","protected":false},"excerpt":{"rendered":"<p>Eagle Sendromu 11. kraniyal siniri s\u0131k\u0131\u015ft\u0131rarak trapeziusu zay\u0131flat\u0131p omzu d\u00fc\u015f\u00fcrebilir ve Torasik Outlet Sendromuna yol a\u00e7abilir: nas\u0131l olur, nas\u0131l te\u015fhis edilir?<\/p>\n","protected":false},"author":1,"featured_media":6879,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"content-type":"","ka_reviewed_on":"","ka_updated_on":"","footnotes":""},"categories":[58],"tags":[],"class_list":["post-7232","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog"],"acf":[],"_links":{"self":[{"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/posts\/7232","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/comments?post=7232"}],"version-history":[{"count":4,"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/posts\/7232\/revisions"}],"predecessor-version":[{"id":7371,"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/posts\/7232\/revisions\/7371"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/media\/6879"}],"wp:attachment":[{"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/media?parent=7232"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/categories?post=7232"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/tags?post=7232"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}