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Surgical Planning (surgical + planning)
Selected AbstractsDental Applications of Computerized Tomography: Surgical Planning for Implant PlacementJOURNAL OF PROSTHODONTICS, Issue 3 2007Alfonso Navarrete DDS [source] The Distribution of Follicular Units in the Chinese Scalp: Implications for Reconstruction of Natural-Appearing Hairlines in OrientalsDERMATOLOGIC SURGERY, Issue 6 2002Ren-Yeu Tsai MD background. Follicular transplantation using hair in its naturally occurring groups, called follicular units (FUs), has become the most popular technique in hair restoration surgery. Recently follicular transplantation was performed with a qualitative and quantitative concept to achieve the best clinical result. The characteristics and distribution of FUs are well studied in Caucasians and widely applied in hair transplantation surgery. objective. In order to understand the normal distribution of FUs in the Chinese scalp, we counted the number of hairs and FUs in normal Chinese scalp to provide general information for surgical planning and design in bald Chinese patients. methods. A total of 50 normal and 50 bald Chinese adults were enrolled to count the hairs on their scalp. One hundred bald patients receiving hairline reconstruction were also prospectively quantitatively evaluated. results. In normal Chinese scalp, an average 71.78 FUs/cm2 and 137.08 hairs/cm2 were calculated with a follicular density of 1.91 hairs/FU. Two-hair FUs are the predominate group (50.29%). In bald patients, an average of 68.07 FUs/cm2 was found, which was less than that of the occipital scalp in normal nonbald patients. In reconstruction of the frontal hairline, a total of 700,1000 FUs were implanted with an average density of 30 FUs/cm2. conclusion. We found the average number of FUs (0.72 FU/mm2) was less than that in Caucasian patients (1 FU/mm2). The average density of 30 FUs/cm2 implanted was suitable to reconstruct a natural frontal hairline in bald Chinese patients, which can achieve about 40% of normal hair density. Our results could provide the hair surgeon with general information about hair distribution on the Chinese scalp for surgical planning and design in their patients. [source] A Simple Tool for Teaching Flap Design with Digital ImagesDERMATOLOGIC SURGERY, Issue 12 2001Daniel Berg MD Background. Defects created by excision or Mohs micrographic surgery must be analyzed and surgical options including flaps must be considered. Teaching flap design to dermatology trainees is often done at the bedside of the patient with the trainee describing or marking a proposed flap. Open discussion of the options in this way is sometimes unnerving for the patient. Blackboard discussions or drawings are limited in their realism. Objective. To describe a rapid, simple method using commonly available software to allow a trainee to draw and redraw a proposed flap on a digital image of the defect without the time and cost of printing. Methods. We describe a feature in the widely used presentation program Microsoft PowerPoint which can be used to draw on an imported digital image in various colors. Results. A digital photograph taken at the bedside can quickly be loaded into PowerPoint and viewed as a full-screen picture on a computer. Using an electronic pen, multiple lines can be drawn and erased on the picture, allowing surgical planning and teaching away from the bedside. Conclusion. Design and analysis of potential incision lines for a flap can be done quickly using a digital image and commonly available software, allowing a new option for teaching flap design. [source] An integrated visualization system for surgical planning and guidance using image fusion and an open MRJOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 6 2001David T. Gering MS Abstract A surgical guidance and visualization system is presented, which uniquely integrates capabilities for data analysis and on-line interventional guidance into the setting of interventional MRI. Various pre-operative scans (T1- and T2-weighted MRI, MR angiography, and functional MRI (fMRI)) are fused and automatically aligned with the operating field of the interventional MR system. Both pre-surgical and intra-operative data may be segmented to generate three-dimensional surface models of key anatomical and functional structures. Models are combined in a three-dimensional scene along with reformatted slices that are driven by a tracked surgical device. Thus, pre-operative data augments interventional imaging to expedite tissue characterization and precise localization and targeting. As the surgery progresses, and anatomical changes subsequently reduce the relevance of pre-operative data, interventional data is refreshed for software navigation in true real time. The system has been applied in 45 neurosurgical cases and found to have beneficial utility for planning and guidance. J. Magn. Reson. Imaging 2001;13:967,975. © 2001 Wiley-Liss, Inc. [source] Imaging in bronchopulmonary sequestrationJOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 1 2009P Abbey Summary Bronchopulmonary sequestration is an uncommon pulmonary disorder characterized by an area of non-functioning abnormal lung tissue, which receives its blood supply from a systemic artery and characteristically has no connection with the tracheobronchial tree. The abnormal lung tissue is located within the visceral pleura of a pulmonary lobe in the intralobar variety, whereas the extralobar form has its own visceral pleura. The venous drainage of the extralobar type is usually into the systemic veins, whereas the intralobar type drains into the pulmonary veins. Radiological imaging plays a vital role in establishing the diagnosis, and even more importantly, in providing to the clinician a vascular roadmap essential for surgical planning. We present here a review of bronchopulmonary sequestration and also discuss the role of various imaging methods in the early diagnosis and management of these cases. [source] Cervical osteochondroma as a cause of spinal cord compression in a patient with hereditary multiple exostoses: Computed tomography and magnetic resonance imaging findingsJOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 3 2002Bayram Çirak SUMMARY Spinal cord compression is a rare but extremely serious complication of hereditary multiple exostoses (HME). Imaging of the spine is important for surgical planning and follow up. We present CT and MR findings in a male patient with HME who developed spinal cord compression from a cervical osteochondroma. Complete recovery was achieved following surgery. [source] The use of magnetic resonance imaging in the management of pharyngeal penetration injuries in dogsJOURNAL OF SMALL ANIMAL PRACTICE, Issue 2 2008M. J. Dobromylskyj Objectives: To investigate the correlation between the magnetic resonance imaging findings and subsequent surgical findings for a series of dogs presenting with suspected pharyngeal stick injuries to the Animal Health Trust, Newmarket, between 1995 and 2004. Methods: Magnetic resonance imaging findings were reviewed for patients undergoing a scan of the pharyngeal or cervical area for suspected foreign bodies during the years 1995 to 2004. Results: Case signalment, history and clinical signs were similar to those reported in previous studies. Magnetic resonance imaging demonstrated foreign material in six of seven cases where this was present. There was good correlation between diagnosis of a foreign body at magnetic resonance imaging and subsequent surgical identification. Clinical Significance: Compared with other imaging modalities, magnetic resonance imaging is very helpful for this type of injury, especially in chronic cases where radiographic evidence of a foreign body is unlikely. It is a valuable aid in the diagnosis of pharyngeal penetration injury and in surgical planning. [source] Advances in collision detection and non-linear finite mixed element modelling for improved soft tissue simulation in craniomaxillofacial surgical planningTHE INTERNATIONAL JOURNAL OF MEDICAL ROBOTICS AND COMPUTER ASSISTED SURGERY, Issue 1 2010Shengzheng Wang Abstract Background There is a huge demand to develop a method for assisting surgeons in automatically predicting soft tissue deformation in terms of a bone-remodelling plan. Methods This paper introduces several novel elements into a system for the simulation of postoperative facial appearances with respect to prespecified bone-remodelling plans. First, a new algorithm for efficient detection of collisions, using the signed distance field, is described. Next, the penalty method is applied to determine the contact load of bone on facial soft tissue. Finally, a non-linear finite mixed element model is developed to estimate the tissue deformation induced by the prescribed bone remodelling plan. Results The performance of the proposed collision detection algorithm has been improved in memory requirements and computational efficiency compared with conventional methods. In addition, the methodology is evaluated over both synthetic and real data, with simulation performance averaging <0.5 mm pointwise error over the facial surface in six mid-face distraction osteotogenesis procedures. Conclusions The experimental results support the novel methodological advancements in collision detection and biomechanical modelling proposed in this work. Copyright © 2009 John Wiley & Sons, Ltd. [source] Cervical thymic anomalies,The Texas Children's Hospital experienceTHE LARYNGOSCOPE, Issue 10 2009Angela K. Sturm-O'Brien MD Abstract Objectives/Hypothesis: To review the presentation and management of cervical thymic cysts and ectopic thymic tissue at Texas Children's Hospital over the last 25 years. Study Design: Case report and case series using retrospective chart review. Methods: A case report is presented of a recently diagnosed thymic cyst highlighting diagnostic, management, and treatment strategies available for optimizing management of patients with significant mediastinal extension. We then present a retrospective review of cervical thymic anomalies at a tertiary academic medical center over a 25-year span (1983,present). Data extracted include patients' characteristics, clinical presentation, diagnostic workup, surgical management, and postoperative complications. Results: Fifteen patients were found to have a pathological diagnosis of cervical thymic cyst, and 10 patients had a diagnosis of ectopic thymic tissue in the neck. This is the largest case series of cervical thymic anomalies presented in the literature to date. Patients' characteristics, diagnostic techniques, and treatment strategies are discussed. Conclusions: Cervical thymic anomalies are a rare but necessary part of the differential diagnosis of a cervical mass. Computed tomography scan can both narrow the preoperative differential diagnosis and aid in surgical planning for thymic cyst excision. A full discussion of the embryology, clinical presentation, and management of cervical thymic cysts and a review of the current literature is presented. Laryngoscope, 2009 [source] Image-guided surgery of liver metastases by three-dimensional ultrasound-based optoelectronic navigationBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 7 2007S. Beller Background: Vessel-oriented surgery and tumour-free resection margins are essential for resection of liver metastases to preserve liver parenchyma and improve oncological outcome. Preoperative three-dimensional models reconstructed from imaging data could facilitate surgical planning with the use of navigation technology. Methods: Thirty-three patients with central and/or impalpable liver metastases were scheduled for navigated hepatic resection. Intraoperative three-dimensional ultrasonography and an infrared-based optical tracking system were used for data registration and image-guided surgery. Postoperative three-dimensional data were compared with the preoperative virtual surgical plan to assess the accuracy of navigation, and clinical results were compared with those of a matched control group of 32 patients. Results: Navigation was successful in 32 of 33 patients. Realization of the preoperative plan and R0 resection was achieved in 30 of these 32 patients. The median discrepancy between the planned and actual vascular dissection level was 6 (range 0,11) mm. There was a reduced rate of R1 resection in the navigated group compared with the control group (two versus four patients), and more parenchyma was preserved. Conclusion: Three-dimensional ultrasound-based optoelectronic navigation technology improves intraoperative orientation and enables parenchyma-preserving surgery with high precision. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] Parenchymal lesions in pharmacoresistant temporal lobe epilepsy: dual and multiple pathologyACTA NEUROLOGICA SCANDINAVICA, Issue 3 2005S. H. Eriksson Objectives,,, Dual pathology is reported in 5,30% of temporal lobe resections performed in pharmacoresistant epilepsy. Dual pathology may be of importance for surgical planning and also for the understanding of the pathogenesis of epilepsy. We describe the frequency of dual or multiple pathology, i.e. more than one histopathological diagnosis, in adults with temporal lobe resections. Material and Methods,,, Surgical specimens from 33 consecutive patients with resections including mesial as well as neocortical temporal structures were reviewed. All histopathological findings were recorded. Post-mortem specimens from 11 control subjects were also reviewed. Results,,, Dual or multiple pathology was found in almost half of the epilepsy patients (48%). Hippocampal sclerosis was found in 25 patients (76%), malformations of cortical development in 15 (46%), of which 12 (36%) were microdysgenesis, and low-grade tumours in seven (21%). Apart from mild gliosis, there were no histopathological changes in the control specimens. Conclusion,,, Dual or multiple pathology was a common finding in this group of adults with temporal lobe resections. In order to increase our understanding of how aetiological factors may combine in the development of seizures, we consider it relevant and important to report all histopathological findings in epilepsy surgery series. [source] Retinal detachment in Falcinelli's modified osteoodontokeratoprosthesisACTA OPHTHALMOLOGICA, Issue 2009P COLLIARDO Purpose Aim is to evaluate the incidence, surgical treatment and outcomes of retinal detachment in eyes that had undergone Falcinelli's modified osteoodontokeratoprosthesis (MOOKP). Methods Technological and surgical advancements allow to treat successfully a severe pathology as retinal detachment, even in eyes with keratoprosthesis (KPro). The autors accurately describe the surgical technique which usually uses an Eckardt or Landers temporary KPro, a pars plana vitrectomy and a gas or silicone oil tamponade, even if in selected cases it is possible to perform just a scleral buckling. Results By the means of the described techniques good anatomical success and improvement in visual acuity have been obtained. Nine retinal detachments were successfully operated, one retinal detachment was unsuccessfully operated, four retinal detachments were judged to be inoperable for severe proliferative vitreoretinopathy because of late turning-up to clinical examination and lack of technology in the 70's. Conclusion The autors point out that an accurate MOOKP procedure it is necessary for preventing the retinal detachment. An early diagnosis by echography performed at every clinical examination during the follow-up in patients with MOOKP and an appropriate surgical planning for each case are fundamental for a better anatomo-functional outcome. [source] Ultrasound biomicroscopy of zonular anatomy in clinically unilateral exfoliation syndromeACTA OPHTHALMOLOGICA, Issue 5 2008Zaher Sbeity Abstract. Purpose:, To evaluate the ability of ultrasound biomicroscopy (UBM) to detect abnormalities in the zonular apparatus in unaffected eyes of patients with clinically unilateral exfoliation syndrome (XFS) using a standardized grading system. Methods:, The affected and unaffected eyes of 17 patients with clinically unilateral XFS and 17 eyes of 17 control subjects underwent UBM. Radial sections detailing the lens and zonules at 12:00, 1:30, 3:00, 4:30, 6:00, 7:30, 9:00 and 10:30 clock hours were obtained. The images were graded by a masked, experienced UBM observer using a standardized scoring system based on the zonular appearance (0, none; 1 and 2, uneven or disrupted zonules with or without patchy deposits; 3, diffuse granulation, thick zonules or both; 4, total zonular disruption). Affected meridians were compared by the Friedman test, while distributions of unaffected and affected eyes were compared using the Student t -test. Results:, In the control group, 15/17 eyes showed normal zonules; the remaining two eyes showed grade 1 changes in some meridians. The mean grade score was 0.33 [standard deviation (SD) 0.84]. Eyes with XFS had a higher score than control eyes, with a mean score of 14.35 (SD 7.14, P < 0.001, Student t -test). In clinically unaffected fellow eyes, the mean score was 10.53 (SD 7.44), and was less than that of XFS eyes (P = 0.008, Student t -test). Twelve XFS eyes (71%) and six unaffected fellow eyes (35%) had grade 3 or 4 in at least one meridian (P = 0.07, Friedman test). Conclusion:, Bilateral zonular involvement is present in subjects with clinically unilateral XFS. These zonular changes may be extensive in fellow eyes without clinically evident exfoliation material. UBM assessment of zonular status in fellow eyes prior to cataract extraction may aid in surgical planning. [source] Anatomy and quantitation of the subscapular nervesCLINICAL ANATOMY, Issue 6 2007R. Shane Tubbs Abstract Information regarding branches of the brachial plexus can be of utility to the surgeon for neurotization procedures following injury. Sixty-two adult cadaveric upper extremities were dissected and the subscapular nerves identified and measured. The upper subscapular nerve originated from the posterior cord in 97% of the cases and in 3% of the cases directly from the axillary nerve. The upper subscapular nerve originated as a single nerve in 90.3% of the cases, as two independent nerve trunks in 8% of the cases and as three independent nerve trunks in 1.6% of the cases. The thoracodorsal nerve originated from the posterior cord in 98.5% of the cases and in 1.5% of the cases directly from the proximal segment of the radial nerve. The thoracodorsal nerve always originated as a single nerve from the brachial plexus. The lower subscapular nerve originated from the posterior cord in 79% of the cases and in 21% of the cases directly from the proximal segment of the axillary nerve. The lower subscapular nerve originated as a single nerve in 93.6% of the cases and as two independent nerve trunks in 6.4% of the cases. The mean length of the lower subscapular nerve from its origin until it provided its branch into the subscapularis muscle was 3.5 cm and the mean distance from this branch until its termination into the teres major muscle was 6 cm. The mean diameter of this nerve was 1.9 mm. The mean length of the upper subscapular nerve from its origin to its termination into the subscapularis muscle was 5cm and the mean diameter of the nerve was 2.3 mm. The mean length of the thoracodorsal nerve from its origin to its termination into the latissimus dorsi muscle was 13.7 cm. The mean diameter of this nerve was 2.6 mm. Our hopes are that these data will prove useful to the surgeon in surgical planning for potential neurotization procedures of the brachial plexus. Clin. Anat. 20:656,659, 2007. © 2007 Wiley-Liss, Inc. [source] Surgical management of intratemporal lesionsCLINICAL OTOLARYNGOLOGY, Issue 5 2001A Bozorg Grayeli In order to evaluate the decisional elements in the surgical strategy of deep-seated and/or extensive intratemporal lesions, a retrospective review of cases followed up between 1985 and 1996 in our department was undertaken. Eighty-one adult patients presenting temporal bone lesions located or extending beyond the middle ear limits excluding vestibular schwannomas and surgically treated were included. The population comprised 38 men and 43 women (mean age: 43 years, range: 17,81). Pre-, intra- and postoperative data were collected from medical files. The principal factors influencing the choice of the surgical approach were the location of the lesion and its presumed aggressiveness, the tumour involvement of the internal carotid artery and the labyrinth on preoperative imaging, and the preoperative hearing loss. A coherent algorithm based on these factors can be proposed for the surgical management of intratemporal lesions. High quality preoperative imaging is mandatory for the surgical planning. [source] | ||||||||||||||||||||||