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presurgical planning

Ali S Haider, Christopher S Graffeo, Avital Perry, Lucas P Carlstrom, Terry C Burns
Insular gliomas were previously considered inoperable lesions and were typically treated via biopsy, chemotherapy and/or radiation, if not observation alone. Stereotactic biopsies of low grade insular gliomas can underestimate tumor grade or fail to establish malignancy. Moreover, the survival advantages of maximal safe resection for insular lesions are increasingly being recognized. As such, early surgical resection is increasingly being performed. As with most lesions, a differential diagnosis exists for apparent insular gliomas, with definitive diagnosis generally obtained upon resection...
January 11, 2018: Curēus
Magdalena Lachowska, Paulina Glinka, Kazimierz Niemczyk
BACKGROUND: Air-conducted and skull-tap cervical vestibular evoked myogenic potentials (AC-cVEMP and Tap-cVEMP) have been shown to be very promising tools in clinical practice. They are noninvasive, easy to obtain and - importantly - they require little time and the cost of the instruments is low. OBJECTIVES: The aim of this study was to evaluate the usefulness of the combined use of ACand Tap-cVEMPs as a diagnostic tool for advanced assessment of vestibular schwannoma in determining tumor origin, and to investigate whether the results are helpful for a surgeon as an additional source of information about the tumor before surgery...
March 13, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Christopher F A Benjamin, Alexa X Li, Hal Blumenfeld, R Todd Constable, Rafeed Alkawadri, Stephan Bickel, Christoph Helmstaedter, Stefano Meletti, Richard Bronen, Simon K Warfield, Jurriaan M Peters, David Reutens, Monika Połczyńska, Dennis D Spencer, Lawrence J Hirsch
The goal of this study was to document current clinical practice and report patient outcomes in presurgical language functional MRI (fMRI) for epilepsy surgery. Epilepsy surgical programs worldwide were surveyed as to the utility, implementation, and efficacy of language fMRI in the clinic; 82 programs responded. Respondents were predominantly US (61%) academic programs (85%), and evaluated adults (44%), adults and children (40%), or children only (16%). Nearly all (96%) reported using language fMRI. Surprisingly, fMRI is used to guide surgical margins (44% of programs) as well as lateralize language (100%)...
March 12, 2018: Human Brain Mapping
Tigran Khachatryan, Marina Khachatryan, Ruben Fanarjyan, Mikayel Grigoryan, Arthur Grigorian
Background: Currently, transsphenoidal surgery (TSS) is the preferred method for surgical treatment of intrasellar pituitary adenomas. However, it carries some risk of intraoperative arterial injuries, which is mainly attributed to direct iatrogenic rupture of the internal carotid artery (ICA). There is anecdotal evidence suggesting that intracranial aneurysms are coincidentally found significantly more frequently in the setting of pituitary adenomas than when the incidence is compared to other intracranial neoplasms...
2018: Surgical Neurology International
Giampietro Farronato, Guido Galbiati, Luca Esposito, Carmen Mortellaro, Federica Zanoni, Cinzia Maspero
OBJECTIVE: This article describes a virtual protocol designed to optimize surgical orthodontic diagnosis and treatment plan. METHODS: A total of 15 patients undergoing orthodontic-surgical treatment have been analyzed with a presurgical virtual three-dimensional (3D) treatment planning, which involves 9 steps. All the patients have been treated with the use of occlusal splint guides projected on the basis of the surgical and orthodontic visualized treatment objective ...
March 8, 2018: Journal of Craniofacial Surgery
Amy Tyberg, Isaac Raijman, Ali Siddiqui, Urban Arnelo, Douglas G Adler, Ming-Ming Xu, Najib Nassani, Divyesh V Sejpal, Prashant Kedia, Yun Nah Lee, Frank G Gress, Sammy Ho, Monica Gaidhane, Michel Kahaleh
INTRODUCTION: In patients with pancreaticobiliary lesions anticipating surgical resection, digital pancreaticocholangioscopy can be used to identify the extent of disease. This presurgical"mapping" could change the surgical plan and optimize patient care. MATERIALS AND METHODS: Patients with pancreaticobiliary lesions anticipating surgery who underwent endoscopic retrograde cholangiopancreatography with digital pancreaticocholangioscopy from 9 international centers were included...
March 6, 2018: Journal of Clinical Gastroenterology
Ulrik Nikolaj Ascanius Felding
Isolated fractures of the orbital floor or medial wall are often referred to as blowout fractures (BOFs). Debilitating double vision and aesthetic deformity may affect the patients' quality of life and daily living skills, for instance, working or driving a car. The management of blowout fractures is, however, challenging, since not all fractures demand surgery. Some patients may have symptoms which subside, or may never develop symptoms. Due to a lack of evidence, there are still considerable differences in opinion on the criteria for surgery...
March 2018: Danish Medical Journal
Abbas Babajani-Feremi, Christen M Holder, Shalini Narayana, Stephen P Fulton, Asim F Choudhri, Frederick A Boop, James W Wheless
OBJECTIVE: To predict the postoperative language outcome using the support vector regression (SVR) and results of multimodal presurgical language mapping. METHODS: Eleven patients with epilepsy received presurgical language mapping using functional MRI (fMRI), magnetoencephalography (MEG), transcranial magnetic stimulation (TMS), and high-gamma electrocorticography (hgECoG), as well as pre- and postoperative neuropsychological evaluation of language. We constructed 15 (24 -1) SVR models by considering the extent of resected language areas identified by all subsets of four modalities as input feature vector and the postoperative language outcome as output...
March 2018: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Chin Siang Ong, Aravind Krishnan, Chen Yu Huang, Philip Spevak, Luca Vricella, Narutoshi Hibino, Juan R Garcia, Lasya Gaur
OBJECTIVE: New platforms for patient imaging present opportunities for improved surgical planning in complex congenital heart disease (CHD). Virtual reality (VR) allows for interactive manipulation of high-resolution representations of patient-specific imaging data, as a supplement to traditional 2D visualizations and 3D printed heart models. DESIGN: We present the novel use of VR for the presurgical planning of cardiac surgery in two infants with complex CHD to demonstrate interactive real-time views of complex intra and extracardiac anatomy...
February 5, 2018: Congenital Heart Disease
Su Liu, Candan Gurses, Zhiyi Sha, Michael M Quach, Altay Sencer, Nerses Bebek, Daniel J Curry, Sujit Prabhu, Sudhakar Tummala, Thomas R Henry, Nuri F Ince
High-frequency oscillations in local field potentials recorded with intracranial EEG are putative biomarkers of seizure onset zones in epileptic brain. However, localized 80-500 Hz oscillations can also be recorded from normal and non-epileptic cerebral structures. When defined only by rate or frequency, physiological high-frequency oscillations are indistinguishable from pathological ones, which limit their application in epilepsy presurgical planning. We hypothesized that pathological high-frequency oscillations occur in a repetitive fashion with a similar waveform morphology that specifically indicates seizure onset zones...
January 30, 2018: Brain: a Journal of Neurology
Jin-Hong Dai, Dong-Dong Xu, Chang-Yuan Yang, Zu-Bing Li, Zhi Li
Sagittal fracture at the temporal root of the zygomatic arch often occurs as a part of zygomaticomaxillary fractures. The authors described the application of computer-assisted navigation in the lag screw insertion for the fixation of sagittal fracture at the temporal root of zygomatic arch. Using the presurgical planning of the computer-assisted navigation system, the trajectory of lag screw insertion was designed, and the insertion depth was calculated. In the presurgical planning, the trajectory of screw insertion was placed with an anterior inclination of 10° to 15° (mean: 12...
January 29, 2018: Journal of Craniofacial Surgery
Hari Guragain, Jan Cimbalnik, Matt Stead, David M Groppe, Brent M Berry, Vaclav Kremen, Daniel Kenney-Jung, Jeffrey Britton, Gregory A Worrell, Benjamin H Brinkmann
OBJECTIVE: To assess the variation in baseline and seizure onset zone interictal high-frequency oscillation (HFO) rates and amplitudes across different anatomic brain regions in a large cohort of patients. METHODS: Seventy patients who had wide-bandwidth (5 kHz) intracranial EEG (iEEG) recordings during surgical evaluation for drug-resistant epilepsy between 2005 and 2014 who had high-resolution MRI and CT imaging were identified. Discrete HFOs were identified in 2-hour segments of high-quality interictal iEEG data with an automated detector...
February 20, 2018: Neurology
Evangelos Kogias, Petros Evangelou, Barbara Schmeiser, Peter C Reinacher, Dirk-Matthias Altenmüller
OBJECTIVE: We share our experience with extratemporal MRI-negative epilepsies that received "image-guided" resection with the use of neuronavigation after invasive presurgical video-EEG monitoring. We describe and discuss our technique of image generation, navigation system registration, and surgical resection. In addition, we evaluate seizure outcome with respect to the preoperatively planned versus achieved resection. PATIENTS AND METHODS: Seven patients with 3 T MRI-negative extratemporal epilepsy received navigation-guided resective surgery...
March 2018: Clinical Neurology and Neurosurgery
Martin Ochoa-Escudero, Diego A Herrera, Arthur B Dublin
A 28-year-old man presented to the emergency room complaining of right proptosis. He also manifested eye pain and facial fullness and redness in this side. Seven years ago, he had right hemifacial gunshot trauma treated with surgical reconstruction. The CT scan showed expansion of the right maxillary sinus due to a hypodense nonenhancing lesion extending to the nasal cavity, masticatory space, and extraconal space of the orbit. MRI was performed showing high signal intensity of the lesion on T2-weighted images indicating a cystic nature...
January 19, 2018: Ophthalmic Plastic and Reconstructive Surgery
Arturo Sanchez-Perez, Paula Boix-Garcia, Pía Lopez-Jornet
OBJECTIVES: To determine the position of the mandibular medial lingual foramen with cone-beam CT (CBCT) 3D imaging modalities when implants are to be placed in the anterior symphysis of the mandible. MATERIALS AND METHODS: A total of 111 CBCTs were considered acceptable and analyzed. The variables measured were as follows: (1) length of the outlet duct; (2) distance from the canal to the buccal cortex; (3) distance from the canal to the inferior cortex; (4) distance from the canal to the lingual cortex; (5) distance from the canal to the alveoli of the nearest tooth in dentate patients and distance from the canal to the marginal crest in edentulous patients; (6) angle of the duct to the horizontal Frankfurt plane; (7) diameter of the exit orifice; and (8) output level of the socket in relation to the teeth and the presence of bifurcations...
February 2018: Implant Dentistry
Joseph C Riney, Nabeel E Sarwani, Shehzad Siddique, Jay D Raman
PURPOSE: To determine the diagnostic accuracy and interobserver variability of radiologic interpretation of magnetic resonance imaging (MRI) performed for surgical planning before prostatectomy. PATIENTS AND METHODS: The records of 233 men undergoing prostatectomy with presurgical multiparametric 3T surface body coil MRI were reviewed. All initial films were read by a fellowship-trained body radiologist provided with relevant clinical information. A senior radiologist then reread all pelvic MRIs blinded to the initial interpretation with findings from both readings compared to final pathology...
January 11, 2018: Urologic Oncology
Razieh Alemi, Seyed Amir Hossein Batouli, Ebrahim Behzad, Mitra Ebrahimpoor, Mohammad Ali Oghabian
OBJECTIVES: Language is an important human function, and is a determinant of the quality of life. In conditions such as brain lesions, disruption of the language function may occur, and lesion resection is a solution for that. Presurgical planning to determine the language-related brain areas would enhance the chances of language preservation after the operation; however, availability of a normative language template is essential. PATIENTS AND METHODS: In this study, using data from 60 young individuals who were meticulously checked for mental and physical health, and using fMRI and robust imaging and data analysis methods, functional brain maps for the language production, perception and semantic were produced...
February 2018: Clinical Neurology and Neurosurgery
Mengqi Dong, Guangzhong Chen, Kun Qin, Xiaowen Ding, Dong Zhou, Chao Peng, Shaojian Zeng, Xianming Deng
PURPOSE: Rapid prototyping technology is used to fabricate three-dimensional (3D) brain arteriovenous malformation (AVM) models and facilitate presurgical patient communication and medical education for young surgeons. METHODS: Two intracranial AVM cases were selected for this study. Using 3D CT angiography or 3D rotational angiography images, the brain AVM models were reconstructed on personal computer and the rapid prototyping process was completed using a 3D printer...
January 15, 2018: British Journal of Neurosurgery
Ulrik Ascanius Felding, Kirstine Karnov, Anne Clemmensen, Carsten Thomsen, Tron A Darvann, Christian von Buchwald, Jørgen Tranum-Jensen
Computed tomography (CT) images have been used in very few studies on distances to the ethmoidal arteries in the orbit. Most other studies have included direct measurements on cadavers and frequently quote the 24-12-6 mm rule to describe distances from the anterior lacrimal crest to the anterior and posterior ethmoidal foramina (AEF and PEF), optic canal (OC), respectively. However, the large interindividual variation of distances renders absolute values less applicable in a clinical setting. Preoperative measurements on CT images may provide more precise distances than absolute rules and thus lead to safer orbital surgery...
January 2018: Journal of Craniofacial Surgery
Joseph A Mole, Simon J Prangnell
Deep Brain Stimulation (DBS) is an effective surgical therapy for several neurological movement disorders. The clinical neuropsychologist has a well-established role in the neuropsychological evaluation and selection of surgical candidates. In this article, we argue that the clinical neuropsychologist's role is much broader, when considered in relation to applied psychologists' core competencies. We consider the role of the clinical neuropsychologist in DBS in relation to: assessment, formulation, evaluation and research, intervention or implementation, and communication...
December 13, 2017: Applied Neuropsychology. Adult
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