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Preoperative planning

C Keskin, Ö Sivas Yilmaz, U Inan, Ö Özdemir
AIM: to compare the incidence, intensity and prediction of postoperative pain after glide path preparation with manual, continuous rotary and a novel reciprocating glide path instrument. METHODOLOGY: The study included 240 patients, which were treated by 4 specialists according to a planned treatment protocol. Following access cavity preparation and prior to glide path preparation, the subjects were randomly assigned to 1 of the 3 groups according to the glide path instrument by choosing a sealed envelope containing the group name: R-Pilot (VDW, Munich, Germany), ProGlider (Dentsply Sirona, Ballaigues, Switzerland) and stainless-steel K-files (Dentsply Sirona) (n = 80)...
December 8, 2018: International Endodontic Journal
Marco Lucioni, Marco Lionello, Piernicola Machin, Federica Sovran, Fabio Canal, Andy Bertolin, Giuseppe Rizzotto
BACKGROUND: Given the relevance of any tumor invasion of the arytenoid cartilage or crico-arytenoid unit to the planning open partial horizontal laryngectomy (OPHL) for laryngeal squamous cell carcinoma (LSCC), it is important to have a reliable radiological test to assess impairments of these structures. METHODS: We retrospectively compared the endoscopic, radiological, and pathological findings in patients with glottic LSCC who underwent OPHL. RESULTS: The endoscopic finding of a reduced (impaired or absent) vocal cord motility proved more sensitive, with better positive and negative predictive values, but less specific than the radiological finding of complete arytenoid sclerosis in detecting histologically assessable infiltration of the arytenoid cartilage...
December 7, 2018: Head & Neck
G Caiti, J G G Dobbe, A C Y Loenen, M Beerens, S D Strackee, G J Strijkers, G J Streekstra
PURPOSE: 3D-printed patient-specific instruments (PSIs), such as surgical guides and implants, show great promise for accurate navigation in surgical correction of post-traumatic deformities of the distal radius. However, existing costs of computer-aided design and manufacturing process prevent everyday surgical use. In this paper, we propose an innovative semiautomatic methodology to streamline the PSIs design. METHODS: The new method was implemented as an extension of our existing 3D planning software...
December 10, 2018: International Journal of Computer Assisted Radiology and Surgery
Massimiliano M Marrocco-Trischitta, Rodrigo M Romarowski, Hector W de Beaufort, Michele Conti, Renato Vitale, Francesco Secchi, Ferdinando Auricchio, Santi Trimarchi
OBJECTIVES: Our goal was to confirm whether the Modified Arch Landing Areas Nomenclature (MALAN) for thoracic endovascular aortic repair, in which each landing area is described by indicating both the proximal landing zone (PLZ) and the type of arch (e.g. 0/I), identifies unfavourable landing zones for endograft deployment in diseased aortas. METHODS: Preoperative computed tomography angiography scans of 10 patients scheduled for thoracic endovascular aortic repair for aneurysm or penetrating ulcer of the arch and with a potential hostile PLZ were reviewed...
December 7, 2018: European Journal of Cardio-thoracic Surgery
H Brun, R A B Bugge, L K R Suther, S Birkeland, R Kumar, E Pelanis, O J Elle
Aims: Proof of concept and feasibility study for preoperative diagnostic use of mixed reality (MR) holograms of individual 3D heart models from standard cardiac computed tomography angiograms (CTA) images. Optimal repair for complex congenital heart disease poses high demands on 3D anatomical imagination. Three-dimensional printed heart models are increasingly used for improved morphological understanding during surgical and interventional planning. Holograms are a dynamic and interactive alternative, probably with wider applications...
December 6, 2018: European Heart Journal Cardiovascular Imaging
Rachael Leung, Michael P Chae, Vicky Tobin, David J Hunter-Smith, Warren M Rozen
Background: There is limited understanding of anatomy of perforator angiosomes, or "perforasomes," of the deep inferior epigastric artery (DIEA). A perforasome is defined as the territory perfused by a single perforator vessel of a named artery, such as the DIEA. Given the clinical significance of this anatomical concept in microsurgical breast reconstruction, this study is a quantitative investigation of DIEA perforasome characteristics and patterns associated with perforasome size, perforator caliber, location and branching, using computed tomographic (CT) angiography...
October 2018: Plastic and Reconstructive Surgery. Global Open
Gennadiy M Kavalerskiy, Valeriy Y Murylev, Yaroslav A Rukin, Pavel M Elizarov, Alexey V Lychagin, Evgeniya Y Tselisheva
Background: Careful preoperative planning in revision cases with complex acetabular defects is crucial for optimal surgery outcome. However, in many cases, computed tomography (CT) scans cannot give a clear understanding of the pelvic destruction. Three-dimensional (3D) models-based on CT data can help surgeon in planning of complex acetabular reconstruction. Materials and Methods: We used 3D plaster pelvic models in 17 revision cases. There were 5 patients with Paprosky II C acetabular defects, 2 patients with Paprosky IIIA defects, and 10 patients with Paprosky IIIB defects (3 patients among them with pelvic discontinuity)...
November 2018: Indian Journal of Orthopaedics
David E Janhofer, Chrisovalantis Lakhiani, Paul J Kim, Cameron Akbari, Iram Naz, Eshetu A Tefera, Christopher E Attinger, Karen Kim Evans
BACKGROUND: In patients with lower extremity wounds, free tissue transfer is often the last option before amputation, making it crucial to optimize preoperative planning in order to prevent flap breakdown. No consensus exists regarding preoperative vascular work ups before lower extremity free tissue transfer. Here we analyzed the utility of using arteriography for lower extremity free flap planning. METHODS: A retrospective review was performed of 57 patients who underwent lower extremity arteriography and 59 free flap operations for lower extremity wounds between November 2014 and August 2017...
November 26, 2018: Plastic and Reconstructive Surgery
Runqi Xue, Qingguo Lai, Shaolong Sun, Lei Lai, Xiaopeng Tang, Jiangbo Ci, Zhichao Zhang, Yang Wang
The reconstruction of orbital-maxillary-zygomatic complex (OMZC) on patients suffering from trauma and space-occupying lesions is challenging due to the irregularity of craniomaxillofacial bones. To overcome the challenge in precise OMZC reconstruction, individual three-dimensional (3D) disease models and mirror-imaged 3D reconstruction models were printed on the basis of the computer tomography. Preoperative planning by rehearsing surgical procedures was made on the 3D disease models and the scaffolds including titanium and absorbable meshes or plates were anatomically premolded using the mirror-imaged 3D models as guide...
December 10, 2018: Journal of Craniofacial Surgery
R Fitzgerald, A Smyth
Patients with cleft lip and palate may require orthognathic surgery to correct severe impairments in midfacial growth. Maxillary advancement in this group, however, is linked to deterioration in velopharyngeal function (VPF), and it is not clear how cleft teams assess this risk. We therefore surveyed surgeons from 15 cleft units who provide orthognathic treatment, to gain an understanding of current practice in the UK and Ireland. A total of 16/21 surgeons from 14/15 units responded. While 14/16 surgeons agreed that these patients are at risk of a deterioration in VPF after maxillary advancement, two disagreed...
December 7, 2018: British Journal of Oral & Maxillofacial Surgery
Jack T Holladay, George Pettit
PURPOSE: To determine in cataract surgery the total surgically induced astigmatism (SIA) that accounts for all factors that contribute to the difference between preoperative keratometric and postoperative refractive astigmatism other than any toricity of an intraocular lens (IOL). SETTING: Twenty surgical sites in the United States. DESIGN: Retrospective case series. METHODS: An analysis was performed of 4 clinical trials involving toric IOLs and nontoric IOLs in standard cataract surgery...
December 6, 2018: Journal of Cataract and Refractive Surgery
Elizabeth Warnack, Shubhada Dhage, Elaheh Johnson, Elizabeth Horowitz, Kathie Ann Joseph
BACKGROUND: Use of MRI for preoperative evaluation of newly diagnosed breast cancer has become more common, despite questionable impact on outcomes. We sought to determine how often and in what manner preoperative breast MRI changed surgical management in an underserved patient population. MATERIALS AND METHODS: We examined the use of preoperative MRI at Bellevue Hospital Center (BHC), a public, tertiary hospital in lower Manhattan with a large underserved population...
February 2019: Journal of Surgical Research
Mauricio Kfuri, Joseph Schatzker
Tibial plateau fractures have a broad spectrum of presentations, depending on the mechanism and energy of the trauma. Many classification systems are currently available to describe these injuries. In 1974, Schatzker proposed a classification based on a two-dimensional representation of the fracture. His classification with the six-principles types became one of the most utilized classification systems for tibial plateau fractures. More than four decades after this original publication, we are revisiting each fracture type in the light of information made available by computed tomography, which today comprises a standard tool in assessing articular fractures...
December 2018: Injury
Joan M Irizarry-Alvarado, Matthew Lundy, Barbara McKinney, Frank A Ray, Virginia E Reynolds, Sher-Lu Pai
In 2008, Mayo Clinic in Jacksonville, Florida, developed the preoperative evaluation (POE) clinic under the department of anesthesiology to provide preoperative history and physical examination, and medical optimization. Over time, the POE clinic expanded to accommodate more than 90% of surgical patients, outgrowing the initial practice model. The increased patient volume with shortened turnaround times bottlenecked patient access. A multidisciplinary quality improvement team used Define, Measure, Analyze, Improve, and Control methodology to understand the issues, test potential solutions, and develop sustainable processes...
December 7, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
Jeremy M C Brown, Gerard G Hanna, Nathanael Lampe, Balder Villagomez-Bernabe, James R Nicol, Jonathan A Coulter, Fred J Currell
A novel treatment planning framework, the Relative Biological Effective Dose (RBED), for high Z nanoparticle (NP)-enhanced photon radiotherapy is developed and tested in silico for the medical exemplar of neoadjuvant (preoperative) breast cancer MV photon radiotherapy. Two different treatment scenarios, conventional and high Z NP enhanced, were explored with a custom Geant4 application that was developed to emulate the administration of a single 2 Gy fraction as part of a 50 Gy radiotherapy treatment plan. It was illustrated that there was less than a 1% difference in the dose deposition throughout the standard and high Z NP-doped adult female phantom...
2018: Cancer Nanotechnology
Lukas A Holzer, Georg Scholler, Stefan Wagner, Jörg Friesenbichler, Werner Maurer-Ertl, Andreas Leithner
INTRODUCTION: Preoperative planning is an essential part of total hip arthroplasty (THA). It facilitates the surgical procedure, helps to provide the correct implant size and aims at restoring biomechanical conditions. In recent times, surgeons rely more and more on digital templating techniques. Although the conversion to picture archiving and communication system had many positive effects, there are still problems that have to be taken into consideration. OBJECTIVES: The core objective was to evaluate the impact of the planners' experience on the accuracy of predicting component size in digital preoperative templating of THA...
December 6, 2018: Archives of Orthopaedic and Trauma Surgery
Norio Imai, Ryota Takubo, Hayato Suzuki, Hayato Shimada, Dai Miyasaka, Kazuki Tsuchiya, Naoto Endo
BACKGROUND: In obese patients, malpositioning of the acetabular cup increases the risk of dislocation in total hip arthroplasty (THA). The aim of this study was to determine whether obesity affects the accuracy of acetabular cup positioning using a computed tomography (CT)-based navigation system. METHODS: We retrospectively evaluated 226 consecutive patients who underwent cementless primary THAs assisted by the CT-based hip navigation system. We divided the patients into three groups according to body mass index (BMI) and examined the difference between preoperative planning and postoperative implantation angles from CT data...
December 3, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Luigi V Stefanelli, Bradley S DeGroot, David I Lipton, George A Mandelaris
PURPOSE: To evaluate the in vivo accuracy of dental implants placed using a dynamic computer-aided dental implant (CAI) navigation system. The impact of various factors on accuracy was also analyzed. MATERIALS AND METHODS: A retrospective, in vivo study was performed during the period of October 2015 to December 2017. Data were obtained on all implants placed during this time frame. A chart review was conducted to identify the type of flap, number of implants placed, number of patients treated, and factors related to the description of edentulism (partial or complete)...
December 5, 2018: International Journal of Oral & Maxillofacial Implants
Eduardo Nascimento Gomes, Ricardo Ribeiro Dias, Bruno Aragão Rocha, José Augusto Duncan Santiago, Fabrício José de Souza Dinato, Eduardo Keller Saadi, Walter J Gomes, Fabio B Jatene
INTRODUCTION: Three-dimensional (3D) printing has become an affordable tool for assisting heart surgeons in the aorta endovascular field, both in surgical planning, education and training of residents and students. This technique permits the construction of physical prototypes from conventional medical images by converting the anatomical information into computer aided design (CAD) files. OBJECTIVE: To present the 3D printing feature on developing prototypes leading to improved aortic endovascular surgical planning, as well as transcatheter aortic valve implantation, and mainly enabling training of the surgical procedure to be performed on patient's specific condition...
September 2018: Brazilian Journal of Cardiovascular Surgery
Noriaki Iizuka, Yoshihiro Ikura, Yasunori Fukuoka, Takashi Shibata, Masashi Okamoto, Akio Kamiya, Tetsuya Oishi, Fumikazu Kotsuji, Yasuhiro Iwai
Primary ovarian lymphomas are rare, but can potentially evoke diagnostic problems. We present a case of ovarian lymphoma, in which an ambiguous intraoperative pathologic report led to overtreatment (unnecessary surgery). A 73-yr-old woman with fatigue and low-grade fever was diagnosed as having a left ovarian tumor by imaging modalities. Exploratory laparotomy was carried out to confirm the diagnosis. The frozen tissue sections of the ovarian tumor showed condensed proliferation of atypical round cells accompanied with a few small lymphocytes...
December 3, 2018: International Journal of Gynecological Pathology
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