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Virtual surgical planning

Georg D Strbac, Albrecht Schnappauf, Katharina Giannis, Michael H Bertl, Andreas Moritz, Christian Ulm
INTRODUCTION: The aim of this study was to introduce an innovative method for autotransplantation of teeth using 3-dimensional (3D) surgical templates for guided osteotomy preparation and donor tooth placement. METHODS: This report describes autotransplantation of immature premolars as treatment of an 11-year-old boy having suffered severe trauma with avulsion of permanent maxillary incisors. This approach uses modified methods from guided implant surgery by superimposition of Digital Imaging and Communications in Medicine files and 3D data sets of the jaws in order to predesign 3D printed templates with the aid of a fully digital workflow...
October 21, 2016: Journal of Endodontics
Yafei Qi, Xiaoyuan Ma, Gang Li, Xiangxing Ma, Qing Wang, Dexin Yu
AIMS: Conventional computed tomography (CT) approaches provides limited visualization of the entire endoluminal changes of aortic dissection (AD), which is essential for its treatment. As an important supplement, three-dimensional CT virtual intravascular endoscopy (VIE) can show relevant details. This study aims to determine the value of VIE in displaying the entry tear and intimal flap of AD. METHODS AND RESULTS: Among 127 consecutive symptomatic patients with suspected AD who underwent CT angiography (CTA), 84 subjects were confirmed to have AD and were included in the study...
2016: PloS One
Harsh Pipalia, Praveen Ganesh, Samarth Shetty, Paul C Salins, Rohan Raut, Kiran Kumar Boyina
Three-dimensional virtual surgery programs are widely available for orthognathic surgery. The advent of imaging software programs has proved to be useful for diagnosis, treatment planning, outcome measurement, and three-dimensional surgical simulation. Complex maxillofacial malformations continue to present challenges in analysis and correction beyond modern technology. Orthomorphic correction for mandibular dysmorphology refers to basal bone movement without any change in dental component. The purpose of this paper is to present a virtual surgery planning for surgeons to perform the orthomorphic surgery with precision and quantification...
October 14, 2016: Journal of Craniofacial Surgery
Abib Agbetoba, Amber Luong, Jin Keat Siow, Brent Senior, Claudio Callejas, Kornel Szczygielski, Martin J Citardi
BACKGROUND: Endoscopic sinus surgery represents a cornerstone in the professional development of otorhinolaryngology trainees. Mastery of these surgical skills requires an understanding of paranasal sinus and skull-base anatomy. The frontal sinus is associated with a wide range of variation and complex anatomical configuration, and thus represents an important challenge for all trainees performing endoscopic sinus surgery. METHODS: Forty-five otorhinolaryngology trainees and 20 medical school students from 5 academic institutions were enrolled and randomized into 1 of 2 groups...
October 18, 2016: International Forum of Allergy & Rhinology
Yan-Lin Liu, Guo-Yang Li, Ping He, Ze-Qi Mao, Yanping Cao
Determining the mechanical properties of brain tissues is essential in such cases as the surgery planning and surgical training using virtual reality based simulators, trauma research and the diagnosis of some diseases that alter the elastic properties of brain tissues. Here, we suggest a protocol to measure the temperature-dependent elastic properties of brain tissues in physiological saline using the shear wave elastography method. Experiments have been conducted on six porcine brains. Our results show that the shear moduli of brain tissues decrease approximately linearly with a slope of -0...
September 21, 2016: Journal of the Mechanical Behavior of Biomedical Materials
Alexandre Hardy, Philippe Loriaut, Benjamin Granger, Ahmed Neffati, Audrey Massein, Laurent Casabianca, Hugues Pascal-Moussellard, Antoine Gerometta
PURPOSE: The arthroscopic Latarjet procedure has provided reliable results in the treatment of anterior shoulder instability. However, this procedure remains technically challenging and is related to several complications. The morphology of the coracoid and the glenoid are inconsistent. Inadequate coracoid and glenoid preparing may lead to mismatching between their surfaces. Inadequate screws lengthening and orientation are a major concern. Too long screws can lead to suprascapular nerve injuries or hardware irritation, whereas too short screws can lead to nonunions, fibrous unions or migration of the bone block...
October 12, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Filip Jonkergouw, Florence Allé, Karim Chellaoui, Jos Vander Sloten, Dieter Vangeneugden
The performance of implant placement technologies are often evaluated based on their achieved post-operative implant alignment. Therefore accurate assessment techniques are necessary to compare pre-operatively planned implant positions with the corresponding post-operatively placed implant positions in total knee arthroplasty. This paper describes a CT based 3D measurement method for evaluation of implant positioning accuracy comparing post-operative implant position to the corresponding pre-operative planned implant position using 3D virtual models...
October 7, 2016: Medical Engineering & Physics
José E Barrera
Multilevel surgery has been established as the mainstay of treatment for the surgical management of obstructive sleep apnea (OSA). Combined with uvulopalatopharyngoplasty, tongue-base surgeries, including the genioglossus advancement (GA), sliding genioplasty, and hyoid myotomy and suspension, have been developed to target hypopharyngeal obstruction. Total airway surgery consisting of maxillomandibular advancement (MMA) with/without GA has shown significant success. Skeletal procedures for OSA with or without a palatal procedure is a proven technique for relieving airway obstruction during sleep...
October 6, 2016: Otolaryngologic Clinics of North America
Wen-Bo Zhang, Yao Yu, Yang Wang, Chi Mao, Xiao-Jing Liu, Chuan-Bin Guo, Guang-Yan Yu, Xin Peng
While vascularized iliac crest flap is widely used for mandibular reconstruction, it is often challenging to predict the clinical outcome in a conventional operation based solely on the surgeon's experience. Herein, we aimed to improve this procedure by using computer-assisted techniques. We retrospectively reviewed records of 45 patients with mandibular tumor who underwent mandibulectomy and reconstruction with vascularized iliac crest flap from January 2008 to June 2015. Computer-assisted techniques including virtual plan, stereomodel, pre-bending individual reconstruction plate, and surgical navigation were used in 15 patients...
August 25, 2016: Journal of Cranio-maxillo-facial Surgery
Willem L J Weijs, Casper Coppen, Ruud Schreurs, Rinaldo D Vreeken, Arico C Verhulst, Matthias A W Merkx, Stefaan J Bergé, Thomas J J Maal
OBJECTIVE: Since reconstruction of composite defects in the head and neck region is a challenging and demanding problem for head and neck surgeons, surgical aids have been sought for decades. The purpose of this study was to evaluate the accuracy of prefabricated surgical resection templates used in mandibular segmental resections in comparison to the virtual surgical plan. MATERIALS AND METHODS: A prospective study was performed in 11 consecutive patients, with a primary T4 oral squamous cell carcinoma or osteoradionecrosis of the mandible...
September 9, 2016: Journal of Cranio-maxillo-facial Surgery
Anders Rosendal Korshoej, Guilherme Bicalho Saturnino, Line Kirkegaard Rasmussen, Gorm von Oettingen, Jens Christian Hedemann Sørensen, Axel Thielscher
OBJECTIVE: The present work proposes a new clinical approach to TTFields therapy of glioblastoma. The approach combines targeted surgical skull removal (craniectomy) with TTFields therapy to enhance the induced electrical field in the underlying tumor tissue. Using computer simulations, we explore the potential of the intervention to improve the clinical efficacy of TTFields therapy of brain cancer. METHODS: We used finite element analysis to calculate the electrical field distribution in realistic head models based on MRI data from two patients: One with left cortical/subcortical glioblastoma and one with deeply seated right thalamic anaplastic astrocytoma...
2016: PloS One
Bryan T Harris, Daniel Montero, Gerald T Grant, Dean Morton, Daniel R Llop, Wei-Shao Lin
This clinical report proposes a digital workflow using 2-dimensional (2D) digital photographs, a 3D extraoral facial scan, and cone beam computed tomography (CBCT) volumetric data to create a 3D virtual patient with craniofacial hard tissue, remaining dentition (including surrounding intraoral soft tissue), and the realistic appearance of facial soft tissue at an exaggerated smile under static conditions. The 3D virtual patient was used to assist the virtual diagnostic tooth arrangement process, providing patient with a pleasing preoperative virtual smile design that harmonized with facial features...
September 22, 2016: Journal of Prosthetic Dentistry
Rajendra Sawh-Martinez, Yassmin Parsaei, Robin Wu, Alexander Lin, Philipp Metzler, Christopher DeSesa, Derek M Steinbacher
PURPOSE: Virtual surgical planning (VSP) using computer-aided design and manufacturing (CAD-CAM) has been reported to aid in craniofacial reconstruction. The reported improvements have been related mainly to operative performance, with limited evaluations of the position and function of the temporomandibular joint (TMJ). This study analyzed the radiographic detail of postoperative outcomes related to the TMJ. MATERIALS AND METHODS: Patients who underwent mandibular reconstruction with and without VSP were analyzed...
August 25, 2016: Journal of Oral and Maxillofacial Surgery
M Lefranc, J Peltier
The ROSA® robot (Medtech, Montpellier, France) is a new medical device designed to assist the surgeon during minimally invasive spine procedures. The device comprises a patient-side cart (bearing the robotic arm and a workstation) and an optical navigation camera. The ROSA® Spine robot enables accurate pedicle screw placement. Thanks to its robotic arm and navigation abilities, the robot monitors movements of the spine throughout the entire surgical procedure and thus enables accurate, safe arthrodesis for the treatment of degenerative lumbar disc diseases, exactly as planned by the surgeon...
October 2016: Expert Review of Medical Devices
Michael S Block, Robert W Emery, Kathryn Lank, James Ryan
PURPOSE: The aim of this prospective study was to determine platform and angle accuracy for dental implants using dynamic navigation, a form of computer-assisted surgery. Three hypotheses were considered: (1) the overall accuracy for implant placement relative to the virtual plan is similar to that of static tooth-borne computerized tomography (CT)-generated guides; (2) the dynamic system is more accurate than freehand methods; and (3) there is a learning curve associated with this method...
September 19, 2016: International Journal of Oral & Maxillofacial Implants
Bernhard Pommer, Dieter Busenlechner, Rudolf Fürhauser, Georg Watzek, Georg Mailath-Pokorny, Robert Haas
INTRODUCTION: Minimally invasive implantology using reduced implant dimensions as well as virtual treatment planning and CAD/CAM stereolithographic templates has gained popularity in recent years. The aim of the present investigation was to analyze prevailing trends in clinical utilization of these graftless therapeutic options. MATERIAL AND METHODS: A total of 12.865 dental implants were placed in 5.365 patients at the Academy for Oral Implantology in Vienna, of which 5...
August 21, 2016: Journal of Cranio-maxillo-facial Surgery
Guo-Chen Sun, Xiao-Lei Chen, Yuan-Zheng Hou, Xin-Guang Yu, Xiao-Dong Ma, Gang Liu, Lei Liu, Jia-Shu Zhang, Hao Tang, Ru-Yuan Zhu, Ding-Biao Zhou, Bai-Nan Xu
OBJECTIVE Endoscopic removal of intracerebral hematomas is becoming increasingly common, but there is no standard technique. The authors explored the use of a simple image-guided endoscopic method for removal of spontaneous supratentorial hematomas. METHODS Virtual reality technology based on a hospital picture archiving and communications systems (PACS) was used in 3D hematoma visualization and surgical planning. Augmented reality based on an Android smartphone app, Sina neurosurgical assist, allowed a projection of the hematoma to be seen on the patient's scalp to facilitate selection of the best trajectory to the center of the hematoma...
September 16, 2016: Journal of Neurosurgery
Nancy Clelland, Jahanzeb Chaudhry, Robert G Rashid, Edwin McGlumphy
PURPOSE: To compare splinted and individual restorations supported by short implants featuring an internal connection utilizing a split-mouth design. MATERIALS AND METHODS: Splinted and nonsplinted implant crowns were prospectively compared in 18 patients. After verifying the need for at least two consecutive implants bilaterally, computed tomography scans were made, virtual planning was done, and qualifying patients were enrolled. Implants were placed using a two-stage surgical approach...
September 2016: International Journal of Oral & Maxillofacial Implants
Amedeo Anselmi, Sophie Collin, Pascal Haigron, Jean-Philippe Verhoye, Erwan Flecher
BACKGROUND: Mechanical and hemodynamic factors are among the determinants of patient-device interaction and early-term and long-term outcomes in left ventricular assist device (LVAD) recipients. MATERIAL AND METHODS: We are currently developing computer simulation tools aimed at (1) analyze the intrathoracic and intracavitary positioning of LVADs after implantation and establish correlation with clinical outcomes; (2) assist surgeons in the choice of device and of left ventricular coring site for optimized intrathoracic placement and function; and (3) facilitate the planning of less-invasive LVAD implantation...
September 2016: Journal of Surgical Research
Ralf A Kockro, Tim Killeen, Ali Ayyad, Martin Glaser, Axel Stadie, Robert Reisch, Alf Giese, Eike Schwandt
OBJECTIVE: Aneurysm surgery demands precise spatial understanding of the vascular anatomy and its surroundings. We report on a decade of experience planning clipping procedures pre-operatively in a virtual reality (VR) workstation and present outcomes with respect to mortality, morbidity and aneurysm occlusion rate. METHODS: Between 2006 and 2015, the clipping of 115 intracranial aneurysms in 105 patients was pre-operatively planned with the Dextroscope, a stereoscopic, patient-specific VR environment...
September 5, 2016: World Neurosurgery
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