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Virtual surgical planning

Stanley Yung-Chuan Liu, Douglas Sidell, Leh-Kiong Huon, Carlos Torre
Large, benign intramandibular lesions are frequently removed by resection followed by extensive free tissue transfer or delayed bone grafting. We outline a protocol to remove benign mandibular lesions using sagittal split osteotomy (SSO) with virtual surgical planning (VSP) to mitigate risks involved with this effective, tissue-saving approach. Patients with benign mandibular lesions accessed by SSO with VSP during 2014 were included in this study. Computed tomographic data were imported into VSP software. Using VSP, the exact locations of mandibular lesions and the inferior alveolar nerve canal were delineated...
March 2018: Ear, Nose, & Throat Journal
Micha Pfeiffer, Hannes Kenngott, Anas Preukschas, Matthias Huber, Lisa Bettscheider, Beat Müller-Stich, Stefanie Speidel
PURPOSE: The data which is available to surgeons before, during and after surgery is steadily increasing in quantity as well as diversity. When planning a patient's treatment, this large amount of information can be difficult to interpret. To aid in processing the information, new methods need to be found to present multimodal patient data, ideally combining textual, imagery, temporal and 3D data in a holistic and context-aware system. METHODS: We present an open-source framework which allows handling of patient data in a virtual reality (VR) environment...
March 17, 2018: International Journal of Computer Assisted Radiology and Surgery
Cheng-Hsin Cheng, Hao-Yu Chuang, Hung-Lin Lin, Chun-Lin Liu, Chun-Hsu Yao
OBJECT: The aim of this research was to evaluate the surgical outcome of a new three-dimensional printing (3DP) technique using prefabrication molds and polymethyl methacrylate (PMMA). PATIENTS AND METHODS: The study included 10 patients with large skull defects (>100 cm2 ) who underwent cranioplasty. The causes of the skull defects were trauma (6), bone resorption (2), tumor (1), and infection (1). Before the operation, computed tomography (CT) scans were used to create a virtual plan, and these were then converted to 3-dimensional (3-D) images...
March 9, 2018: Clinical Neurology and Neurosurgery
J S Zhang, L Qu, Q Wang, Q P Gui, Y Z Hou, G C Sun, F Y Li, Z Z Zhang, X L Chen, J Zhang, Z H Sun, X G Yu, B N Xu
Objective: To investigate the clinical value of multimodal navigation-based virtual reality (MNVR) in the needle biopsy of intracranial eloquent lesions. Methods: From January 2016 to January 2017, 20 patients with intracranial deep-seated lesions involving eloquent brain areas underwent MNVR-aided needle biopsy at Department of Neurosurgery, People's Liberation Army General Hospital. Preoperatively, MNVR was used to propose and revise the biopsy planning. Intraoperatively, navigation helped trajectory avoid the eloquent structures...
March 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
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
D Pauchet, J-L Pigot, F Chabolle, C-A Bach
Free fibula transplant is routinely used for mandibular reconstruction in head and neck cancer. Dental rehabilitation, the objective of mandibular reconstruction, requires the use of dental implants as supports for fixed or removable dentures. Positioning of fibular bone grafts and implants determines implant osseointegration and the possibilities of dental rehabilitation. Prefabrication of a fibula free flap with dental implants prior to harvesting as a free flap can promote implant osseointegration. The position of the implants must then be precisely planned...
March 2, 2018: European Annals of Otorhinolaryngology, Head and Neck Diseases
Aladdin Al-Ardah, Nasser Alqahtani, Abdulaziz AlHelal, Brian Goodacre, Rajesh Swamidass, Antoanela Garbacea, Jaime Lozada
This technique describes a novel approach for planning and augmenting a large bony defect using a titanium mesh (TiMe). A 3-dimensional (3D) surgical model was virtually created from a cone beam computed tomography (CBCT) and wax-pattern of the final prosthetic outcome. The required bone volume (horizontally and vertically) was digitally augmented and then 3D printed to create a bone model. The 3D model was then used to contour the TiMe in accordance with the digital augmentation. With the contoured / preformed TiMe on the 3D printed model a positioning jig was made to aid the placement of the TiMe as planned during surgery...
March 2, 2018: Journal of Oral Implantology
Alessandro Pozzi, Lorenzo Arcuri, Peter K Moy
The growing interest in minimally invasive implant placement and delivery of a prefabricated provisional prosthesis immediately, thus minimizing "time to teeth," has led to the development of numerous 3-dimensional (3D) planning software programs. Given the enhancements associated with fully digital workflows, such as better 3D soft-tissue visualization and virtual tooth rendering, computer-guided implant surgery and immediate function has become an effective and reliable procedure. This article describes how modern implant planning software programs provide a comprehensive digital platform that enables efficient interplay between the surgical and restorative aspects of implant treatment...
March 2018: Compendium of Continuing Education in Dentistry
Nicholas Marongiu
When planned and implemented appropriately, single-unit implant dentistry in the smile zone can be an excellent alternative to attempting to save a failing natural tooth. Historically, implant success has revolved around assessment of osseointegration and the healing of bone around the implant, without much regard for esthetics upon completion. As implant dentistry has evolved, the expectations of both restoring clinicians and patients have expanded to emphasize the esthetic outcome as well as faster treatment with immediate implant placement...
March 2018: Compendium of Continuing Education in Dentistry
Alexandra Macmillan, Joseph Lopez, Gerhard S Mundinger, Melanie Major, Miguel A Medina, Amir H Dorafshar
BACKGROUND: Late treatment of scaphocephaly presents challenges including need for more complex surgery to achieve desired head shape. Virtual surgical planning for total vault reconstruction may mitigate some of these challenges, but has not been studied in this unique and complex clinical setting. METHODS: A retrospective chart review was conducted for patients with scaphocephaly who presented to our institution between 2000 and 2014. Patients presenting aged 12 months or older who underwent virtual surgical planning-assisted cranial vault reconstruction were included...
February 23, 2018: Journal of Craniofacial Surgery
Elliot Pascal, Claire Majoufre, Mathieu Bondaz, Adrien Courtemanche, Maïlys Berger, Pierre Bouletreau
Since the advent of orthognathic surgery major efforts have been made to render these surgical procedures more reliable, accurate, reproducible, and shorter. Such improvements imply the enhancement of surgical planning (SP) techniques and optimization of SP transfer tools. Most widespread current SP methods are based on physical examination / anthropometric measurements combined with cephalometric analysis. Most surgeons currently use handmade acrylic surgical splints or sometimes freehand surgery as transfer tool...
February 21, 2018: Journal of Stomatology, Oral and Maxillofacial Surgery
Max J H Witjes, Rutger H Schepers, Joep Kraeima
PURPOSE OF REVIEW: This review describes the advances in 3D virtual planning for mandibular and maxillary reconstruction surgical defects with full prosthetic rehabilitation. The primary purpose is to provide an overview of various techniques that apply 3D technology safely in primary and secondary reconstructive cases of patients suffering from head and neck cancer. RECENT FINDINGS: Methods have been developed to overcome the problem of control over the margin during surgery while the crucial decision with regard to resection margin and planning of osteotomies were predetermined by virtual planning...
April 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Johnny I Efanov, Andrée-Anne Roy, Ke N Huang, Daniel E Borsuk
Objective: Over the past few years, virtual surgical planning (VSP) has evolved into a useful tool for the craniofacial surgeon. Virtual planning and computer-aided design and manufacturing (CAD/CAM) may assist in orthognathic, cranio-orbital, traumatic, and microsurgery of the craniofacial skeleton. Despite its increasing popularity, little emphasis has been placed on the learning curve. Methods: A retrospective analysis of consecutive virtual surgeries was done from July 2012 to October 2016 at the University of Montreal Teaching Hospitals...
January 2018: Plastic and Reconstructive Surgery. Global Open
Manon L Tolhuisen, Guido A de Jong, Ruud J M van Damme, Ferdinand van der Heijden, Hans H K Delye
Virtual planning of open cranial vault reconstruction is used to simulate and define an pre-operative plan for craniosynostosis surgery. However, virtual planning techniques are subjective and dependent on the experience and preferences of the surgical team. To develop an objective automated 3D pre-operative planning technique for open cranial vault reconstructions, we used curvature maps for the shape comparison of the patient's skull with an age-specific reference skull. We created an average skull for the age-group of 11-14 months...
February 20, 2018: Scientific Reports
Andrew J Kobets, Adam Ammar, Jonathan Nakhla, Aleka Scoco, Rani Nasser, James T Goodrich, Rick Abbott
INTRODUCTION: Sagittal synostosis affects 1 in 1000 live births and may result in increased intracranial pressure, hindrance of normal neural development, and cosmetic deformity due to scaphocephaly. Historically, several approaches have been utilized for surgical correction and recently, computed tomography (CT)-guided reconstruction procedures are increasingly used. In this report, the authors describe the use of a CT-derived virtual and stereolithographic (3D printed) craniofacial models, which are used to guide intraoperative bone placement, and intraoperative CT guidance for confirmation of bone placement, to ensure the accuracy of surgical correction of scaphocephaly, as demonstrated to parents...
February 19, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
M Boudissa, H Oliveri, M Chabanas, J Tonetti
Preoperative planning for the management of acetabular fracture is founded on geometric models allowing virtual repositioning of the bone fragments, but not taking account of soft tissue and the realities of the surgical procedure. The present technical note reports results using the first simulator to be based on a patient-specific biomechanical model, simulating the action of forces on the fragments and also the interactions between soft issue and bone: muscles, capsules, ligaments, and bone contacts. In all 14 cases, biomechanical simulation faithfully reproduced the intraoperative behavior of the various bone fragments and reduction quality...
February 16, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
José Thiers Carneiro Júnior, Paulo Hemerson de Moraes, Douglas Voss de Oliveira, Nayara Cristina Monteiro Carneiro
Patients with considerable maxillomandibular anteroposterior discrepancies and maxillary hypoplasia require corrective treatment through orthognathic surgery. However, in the treatment of severe maxillary retrognathism, it is necessary to reconstruct areas of bone deficiency through grafting techniques in addition to maxillary advancement using only the Le Fort I osteotomy. Treatment in these patients is more challenging and requires high surgical predictability. Alloplastic materials often have been used for the reconstruction of poor bone contours...
January 31, 2018: Journal of Oral and Maxillofacial Surgery
Ji-Hyeon Oh
With the development of computer-aided design/computer-aided manufacturing (CAD/CAM) technology, it has been possible to reconstruct the cranio-maxillofacial defect with more accurate preoperative planning, precise patient-specific implants (PSIs), and shorter operation times. The manufacturing processes include subtractive manufacturing and additive manufacturing and should be selected in consideration of the material type, available technology, post-processing, accuracy, lead time, properties, and surface quality...
December 2018: Maxillofacial Plastic and Reconstructive Surgery
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
A Modabber, N Ayoub, A Bock, S C Möhlhenrich, B Lethaus, A Ghassemi, D A Mitchell, F Hölzle
No abstract text is available yet for this article.
February 1, 2018: British Journal of Oral & Maxillofacial Surgery
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