Search results for "procedures"
showing 10 items of 1678 documents
Temporobasal, Transsphenoidal Meningoencephalocele Becoming Symptomatic with Spontaneous Cerebrospinal Fluid Rhinorrhea: Diagnostic Work-up and Micro…
2012
Background We report the rare case of an adult transsphenoidal meningoencephalocele and outline the microneurosurgical strategy. Clinical history, the findings of computerized tomography (CT) scans and magnetic resonance imaging (MRI), the microsurgical procedure, and histopathology are reported. Case Report A 54-year-old female patient complained about cerebrospinal fluid (CSF) rhinorrhea; a transnasal biopsy of a mass in the maxillar sinus prior to diagnostic work-up was performed elsewhere. Persisting CSF leakage prompted CT and MRI, which showed brain tissue extending from the left middle cranial fossa into the left sphenoid sinus through several bony defects. The diagnosis of a trans…
Microsurgical treatment of midfacial tumours involving the skull base
1998
Various approaches to the base of the skull for the treatment of cranial base tumours are described in detail. Advantages and disadvantages of the particular approaches are discussed. This clinical experience is based on 303 neoplasms involving the base of the skull, operated on by the authors. Retrospective survival studies are presented and a review of the literature on the subject is discussed. Utilizing microsurgical techniques the 2-, 3- and 5-year survival rates were significantly improved. The functional and aesthetic outcomes were also dramatically superior compared with standard ablative procedures. Reconstructive postoperative strategies are suggested.
Microsurgical fenestration of perineural cysts to the thecal sac at the level of the distal dural sleeve
2011
Background Surgery for symptomatic sacral perineural cysts remains an issue of discussion. Assuming micro-communications between the cyst and thecal sac resulting in a valve mechanism and trapping of CSF as a pathomechanism, microsurgical fenestration from the cyst to the thecal sac was performed to achieve free CSF communication. Methods In 13 consecutive patients (10 female, 3 male), MRI revealed sacral perineural cysts and excluded other pathologies. Micro-communication between the thecal sac and the cysts was shown by delayed contrast filling of the cysts on postmyelographic CT. Surgical fenestration achieved free CSF communication between the thecal sac and cysts in all patients. The p…
Minimally invasive superficial temporal artery to middle cerebral artery bypass through a minicraniotomy: benefit of three-dimensional virtual realit…
2009
Object The aim of the authors in this study was to introduce a minimally invasive superficial temporal artery to middle cerebral artery (STA-MCA) bypass surgery by the preselection of appropriate donor and recipient branches in a 3D virtual reality setting based on 3-T MR angiography data. Methods An STA-MCA anastomosis was performed in each of 5 patients. Before surgery, 3-T MR imaging was performed with 3D magnetization-prepared rapid acquisition gradient echo sequences, and a high-resolution CT 3D dataset was obtained. Image fusion and the construction of a 3D virtual reality model of each patient were completed. Results In the 3D virtual reality setting, the skin surface, skull surface…
Evaluation of demineralized bone and bone transplantsin vitroandin vivowith cone beam computed tomography imaging
2010
The objective of this study was to determine the ability of two flat panel cone beam CT (CBCT) devices to identify demineralized bone and bone transplants in vivo and in vitro.Datasets from patients with autologous bone grafts (n = 9, KaVo 3DeXam (KaVo, Biberach, Germany); n = 38, Accuitomo 40 (Morita, Osaka, Japan)) were retrospectively evaluated. Demineralized and non-demineralized porcine cancellous bone blocks were examined with the two CBCT devices. A SawBone skull (Pacific Research Laboratories, Vashon, WA) was used as a positioning tool for the bone blocks. Descriptive evaluation and image quality assessment were conducted on the KaVo 3DeXam data (voxel size 0.3 mm) using the OsiriX …
Three-Dimensional Reconstruction of the Bony Nasolacrimal Canal by Automated Segmentation of Computed Tomography Images.
2016
Objective To apply a fully automated method to quantify the 3D structure of the bony nasolacrimal canal (NLC) from CT scans whereby the size and main morphometric characteristics of the canal can be determined. Design Cross-sectional study. Subjects 36 eyes of 18 healthy individuals. Methods Using software designed to detect the boundaries of the NLC on CT images, 36 NLC reconstructions were prepared. These reconstructions were then used to calculate NLC volume. The NLC axis in each case was determined according to a polygonal model and to 2nd, 3rd and 4th degree polynomials. From these models, NLC sectional areas and length were determined. For each variable, descriptive statistics and nor…
Patient-Specific Rehearsal Feasibility Before Endovascular Repair of Ruptured Abdominal Aortic Aneurysm.
2019
Purpose: To evaluate the feasibility of a patient-specific rehearsal (PsR) before emergency endovascular aneurysm repairs (eEVAR) and its influence on the operation. Materials and Methods: From February 2016 to October 2016, 10 consecutive patients (mean age 75 +/- 7.4 years; 9 men) presenting with a ruptured abdominal aortic aneurysm (rAAA) suitable for standard EVAR were enrolled in the study. A 3-dimensional (3D) model of the abdominal aorta was generated on a virtual reality simulator based on the patient's computed tomography (CT) images. Following the patient-specific simulation setup, PsR was conducted during patient admission or in parallel with the preoperative eEVAR workup. Measur…
Arch expansion with the Invisalign system: Efficacy and predictability.
2020
Background In adult patients, treatment of skeletal crossbite requires combined treatment by fixed or removable appliances and orthognathic surgery. In cases of dentoalveolar crossbite, expansion can be achieved with fixed multibrackets and removable transparent aligners. Various researchers have already assessed the Invisalign system’s predictability for arch expansion. However, most of this research was conducted using older appliances, making it necessary to assess the characteristics of the updated system SmartTrack. Material and methods A sample of 114 patients with transverse malocclusion were treated with SmartTrack. The predictability of the system’s software (Clincheck) was assess…
An investigation of the diagnostic, predictive, and prognostic impacts of three colonic biopsy grading systems for acute graft versus host disease.
2021
Acute graft versus host disease (aGvHD) is an important, life-threatening complication after allogeneic hematopoietic stem cell transplantation (alloHSCT). To investigate the value of multiple simultaneous colon biopsies in improving diagnostic accuracy in patients with aGvHD, we retrospectively analyzed 157 patients after alloHSCT. The biopsies were evaluated individually using three established histological grading systems (Lerner, Sale, and Melson). The maximum, minimum, median, and mean histological aGvHD grades were calculated for each patient, and the results were correlated with the Glucksberg grade of clinical manifestation of GvHD, steroid therapy status, and outcome. We found that…
Predicting positive surgical margins in partial nephrectomy: A prospective multicentre observational study (the RECORd 2 project)
2020
PURPOSE: to evaluate clinical predictors of positive surgical margins (PSMs) in a large multicenter prospective observational study and to develop a clinic nomogram to predict the likelihood of PSMs after partial nephrectomy (PN). MATERIALS AND METHODS: We prospectively evaluated 4308 patients who had surgical treatment for renal tumors between January 2013 and December 2016 at 26 urological Italian Centers (RECORd 2 project). Two multivariable logistic models were evaluated to predict the likelihood of PSMs. Center caseload was dichotomized using a visual assessment adjusted for several predictors of PSMs. A nomogram predicting PSMs was developed. RESULTS: Overall, 2076 patients treated wi…