Treatment planning for sinus lift augmentations through use of 3-dimensional milled models derived from computed tomography scans

Author(s):  
Alexander Gaggl ◽  
Günter Schultes ◽  
Gert Santler ◽  
Hans Kärcher
2014 ◽  
Vol 145 (2) ◽  
pp. 256-264 ◽  
Author(s):  
Kyung-Yen Nahm ◽  
Yong Kim ◽  
Yong-Suk Choi ◽  
Jeongjin Lee ◽  
Seong-Hun Kim ◽  
...  

2011 ◽  
Vol 68 (suppl_1) ◽  
pp. ons125-ons129 ◽  
Author(s):  
Ealmaan Kim ◽  
Johnny B. Delashaw

Abstract BACKGROUND: A standard pterional approach with a free bone flap to treat brain aneurysms was first introduced and popularized by Yaşargil. OBJECTIVE: To describe a modified pterional craniotomy technique and that mobilizes part of the sphenoid wing and the pterion in a block with the temporalis muscle to enhance cosmetic results. METHODS: A subperiosteal corridor is provided inferiorly by separating the temporalis muscle from the underlying bone in a retrograde dissection. Inferior chisel cuts from the front and back enter the sphenoid wing, enabling removal of part of the sphenoid wing and the pterion in 1 piece, along with the bone flap. Forty patients with aneurysms were treated in this fashion, and the cosmetic outcome was examined at 6 months postoperatively. RESULTS: Thirty-seven patients (92.5%) demonstrated an unremarkable degree of temporalis muscle atrophy. Excellent configuration and fusion of the pterional bone flap were observed on 3-dimensional computed tomography scans. CONCLUSION: With the use of this muscle-preserving and bone-sparing pterional approach and with little additional labor, temporalis muscle function is preserved and improved cosmesis is obtained.


2019 ◽  
Vol 13 (Supl 1) ◽  
pp. 52S
Author(s):  
Bruno Rodrigues de Miranda ◽  
Rui Dos Santos Barroco ◽  
Leticia Zaccaria Prates de Oliveira ◽  
Mahmoud Beerens Abdul Ghani Abdul Ghani ◽  
Antonio Candido de Paula Neto ◽  
...  

Introduction: Hallux valgus is a 3-dimensional deformity involving an increased intermetatarsal I/II angle and a rotational deformity of the first metatarsal bone. Kim et al. developed a method for measuring the tibial sesamoid position relative to the coronal rotation of the first metatarsal bone in computed tomography scans under simulated weight-bearing conditions. Objective: To describe a method for the topographic assessment of the correction of tibial sesamoid and metatarsal pronation using computed tomography scans under simulated weight-bearing and active toe extension. Method: We performed computed tomography under simulated weight-bearing conditions with and without active toe dorsiflexion, observing the degree of metatarsal pronation and sesamoid subluxation. For measurement purposes, we used the classifications of Kim et al. and Smith et al. Results: We observed tomographic correction, both angular and rotational, by measuring the intermetatarsal angle and tibial sesamoid position, which were confirmed by the change in the alpha angle suggested by Kim et al. Discussion: Toe extension was described as a peroneus longus tendon activation test by Klemola et al., who used this maneuver to demonstrate clinical rotational correction of hallux valgus. We described the use of a tomographic technique that followed this principle to preoperatively observe the underlying factors that may affect the rotational correction of the deformity. Conclusion: The method has the capacity for correction in various planes involving derotation of the first metatarsal bone and the relationship between such derotation and the change in sesamoid position in relation to the coronal plane of the foot.


Author(s):  
Stephen A. Parada ◽  
Josef K. Eichinger ◽  
Guillaume D. Dumont ◽  
Carrie A. Parada ◽  
Alyssa R. Greenhouse ◽  
...  

2019 ◽  
Vol 18 ◽  
pp. 153303381987989
Author(s):  
Xuanzi Sun ◽  
Yi Li ◽  
Junjun Li ◽  
Xiaozhi Zhang

Purpose: Large tumor motion often leads to larger dosimetric variation, especially in lung tumors located in lower lobe and adhered to chest wall or diaphragm. The purpose of this work is to discuss the impact of the time proportion of each respiratory phase on dosimetry in stereotactic body radiation therapy with lung cancer tumor close to chest wall or diaphragm. Methods: Participants include 14 patients with lung cancer located in the lower lobe. Each patient received treatment planning 3-dimensional computed tomography and an additional 4-dimensional computed tomography simulation under free-breathing condition. The percentage of time intervals for each respiratory phase in a whole respiratory cycle was calculated from respiratory motion curves recorded during 4-dimensional computed tomography scanning. Treatment plan was made upon treatment planning 3-dimensional computed tomography and then transformed onto each image of 4-dimensional computed tomography. The transformed doses on each image of 4-dimensional computed tomography were accumulated with equal weight or with weight of time proportion for each respiratory phase. Results: Compared to treatment planning 3-dimensional computed tomography dose, the mean dose of tumor, affected lung, contralateral lung, bilateral lungs, and V20 of affected lung decreased by 2.7%, 4.5%, 1.5%, 1.2%, and 4.1%, respectively, after equal-weighted accumulation, while mean dose of heart increased by 3.6% ( P < .05). Accumulated dose with weight of actual time proportion decreased in the mean dose of tumor, affected lung, contralateral lung, bilateral lungs, and V20 of affected lung by 2.37%, 5.19%, 3.61%, 3.46%, and 5.08%, respectively compared to treatment planning 3-dimensional computed tomography dose, but mean dose of heart increased by 5.12% ( P < .05). Conclusions: Doses received by tumor, lungs, and heart changed more significantly after time-weighted 4-dimensional accumulation than equal-weight 4-dimensional accumulation. Utilizing 4-dimensional computed tomography and deformable image registration to introduce time proportions of each respiratory phase to dose distribution evaluation is of significance for accuracy in lung cancer during stereotactic body radiation therapy treatment.


2017 ◽  
Vol 16 (3) ◽  
pp. 352-356 ◽  
Author(s):  
Omar Iskanderani ◽  
Dominique Béliveau-Nadeau ◽  
Robert Doucet ◽  
Geneviève Coulombe ◽  
Deborah Pascale ◽  
...  

Purpose: Our preferred treatment for juxtapapillary choroidal melanoma is stereotactic radiotherapy. We aim to describe our immobilization system and quantify its reproducibility. Materials and Methods: Patients were identified in our radiosurgery database. Patients were imaged at computed tomography simulator with an in-house system which allows visual monitoring of the eye as the patient fixates a small target. All patients were reimaged at least once prior to and/or during radiotherapy. The patients were treated on the CyberKnife system, 60 Gy in 10 daily fractions, using skull tracking in conjunction with our visual monitoring system. In order to quantify the reproducibility of the eye immobilization system, computed tomography scans were coregistered using rigid 6-dimensional skull registration. Using the coregistered scans, x, y, and z displacements of the lens/optic nerve insertion were measured. From these displacements, 3-dimensional vectors were calculated. Results: Thirty-four patients were treated from October 2010 to September 2015. Thirty-nine coregistrations were performed using 73 scans (2-3 scans per patient). The mean displacements of lens and optic nerve insertion were 0.1 and 0.0 mm. The median 3-dimensional displacements (absolute value) of lens and nerve insertion were 0.8 and 0.7 mm (standard deviation: 0.5 and 0.6 mm). Ninety-eight percent of 3-dimensional displacements were below 2 mm (maximum 2.4 mm). The calculated planning target volume (PTV) margins were 0.8, 1.4, and 1.5 mm in the anterior–posterior, craniocaudal, and right–left axes, respectively. Following this analysis, no further changes have been applied to our planning margin of 2 to 2.5 mm as it is also meant to account for uncertainties in magnetic resonance imaging to computed tomography registration, skull tracking, and also contouring variability. Conclusion: We have found our stereotactic eye immobilization system to be highly reproducible (<1 mm) and free of systematic error.


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