Improved Planning of Skull Base Surgery by Coregistration of Three-Dimensional Data Sets of Different Angiographic Imaging Modalities Including rDSA, MRA, CTA, and T1-MRI Volume Data

Abstract Objective The aim of this study is to determine feasibility of incorporating three-dimensional (3D) tractography into routine skull base surgery planning and analyze our early clinical experience in a subset of anterior cranial base meningiomas (ACM). Methods Ninety-nine skull base endonasal and transcranial procedures were planned in 94 patients and retrospectively reviewed with a further analysis of the ACM subset. Main Outcome Measures (1) Automated generation of 3D tractography; (2) co-registration 3D tractography with computed tomography (CT), CT angiography (CTA), and magnetic resonance imaging (MRI); and (3) demonstration of real-time manipulation of 3D tractography intraoperatively. ACM subset: (1) pre- and postoperative cranial nerve function, (2) qualitative assessment of white matter tract preservation, and (3) frontal lobe fluid-attenuated inversion recovery (FLAIR) signal abnormality. Results Automated 3D tractography, with MRI, CT, and CTA overlay, was produced in all cases and was available intraoperatively. ACM subset: 8 (44%) procedures were performed via a ventral endoscopic endonasal approach (EEA) corridor and 12 (56%) via a dorsal anteromedial (DAM) transcranial corridor. Four cases (olfactory groove meningiomas) were managed with a combined, staged approach using ventral EEA and dorsal transcranial corridors. Average tumor volume reduction was 90.3 ± 15.0. Average FLAIR signal change was –30.9% ± 58.6. 11/12 (92%) patients (DAM subgroup) demonstrated preservation of, or improvement in, inferior fronto-occipital fasciculus volume. Functional cranial nerve recovery was 89% (all cases). Conclusions It is feasible to incorporate 3D tractography into the skull base surgical armamentarium. The utility of this tool in improving outcomes will require further study.

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Three-Dimensional Printing: Current Use in Rhinology and Endoscopic Skull Base Surgery

American Journal of Rhinology and Allergy ◽

10.1177/1945892419866319 ◽

2019 ◽

Vol 33 (6) ◽

pp. 770-781 ◽

Cited By ~ 2

Author(s):

Christopher M. Low ◽

Jonathan M. Morris ◽

Daniel L. Price ◽

Jane S. Matsumoto ◽

Janalee K. Stokken ◽

...

Keyword(s):

Patient Education ◽

3D Printing ◽

Skull Base ◽

Surgical Planning ◽

Skull Base Surgery ◽

Three Dimensional ◽

Educational Practice ◽

3 Dimensional ◽

Endoscopic Skull Base Surgery ◽

Surgical Teaching

Background In the discipline of rhinology and endoscopic skull base surgery (ESBS), 3-dimensional (3D) printing has found meaningful application in areas including preoperative surgical planning as well as in surgical education. However, its scope of use may be limited due to the perception among surgeons that there exists a prohibitively high initial investment in resources and time to acquire the requisite technical expertise. Nevertheless, given the ever decreasing cost of advancing technology coupled with the need to understand the complex spatial relationships of the paranasal sinuses and skull base, the use of 3D printing in rhinology and ESBS is poised to blossom. Objective Help the reader identify current or potential future uses of 3D printing technology relevant to their rhinologic clinical or educational practice. Methods A review of published literature relating to 3D printing in rhinology and ESBS was performed. Results Results were reviewed and organized into 5 overarching categories including an overview of the 3D printing process as well as applications of 3D printing including (1) surgical planning, (2) custom prosthetics and implants, (3) patient education, and (4) surgical teaching and assessment. Conclusion In the discipline of rhinology and ESBS, 3D printing finds use in the areas of presurgical planning, patient education, prosthesis creation, and trainee education. As this technology moves forward, these products will be more broadly available to providers in the clinical and educational setting. The possible applications are vast and have great potential to positively impact surgical training, patient satisfaction, and most importantly, patient outcomes.

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Visualizing Vertebrate Embryos with Episcopic 3D Imaging Techniques

The Scientific World JOURNAL ◽

10.1100/tsw.2009.154 ◽

2009 ◽

Vol 9 ◽

pp. 1423-1437 ◽

Cited By ~ 26

Author(s):

Stefan H. Geyer ◽

Timothy J. Mohun ◽

Wolfgang J. Weninger

Keyword(s):

3D Imaging ◽

Imaging Techniques ◽

Three Dimensional ◽

Computer Models ◽

Hereditary Diseases ◽

Data Sets ◽

Data Generation ◽

Volume Data ◽

Vertebrate Embryos ◽

Technical Principles

The creation of highly detailed, three-dimensional (3D) computer models is essential in order to understand the evolution and development of vertebrate embryos, and the pathogenesis of hereditary diseases. A still-increasing number of methods allow for generating digital volume data sets as the basis of virtual 3D computer models. This work aims to provide a brief overview about modern volume data–generation techniques, focusing on episcopic 3D imaging methods. The technical principles, advantages, and problems of episcopic 3D imaging are described. The strengths and weaknesses in its ability to visualize embryo anatomy and labeled gene product patterns, specifically, are discussed.

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USE OF THREE-DIMENSIONAL ENDOSCOPY IN ENDONASAL AND ANTERIOR SKULL BASE SURGERY

10.22541/au.164001796.63082126/v1 ◽

2021 ◽

Author(s):

Amr Kholief ◽

Ahmed Youseef ◽

Ahmed Ibrahim ◽

Samy Elwany ◽

Shahz Ahmed

Keyword(s):

Clinical Study ◽

Skull Base ◽

Surgical Procedures ◽

Skull Base Surgery ◽

Intraoperative Complications ◽

Three Dimensional ◽

Anterior Skull Base ◽

Anatomical Landmarks ◽

Intraoperative Complication ◽

3D Endoscope

Objectives: The three dimensional (3D) endoscope is considered as a new surgical tool which used in different approaches in intranasal and anterior skull base surgical procedures. There are many advantages of the 3D endoscopy over the two dimensional (2D) one that have been demonstrated along clinical applications, surgical training and different experimental studies. Our study aimed to show the difference between using the 3D & 2D endoscopes during endonasal and anterior skull base surgery and its importance specially when used by novice users. Design: Our study is divided into two phases (clinical & cadaveric phases).In the clinical study we have done 52 endonasal & anterior skull base surgical procedures (26 study cases and 26 control cases).We recorded accuracy, duration and intraoperative complication for each case. The cadaveric study was performed on three cadavers, difference in accuracy and dissection time were recorded using 3D & 2D endoscopy for each side chosen by randomization. Results: In the clinical study, the cases done by 3D endoscope were significantly faster and more accurate with less intraoperative complications compared to cases done using 2D endoscope. In cadaveric dissection while using 3D endoscope there was better depth of perception regarding the anatomical landmarks compared to 2D endoscope. Conclusion: 3D endoscopy is an advanced instrument that allows better training for the coming generation of ENT surgeons. Both clinical and cadaveric studies offer a promising outcomes in both endonasal and anterior skull base surgery.

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Expanding Cranial Base Surgery

Otolaryngology ◽

10.1016/s0194-5998(05)80353-5 ◽

1995 ◽

Vol 112 (5) ◽

pp. P136-P136

Author(s):

Ivo P. Janecka ◽

Daniel Nuss ◽

David Vernick ◽

Gerhard Oberascher

Keyword(s):

Skull Base ◽

Skull Base Surgery ◽

Cranial Base ◽

Imaging Modalities ◽

Educational Objectives ◽

Congenital Lesions ◽

New Approaches ◽

Cranial Base Surgery ◽

Technical Principles

Educational objectives: To determine the applicability and become familiar with technical principles of new approaches to skull base for oncologic as well as congenital lesions and to understand the current advances in imaging modalities as well as current achievable outcome with skull base surgery.

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Three-Dimensional Volumetric Spatially Angle-Corrected Pixelwise Fetal Flow Volume Measurement

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/s-0031-1281867 ◽

2011 ◽

Vol 32 (S 02) ◽

pp. E122-E128 ◽

Cited By ~ 1

Author(s):

T. Scholbach ◽

J. Stolle ◽

J. Scholbach

Keyword(s):

Umbilical Vein ◽

Color Doppler ◽

Three Dimensional ◽

Volume Measurement ◽

Data Sets ◽

Volume Data ◽

Flow Measurements ◽

Perfusion Measurement ◽

Actual Flow ◽

Relationship Of

Abstract Purpose: Early attempts to calculate fetal global perfusion used 2 D images. The results were not sufficiently reliable. That‘s why RI measurements are still in use despite the fact that they do not reflect the amount of blood passing through the fetus. We present a novel three-dimensional approach to overcome these limitations. Materials and Methods: In 124 singleton pregnancies between the 23rd and 4st gestational week, a three-dimensional color Doppler sonographic record of the umbilical cord was made, resulting in 281 volume data sets. With dedicated software (PixelFlux) the spatial angle of the umbilical vein was calculated and the true global fetal perfusion was calculated from its horizontal transection as the product of the area of all pixels and the spatial angle-corrected velocity. To validate the PixelFlux technique, phantom flow measurements were carried out. Results: Phantom flow measurements revealed a highly significant correlation of actual flow volumes and those measured by the PixelFlux technique (p < 0.001; rPearson = 0.987 – 0.991) with an even higher interobserver correlation (p < 0.001; rPearson = 0.997). We found a significant correlation of fetal volume flow to gestational age and weight (r = 0.529 at spatial angles below 30° to r = 0.724 at spatial angles below 5°) and a significant influence of the spatial angle on this correlation (p = 0.003; r = – 0.865). Conclusion: Spatial angle-corrected global fetal perfusion measurement improves existing approaches to fetal perfusion evaluation, and is feasible, simple and fast. Thus, it can be recommended to explore the relationship of fetal perfusion and disturbances of fetal development.

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