Piezosurgery—A Safe Technique to Perform Lateral Suboccipital Craniotomy?

2017 ◽  
Vol 15 (6) ◽  
pp. 664-671 ◽  
Author(s):  
Juergen Grauvogel ◽  
Waseem Masalha ◽  
Dieter Henrik Heiland ◽  
Nadja Jarc ◽  
Tanja Daniela Grauvogel ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Petrous Bone ◽  
Burr Hole ◽  
Neurosurgical Department ◽  
Surrounding Soft Tissue ◽  
Suboccipital Craniotomy ◽  
Safe Technique ◽  
Dural Tears ◽  
Incidental Durotomy ◽  
Transverse Sinuses

Abstract BACKGROUND Piezosurgery (PS) is a relatively new technique based on microvibrations generated by the piezoelectric effect. It selectively cuts bone tissue and preserves the surrounding soft tissue. OBJECTIVE To evaluate the use of PS for performing lateral suboccipital craniotomy. METHODS PS was used to perform a lateral suboccipital craniotomy in 22 patients who underwent surgery for different cerebellopontine angle (CPA) pathologies in the neurosurgical department. The applicability of PS for lateral suboccipital craniotomy was evaluated with respect to safety, preciseness of bone cutting, and in particular the preservation of the adjacent dura and sigmoid and transverse sinuses. RESULTS Lateral suboccipital craniotomy in 22 patients who underwent surgery for different CPA pathologies (13 vestibular schwannoma, 5 petrous bone meningioma, 1 petroclival meningioma, 2 epidermoid cysts, and 1 petrous bone cholesterol granuloma) was performed with PS without any complications. A burr hole was set before piezosurgical craniotomy in 6 patients, with no prior burr hole in 16 patients. Incidental durotomy during piezosurgical craniotomy occurred in 6 patients, and small lacerations of the sigmoid sinus caused by the piezosurgical device were observed in 3 patients. CONCLUSION Although PS is a safe and selective bone cutting technique that preserves the surrounding soft tissue, it can still lead to unintended dural tears during lateral suboccipital craniotomy. This must be kept in mind when using PS for craniotomies and relying on the selective bone cutting properties of PS.

scholarly journals Use of CAD–CAM Bridging Mandibular Prosthesis in Osteonecrosis of the Jaw: The Experience of Our School

2020 ◽  
Vol 9 (11) ◽  
pp. 3516
Author(s):  
Francesco Ricotta ◽  
Salvatore Battaglia ◽  
Federico Bolognesi ◽  
Francesco Ceccariglia ◽  
Claudio Marchetti ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Secondary Infection ◽  
Case Series ◽  
Osteonecrosis Of The Jaw ◽  
Reconstructive Procedures ◽  
Surrounding Soft Tissue ◽  
Cad Cam ◽  
Safe Technique ◽  
Bone Exposure

Osteonecrosis of the jaw (ONJ) is a disease that affects the jaw. It is mainly related to radiation or bisphosphonates therapy, and the symptoms and signs consist of pain, bone exposure, inflammation of the surrounding soft tissue swelling, and secondary infection or drainage. In the case of advanced disease of the mandibular area, the treatment of choice is mandibular resection and reconstruction. In the present study, we report a case series of patients affected by ONJ and treated with a customised bridging mandibular prosthesis-only technique. From 2016 to 2018, we treated five consecutive patients affected by ONJ: three patients were affected by biphosphonate-related osteonecrosis of the mandible (BRONJ) and two were affected by osteoradionecrosis of the mandible (ORNJ). Three patients needed a soft tissue free flap to permit optimal wound closure, intra- and/or extraorally. All reconstructive procedures were carried out successfully, with no major or minor microvascular complication. The average postoperative follow-up was 24.8 (range 10–41) months. Considering that microvascular bone transfer is a high-risk procedure in BRONJ patients, we can conclude that the positioning of a customised bridging mandibular prosthesis (CBMP), whether or not associated with a microvascular soft tissue transfer, is a safe technique in terms of surgical outcome and feasibility.

Analysis of Titanium Dental Implants Surrounding Soft Tissue Using X-ray Absorption Fine Structure (XAFS) Analysis

2005 ◽  
Vol 34 (6) ◽  
pp. 776-777 ◽  
Author(s):  
Motohiro Uo ◽  
Kiyotaka Asakura ◽  
Atsuro Yokoyama ◽  
Kazuchika Tamura ◽  
Yasunori Totsuka ◽  
...  
Keyword(s):  
Fine Structure ◽  
Soft Tissue ◽  
Dental Implants ◽  
Surrounding Soft Tissue ◽  
X Ray ◽  
Absorption Fine ◽  
X Ray Absorption ◽  
Titanium Dental Implants

scholarly journals AN UNUSUAL INJURY FROM TOOTHBRUSH: A CASE REPORT

2018 ◽  
Vol 6 (1) ◽  
pp. 66-68
Author(s):  
Deepak Yadav ◽  
Shashank Tripathi ◽  
Ravish Mishra ◽  
Laxmi Kandel ◽  
Saurav Karna ◽  
...  
Keyword(s):  
Case Report ◽  
Oral Health ◽  
Soft Tissue ◽  
Surgical Intervention ◽  
Dental Hygiene ◽  
Vital Role ◽  
Poor Oral Hygiene ◽  
Surrounding Soft Tissue ◽  
Inherent Risk ◽  
Unusual Injury

Tooth brush plays a vital role in the maintenance of oral health and dental hygiene. Regular brushing is widely advocated by dental surgeon in terms of decreasing dental caries and periodontal problems. Though, there has been decrease in diseases due to sequale of poor oral hygiene, at the same time there are also inherent risk of accidental trauma to the surrounding soft tissue during the act of brushing, more commonly when handled by children. This paper presents a case report of a penetrating toothbrush trauma embedded in buccal soft tissue which required surgical intervention in a child patientJournal of Universal College of Medical SciencesVol. 6, No. 1, 2018, Page: 66-68 

Role of spectral-detector CT in reduction of artifacts from contrast media in axillary and subclavian veins: single institution study in 50 patients

2019 ◽  
Vol 61 (4) ◽  
pp. 450-460 ◽  
Author(s):  
Kai Roman Laukamp ◽  
Amit Gupta ◽  
Nils Große Hokamp ◽  
Verena Carola Obmann ◽  
Frank Philipp Graner ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Contrast Media ◽  
Intraclass Correlation ◽  
Ct Images ◽  
Diagnostic Assessment ◽  
Surrounding Soft Tissue ◽  
Iodinated Contrast ◽  
Spectral Detector Ct ◽  
Virtual Monoenergetic Images ◽  
Monoenergetic Images

Background In CT imaging, a high concentration of iodinated contrast media in axillary and subclavian veins after brachial application can cause perivenous artifacts impairing diagnostic assessment of local vascular structures and soft tissue. Purpose To investigate reduction of perivenous hypo- and hyperattenuating artifacts of the axillary and subclavian veins using virtual monoenergetic images (VMI) in comparison to conventional CT images (CI), acquired on spectral-detector CT. Material and Methods 50 spectral-detector CT datasets of patients with perivenous artifacts from contrast media were included in this retrospective, institutional review board-approved study. CT images and virtual monoenergetic images (range 40–200 keV, 10-keV increments) were reconstructed from the same scans. Quantitative analysis was performed by region of interest-based assessment of mean attenuation (HU) and standard deviation in most pronounced hypo- and hyperdense artifacts and artifact-impaired arteries as well as muscle. Visually, artifact reduction, assessment of vessels, and surrounding soft tissue were rated on 5-point Likert-scales by two radiologists. Results In comparison to CT images, virtual monoenergetic images of ≥90 keV showed a significant reduction of hypo- and hyperattenuating artifacts (hypodense: CI -220.0±171.2 HU; VMI130keV -13.4±49.1 HU; hyperdense: CI 274.6±184.4 HU; VMI130keV 24.2±84.9 HU; P<0.001). Subjective analysis confirmed that virtual-monoenergetic images of ≥100 keV significantly reduced artifacts (hypodense: CI 2[1–3]; VMI130keV 5[4–5], hyperdense: CI 2[1–4]; VMI130keV 5[5–5], P<0.001) and improved diagnostic assessment. Best results for diagnostic assessment were noted for virtual monoenergetic images at 130 keV. Overcorrection of artifacts was observed at higher keV values. Interrater agreement was excellent for each evaluation and keV value (intraclass correlation coefficient 0.89). Conclusion Higher keV virtual monoenergetic images yielded significant reduction of contrast media artifacts and led to improved assessment of vessels and surrounding soft tissue. Recommended keV values for best diagnostic assessment are in the range of 100–160 keV.

scholarly journals Novel Applications of Ultrasound Technology to Visualize and Characterize Myofascial Trigger Points and Surrounding Soft Tissue

2009 ◽  
Vol 90 (11) ◽  
pp. 1829-1838 ◽  
Author(s):  
Siddhartha Sikdar ◽  
Jay P. Shah ◽  
Tadesse Gebreab ◽  
Ru-Huey Yen ◽  
Elizabeth Gilliams ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Trigger Points ◽  
Myofascial Trigger Points ◽  
Surrounding Soft Tissue ◽  
Ultrasound Technology ◽  
Novel Applications

scholarly journals An Investigation of a Novel Dural Repair Device for Intraoperative Incidental Durotomy Repair

2021 ◽  
Vol 8 ◽  
Author(s):  
Kartik Shenoy ◽  
Chester J. Donnally ◽  
Evan D. Sheha ◽  
Krishn Khanna ◽  
Srinivas K. Prasad
Keyword(s):  
Simulation Model ◽  
Csf Leak ◽  
The Novel ◽  
Clinical Experiences ◽  
Dural Repair ◽  
Novel Device ◽  
Clinical Scenarios ◽  
Dural Tears ◽  
Incidental Durotomy ◽  
Tools And Techniques

Incidental durotomies, or dural tears, can be very difficult and time consuming to repair properly when they are encountered in confined spaces. A novel dural repair device was developed to address these situations. In this paper, the novel device was assessed against the use of traditional tools and techniques for dural repairs in two independent studies using an intricate clinical simulation model. The aim was to examine the results of the two assessments and link the outcomes to the clinical use of the novel device in the operating room. The novel device outperformed conventional techniques as measured by dural repair time, CSF leak pressure and nerve root avoidance in the simulation. The results were generally replicable clinically, however, numerous additional clinical scenarios were also encountered that the simulation model was unable to capture due to various inherent limitations. The simulation model design, potential contributors to watertightness, clinical experiences, and limitation are discussed.

scholarly journals Case of Chondrosarcoma Hip

JMS SKIMS ◽  
2013 ◽  
Vol 16 (2) ◽  
pp. 99
Author(s):  
Naheena Naheena ◽  
Iqbal Lone ◽  
Duri Mateen ◽  
Tazeen Tazeen
Keyword(s):  
Soft Tissue ◽  
Hip Joint ◽  
Iliac Bone ◽  
Surrounding Soft Tissue

CASE: 45 year old female presenting with pain in the hip joint. Radiology of the hip joint revealed a huge mass arising from the iliac bone infiltrating the surrounding soft tissue. Opinion of tumor arising from bone? Chondrosarcoma was made. Patient underwent hemipelvictomy. Gross specimen showed a huge mass arising from the iliac bone. Cut section showed myxoid and cartilaginous areas. JMS 2013;16(2):99

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