Expert Technique: Pediatric Tracheal Surgery

2021 ◽  
Vol 12 (3) ◽  
pp. 414-417
Author(s):  
Elizabeth H. Stephens ◽  
Joshua P. Wiedermann ◽  
Joseph A. Dearani ◽  
Carl L. Backer
Keyword(s):  
Computed Tomography ◽  
Cardiopulmonary Bypass ◽  
Granulation Tissue ◽  
Surgical Planning ◽  
Suture Line ◽  
Preoperative Imaging ◽  
Tracheal Surgery ◽  
Needle Localization ◽  
The Past ◽  
Slide Tracheoplasty

Substantial improvements in techniques of tracheal surgery for children have occurred in the past 20 years. Precise preoperative imaging with computed tomography clearly defines the anatomy for surgical planning and is assisted by on-the-table needle localization. The use of cardiopulmonary bypass greatly facilitates creation of an airtight, widely patent trachea. The use of Ciprodex as a postoperative nebulizer has significantly decreased granulation tissue along the suture line. Most important has been the adoption of slide tracheoplasty as the procedure of choice.

Imaging the Cerebrovascular Tree in the Cadaveric Head for Planning Surgical Strategy

Neurosurgery ◽  
2002 ◽  
Vol 51 (5) ◽  
pp. 1222-1228 ◽  
Author(s):  
Jin-Cheng Zhao ◽  
Chi Chen ◽  
Sami S. Rosenblatt ◽  
Joel R. Meyer ◽  
Robert R. Edelman ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Contrast Agent ◽  
Skull Base ◽  
Surgical Planning ◽  
Soft Tissues ◽  
Three Dimensional ◽  
Surgical Anatomy ◽  
Vascular Lesions ◽  
Preoperative Imaging ◽  
Computed Tomographic

Abstract OBJECTIVE The objective of the study was to identify whether an integration of cadaveric dissections with preoperative imaging information may enable a better understanding of pathological anatomy, especially vascular lesions, and thus allow for greater precision in surgical planning. METHODS We selected a computed tomographic contrast agent and experimentally determined the proportion of it that could mix compatibly with the silicone compound. The resultant mixture was injected into the cerebrovascular systems of six fresh human cadaveric heads. The specimens underwent computed tomography for the purpose of digital virtual exposures in parallel with laboratory dissections performed on these specimens. RESULTS The 1:8 ratio of contrast agent to silicone rubber was determined to be appropriate for both computed tomography and subsequent laboratory dissection of the specimens. The blood vessels in computed tomographic scans demonstrated a higher attenuation than surrounding soft tissues. The opacity consistency of the injected vessels was a critical parameter for a clear three-dimensional rendering of the vascular structures in the natural surroundings of the skull base. Static and dynamic three-dimensional images of the cadaveric vascular tree were obtained as viewed through surgical corridors of various skull base approaches. CONCLUSION We demonstrated a new cadaveric preparation model for imaging and dissection. This model allows for static and dynamic three-dimensional examination of the surgical anatomy from a neurosurgeon's perspective. It may facilitate the study of cerebrovascular system morphology/pathology in relation to the skull base as a tool for surgical planning.

scholarly journals 3D-printed models for periacetabular osteotomy surgical planning

2021 ◽  
Author(s):  
B Keegan Markhardt ◽  
Matthew A Beilfuss ◽  
Scott J Hetzel ◽  
David C Goodspeed ◽  
Andrea M Spiker
Keyword(s):  
Radiation Dose ◽  
Blood Loss ◽  
Surgical Planning ◽  
Preoperative Planning ◽  
Periacetabular Osteotomy ◽  
Total Blood Loss ◽  
Preoperative Imaging ◽  
Total Blood ◽  
Patient Age ◽  
3D Printed

Abstract The purpose of this study was to determine the feasibility and clinical benefits of using 3D-printed hemipelvis models for periacetabular osteotomy preoperative planning in the treatment of hip dysplasia. This retrospective study included 28 consecutive cases in 26 patients, with two bilateral cases, who underwent periacetabular osteotomy between January 2017 and February 2020 and had routine radiographs, CT and MR imaging. Of these, 14 cases [mean patient age 30.7 (SD 8.4) years, 11 female] had routine preoperative imaging, and 14 cases [mean patient age 28.0 (SD 8.7) years, 13 female] had routine preoperative imaging and creation of a full-scale 3D-printed hemipelvis model from the CT data. The expected surgical cuts were performed on the 3D-printed models. All patients underwent Bernese periacetabular osteotomy. Operative times, including time to achieve proper acetabular position and total periacetabular osteotomy time, fluoroscopy radiation dose and estimated total blood loss were compiled. ANOVA compared outcome variables between the two patient groups, controlling for possible confounders. On average, patients who had additional preoperative planning using the 3D-printed model had a 5.5-min reduction in time to achieve proper acetabular position and a 14.5-min reduction in total periacetabular osteotomy time; however, these changes were not statistically significant (P = 0.526 and 0.151, respectively). No significant difference was identified in fluoroscopy radiation dose or total blood loss. Detailed surgical planning for periacetabular osteotomy using 3D-printed models is feasible using widely available and affordable technology and shows promise to improve surgical efficiency.

Computed tomography—guided needle localization of nonpalpable breast lesions: Review of 24 cases

1996 ◽  
Vol 3 (2) ◽  
pp. 115-120 ◽  
Author(s):  
Robert M. Spillane ◽  
Gary J. Whitman ◽  
Kathleen A. McCarthy ◽  
Carol A. Hulka ◽  
Deborah A. Hall ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Breast Lesions ◽  
Needle Localization ◽  
Nonpalpable Breast Lesions

Abstract 18291: Computed Tomography Angiography Can Replace Cardiac Catheterization in the Surgical Planning of Select Neonates with Major Aortopulmonary Collaterals

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Holly Bauser-Heaton ◽  
Lynn Peng ◽  
Stanton B Perry ◽  
Jeffrey A Feinstein ◽  
Frank L Hanley ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ct Angiography ◽  
Cardiac Catheterization ◽  
Surgical Planning ◽  
Surgical Intervention ◽  
Neonatal Period ◽  
Aortopulmonary Collaterals ◽  
Initial Hospitalization ◽  
The Cost ◽  
Major Aortopulmonary Collaterals

Introduction: Neonates with Tetralogy of Fallot (TOF) and major aortopulmonary collaterals (MAPCAs) routinely undergo cardiac catheterization in the neonatal period. We have recently incorporated CT angiography into the neonatal evaluation with the hope of eliminating catheterization in those not needing neonatal intervention. We reviewed our experience with CT angiography and its accuracy in determining the need for neonatal intervention. Methods: Retrospective review of all patients from April 2005-October 2013 with MAPCAs who had both CTA and cardiac catheterization during the first 120 days of life and within 14 days of one another. The radiologist and interventionalist responsible for reading the studies were blinded to the results of the procedures and each other’s readings. The need for neonatal intervention as predicted by CTA was compared to the ultimate, cath-based decision. Results: 19 patients (mean age 3.73 days, range 1-9 days of age) were included in the study. In all patients CT was able to predict the need for surgical intervention correctly. CTA was found to be 87% sensitive, 93% specific and 91% sensitive with respect to number of MAPCAs, origin and distribution. Conclusion: CT angiography can accurately predict the need for neonatal intervention. In those not requiring neonatal intervention, neonatal cardiac catheterization is not required. CTA may also aid in guiding the subsequent, pre-operative catheterization but cannot replace it. This algorithm eliminates neonatal catheterization in the majority of TOF/MAPCAs patients, and with it the associated risks, and radiation, as well as substantially reducing the cost of the initial hospitalization.

Radiographic Staging of Colorectal Cancer

2019 ◽  
Author(s):  
Maurits P. Engbersen ◽  
Max J. Lahaye ◽  
Regina G.H. Beets-Tan
Keyword(s):  
Magnetic Resonance Imaging ◽  
Colorectal Cancer ◽  
Computed Tomography ◽  
Rectal Cancer ◽  
Magnetic Resonance ◽  
Tumor Staging ◽  
Tnm Staging ◽  
Preoperative Imaging ◽  
Resonance Imaging ◽  
Colon And Rectal Cancer

Imaging increasingly plays an important role in selecting the most optimal treatment for patients with colon and rectal cancer. While in colon cancer, computed tomography (CT) remains the modality of choice for local and distant staging, in patients with rectal cancer magnetic resonance imaging (MRI) is the main modality and mandatory for local staging. Endoluminal rectal ultrasound (ERUS) is the preferred staging method for superficial rectal tumors. This chapter addresses the current role of various imaging modalities in colorectal tumor staging. This review contains 4 figures and 50 references. Key words: Preoperative imaging, Colorectal cancer, Magnetic resonance imaging, Diffusion weighted MRI, Computed tomography, Mesorectal fascia, TNM staging, Treatment stratification

Radiographic Staging of Colorectal Cancer

2019 ◽  
Author(s):  
Maurits P. Engbersen ◽  
Max J. Lahaye ◽  
Regina G.H. Beets-Tan
Keyword(s):  
Magnetic Resonance Imaging ◽  
Colorectal Cancer ◽  
Computed Tomography ◽  
Rectal Cancer ◽  
Magnetic Resonance ◽  
Tumor Staging ◽  
Tnm Staging ◽  
Preoperative Imaging ◽  
Resonance Imaging ◽  
Colon And Rectal Cancer

Imaging increasingly plays an important role in selecting the most optimal treatment for patients with colon and rectal cancer. While in colon cancer, computed tomography (CT) remains the modality of choice for local and distant staging, in patients with rectal cancer magnetic resonance imaging (MRI) is the main modality and mandatory for local staging. Endoluminal rectal ultrasound (ERUS) is the preferred staging method for superficial rectal tumors. This chapter addresses the current role of various imaging modalities in colorectal tumor staging. This review contains 4 figures and 50 references. Key words: Preoperative imaging, Colorectal cancer, Magnetic resonance imaging, Diffusion weighted MRI, Computed tomography, Mesorectal fascia, TNM staging, Treatment stratification

scholarly journals Raupp: 50 years of neuroradiology

2011 ◽  
Vol 69 (3) ◽  
pp. 552-554
Author(s):  
Daison Nelson Ferreira Dias
Keyword(s):  
Computed Tomography ◽  
Literature Review ◽  
Search Term ◽  
Medical Residency ◽  
Residency Programs ◽  
Avant Garde ◽  
The Past ◽  
Therapeutic Techniques

OBJECTIVE: Evaluate the laboral and intellectual contributions of a founder of Brazilian Neuroradiology to the development of specialty. METHOD: Interviews were conducted with Dr. Raupp and contemporary doctors. Then we made a literature review with the Raupp search term aiming to identify those papers which included major changes in the diagnostic and therapeutic neurosurgical. RESULTS: The colleagues consulted were unanimous in recognizing the work of avant-garde and the importance of Dr. Raupp to the development of neuroradiological methods, especially in the pre-computed tomography fase. CONCLUSION: The work of Dr. Raupp was fundamental for the consolidation of Brazilian Neuroradiological School over the past five decades. He developed diagnostic and therapeutic techniques in congruence with the practices of the specialty on the global stage and he promoted education through medical residency programs.

Application of intraoperative high-field magnetic resonance imaging in pediatric neurosurgery

2009 ◽  
Vol 4 (5) ◽  
pp. 467-474 ◽  
Author(s):  
Ron Levy ◽  
Robin G. Cox ◽  
Walter J. Hader ◽  
Terry Myles ◽  
Garnette R. Sutherland ◽  
...  
Keyword(s):  
Surgical Planning ◽  
Pediatric Neurosurgery ◽  
Extent Of Resection ◽  
Neurosurgical Procedures ◽  
Spinal Disease ◽  
Operative Strategy ◽  
The Past ◽  
Imaging Results ◽  
Age At Surgery ◽  
Quality Imaging

Object Over the past decade, the use of intraoperative MR (iMR) imaging in the pediatric neurosurgical population has become increasingly accepted as an innovative and important neurosurgical tool. The authors summarize their experience using a mobile 1.5-T iMR imaging unit with integrated neuronavigation with the goal of identifying procedures and/or pathologies in which the application of this technology changed the course of surgery or modified the operative strategy. Methods A database has been prospectively maintained for this patient population. The authors reviewed the hospital charts and imaging results for all patients in the database. This review revealed 105 neurosurgical procedures performed in 98 children (49 male and 49 female) between March 1998 and April 2008. Intradissection (ID) and/or quality assurance images were obtained at the discretion of the surgeon. Results The median age at surgery was 12 years (4 months–18 years). One hundred intracranial and 5 spinal procedures were performed; 22 of these procedures were performed for recurrent pathology. Surgical planning scans were obtained for 102 procedures, and neuronavigation was used in 93 patients. The greatest impact of iMR imaging was apparent in the 55 procedures to resect neoplastic lesions; ID scans were obtained in 49 of these procedures. Further surgery was performed in 49% of the procedures during which ID scans had been obtained. A smaller proportion of ID scans in the different cranial pathology groups (5 of 21 epilepsy cases, 4 of 9 vascular cases) resulted in further resections to meet the surgical goal of the surgeon. Two ID scans obtained during 5 procedures for the treatment of spinal disease did not lead to any change in surgery. Postoperative scans did not reveal any acute adverse events. There was 1 intraoperative adverse event in which a Greenberg retractor was inadvertently left on during ID scanning but was removed after the scout scans. Conclusions The application of iMR imaging in the pediatric neurosurgical population allows, at minimum, the opportunity to perform less invasive surgical exposures. Its potential is greatest when its high-quality imaging ability is coupled with its superior neuronavigation capabilities, which permits tracking of the extent of resection of intracranial tumors and, to a lesser extent, other lesions during the surgical procedure.

scholarly journals Tomographic diagnosis and relevant aspects of otosclerosis

2013 ◽  
Vol 46 (5) ◽  
pp. 307-312 ◽  
Author(s):  
Juliana Oggioni Gaiotti ◽  
Natália Delage Gomes ◽  
Ana Maria Doffémond Costa ◽  
Caroline Laurita Batista Couto Villela ◽  
Wanderval Moreira ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Hearing Loss ◽  
Differential Diagnosis ◽  
Multidetector Computed Tomography ◽  
Surgical Planning ◽  
Otic Capsule ◽  
Metabolic Derangement ◽  
Pictorial Essay ◽  
Temporal Bone Anatomy ◽  
Endochondral Layer

A literature review and pictorial essay were developed to discuss the importance of knowing the main findings and locations of otosclerosis at multidetector computed tomography (MDCT). The authors performed a retrospective review of cases of otosclerosis diagnosed in their institution by means of high resolution multidetector computed tomography. Otosclerosis corresponds to otic capsule dysplasia characterized by metabolic derangement of its endochondral layer. Such condition constitutes a relevant cause of sensorineural hearing loss, affecting about 7% to 10% of the general population. The diagnosis is usually clinical, but imaging methods play a significant role in the anatomical detailing, differential diagnosis, surgical planning and evaluation of postoperative complications. Among such methods, the relevance of MDCT is highlighted. Radiologists should be familiar with the MDCT findings of otosclerosis, as well as with the temporal bone anatomy to assist in the appropriate clinical management of this disease.

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