scholarly journals Accuracy of Mixed Reality Combined With Surgical Navigation Assisted Oral and Maxillofacial Tumor Resection

2022 ◽  
Vol 11 ◽  
Author(s):  
Zu-Nan Tang ◽  
Lei-Hao Hu ◽  
Hui Yuh Soh ◽  
Yao Yu ◽  
Wen-Bo Zhang ◽  
...  

ObjectiveTo evaluate the feasibility and accuracy of mixed reality combined with surgical navigation in oral and maxillofacial tumor surgery.MethodsRetrospective analysis of data of seven patients with oral and maxillofacial tumors who underwent surgery between January 2019 and January 2021 using a combination of mixed reality and surgical navigation. Virtual surgical planning and navigation plan were based on preoperative CT datasets. Through IGT-Link port, mixed reality workstation was synchronized with surgical navigation, and surgical planning data were transferred to the mixed reality workstation. Osteotomy lines were marked with the aid of both surgical navigation and mixed reality images visualized through HoloLens. Frozen section examination was used to ensure negative surgical margins. Postoperative CT datasets were obtained 1 week after the surgery, and chromatographic analysis of virtual osteotomies and actual osteotomies was carried out. Patients received standard oncological postoperative follow-up.ResultsOf the seven patients, four had maxillary tumors and three had mandibular tumors. There were total of 13 osteotomy planes. Mean deviation between the planned osteotomy plane and the actual osteotomy plane was 1.68 ± 0.92 mm; the maximum deviation was 3.46 mm. Chromatographic analysis showed error of ≤3 mm for 80.16% of the points. Mean deviations of maxillary and mandibular osteotomy lines were approximate (1.60 ± 0.93 mm vs. 1.86 ± 0.93 mm). While five patients had benign tumors, two had malignant tumors. Mean deviations of osteotomy lines was comparable between patients with benign and malignant tumors (1.48 ± 0.74 mm vs. 2.18 ± 0.77 mm). Intraoperative frozen pathology confirmed negative resection margins in all cases. No tumor recurrence or complications occurred during mean follow-up of 15.7 months (range, 6-26 months).ConclusionThe combination of mixed reality technology and surgical navigation appears to be feasible, safe, and effective for tumor resection in the oral and maxillofacial region.

2010 ◽  
Vol 3 (1) ◽  
pp. 25-32 ◽  
Author(s):  
André M. Eckardt ◽  
Enno-Ludwig Barth ◽  
Johannes Berten ◽  
Nils-Claudius Gellrich

Reconstruction of mandibular defects following tumor resection in infants is a particular challenge. Although autogenous rib grafts have no relevance in the restoration of mandibular bone defects occurring after ablative tumor surgery due to limited bone stock and the availability of other donor areas, they are a useful surgical alternative following tumor surgery in infants. We here report on a 2, 5, 8, and 15-year follow-up of four children who were diagnosed with benign tumors of the mandible with osseous destruction at the age of 4, 6, 15, and 18 months, respectively. Histologic diagnoses were melanotic neuroectodermal tumor ( n=2), hemangioendothelioma of the mandible ( n=1), and ameloblastoma ( n=1). Following continuity resection of the mandible, lateromandibular bone defects were restored using autogenous rib grafts. Both clinical and radiologic follow-up visits were performed for all children to assess growth of the facial skeleton and the mandible. One child was already further reconstructed using bone augmentation at the age of 15 years. Cephalometric measurements on panorex films and three-dimensional computed tomographic scans revealed a slight vertical growth excess and transversal growth inhibition of the reconstructed mandible compared with the nonoperated side. Although further growth of rib grafts is difficult to predict and occlusal disharmony may occur due to physiologic maxillary growth and growth of the unaffected mandible, we believe that autogenous rib grafts can be ideally used for the restoration of mandibular continuity defects in newborns and young children. Clinical follow-up visits on a yearly basis and orthodontic controls are useful for early orthodontic treatment of growth deficits. Further corrective surgery with bone augmentation or osseous distraction is required following completion of growth of the facial skeleton.


Author(s):  
Huanhuan Gao ◽  
Shuai Yuan ◽  
Zhiqiang Hu ◽  
Zhelan Zheng ◽  
Shengjun Wu

Background: Cardiac fibromas are rare benign tumors of the heart composed of fibroblasts and collagen. They are common among children and adolescents but are rarely present in adults. Case presentation: We here report the case of a fifty-seven-year-old man who complaining of a 2-year history of chest tightness at rest. Transthoracic echocardiography detected a severe calcified mass protruding outside the right ventricular anterior wall near the apex. The patient was referred for tumor resection. The calcified mass was determined to be a cardiac fibroma with postoperative histopathological examination. The patient experienced an unremarkable post-operative recovery and was discharged 8 days later. Subsequent follow-up has shown complete freedom from his troublesome symptom. Conclusions: Preoperative diagnosis with various imaging modalities and early surgery are the keys to improve prognosis of patients with cardiac fibromas.


2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Zheng Jie Zhu ◽  
Qi Huang ◽  
Lan Cheng ◽  
Jun Yang

Abstract Background Nasal chondromesenchymal hamartomas (NCMHs) are extremely rare benign tumors that most commonly affect children in the first year of life. The purpose of this study was to investigate and summarize the characteristics of NCMH cases and the efficacy of transnasal endoscopic resection of NCMHs. Methods This is a retrospective study including 5 cases of infant diagnosed as NCMH between April 2016 and April 2020. Diagnostic techniques include nasoendoscopy, computerized tomography (CT) scan, magnetic resonance imaging (MRI) with contrast and microscopic and immunohistologic studies. Data collected included patient demographics, patient symptoms, radiographic findings, characteristics of tumor growth, follow-up time, recurrence, and postoperative complications. Results In 5 cases, 3 were males and 2 were females who aged 1, 2, 3, 6 months and 1 year, respectively. The size of the mass measured 1.6 cm*1.9 cm*1.8 cm at its smallest and largest was 4.0 cm*3.5 cm*3.0 cm. All five patients underwent tumor resection via transnasal endoscopic approach. Four tumors were completely removed, and one underwent partial resection, which was completely resected by midfacial degloving operation 13 months after the first surgery. There was no postoperative complication. The current postoperative follow-up period was 1 to 4 years, and no recurrence has been observed. Conclusions Complete surgical resection of NCHM is necessary to resolve the symptoms and prevent recurrence. Transnasal endoscopic approach is a safe and effective choice for pediatric NCMH patients.


1994 ◽  
Vol 110 (6) ◽  
pp. 539-546 ◽  
Author(s):  
Iva P. Janecka ◽  
Chandranath Sen ◽  
Laligam N. Sekhar ◽  
Sai Ramasastry ◽  
Hugh D. Curtin ◽  
...  

OBJECTIVE: To learn about the effects of cranial base surgery. DESIGN: Cohort study with a mean follow-up of 30 months. SETTING: Population-based. PATIENTS: A consecutive sample of 183 patients who underwent cranial base surgery; 118 patients had malignant skull base tumors, the majority of which were previously treated; 50 had benign tumors; 9 had congenital malformations of the skull base; 3 had inflammatory lesions, and 3 had traumatic defects of the skull base. MAIN OUTCOME MEASURES: Disease-free Interval, overall survival, and rate of complications and functional status. INTERVENTION: Cranial base surgery was followed by radiotherapy (In previously untreated patients). RESULTS: After completion of follow-up (mean, 30 months), 30 (25.4%) patients had died of their malignant tumors and 8 (6.8%) had died of other causes. One patient (0.84%) was lost to follow-up. The overall cancer survival rate without regard to histologic type was 67% (63% with no evidence of disease). Among the patients who were treated for benign neoplasm, 72% had no evidence of disease at a mean follow-up of 39 months. The group of patients with congenital malformations and inflammatory and traumatic lesions demonstrated successful correction of their presurgical problem with skull base surgery. One patient (who had invasive aspergillosis) died of disease. The overall surgical-medical mortality rate was 2%; the complication rate was 33%, and the Kamofsky performance score was improved or unchanged after surgery in 83% of patients. The average duration of surgery, number of blood transfusions used, and length of the hospital stay were 10 hours, 3 units, and 15 days, respectively. CONCLUSIONS: Cranial base surgery is a valid surgical technique for treatment of cranial base afflictions. In this study It was found to be beneficial In controlling benign and malignant disease and to be the treatment of choice for selected congenital malformations, trauma, and inflammatory lesions.


1996 ◽  
Vol 4 (1) ◽  
pp. 14-17
Author(s):  
Rajendar Krishan Suri ◽  
Raghuvir Singh Kanwar ◽  
Harjinder Singh ◽  
Rajinder Singh Dhaliwal ◽  
Sandeep Singh Rana ◽  
...  

Over a period of 18 years, 39 cases of cardiac tumors were operated upon in the Department of Cardiothoracic Surgery at the Postgraduate Institute of Medical Education and Research, Chandigarh. These included 34 (87%) patients with benign tumors and 5 (13%) patients with primary malignant tumors. All the benign tumors were myxomas, of which 31 (91.2%) were in the left atrium and 3 (8.8%) in right atrium. Primary malignant tumors comprised 2 rhabdomyosarcomas, 1 angiosarcoma, 1 lymphoma and 1 case of pleomorphic malignant fibrous histiocytoma. The diagnosis was established by echocardiography, angiocardiography and computed tomography. In one case the diagnosis was made at autopsy. All myxomas, except tricuspid valve myxoma, were removed completely through right atrial or biatrial approach with the use of cardiopulmonary bypass. Four cases of primary malignant tumors were non-resectable. Near total resection of a malignant fibrous histiocytoma arising from the right middle pulmonary vein and left atrial junction was achieved. There were 2 operative deaths (5.1 %). The follow-up ranged from 3 months to 10 years with a mean of 5.7 years. There was 1 recurrence (2.9%) in the benign group. In the malignant group, 3 cases (60%) died within 5 to 8 months of surgery due to further local and metastatic spread of the tumor. The case of malignant fibrous histiocytoma was treated with postoperative radiotherapy to the right mediastinum and is doing well at follow-up 3 months after surgery.


Neurosurgery ◽  
1989 ◽  
Vol 24 (1) ◽  
pp. 18-30 ◽  
Author(s):  
Laligam N. Sekhar ◽  
Chandra N. Sen ◽  
Hae Dong Jho ◽  
Ivo P. Janecka

Abstract Forty-two patients with neoplasms involving the cavernous sinus had operations between 1983 and 1987. The lesions included 25 benign tumors (e.g., meningioma, neurilemoma) and 17 malignant tumors (e.g., chondrosarcoma, adenoid cystic carcinoma). The cavernous sinus was entered by inferior, anterolateral, or medial extradural approaches or by superior or lateral intradural approaches. The intracavernous internal carotid artery was managed by dissecting tumor away from it or by occlusion and excision with or without direct vein graft reconstruction, based on the results of a preoperative balloon occlusion test. Cranial nerves III, IV, V, and VI usually were dissected from tumor, but in 3 cases of tumor invasion, the excised nerve segment was reconstructed by direct suture or with a sural nerve interposition graft. Twenty-one of the benign tumors and 8 of the malignant tumors were excised totally and the remainder subtotally. On follow-up ranging from 3 to 48 months, one subtotally excised meningioma recurred and was treated with reexcision and adjuvant radiation therapy. Two “totally” excised malignant tumors recurred outside the cavernous sinus at the margins of excision. There was no operative mortality or permanent cerebral morbidity. Postoperatively, the ocular and neurological function of most patients was similar to the preoperative status; in some, it was significantly improved. Thirteen additional patients with intracavernous neoplasms also were evaluated during the same period and followed without operation. The early follow-up information regarding these patients is provided.


Author(s):  
AM Bueckert ◽  
J Pugh ◽  
T Snyder ◽  
M Wheatley ◽  
F Jacob ◽  
...  

Background: Dysembryoblastic neuroepithelial tumors (DNETs) are benign tumors of the cerebral cortex that most commonly occur in children or young adults. Seizures are a frequent presenting feature, with an incidence of 80-100%, and are often an indication for surgical resection. Methods: We performed a retrospective chart review of children with DNETs who underwent epilepsy surgery between 1998 and 2014. Results: A total of 12 subjects were identified (6 males, 6 females), all of whom had seizures prior to surgical resection. Of these patients, 1 had infantile spasms, 2 had simple partial seizures and 10 had complex partial seizures. Tumors were located in the temporal (n=7), frontal (n=3) or parietal (n=2) cortex. These patients went on to have surgery on average 15 months after seizure onset, 3 had incomplete resections. At an average follow up of 6 years 4 months, all patients were class 1 on Engel’s Classification. All but one subject with rare non-disabling seizures were seizure free, with only 6 on medication. Follow up MR imaging revealed tumor recurrence in 1 subject. Conclusions: Despite differing seizure seminology and tumor location, surgical resection of these low-grade tumors resulted in excellent seizure outcome even in the setting of incomplete tumor resection.


2006 ◽  
Vol 91 (8) ◽  
pp. 3080-3083 ◽  
Author(s):  
Chun-Hou Liao ◽  
Shih-Chieh Chueh ◽  
Ming-Kuen Lai ◽  
Po-Jen Hsiao ◽  
Jun Chen

Abstract Purpose: Laparoscopic adrenalectomy (LA) is controversial for large, potentially malignant tumors. We report a series of LA or hand-assisted LA for large (>5 cm) adrenal tumors. Patients and Methods: Among 210 LAs performed in 6 yr, 39 patients had potentially malignant tumors greater than 5 cm in diameter. Their perioperative and follow-up data were retrospectively analyzed. Results: All 39 patients had successful LAs without perioperative mortality, conversion to open surgery, or capsular disruption during dissection. The mean tumor size was 6.2 cm (range, 5–12 cm), operative time 207 min (115–315 min), and blood loss 75 ml (minimal–1400 ml). Complications included one intraoperative diaphragmatic perforation, three mild wound infections, and one pneumonia. Preoperatively there were 27 nonfunctioning tumors, seven pheochromocytomas, three cortisol-secreting tumors, and two virilizing tumors. Final pathology revealed eight malignant (four adrenocortical carcinomas and four metastatic carcinomas) and 31 benign tumors (14 cortical adenomas, eight pheochromocytomas, six myelolipomas, and three ganglioneuromas). Median follow-up was 39 months. Four patients (two adrenocortical carcinomas, one metastatic hepatoma, and one lymphoma) died 24, 10, 9, and 3 months after surgery, respectively. A hand-assisted device was used in 10 patients. Only the tumor size was larger and length of postoperative hospital stay longer for those in the hand-assisted group. Conclusions: LA is a reasonable option for selected large adrenal tumors when complete resection is technically feasible and there is no evidence of local invasion. Hand-assisted LA is a good alternative to open conversion if a difficult dissection is encountered intraoperatively.


2005 ◽  
Vol 19 (3) ◽  
pp. 307-315 ◽  
Author(s):  
David M. Poetker ◽  
Robert J. Toohill ◽  
Todd A. Loehrl ◽  
Timothy L. Smith

Background The increased experience with the endoscopic approach to sinonasal inflammatory disease has resulted in the increased use of endoscopes to manage many different sinonasal pathologies. Methods A chart review of patients with sinonasal tumors treated with primary endoscopic management, from January, 1993 to November, 2003 was performed. Results Forty patients were identified (26 men and 14 women). The mean age was 53.2 years, and the mean follow-up was 31.1 months. For benign tumors, 24 patients were identified with a mean age of 50.7 years, a mean follow-up of 17.5 months, and a recurrence rate of 4.2%. For malignant tumors, 16 patients were identified, with a mean age of 57.3 years, a mean follow-up of 51.5 months, and a recurrence rate of 31.3%. The overall survival rate was 87.5%. Conclusion Endoscopic surgical excision of selective sinonasal tumors may be an effective therapeutic modality. In some cases, adjuvant external procedures may be required based on tumor location.


1981 ◽  
Vol 67 (5) ◽  
pp. 447-453 ◽  
Author(s):  
Valter Castiglione ◽  
Adelaide D'Antona ◽  
Luigi Dellafiore ◽  
Luisa Ferrario ◽  
Guido Luzzatti ◽  
...  

The analytical study of the case material has allowed a precise evaluation of the distribution by age groups of the different pathologic processes of the breast, of the localization and dimensions of malignant tumors, as well as the diagnostic accuracy for those cases histologically ascertained and those with a follow-up. The diagnostic accuracy and the consequent reliability of the xeroradiographic method for the diagnosis of breast cancer is distinctly superior to that reported in the literature for traditional mammography, whereas for the differential diagnosis between circumscribed dysplastic manifestations and benign tumors xeromammography is not sufficiently reliable. The authors critically discuss the results and in particular the problem of false positives, which also include diagnostic errors that cannot be avoided in that they directly derive from the pathologic morphology of the disease process (plasma cell mastitis and sclerosing adenosis). As regards the problem of false negatives, they can be reduced within certain limits by resorting to other instrumental investigations. However, there are cases (1% of the malignant neoplasias histologically ascertained) that present a completely negative xeroradiographic finding. These are the limits of the radiologic investigation which cannot in any way be surmounted.


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