scholarly journals Navigation-Guided Transnasal Endoscopic Delineation of the Posterior Margin for Maxillary Sinus Cancers: A Preclinical Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Stefano Taboni ◽  
Marco Ferrari ◽  
Michael J. Daly ◽  
Harley H. L. Chan ◽  
Donovan Eu ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Maxillary Sinus ◽  
Posterior Margin ◽  
Surgical Navigation ◽  
Virtual Endoscopy ◽  
Preclinical Study ◽  
Substantial Improvement ◽  
Tumor Models ◽  
Transnasal Approach ◽  
Cross Sectional

BackgroundThe resection of advanced maxillary sinus cancers can be challenging due to the anatomical proximity to surrounding critical anatomical structures. Transnasal endoscopy can effectively aid the delineation of the posterior margin of resection. Implementation with 3D-rendered surgical navigation with virtual endoscopy (3D-SNVE) may represent a step forward. This study aimed to demonstrate and quantify the benefits of this technology.Material and MethodFour maxillary tumor models with critical posterior extension were created in four artificial skulls (Sawbones®). Images were acquired with cone-beam computed tomography and the tumor and carotid were contoured. Eight head and neck surgeons were recruited for the simulations. Surgeons delineated the posterior margin of resection through a transnasal approach and avoided the carotid while establishing an adequate resection margin with respect to tumor extirpation. Three simulations were performed: 1) unguided: based on a pre-simulation study of cross-sectional imaging; 2) tumor-guided: guided by real-time tool tracking with 3D tumor and carotid rendering; 3) carotid-guided: tumor-guided with a 2-mm alert cloud surrounding the carotid. Distances of the planes from the carotid and tumor were classified as follows and the points of the plane were classified accordingly: “red”: through the carotid artery; “orange”: <2 mm from the carotid; “yellow”: >2 mm from the carotid and within the tumor or <5 mm from the tumor; “green”: >2 mm from the carotid and 5–10 mm from the tumor; and “blue”: >2 mm from the carotid and >10 mm from the tumor. The three techniques (unguided, tumor-guided, and carotid-guided) were compared.Results3D-SNVE for the transnasal delineation of the posterior margin in maxillary tumor models significantly improved the rate of margin-negative clearance around the tumor and reduced damage to the carotid artery. “Green” cuts occurred in 52.4% in the unguided setting versus 62.1% and 64.9% in the tumor- and carotid-guided settings, respectively (p < 0.0001). “Red” cuts occurred 6.7% of the time in the unguided setting versus 0.9% and 1.0% in the tumor- and carotid-guided settings, respectively (p < 0.0001).ConclusionsThis preclinical study has demonstrated that 3D-SNVE provides a substantial improvement of the posterior margin delineation in terms of safety and oncological adequacy. Translation into the clinical setting, with a meticulous assessment of the oncological outcomes, will be the proposed next step.

scholarly journals Association between Odontogenic and Maxillary Sinus Conditions: A Retrospective Cone-Beam Computed Tomographic Study

2021 ◽  
Vol 10 (13) ◽  
pp. 2849
Author(s):  
Piotr Kuligowski ◽  
Aleksandra Jaroń ◽  
Olga Preuss ◽  
Ewa Gabrysz-Trybek ◽  
Joanna Bladowska ◽  
...  
Keyword(s):  
Bone Loss ◽  
Maxillary Sinus ◽  
Mucous Membrane ◽  
Maxillary Sinusitis ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Odontogenic Infections ◽  
Computed Tomographic ◽  
Periodontal Bone Loss ◽  
Maxillary Sinuses

Odontogenic infections can directly trigger maxillary sinusitis. CBCT is an excellent choice for precise examination of maxillary sinuses and hard tissues within the oral cavity. The objective of this retrospective and the cross-sectional study was to analyze the influence of odontogenic conditions on the presence and intensity of maxillary sinus mucous membrane thickening using CBCT imaging. Moreover, periodontal bone loss and anatomic relationship between adjacent teeth and maxillary sinuses were assessed to evaluate its possible impact on creating maxillary thickening. The study sample consisted of 200 maxillary sinuses of 100 patients visible on CBCT examination with a field of view of 13 × 15 cm. The presented study revealed a significant influence of periapical lesions, inappropriate endodontic treatment, severe caries, and extracted teeth on the presence of increased thickening of maxillary sinus mucous membrane. In addition, an increase in the distance between root apices and maxillary sinus floor triggered a significant reduction of maxillary sinus mucous membrane thickening. The presence of periodontal bone loss significantly increases maxillary sinus mucous membrane thickening.

scholarly journals Association of Carotid Atherosclerosis With White Matter Hyperintensity in an Asymptomatic Japanese Population: A Cross-Sectional Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Li Zhang ◽  
Quan Zhou ◽  
Li Hua Shao ◽  
Jun Wen ◽  
Jun Xia
Keyword(s):  
White Matter ◽  
Carotid Artery ◽  
Japanese Population ◽  
Carotid Atherosclerosis ◽  
Smoking Status ◽  
White Matter Hyperintensity ◽  
Large Artery ◽  
Cross Sectional ◽  
Carotid Artery Plaque ◽  
Plaque Score

Objective: A limited number of scholars concentrated on the relationship between carotid atherosclerosis (CAS) and white matter hyperintensity (WMH) (i.e., CAS-WMH relationship). The current research aimed to clarify the CAS-WMH relationship in Japanese population.Methods: All participants underwent MRI of head and ultrasonography of the carotid artery. WMH was diagnosed from MRI results. The carotid ultrasound findings, carotid artery plaque score (PS), and plaque number (PN) could be achieved to indicate the severity of CAS. We also employed multivariate logistic regression models to estimate the CAS-WMH relationship. Interaction and stratified analyses were undertaken on the basis of a number of factors (e.g., gender, age, smoking status, drinking habit, and history of chronic diseases).Results: A total of 1,904 Japanese subjects were included, and the prevalence of WMH was 54.8% (1,044/1,904). It was unveiled that frequency of CAS was greater in cases with WMH. In a fully adjusted model, high PS was associated with the frequency of WMH, followed by high PN. Further analyses revealed a dose-response relationship between PS and incidence of WMH.Conclusion: PS and PN exhibited the greatest influences on determining the frequency of WMH, highlighting the potentially important pathophysiological role of large artery atherosclerosis in intensifying WMH.

Abstract 273: New Reconstruction Technique for MRA to “Fly Through” the Lumen of the Cerebral Vasculature

2013 ◽  
Vol 33 (suppl_1) ◽  
Author(s):  
Mallikarjunarao Kasam ◽  
Siva S Ketha ◽  
Soumya Konduru
Keyword(s):  
Virtual Endoscopy ◽  
Statistical Parameter ◽  
Computation Time ◽  
Reconstruction Technique ◽  
Cross Sectional ◽  
Root Area ◽  
Contrast Enhanced ◽  
3.0 T ◽  
Area Product ◽  
Sectional Structure

Methods Patient exams were performed under an IRB-approved protocol. Two 3D SWIRLS [3] single phase contrast-enhanced angiographies with 1mm3 spatial resolution were used for this work. Clinical exams were acquired on 3.0 T scanners (GE, DVMR 20.1IB, Milwaukee, WI). Data analysis The angiogram was post-processed using tree analysis and virtual endoscopy modules of Analyze 11.0 software (Analyze 11.0; Biomedical Imaging Resource, Mayo Clinic, Rochester, MN) to fly through the artery. A statistical parameter called Brightness Area Product (BAP) was defined as the sum of the intensities above the sample minimum intensity/threshold set by the user. Results and Discussions Figures (I-IV) show the methodology to fly through the part of anterior carotid artery (ACA) and all statistics of part of the artery (Fig. IV) with angles from the “Root” to its different branches of A1 to G2 (Fig. III). Figure II shows the snap shot of the fly through/internal cross sectional structure of ACA of branch “E2”, at the location marked as “red dot”. Table (IV) represents different statistics including length, angle from the root, area of cross section and the BAP of the branches mentioned in Fig. III. The computation time for this method is < 5 minutes compared to the other reconstruction techniques (>~30 minutes). We proposed a simple and fast automated post-processing method to fly through the artery using Analyze 11.0 software. This technique can be extended to any arteries to monitor internal vasculature and to estimate the stenosis using the statistical parameter BAP, which generates a master profile/database of arteries. References 1 Shu Y, Bernstein MA, ISMRM 2009 p764.

Abstract 3136: Lipid-Lowering Medication Modifies The Gene-Diet Association Between 5-Lipoxygenase Promoter Polymorphisms And Carotid Artery Atherosclerosis

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Nitzan C Roth ◽  
Susanna Vikman ◽  
Hooman Allayee ◽  
Wendy J Mack ◽  
Howard N Hodis
Keyword(s):  
Carotid Artery ◽  
Intima Media Thickness ◽  
Lipid Lowering ◽  
Wild Type ◽  
Promoter Polymorphisms ◽  
Cross Sectional ◽  
Carotid Artery Atherosclerosis ◽  
Randomized Controlled ◽  
Inflammatory State ◽  
Rate Limiting

Background: 5-Lipoxygenase (5-LOX) is the rate-limiting enzyme in the biosynthesis of leukotrienes from arachidonic acid (Ara), an n-6 polyunsaturated fatty acid (PUFA). Previous studies suggest that polymorphisms in the number of tandem Sp1 binding sites in the promoter of the 5-LOX gene may have an atherogenic effect due to a heightened inflammatory state when dietary Ara is high and dietary long-chain n-3 PUFAs (eicosapentaenoic acid, EPA, plus docosahexaenoic acid, DHA) are low. Methods: We determined 5-LOX genotypes in 1,663 adults participating in one of five randomized controlled atherosclerosis trials using carotid artery intima-media thickness (CIMT) as the outcome. Baseline data on participant characteristics and clinic and laboratory measurements, including fasting lipids and CIMT, were obtained using the same methods in all trials. Diet was measured using 3-day records and intake of each PUFA was categorized as above or below the median. We used linear regression to examine the cross-sectional associations between 5-LOX genotype, dietary PUFAs, and CIMT. Results: Alleles were classified as wild-type (W, with 5 repeats), deletion (D, with 2– 4 repeats), or addition (A, with 6–9 repeats). The frequencies of the six genotypes were: 60.6% WW, 27.1% WD, 4.9% WA, 4.9% DD, 2.2% DA, and 0.4% AA. Among participants using lipid-lowering medication, mean CIMT was significantly elevated by 79.1 μm (95% CI = 5.3–152.9) in DD individuals compared to WW individuals after adjustment for sex, race, age, trial, and BMI >25 kg/m 2 . High dietary EPA+DHA blunted the gene-CIMT association (p for interaction = 0.007). In contrast, DD genotype was not associated with CIMT among non-users of lipid-lowering medication. Conclusion: The atherogenic effect of the shorter promoter alleles is modulated by dietary intake, especially in individuals using lipid-lowering medication, indicating a complex mechanism involving both inflammation and lipids.

An Angle-Independent Cross-Sectional Doppler Method for Flow Estimation in the Common Carotid Artery

2020 ◽  
Vol 67 (8) ◽  
pp. 1513-1524
Author(s):  
Luuk van Knippenberg ◽  
Ruud J. G. van Sloun ◽  
Sergei Shulepov ◽  
R. Arthur Bouwman ◽  
Massimo Mischi
Keyword(s):  
Carotid Artery ◽  
Common Carotid Artery ◽  
Cross Sectional ◽  
Flow Estimation ◽  
Doppler Method ◽  
The Common
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