Computer–Aided Simulation of Mastoidectomy

AbstractObjectiveTo establish a three–dimensional model of the temporal bone using CT scan images for study of temporal bone structures and simulation of mastoidectomy procedures.MethodsCT scan images from 6 individuals (12 temporal bones) were used to reconstruct the Fallopian canal, internal auditory canal, cochlea, semicircular canals, sigmoid sinus, posterior fossa floor and jugular bulb on a computer platform. Their anatomical relations within the temporal bone were restored in the computed model. The same model was used to simulate mastoidectomy procedures.ResultsThe reconstructed computer model provided accurate and clear three–dimensional images of temporal bone structures. Simulation of mastoidectomy using these images provided procedural experiences closely mimicking the real surgical procedure.ConclusionComputer–aided three dimensional reconstruction of temporal bone structures using CT scan images is a useful tool in surgical simulation and can aid surgical procedure planning. Key words three–dimension reconstruction, CT scan, surgery simulatio

The Practice of Computer-Assisted Planning and Navigation for Hip Arthroscopy

Despite significant developments in hip arthroscopic surgery in recent years, precise preoperative planning and accurate performance remain challenging. Preoperative planning is particularly important in cases of osteochondroplasty for cam-type femoroacetabular impingement (FAI), and can be aided by several computer-assisted tools, including three-dimensional imaging analysis or kinematic analysis. Initially, the exact point of the bony impingement is identified using simulation analysis; then, virtual osteochondroplasty is performed. Improvements in the range of motion can then be evaluated using computer simulation again. In this way, the required area and depth of bone resection can be assessed preoperatively. In addition, computed tomography-based navigation assistance can be used to complete the osteochondroplasty in accordance with the preoperative planning. After surgery, postoperative evaluation provides valuable feedback to improve future planning and procedures. In this chapter, we describe the practice of computer-assisted planning and navigation for hip arthroscopy

3D-printing techniques in a medical setting : a systematic literature review

Background: Three-dimensional (3D) printing has numerous applications and has gained much interest in the medical world. The constantly improving quality of 3D-printing applications has contributed to their increased use on patients. This paper summarizes the literature on surgical 3D-printing applications used on patients, with a focus on reported clinical and economic outcomes. Methods: Three major literature databases were screened for case series (more than three cases described in the same study) and trials of surgical applications of 3D printing in humans. Results: 227 surgical papers were analyzed and summarized using an evidence table. The papers described the use of 3D printing for surgical guides, anatomical models, and custom implants. 3D printing is used in multiple surgical domains, such as orthopedics, maxillofacial surgery, cranial surgery, and spinal surgery. In general, the advantages of 3D-printed parts are said to include reduced surgical time, improved medical outcome, and decreased radiation exposure. The costs of printing and additional scans generally increase the overall cost of the procedure. Conclusion: 3D printing is well integrated in surgical practice and research. Applications vary from anatomical models mainly intended for surgical planning to surgical guides and implants. Our research suggests that there are several advantages to 3D- printed applications, but that further research is needed to determine whether the increased intervention costs can be balanced with the observable advantages of this new technology. There is a need for a formal cost-effectiveness analysis

Radiological Society of North America (RSNA) 3D printing Special Interest Group (SIG): Guidelines for medical 3D printing and appropriateness for clinical scenarios

Este número da revista Cadernos de Estudos Sociais estava em organização quando fomos colhidos pela morte do sociólogo Ernesto Laclau. Seu falecimento em 13 de abril de 2014 surpreendeu a todos, e particularmente ao editor Joanildo Burity, que foi seu orientando de doutorado na University of Essex, Inglaterra, e que recentemente o trouxe à Fundação Joaquim Nabuco para uma palestra, permitindo que muitos pudessem dialogar com um dos grandes intelectuais latinoamericanos contemporâneos. Assim, buscamos fazer uma homenagem ao sociólogo argentino publicando uma entrevista inédita concedida durante a sua passagem pelo Recife, em 2013, encerrando essa revista com uma sessão especial sobre a sua trajetória

Computer-aided position planning of miniplates to treat facial bone defects

In this contribution, a software system for computer-aided position planning of miniplates to treat facial bone defects is proposed. The intra-operatively used bone plates have to be passively adapted on the underlying bone contours for adequate bone fragment stabilization. However, this procedure can lead to frequent intra-operatively performed material readjustments especially in complex surgical cases. Our approach is able to fit a selection of common implant models on the surgeon's desired position in a 3D computer model. This happens with respect to the surrounding anatomical structures, always including the possibility of adjusting both the direction and the position of the used osteosynthesis material. By using the proposed software, surgeons are able to pre-plan the out coming implant in its form and morphology with the aid of a computer-visualized model within a few minutes. Further, the resulting model can be stored in STL file format, the commonly used format for 3D printing. Using this technology, surgeons are able to print the virtual generated implant, or create an individually designed bending tool. This method leads to adapted osteosynthesis materials according to the surrounding anatomy and requires further a minimum amount of money and time.Comment: 19 pages, 13 Figures, 2 Table

Three-dimension-printed custom-made prosthetic reconstructions: from revision surgery to oncologic reconstructions

Background The use of custom-made 3D-printed prostheses for reconstruction of severe bone defects in selected cases is increasing. The aims of this study were to evaluate (1) the feasibility of surgical reconstruction with these prostheses in oncologic and non-oncologic settings and (2) the functional results, complications, and outcomes at short-term follow-up. Methods We analyzed 13 prospectively collected patients treated between June 2016 and January 2018. Diagnoses were primary bone tumour (7 patients), metastasis (3 patients), and revision of total hip arthroplasty (3 patients). Pelvis was the most frequent site of reconstruction (7 cases). Functional results were assessed with MSTS score and complications according to Henderson et al. Statistical analysis was performed using Kaplan-Meier and log-rank test curves. Results At a mean follow-up of 13.7 months (range, 6 \u2013 26 months), all patients except one were alive. Oncologic outcomes show seven patients NED (no evidence of disease), one NED after treatment of metastasis, one patient died of disease, and another one was alive with disease. Overall survival was 100% and 80% at one and two years, respectively. Seven complications occurred in five patients (38.5%). Survival to all complications was 62% at two years of follow-up. Functional outcome was good or excellent in all cases with a mean score of 80.3%. Conclusion 3D-printed custom-made prostheses represent a promising reconstructive technique in musculoskeletal oncology and challenging revision surgery. Preliminary results were satisfactory. Further studies are needed to evaluate prosthetic design, fixation methods, and stability of the implants at long-ter