11 research outputs found
Extraoral Osseous Choristoma in the Head and Neck Region: Case Report and Literature Review
An osseous choristoma is a benign tumor consisting of regular bone tissue in an irregular localization. Choristomas in the head
and neck region are rare. Most frequently, they are found in the region of the tongue or oral mucosa. There are also very few
reports on osseous choristomas in the submandibular region. We present the case of a woman with a large, caudal osseous
choristoma within the lateral cervical triangle. Literature review is given about all of the reported cases in the region of the neck.
The pathogenesis is yet unexplained. Our case supports the theory that the development of an osseous choristoma is a reaction to a
former trauma. Cervical osseous choristomas are seldom, but they represent an important differential diagnosis when dealing with
a cervical tumo
Longitudinal Testing of Olfactory and Gustatory Function in Patients with Multiple Sclerosis
Background The aim of the study was to investigate changes of the olfactory
and gustatory capacity in patients with multiple sclerosis (MS). Methodology
20 MS patients were tested longitudinally for 3 years after initial testing.
The Threshold Discrimination Identification test (TDI) was used for subjective
olfactometry. Objective olfactometry was performed by registering olfactory
evoked potentials (OEP) by EEG. The Taste Strip Test (TST) was used for
gustatory testing. Results 45% of the patients showed olfactory dysfunction in
the follow-up TDI test and 50% showed delayed OEP´s. 20% of the patients
showed gustatory dysfunction on follow-up visit. The patients showed mild
disease activity with 0,3 ± 0,5 relapses over the testing period and no
significant change of their olfactory and gustatory capacity. The olfactory
capacity for the discrimination of odors correlated inversely with the number
of relapses (r = -0.5, p ≤ 0.05). The patients were aware of their olfactory
deficit. Conclusions Olfactory and gustatory dysfunction is a symptom in MS
patients and may be a useful parameter to estimate disease progression in MS
patients. As the discrimination of odors is processed in higher central
regions of the central nervous system (CNS), the results suggest that
olfactory dysfunction could be due to CNS damage
First experience with augmented reality neuronavigation in endoscopic assisted midline skull base pathologies in children
Introduction: Endoscopic skull base approaches are broadly used in modern neurosurgery. The support of neuronavigation can help to effectively target the lesion avoiding complications. In children, endoscopic-assisted skull base surgery in combination with navigation systems becomes even more important because of the morphological variability and rare diseases affecting the sellar and parasellar regions. This paper aims to analyze our first experience on augmented reality navigation in endoscopic skull base surgery in a pediatric case series.
Patients and methods: A retrospective review identified seventeen endoscopic-assisted endonasal or transoral procedures performed in an interdisciplinary setting in a period between October 2011 and May 2020. In all the cases, the surgical target was a lesion in the sellar or parasellar region. Clinical conditions, MRI appearance, intraoperative conditions, postoperative MRI, possible complications, and outcomes were analyzed.
Results: The mean age of our patients was 14.5 ± 2.4 years. The diagnosis varied, but craniopharyngiomas (31.2%) were mostly represented. AR navigation was experienced to be very helpful for effectively targeting the lesion and defining the intraoperative extension of the pathology. In 65% of the oncologic cases, a radical removal was proven in postoperative MRI. The mean follow-up was 89 +/- 79 months. There were no deaths in our series. No long-term complications were registered; two cerebrospinal fluid (CSF) fistulas and a secondary abscess required further surgery.
Conclusion: The implementation of augmented reality to endoscopic-assisted neuronavigated procedures within the skull base was feasible and did provide relevant information directly in the endoscopic field of view and was experienced to be useful in the pediatric cases, where anatomical variability and rarity of the pathologies make surgery more challenging
Advances in electrical stimulation-based therapy for tinnitus
Tinnitus is a phantom percept of noise heard only by the affected person. The principal problem of persons suffering from tinnitus is the inability to deflect their attention from the phantom sound, resulting in insomnia and problems with concentration, followed by significant health issues. To date, no therapy would relieve patients from the phantom sound. Instead, commonly used therapeutic approaches for tinnitus aim primarily at the reduction of tinnitus-induced distress and are based on various tinnitus habituation methods. Our project aims to quench the tinnitus percept using an implant. To develop such an implant, this research group joined the INTAKT network initiated by the German Federal Ministry of Education and Research and dedicated to the development of smart implants. During this still ongoing, prospective clinical study, the efficacy of two protocols using electrical stimulation is assessed for tinnitus silencing. The electrical stimulation used in the presented study is non-invasive and applied on three consecutive days in the form of short sessions. In a sample of 48 subjects, following three stimulation sessions, 48% of patients reported a significant reduction of tinnitus loudness; 10% reported a brief increase of tinnitus loudness, and 42% stated no change. In one case, the first course of stimulation led to the total distinguishing of tinnitus. On average, the stimulation did not affect the grade of tinnitus-induced distress during the time of measurement. Our current results prompt us to broaden our investigations, expand the subject sample, and further optimize the stimulation conditions
First experience with augmented reality neuronavigation in endoscopic assisted midline skull base pathologies in children
Introduction!#!Endoscopic skull base approaches are broadly used in modern neurosurgery. The support of neuronavigation can help to effectively target the lesion avoiding complications. In children, endoscopic-assisted skull base surgery in combination with navigation systems becomes even more important because of the morphological variability and rare diseases affecting the sellar and parasellar regions. This paper aims to analyze our first experience on augmented reality navigation in endoscopic skull base surgery in a pediatric case series.!##!Patients and methods!#!A retrospective review identified seventeen endoscopic-assisted endonasal or transoral procedures performed in an interdisciplinary setting in a period between October 2011 and May 2020. In all the cases, the surgical target was a lesion in the sellar or parasellar region. Clinical conditions, MRI appearance, intraoperative conditions, postoperative MRI, possible complications, and outcomes were analyzed.!##!Results!#!The mean age of our patients was 14.5 ± 2.4 years. The diagnosis varied, but craniopharyngiomas (31.2%) were mostly represented. AR navigation was experienced to be very helpful for effectively targeting the lesion and defining the intraoperative extension of the pathology. In 65% of the oncologic cases, a radical removal was proven in postoperative MRI. The mean follow-up was 89 ± 79 months. There were no deaths in our series. No long-term complications were registered; two cerebrospinal fluid (CSF) fistulas and a secondary abscess required further surgery.!##!Conclusion!#!The implementation of augmented reality to endoscopic-assisted neuronavigated procedures within the skull base was feasible and did provide relevant information directly in the endoscopic field of view and was experienced to be useful in the pediatric cases, where anatomical variability and rarity of the pathologies make surgery more challenging
Telepresence for surgical assistance and training using eXtended reality during and after pandemic periods
Existing challenges in surgical education (See one, do one, teach one) as well as the COVID-19 pandemic make it necessary to develop new ways for surgical training. Therefore, this work describes the implementation of a scalable remote solution called “TeleSTAR” using immersive, interactive and augmented reality elements which enhances surgical training in the operating room. The system uses a full digital surgical microscope in the context of Ear–Nose–Throat surgery. The microscope is equipped with a modular software augmented reality interface consisting an interactive annotation mode to mark anatomical landmarks using a touch device, an experimental intraoperative image-based stereo-spectral algorithm unit to measure anatomical details and highlight tissue characteristics. The new educational tool was evaluated and tested during the broadcast of three live XR-based three-dimensional cochlear implant surgeries. The system was able to scale to five different remote locations in parallel with low latency and offering a separate two-dimensional YouTube stream with a higher latency. In total more than 150 persons were trained including healthcare professionals, biomedical engineers and medical students.</p
Boxplot of longitudinal TDI testing results.
<p>X-axis: time points (baseline and follow-up in years). Y-axis: TDI score (TDI = Threshold Discrimination Identification). The median is shown with first and third quartiles. The scores of the whiskers represent the minimum and maximum scores.</p