Endoscopic Drainage of an Odontogenic Pterygoid Muscle Abscess

The infratemporal fossa (ITF) is a potential space bounded by bony structures that can be occupied by both benign and malignant tumors. It is also a potential area of abscess development, most commonly of dental origin. As with any abscess, the treatment of an ITF abscess is surgical drainage. We present a case of an ITF abscess involving the pterygoid muscles following dental extraction in a poorly controlled diabetic patient. The ITF was accessed with an endoscopic transseptal approach through the maxillary sinus to drain the abscess. This case of successful management supports the feasibility of the endoscopic approach in dealing with abscesses of the ITF

Curvature coding is tuned for motion direction

We have investigated the global and local motion tuning properties of curvature coding mechanisms using two shape after-effects believed to be mediated by curvature-sensitive mechanisms: the shape-frequency after-effect, or SFAE, and the shape-amplitude after-effect, or SAAE. The SFAE and SAAE are the phenomena in which adaptation to a sine-wave-shaped contour causes a shift in respectively the apparent shape-frequency and apparent shape-amplitude of a test contour in a direction away from that of the adapting stimulus. In the global motion condition the sinusoidal-shaped contours were made to drift within a fixed stimulus window in the direction of their axis of modulation. In the local motion condition the contour was constructed from a string of Gabors, and their carriers but not envelopes moved. We investigated selectivity to motion direction by using adaptor and test contours that moved either in the same or opposite directions. We found that in the global motion condition both the SFAE and SAAE showed selectivity to motion direction, and that for the same-motion-direction condition, both after-effects increased with shape temporal frequency. We then examined the effect of luminance spatial frequency and luminance temporal frequency on global motion direction selectivity. Luminance temporal frequency accounted for some of the increase in after-effect magnitude with shape temporal frequency, but shape temporal frequency also contributed. The local motion after-effects on the other hand were neither selective to motion direction nor increased with luminance temporal frequency. Taken together, the results are best understood by supposing that curvature is encoded by mechanisms that are selective to motion direction and that the directional selectivity best manifests itself psychophysically when there is sufficient spatio-temporal coverage of the stimulus to stimulate the full array of potentially responsive curvature-coding mechanisms

Development of the McGill simulator for endoscopic sinus surgery : a new high-fidelity virtual reality simulator for endoscopic sinus surgery

Background: The technical challenges of endoscopic sinus surgery (ESS) and the high risk of complications support the development of alternative modalities to train residents in these procedures. Virtual reality simulation is becoming a useful tool for training the skills necessary for minimally invasive surgery; however, there are currently no ESS virtual reality simulators available with valid evidence supporting their use in resident education. Our aim was to develop a new rhinology simulator, as well as to define potential performance metrics for trainee assessment. Methods: The McGill simulator for endoscopic sinus surgery (MSESS), a new sinus surgery virtual reality simulator with haptic feedback, was developed (a collaboration between the McGill University Department of Otolaryngology-Head and Neck Surgery, the Montreal Neurologic Institute Simulation Lab, and the National Research Council of Canada). A panel of experts in education, performance assessment, rhinology, and skull base surgery convened to identify core technical abilities that would need to be taught by the simulator, as well as performance metrics to be developed and captured. Results: The MSESS allows the user to perform basic sinus surgery skills, such as an ethmoidectomy and sphenoidotomy, through the use of endoscopic tools in a virtual nasal model. The performance metrics were developed by an expert panel and include measurements of safety, quality, and efficiency of the procedure. Conclusion: The MSESS incorporates novel technological advancements to create a realistic platform for trainees. To our knowledge, this is the first simulator to combine novel tools such as the endonasal wash and elaborate anatomic deformity with advanced performance metrics for ESS.Peer reviewed: YesNRC publication: Ye

The McGill simulator for endoscopic sinus surgery (MSESS): a validation study

Endoscopic sinus surgery (ESS) is a technically challenging procedure, associated with a significant risk of complications. Virtual reality simulation has demonstrated benefit in many disciplines as an important educational tool for surgical training. Within the field of rhinology, there is a lack of ESS simulators with appropriate validity evidence supporting their integration into residency education. The objectives of this study are to evaluate the acceptability, perceived realism and benefit of the McGill Simulator for Endoscopic Sinus Surgery (MSESS) among medical students, otolaryngology residents and faculty, and to present evidence supporting its ability to differentiate users based on their level of training through the performance metrics