Pathology quiz case: Sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease).
Explore the source record for details and available documents.
Adult↗
Biomedical subjects
Bryan M Davis
Publications and source records attributed to Bryan M Davis.
Image-guided surgery: what is the accuracy?
PURPOSE OF REVIEW: Use of image-guided surgery (IGS) systems in otolaryngology, particularly rhinology, has grown exponentially in recent years. Central to their use is the understanding of the accuracy of each system. The purpose of this review is to discuss the error inherent in all IGS systems. A standardized technique (currently used in the engineering literature) for understanding and reporting error in IGS systems is reviewed. Using this technique, the error of commercially available IGS systems is reviewed. RECENT FINDINGS: The most commonly used IGS systems depend on the conformation of the skin, as opposed to relying on bone-implanted devices. For these systems, mean accuracies 2 mm or less are routinely reported. This finding is independent of fiducial markers (eg, proprietary headsets, skin-affixed markers, or laser scanning of skin surfaces). Techniques of fiducial localization and registration of CT scans to intraoperative anatomy are proprietary to each company. As such, there is great variability in reporting system specifications-particularly error of IGS systems. This lack of standardization makes comparison of one system to another difficult if not impossible. SUMMARY: Image-guided surgery systems commonly used in rhinology report mean accuracies of 2 mm or less. Surgeons must be aware that this value represents a mean of a distribution of errors. As such, 95% of the time error can be expected to be less than approximately 1.7 times its mean value. However, outliers (errors much larger and much smaller than the mean) may exist for each IGS intervention. As noted, IGS systems function to complement-not replace-knowledge of surgical anatomy.
Humans↗
Cochlear implant fixation using polypropylene mesh and titanium screws.
HYPOTHESIS: Fixation of cochlear implants using prosthetic mesh is an improvement of the traditional fixation methods. STUDY DESIGN: A retrospective chart review was performed examining all adult and pediatric patients between 1998 and 2003 who underwent cochlear implantation using polypropylene mesh and titanium screws to fix the cochlear implant internal receiver. Patient age at implantation, postoperative infections, device failures, device migrations or extrusions, cerebrospinal fluid (CSF) leaks, flap complications, epidural hematoma data, and follow-up data were evaluated. RESULTS: Two hundred and eighty-five patients were identified who received cochlear implantation using the polypropylene mesh securing technique. There were five postoperative infections, two device failures, zero flap complications, zero device migrations or extrusions, zero cerebral spinal fluid leaks, and zero epidural hematomas. The two delayed device failures in this series were not related to fixation technique. CONCLUSIONS: We conclude that this technique is widely applicable, technically superior, and not associated with increased complications.
Adolescent↗