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Biomedical subjects

E Koekelkoren

Publications and source records attributed to E Koekelkoren.

16 recordsLinked to original sources
PubMed2003

Image guided surgery for petrous apex lesions.

OBJECTIVES: To evaluate whether computer-assisted frameless stereotactic navigation in the temporal bone provides sufficient clinical application accuracy and thus a useful tool in temporal bone surgery. METHODS: Two patients with petrous apex cholesterol granuloma were operated on by an epidural middle fossa approach using a Stealth/Medtronic trade mark neuronavigation system. Based on literature data optimal skin fiducial placement and registration methods were used. Intra-operative accuracy was checked using three precise anatomical landmarks. Drilling of the petrous apex bone was guided by neuronavigation. Postoperative Computed Tomography (CT) images were fused with the preoperative CT and planning. RESULTS: The application of image-guidance in temporal bone surgery causes no additional burden to the patient nor prolongs the operating time. The accuracy measured at the anatomical landmarks was under 2,0 mm. This is confirmed by evaluation of bone removal through image fusion of pre- and postoperative CT-scan. CONCLUSIONS: The clinical application of a neuronavigation system during petrous apex surgery can be regarded as useful. Using all available data on registration methods it seems possible to obtain intra-operative application accuracies of <2,0 mm. Additional cadaver work is being performed to support these data.

Adult↗
PubMed2001

Wegener's granulomatosis triggered by infection?

Wegener's granulomatosis is a systemic disease of unknown origin, although recent studies suggest that auto-immune mechanisms and infection play a role in the pathogenesis of this disease. Wegener is characterized by a necrotizing vasculitis involving the lungs (pulmonary infiltrates), the upper airways and the kidneys (rapidly progressive glomerulonephritis). We present a case of a male patient admitted because of progressive deterioration of the general condition with weight loss, a unilateral neck mass, unilateral purulent rhinorrea and fever. CT-scan evaluation demonstrated a unilateral expanding mass in the sing-nasal cavity, obliterating the ethmoid complex. MRI revealed signs of intracranial inflammatory reaction and onset of absedation. A malignancy was suspected but a diagnosis of Wegener's granulomatosis was established based on histologic criteria (nasal biopsy) and a positive titer for anti-cytoplasmic antibodies (cANCA). During follow-up, nasal carriage of Staphyloccocus Aureus could be documented. An overview of Wegener's granulomatosis will be provided with emphasis on the potential role of acute infections as a trigger for Wegener's granulomatosis and the head and neck manifestations.

Acute Disease↗
PubMed2000

Accuracy of computer navigation in ear, nose, throat surgery: the influence of matching strategy.

OBJECTIVE: To measure the effect of 4 different matching strategies on the accuracy of computer navigation on the face and within the nose and rhinopharynx. DESIGN: Survey. SETTING: Laboratory study. SUBJECTS: Six human cadavers studied within 24 hours of death. INTERVENTIONS: A commercially available navigation system with infrared optical tracking was used for computer navigation on the face and within the nose of the subjects after matching with external fiducials or with 3 different configurations of anatomical landmarks. Navigation errors were measured and correlated to matching strategies and compared through statistical analysis. RESULTS: Matching with external fiducials on the face results in smaller navigation error than matching with anatomical landmarks. The configuration of matching strategies with anatomical landmarks also significantly determines the accuracy of computer navigation, especially when different locations of accuracy measurement are considered. CONCLUSION: Statistically significant findings have shown that the choice of a matching strategy is a major factor in the accuracy of computer navigation for ear, nose, throat surgery. Arch Otolaryngol Head Neck Surg. 2000;126:1462-1466

Cadaver↗
PubMed1999

Computer assisted E.N.T. surgery, a preliminary report.

The Medivision Image Guided Surgery System was used in the E.N.T. Department of the Antwerp University Hospital in 10 different E.N.T. surgical procedures between October 1997 and February 1998. The authors report and discuss the procedure for computer assisted surgery in E.N.T. interventions, based on this preliminary experience, and conclude that computer assisted surgery has many useful applications in our speciality.

Humans↗
PubMed1998

Cochlear implantation: an overview of existing implants.

Cochlear implants (CI) bypass the external and middle ear and parts of the inner ear, by delivering electrical stimuli to the remaining neural fibres of the acoustic nerve in a meaningful way. Many features of current CI are similar. They are all multi-channel devices with intracochlear placement of the active electrodes and with transcutaneous information and energy transfer. Factors affecting the auditory performance of CI recipients are patient-linked factors and device factors. An overview is given of key design parameters, processing characteristics and specifications of following CI platforms: Clarion S-Series, Combi 40 and Combi 40+, Digisonic DX 10, Laura-Flex and nucleus CI22 and CI24M. These data, combined with outcome parameters can enhance the information of CI-teams, patients or parents of children in their decision making process when faced with a hearing impairment to such an extent that hearing aids are of little or no benefit.

Cochlear Implantation↗
PubMed1997

Definition, classification and reporting of Menière's disease and its symptoms.

This review describes the practicalities of using both the inner Ear Profile to define hydrops labyrinthi, and the American Academy of Otolaryngology and Head and Neck Surgery (AAO-HNS) guidelines to define Meniere's disease. The requirement for standardisation is stressed since either system alone may be inadequate. It is suggested that the Inner Ear Profile could be adapted to the AAO-HNS criteria to create a unified method of evaluation.

Endolymphatic Hydrops↗
PubMed1995

Preoperative computed tomography in patients requiring a bone-anchored hearing aid.

A preoperative computed tomography technique, "Dentascan" or "Dentatool", was used to find the optimal site for implant installation in patients requiring a bone-anchored hearing aid. The technique is demonstrated in a patient with bilateral bone conduction hearing loss who was treated with bilateral bone-anchored hearing aids.

Bone Conduction↗
PubMed1992

[Place of the otorhinolaryngologist in the multidisciplinary approach to neurofibromatosis].

Neurofibromatosis is one of the most common inherited human disorders. Two types have been recognized, NF 1 and NF 2. Clinical and genetic aspects of the disease clear the way to the aims and indications of the multidisciplinary approach of the neurofibromatosis patients and their families. To study the uniformity of patient management (protocol), a number of Belgian and Dutch medical centres were contacted. Great importance is attached to the common as well as the varying points of these protocols. We emphasize the part played by the ENT specialist in the multidisciplinary approach of neurofibromatosis type 1 and 2.

Algorithms↗
PubMed1991

Tympano-ossicular allografts following J. Marquet: the evaluation of a school.

The experience with 1.645 transplantation procedures by ENT surgeons, trained in tympano-ossicular allograft technique following J. Marquet, is reported. The grafts originated from different tissue banks. The anatomical and functional results one year postoperatively were analysed. There appeared to be no statistical differences between tissue banks, nor between surgeons. Contrary to the anatomical results, functional differences existed between allograft tympanoplasties and some types of allograft tympano-ossiculoplasties. It was concluded that the routine use of allograft tympano-ossiculoplasty offers a major tool in otological surgery and that it is the method of choice by the ENT surgeons trained by the School of J. Marquet.

Belgium↗
PubMed1990

Allograft tympanoplasty: predictive value of preoperative status.

The functional and anatomical results of a series of 181 consecutive allograft tympanoplasties for ears with drum perforation and an intact ossicular chain were retrospectively reviewed and related to preoperative factors. Drum closure was realized in 92% (166 of 181 cases evaluated 1 year after surgery), and 96.6% of the reconstructed drums were still intact 3 years after surgery (118 cases evaluated). An air-bone gap of less than 21 dB was reached in 79.6% (of a total of 162 cases) 1 year after surgery, and in 78% (of a total of 118 cases) 3 years after surgery. Age, contralateral pathology, the wet or dry status of the ear preoperatively, and the preoperative air-bone gap had no influence on anatomical results. The preoperative air-bone gap did not predict the postoperative air-bone gap. The influence of age and existence of contralateral pathology on hearing gain was only visible in some of the strictly defined patient groups. The wet preoperative status of the ear generally predicted lower functional gain.

Adolescent↗
PubMed1990

[Esophageal perforation caused by a foreign body: a conservative approach].

The etiology, diagnosis and therapy of esophageal perforations due to foreign bodies are discussed on the basis of a case and a literature survey. Eighty percent of the esophageal perforations are iatrogenic. Pain is the first symptom. When appearing after manipulation of the esophagus, a perforation should be ruled out by means of radiology. This should be done by soft tissues radiography of the neck, barium study of the esophagus and chest radiography. The early prevention of contamination and administration of antibiotics are important conditions of a successful conservative therapy.

Anti-Bacterial Agents↗
PubMedDate not supplied

CT diagnosis and differential diagnosis of otodystrophic lesions of the temporal bone.

The purpose of this study was to assess the diagnostic and differential value of high-resolution computed tomography in the evaluation of temporal-bone dystrophies. The study group included 55 patients with osseous abnormalities of the temporal bone in general, and the labyrinthine capsule in particular. In 27 patients the CT scan revealed evidence of otodystrophic lesions. The CT findings in patients with otosclerosis (21 patients), osteogenesis imperfecta (two patients), fibrous dysplasia (one patient), Paget's disease (one patient) and osteopetrosis (two patients) are described. The CT scans of 17 patients revealed secondary osseous lesions due to metastasis (five patients), post-inflammatory changes (10 patients) or labyrinthitis ossificans (two patients). Normal variants and congenital mineralization defects were diagnosed in nine patients, Down's syndrome in two. Our results indicate the importance of high-resolution computed tomography as the primary imaging modality in evaluating osseous lesions of the temporal bone and labyrinth.

Adolescent↗
PubMedDate not supplied

[The contribution of oto-vestibular studies in the diagnosis of vertebrobasilar insufficiency--(VBI)].

The high incidence of oto-vestibular complaints in patients presenting vertebro-basilar insufficiency (VBI) is emphasized. In some studies up to 90% of the patients are complaining from dizziness, oscillopsia or tinnitus. The indications of the oto-vestibular evaluation and its importance in the diagnosis of VBI is discussed. The authors lay stress on the fact that the Romberg test is not valuable as a vestibular functional screening test, but that only a full oto-vestibular evaluation will contribute to the diagnosis of VBI.

Evoked Potentials, Auditory↗
PubMedDate not supplied

Surgical treatment of benign tumours of the salivary glands.

In this multicentre retrospective study 30 patients with benign salivary gland tumours are reviewed. Initial operation consisted of total parotidectomy in 6 patients, superficial lobectomy in 13 and tumour enucleation in 11. There were 5 recurrences, treated by enucleation in 1, superficial lobectomy in 2 and extensive total resection in 2 patients. In 18 cases a typical facial nerve dissection was performed. The resected specimens showed a pleiomorph adenoma in 24 cases and monomorph adenoma's in 6 cases. Complications were haematoma formation, Frey syndrome and facial nerve paresis. Recurrences were related to incomplete resection or fragmentation during operation. In this study benign tumours of the salivary glands proved to have a good prognosis, provided a total tumour excision with nerve dissection is performed; the excision should consist of a superficial lobectomy or total parotidectomy depending on the location of the tumour in the lateral or medial part of the gland.

Adenoma↗