PubMed HealthSearch

Biomedical subjects

G Enislidis

Publications and source records attributed to G Enislidis.

9 recordsLinked to original sources

Computed intraoperative navigation guidance--a preliminary report on a new technique.

OBJECTIVE: To assess the value of a computer-assisted three-dimensional guidance system (Virtual Patient System) in maxillofacial operations. DESIGN: Laboratory and open clinical study. SETTING: Teaching Hospital, Austria. SUBJECTS: 6 patients undergoing various procedures including removal of foreign body (n=3) and biopsy, maxillary advancement, and insertion of implants (n=1 each). INTERVENTIONS: Storage of computed tomographic (CT) pictures on an optical disc, and imposition of intraoperative video images on to these. The resulting display is shown to the surgeon on a micromonitor in his head-up display for guidance during the operations. MAIN OUTCOME MEASURES: To improve orientation during complex or minimally invasive maxillofacial procedures and to make such operations easier and less traumatic. RESULTS: Successful transferral of computed navigation technology into an operation room environment and positive evaluation of the method by the surgeons involved. CONCLUSIONS: Computer-assisted three-dimensional guidance systems have the potential for making complex or minimally invasive procedures easier to do, thereby reducing postoperative morbidity.

Adult

Solitary plasmocytoma of the mandible--a combined approach for treatment and reconstruction.

A 44-year-old man presented with a solitary plasmocytoma in the left mandible. After neoadjuvant radiation therapy and chemotherapy, a bone marrow biopsy was taken for cryopreservation. In simulation surgery, tumour resection and primary reconstruction were planned on an individual stereolithographic 3-D skull model. Radical tumour resection and primary reconstruction using a microvascular iliac crest bone graft was performed. In case of extensive osteolysis and/or mandibular asymmetry due to tumourous bone enlargement, preoperative model planning has proved to be a useful tool for primary reconstruction. In the three-year follow up, the patient showed no recurrence of disease.

Adult

Remote stereotactic visualization for image-guided surgery: technical innovation.

Additional data from imaging sources using computer navigation assistance enables virtual visualization of anatomical structures in three dimensions for stereotactic navigation during an operation. Recent developments in communication technology enable the broadcasting not only of video data, but also of stereotactic navigation data via the network. By telepresence/teleconsulting, the composite images and overlapping graphics (instrument, target structure, landmark, contour) can be seen in connected clinics, with the possibility of interactive graphic assistance. In cranio-maxillofacial surgery, the first surgical teleconsultation in real time via telecommunication of stereotactic data was performed in August 1996. A patient suffering from a post-traumatic deformity following multiple comminuted midface fractures was re-osteotomized with the aid of image-guided surgery using teleconsultation: the intraoperative position achieved could be discussed with different surgeons with regard to symmetry, hard/soft tissue relationships and occlusal details, with the possibility of on-screen planning interaction and real time evaluation of the results, over a distance of 500 km.

Computer Graphics

Lactosorb panel and screws for repair of large orbital floor defects.

In a series of five patients with extensive fractures of the orbital floor, we used a biodegradable sheet for bridging of the bony defects. To achieve optimal support of the orbital contents in their anatomically correct position, we fixed the sheet with at least two resorbable screws to the infraorbital rim. This new technique appears to be superior to conventional methods because it offers reproducible results without the need for secondary interventions.

Adolescent

Computer-aided navigation in secondary reconstruction of post-traumatic deformities of the zygoma.

Augmented reality technology was used in 5 patients for secondary reconstruction of post-traumatic unilateral deformities of the zygomaticomaxillary complex. Three electromagnetic sensors interfaced to a computer-aided navigation system (ARTMA Biomedical Inc.) were utilized. The computer navigation procedure was planned by drawing graphic lines on the CT scan at the level of the zygomatic arch, representing the outer surface of the zygoma. The desired position of the displaced zygoma was planned by mirroring from the healthy side, using a virtual mid-sagittal plane. These virtual graphics were presented intraoperatively on a TV monitor and also on the surgeon's see-through head-mounted display. Correct reduction was assumed when the virtual line representing the position of the zygoma before the osteotomy reached the virtual line defined preoperatively as the desired position. The advantages of the technique presented are that a complete exposure of the zygomatic bone is no longer necessary, and coronal and subciliary incisions may be avoided unless enophthalmos correction has to be carried out, which was in fact necessary in 2 patients. The results of zygomatic reconstruction have been satisfactory in all 5 patients.

Adult

Image-guided surgery.

Interventional video tomography (IVT), a new imaging modality, achieves virtual visualization of anatomic structures in three dimensions for intraoperative stereotactic navigation. Partial immersion into a virtual data space, which is orthotopically coregistered to the surgical field, enhances, by means of a see-through head-mounted display (HMD), the surgeon's visual perception and technique by providing visual access to nonvisual data of anatomy, physiology, and function. The presented cases document the potential of augmented reality environments in maxillofacial surgery.

Foreign Bodies

[Experiences and results in management of mandibular fractures with the modified Krenkel lag screw--a retrospective study].

The stable osteosynthesis of mandibular fractures with the modified lag screw (Krenkel) has proven superior to conventional lag screws in theoretical models and clinical use. Compared to osteosynthesis with plate systems, the lag screw technique is more difficult to learn for the unexperienced, but the reduction of fragments under compression with a lag screw and the stabilisation of lower jaw rotation with an additional short miniplate in our experience has proven successful in clinical use.

Adolescent

Virtual image guided navigation in tumor surgery--technical innovation.

We present a new visualization system for image-guided stereotactic navigation in tumor surgery. The combination of frameless stereotactic localization technology with real-time video processing permits the visualization of medical imaging data as a video overlay during the actual surgical procedure. Virtual computer-generated anatomical structures are displayed intraoperatively in a semi-immersive head-up display. This results in surgical navigation assistance without limiting the judgement of the physician based on the continuous observation of the operating field. The case presented documents the potential of augmented reality visualization concepts in tumor surgery of the head.

Computer Simulation

[Computer-assisted intraoperative visualization of dental implants. Augmented reality in medicine].

In this paper, a recently developed computer-based dental implant positioning system with an image-to-tissue interface is presented. On a computer monitor or in a head-up display, planned implant positions and the implant drill are graphically superimposed on the patient's anatomy. Electromagnetic 3D sensors track all skull and jaw movements; their signal feedback to the workstation induces permanent real-time updating of the virtual graphics' position. An experimental study and a clinical case demonstrates the concept of the augmented reality environment--the physician can see the operating field and superimposed virtual structures, such as dental implants and surgical instruments, without loosing visual control of the operating field. Therefore, the operation system allows visualization of CT planned implantposition and the implementation of important anatomical structures. The presented method for the first time links preoperatively acquired radiologic data, planned implant location and intraoperative navigation assistance for orthotopic positioning of dental implants.

Computer Graphics