Current Issue : April-June Volume : 2025 Issue Number : 2 Articles : 5 Articles
The aim of this systematic review was to assess the scientific literature on the accuracy of guided implant surgery and the methods used for its quantification. Two reviewers searched PubMed and the Cochrane Library to identify relevant articles published before 2023. Two methodological quality-assessment tools were used to assess the quality of the studies included. Inter-investigator reliability was verified using kappa statistics. Twenty-three clinical studies out of the 3299 articles initially identified met the inclusion criteria. The “radiographic matching method” and “digital registration method” were used to assess accuracy in guided surgery. The mean angular, coronal, and apical deviations of mucosa-supported guides ranged from 2.7◦ to 5.14◦, 0.87 mm to 2.05 mm, and 1.08 mm to 2.28 mm, respectively. With bone-supported guides, these ranged from 2.49◦ to 5.08◦, 0.71 mm to 1.60, and 0.77 mm to 1.65 mm, respectively. In tooth-supported guides, deviations were from 2.5◦ to 5.62◦, 0.39 mm to 1.63 mm and 0.28 mm, and 1.84 mm, respectively. Regardless of the evaluation method, all systems exhibit some error. The minimum and maximum deviation ranges found between the planned and placed implants show that, although deviations occur, guided surgery is not far from accurate....
In glioma surgery, maximizing the extent of resection while preserving cognitive functions requires an understanding of the unique architecture of the white matter (WM) pathways of the single patient and of their spatial relationship with the tumor. Tractography enables the reconstruction of WM pathways, and bundle segmentation allows the identification of critical connections for functional preservation. This study evaluates the effectiveness of a streamline-based approach for bundle segmentation on a clinical dataset as compared to the traditional ROI-based approach. We performed bundle segmentation of the arcuate fasciculus, of its indirect anterior and posterior segments, and of the inferior fronto-occipital fasciculus in the healthy hemisphere of 25 high-grade glioma patients using both ROI- and streamline-based approaches. ROI-based segmentation involved manually delineating ROIs on MR anatomical images in Trackvis (V0.6.2.1). Streamline-based segmentations were performed in Tractome, which integrates clustering algorithms with the visual inspection and manipulation of streamlines. Shape analysis was conducted on each bundle. A paired t-test was performed on the irregularity measurement to compare segmentations achieved with the two approaches. Qualitative differences were evaluated through visual inspection. Streamline-based segmentation consistently yielded significantly lower irregularity scores (p < 0.001) compared to ROI-based segmentation for all the examined bundles, indicating more compact and accurate bundle reconstructions. Qualitative assessment identified common biases in ROI-based segmentations, such as the inclusion of anatomically implausible streamlines or streamlines with undesired trajectories. Streamline-based bundle segmentation with Tractome provides reliable and more accurate reconstructions compared to the ROI-based approach. By directly manipulating streamlines rather than relying on voxel-based ROI delineations, Tractome allows us to discern and discard implausible or undesired streamlines and to identify the course of WM bundles even when the anatomy is distorted by the lesion. These features make Tractome a robust tool for bundle segmentation in clinical contexts....
Background: In vivo visualization of malignant tumors remains the main challenge during head and neck cancer surgery. This can result in inadequate tumor margin assessment and incomplete tumor resection, adversely affecting patient outcomes. Hyperspectral imaging (HSI) is a promising approach to address this issue. However, its application in surgery has been limited by the lack of medically approved HSI devices compliant with MDR regulations, as well as challenges regarding the integration into the surgical workflow. Methods: In this feasibility study, we employed endoscopic HSI during surgery to visualize the tumor sites of 12 head and neck cancer patients. We optimized the HSI workflow to minimize time required during surgery and to reduce the adaptation period needed for surgeons to adjust to the new workflow. Additionally, we implemented data processing to enable real-time classification and visualization of HSI within the intraoperative setting. HSI evaluation was conducted using principal component analysis and k-means clustering, with this clustering validated through comparison with expert annotations. Results: Our complete HSI workflow requires two to three minutes, with each HSI measurement—including evaluation and visualization—taking less than 10 s, achieving an accuracy of 79%, sensitivity of 72%, and specificity of 84%. Medical personnel became proficient with the HSI system after two surgeries. Conclusions: This study presents an HSI workflow for in vivo tissue differentiation during head and neck cancer surgery, providing accurate and visually accessible results within minimal time. This approach enhances the in vivo evaluation of tumor margins, leading to more clear margins and, consequently, improved patient outcomes....
Introduction: Relapsed Congenital Talipes Equino Varus (CTEV) refers to clubfoot diagnosed after walking age. We refer to this entity as residual deformities of a previously treated clubfoot or a complete recurrence following treatment. For its treatment, several techniques have been used to improve the foot’s functional outcome while remaining minimally invasive. Correction by distraction using the Ilizarov external fixator is a promising technique. This single-center study aims to evaluate the anatomical and functional outcomes of treatment by distraction and compression with the Ilizarov fixator in relapsed club feet. Patients and Method: We carried out a retrospective, singlecenter study over 5 years. In total 16 clubfeet in 14 patients, including 9 males and 5 females were retained for final analysis. The average age of the patients at the time of the intervention was 15.16 years. K-wires were placed using the original technique. The average duration of the fixator in our series was 4.27 months. The functional assessment of patients was based on pre-and post-operative evaluation of the Foot and ankle function according to the AOFAS score. Results: Anatomic assessment was done according to the Dimeglio classification. There was a significant improvement at post-operative period with an average score of 4.47 against 10.07 at pre-operative period. We obtained 43.8% good and very good functional outcomes according to the global AOFAS score increasing from 63.07 at pre-operative period to 77.88 at post-operative period. Two cases of reinterventions were recorded. Conclusion: Distraction with the Ilizarov external fixator occupies a place of choice in the management of relapsed club foot. A good mastery of the technique and patient selection produce good functional outcomes....
Orthopedic surgeries often require a long recovery period, but Hui medicine offers promising strategies for rapid rehabilitation. This paper explores the integration of Hui medicine into postoperative care, focusing on herbal remedies, physical therapies, and dietary adjustments. It uses a variety of methods, such as pasting, Tazi, acupuncture, diet therapy, medicine therapy, etc., to provide comprehensive treatment for various bone diseases. In the field of Hui medicine, through in-depth research and clinical verification, more therapies and drugs with unique curative effects have been discovered. Orthopedic rehabilitation and fumigation therapy play an important role in the rehabilitation stage of the disease, helping patients recover limb function, reduce pain, and improve quality of life. This paper elaborates on the spread and influence of Islamic Arab medical civilization in China and introduces the outstanding achievements of Hui medicine department and Hui medicine as important branches of this medical system. Through the in-depth study of relevant literature and historical data, the brilliant achievements of Hui medicine in inheritance and innovation are further revealed. In addition, the article also discusses the combination of modern science, technology, and traditional medicine-- which has injected new vitality into the development of traditional medicine. Hui medicine, with its unique theoretical system and therapeutic methods, offers promising approaches to enhance the recovery process. Rehabilitation, acupuncture and fumigation treatment are typical representatives of the Sinicization of Islamic Arab medical civilization, and have made important contributions to the development of traditional Chinese medicine. At the same time, the rich experience and unique therapy of Hui medicine provide useful reference and inspiration for modern medicine. This paper overviews the effectiveness of Hui medicine in promoting rapid rehabilitation after orthopedic surgery....
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