Accuracy of a smartphone-assisted novel labeling method for marking target axial position in cataract surgery / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the convenience and accuracy of a novel smartphone-assisted “any-point two-step method” for finding the target axial position in cataract phacoemulsification combined with intraocular lens(IOL)implantation.METHODS: Prospective observational study. A total of 62 cases(62 eyes)of patients with age-related cataracts who underwent cataract phacoemulsification combined with IOL implantation in our hospital from October 2021 to April 2022 were selected. They were randomly divided into two groups: 31 cases(31 eyes)in the control group were applied with the “traditional two-step method” using slit lamp to mark the target axial position of the IOL, and 31 cases(31 eyes)in the experimental group were applied with the smartphone-assisted “two-step method” to mark the target axial position of the IOL. The Callisto eye navigation system was used as a standard reference, and the deviation of the reference marking point(deviation-1), the deviation of the target axial marking point(deviation-total), and the deviation of the angle from the reference marking point to the target axial marking point(deviation-2)were calculated and recorded as the preoperative axial marking time.RESULTS:Both deviation-1 and deviation-total values were lower in the experimental group than those in the control group(1.06°±1.39° vs 2.48°±2.23°, 1.77°±1.54° vs 2.81°±1.58°, all P<0.01), but there was no significant difference in the deviation-2 values between the two groups(1.35°±1.40° vs 1.48°±1.79°, P>0.05). The preoperative axial marking took shorter time in the experimental group than in the control group(1.77±1.70 min vs 2.88±3.20 min, P<0.01).CONCLUSION: The smartphone-assisted “any-point two-step method” for finding the target axial position in cataract phacoemulsification combined with IOL implantation is simple, time-saving, and accurate compared with the “traditional two-step method”.

O-arm navigation versus C-arm navigation for guiding percutaneous long sacroiliac screws placement in treatment of Denis type Ⅱ sacral fractures / 中国修复重建外科杂志

OBJECTIVE@#To compare the effectiveness of O-arm navigation and C-arm navigation for guiding percutaneous long sacroiliac screws in treatment of Denis type Ⅱ sacral fractures.@*METHODS@#A retrospective study was conducted on clinical data of the 46 patients with Denis type Ⅱ sacral fractures between April 2021 and October 2022. Among them, 19 patients underwent O-arm navigation assisted percutaneous long sacroiliac screw fixation (O-arm navigation group), and 27 patients underwent C-arm navigation assisted percutaneous long sacroiliac screw fixation (C-arm navigation group). There was no significant difference in gender, age, causes of injuries, Tile classification of pelvic fractures, combined injury, the interval from injury to operation between the two groups ( P>0.05). The intraoperative preparation time, the placement time of each screw, the fluoroscopy time of each screw during placement, screw position accuracy, the quality of fracture reduction, and fracture healing time were recorded and compared, postoperative complications were observed. Pelvic function was evaluated by Majeed score at last follow-up.@*RESULTS@#All operations were completed successfully, and all incisions healed by first intention. Compared to the C-arm navigation group, the O-arm navigation group had shorter intraoperative preparation time, placement time of each screw, and fluoroscopy time, with significant differences ( P<0.05). There was no significant difference in screw position accuracy and the quality of fracture reduction ( P>0.05). There was no nerve or vascular injury during screw placed in the two groups. All patients in both groups were followed up, with the follow-up time of 6-21 months (mean, 12.0 months). Imaging re-examination showed that both groups achieved bony healing, and there was no significant difference in fracture healing time between the two groups ( P>0.05). During follow-up, there was no postoperative complications, such as screw loosening and breaking or loss of fracture reduction. At last follow-up, there was no significant difference in pelvic function between the two groups ( P>0.05).@*CONCLUSION@#Compared with the C-arm navigation, the O-arm navigation assisted percutaneous long sacroiliac screws for the treatment of Denis typeⅡsacral fractures can significantly shorten the intraoperative preparation time, screw placement time, and fluoroscopy time, improve the accuracy of screw placement, and obtain clearer navigation images.

Application of digital technology in the reconstruction of orbital fractures: research progress / 中华创伤杂志

Orbital fracture often leads to facial collapse, diplopia, enophthalmos, and even blindness. Traditional surgery relies on the experiences of physicians to achieve fracture reduction and orbital wall reconstruction, but the repair effect is not satisfactory. In recent years, with the development of digital technology, technologies such as computer-assisted surgery, 3D printing, surgical navigation systems, and intraoperative CT imaging have become increasingly widespread in the field of orbital reconstruction. Such techniques can avoid dependence on physicians′ experiences and make it easy for estimating and positioning the implantation sites, which subsequently contributes to better surgery efficiency and precise reconstruction of the orbit, improving aesthetics and visual function of patients. To this end, the authors reviewed the recent progress in application of digital technology for orbital fracture reconstruction, so as to provide reference and theoretical basis for clinical practice.

Efficacy of O-arm combined with CT three-dimensional navigation system assisted versus manual screw placement in the treatment of lower cervical fracture and dislocation / 中华创伤杂志

Objective:To compare the clinical efficacies of O-arm combined with CT three-dimensional navigation system assisted screw placement versus manual screw placement in treating lower cervical fracture and dislocation.Methods:A retrospective cohort study was used to analyze the clinical data of 41 patients with lower cervical fracture and dislocation, who were treated in Honghui Hospital, Xi′an Jiaotong University from May 2021 to February 2022. The patients included 26 males and 15 females, aged 31.5-48.6 years [(41.5±15.0)years]. The injured segments were C 3 in 3 patients, C 4 in 12, C 5 in 13, C 6 in 10 and C 7 in 3. Nineteen patients were treated with cervical pedicle screws by O-shaped arm combined with CT three-dimensional navigation system (navigation group, 76 screws) and 22 by bare hands (traditional group, 88 screws). The total operation time, effective operation time, single nail placement time, single screw correction times, screw distance from anterior cortex, intraoperative blood loss, intraoperative fluoroscopic radiation dose, incision length and length of hospital stay were compared between the two groups, and the height of intervertebral space, Cobb angle, interbody slip distance and American Spinal injury Association (ASIA) grade were compared before operation and at 3 days after operation. Visual analogue score (VAS), Japanese Orthopedic Association (JOA) score, and neck dysfunction index (NDI) were evaluated before operation, at 3 days, 3 months after operation and at the last follow-up. Accuracy of screw placement and incidence of complications (adjacent facet joint invasion, infection, screw loosening) were detected as well. Results:All the patients were followed up for 11.1-13.9 months [(12.5±1.4)months]. The total operation time, intraoperative blood loss, intraoperative fluoroscopic radiation dose and incision length in the navigation group were more or longer than those in the traditional group (all P<0.05). The effective operation time, single nail placement time, single nail correction times and screw distance from anterior cortex in the navigation group were markedly less or smaller than those in the traditional group (all P<0.05). There was no significant difference in the length of hospital stay between the two groups ( P>0.05). There were significant improvements in the height of intervertebral space, Cobb angle and interbody slip distance between the two groups at 3 days after operation (all P<0.05). There was no significant difference in the height of intervertebral space, Cobb angle, interbody slip distance or ASIA grade between the two groups before operation or at 3 days after operation (all P>0.05). Compared with pre-operation, the VAS, JOA score and NDI were significantly improved in both groups at 3 days, 3 months after operation and at the last follow-up (all P<0.05), with further improvement with time. There was no significant difference in VAS between the two groups before operation or at 3 months after operation (all P>0.05), but it was markedly lower in the navigation group compared with the traditional group at 3 days after operation and at the last follow-up (all P<0.05). There were no significant differences in JOA score or NDI between the two groups before operation or at 3 days and 3 months after operation (all P>0.05), but both were lower in the navigation group compared with the traditional group at the last follow-up (all P<0.05). The accuracies of placement of grade 0 and grade 0+1 screws were 92.0% (70/76) and 96.6% (73/76) in the navigation group, respectively, which were markedly higher than 88.7% (78/88) and 93.5% (82/88) in the traditional group (all P<0.05). The rates of adjacent facet joint invasion of A, B, and C degrees were 71.2% (54/76), 28.8% (22/76) and 0% (0/76) in the navigation group, respectively, while the invasion rates were 60.5% (53/88), 32.3% (28/88) and 7.3% (7/88) in the traditional group ( P<0.05). No screw loosening was noted in the navigation group, but the screw loosening rate was 9.1% (8/88) in the traditional group ( P<0.01). Conclusion:Compared with manual screw placement, O-arm combined with CT three-dimensional navigation system assisted screw placement for lower cervical fracture and dislocation has the advantages of shorter effective operation time, quicker screw placement, stronger screw holding force, better cervical stability, slighter postoperative pain, higher screw placement accuracy, and lower facet joint invasion and screw loosening rates.

Fluorescence imaging in intraoperative visualization of neurovascular bundles (NVBs) surrounding the prostate: a literature review / 中华泌尿外科杂志

Preservation of erectile function is an important goal of radical prostatectomy. The neurovascular bundles (NVBs), which is closely related to erectile function, are quite susceptible to intraoperative injury because it is difficult to be identified and localized during surgical process. As a result, long-term postoperative potency rate is not satisfying. Techniques of monitoring pro-erectile neurovascular bundles, such as electrical stimulation, ultrasound and MRI have significant limitations in the context of real-time identification during operation. Advances of fluorescence imaging in the surgical navigation field has made it possible to achieve real-time visualization of NVBs in vivo. At present, there have already been many fluorescent agents worldwide targeting different structures within nerves, such as the axon, myelin, perineurium and vaso nervorum, and they varied in their affinity to nerves and imaging efficacies. Some lipophilic molecules, oxazine dyes and peptide-dye conjugates have successfully visualized in periprostatic autonomic nerves in rodents or in human prostate specimen. Indocyanine Green (ICG), a non-specific neurovascular dye, has already been used in clinical setting to guide during nerve-sparing radical prostatectomy. This review focused on fluorescent nerve imaging technique and its application in research on real-time imaging of NVBs in radical prostatectomy.

Prospect and hybridization of three-channel multi-mirror robot for early lung cancer diagnosis and treatment / 中国胸心血管外科临床杂志

@#Nowadays, the development of the medical instrument industry makes rapid changes in clinical practice. Hybridization of latest technology is playing an increasingly important role in the diagnosis and treatment of disease. Especially, the trend of the integration of three-channel hybrid technology in diagnosis and treatment of early lung cancer has become increasingly obvious. This paper will focus on the technical advance of the three-channel multi- mirror robot and its application in the diagnosis and treatment of early lung cancer.

A retrospective study to compare the treatment outcomes with and without surgical navigation for fracture of the orbital wall / 中华创伤杂志(英文版)

PURPOSE@#To evaluate the outcomes with and without aid of a computer-assisted surgical navigation system (CASNS) for treatment of unilateral orbital wall fracture (OWF).@*METHODS@#Patients who came to our hospital for repairing unilateral traumatic OWF from 2014 to 2017 were included in this study. The patients were divided into the navigation group who accepted orbital wall reconstruction aided by CASNS and the conventional group. We evaluated the surgical precision in the navigation group by analyzing the difference between actual postoperative computed tomography data and preoperative virtual surgical plan through color order ratios. We also compared the duration of surgery, enophthalmos correction, restoration of orbital volumes, and improvement of clinical symptoms in both groups systemically. Quantitative data were presented as mean ± SD. Significance was determined by the two-sample t-test using SPSS Version 19.0 A p < 0.05 was considered statistically significant.@*RESULTS@#Seventy patients with unilateral OWF were included in the study cohort. The mean difference between preoperative virtual planning and actual reconstruction outcome was (0.869 ± 0.472) mm, which means the reconstruction result could match the navigation planning accurately. The mean duration of surgery in the navigation group was shorter than it is in the control group, but not significantly. Discrepancies between the reconstructed and unaffected orbital-cavity volume and eyeball projection in the navigation group were significantly less than that in the conventional group. One patient had remnant diplopia and two patients had enophthalmos after surgery in the navigation group; two patients had postoperative diplopia and four patients had postoperative enophthalmos in the conventional group.@*CONCLUSION@#Compare with the conventional treatment for OWF, the use of CASNS can provide a significantly better surgical precision, greater improvements in orbital-cavity volume and eyeball projection, and better clinical results, without increasing the duration of surgery.

Accuracy of bone tunnel in anterior cruciate ligament reconstruction using electromagnetic navigation system / 中国组织工程研究

BACKGROUND: Accuracy and repeatability of bone tunnel in anterior cruciate ligament reconstruction has been a difficult point in surgery. As a new navigation technology, electromagnetic navigation system can realize three-dimensional positioning in application, hoping to make up for the mistakes made by surgeons. OBJECTIVE: To evaluate the feasibility and accuracy of a new electromagnetic navigation system in anterior cruciate ligament reconstruction. METHODS: Totally 30 cases of fresh frozen knee joint were treated with anterior cruciate ligament amputation to prepare knee joint specimens with anterior cruciate ligament rupture. They were randomly divided into two groups, using magnetic channel navigation combined with arthroscopy (navigation group) and traditional arthroscopy (control group). Postoperative lateral radiography of knee joint was performed to observe the exit position of bone tunnel in two groups, to measure the position of the middle of the tibial tunnel on the tibial plateau, to measure the a angle between the Blumensaat line and the axis of the tibial tunnel, and to measure the position of the femoral tunnel on the Blumensaat line. RESULTS AND CONCLUSION: (1) In the navigation group, the lateral X-ray radiographs of knee joint extension showed that the front edge of all tibial tunnels was slightly behind of Blumensaat line, avoiding intercondylar collision. In control group, two cases were located slightly ahead of Blumensaat line. (2) The distance (a) between the Blumensaat line at the level of tibial plateau and the front edge of the tibial tunnel, the ratio of a to width of tibial plateau anteroposterior diameter (c) and alpha angles of tibial tunnel were smaller in the navigation group than in the control group (P < 0.05). This increased the accuracy of tibial tunnel positioning. (3) There was no significant difference in the location of the tibial tunnel between the two groups (P=0.323). However, the range of the central position of the tunnel (38.1 %-53.8%) was slightly lower in the navigation group than that in the control group (30.4%-56.4%). The range of a distance (0.1-3.2 mm) in the navigation group was smaller than that in the control group (-2.1-5.7 mm), and the location of bone marrow tract was more stringent, which increased the repeatability of location tibial tunnel. (4) The position of femoral tunnel was in the position of the posterior upper quadrant (4/4) in all navigation groups and in 13 cases of the control group. The position of femoral tunnel in the navigation group was more backward compared with the control group (P=0.001). The femoral tunnel in the navigation group could ensure the stability of the knee. (5) In the cadaveric knee joint experiment, magnetic navigation technology can be used to assist the location of bone tunnel in anterior cruciate ligament reconstruction, increase the accuracy and repeatability of bone tunnel, but there are still artificial and magnetic channel navigation system errors, which still need to be improved in clinical application.

3D navigation assisted percutaneous vertebroplasty combined with postoperative lower-back muscles training in treatment of osteoporotic vertebral compression fracture / 中国介入影像与治疗学

Objective: To observe value of 3D navigation assisted percutaneous vertebroplasty (PVP) combined with postoperative lower-back muscles training in treatment of osteoporotic vertebral compression fracture (OVCF). Methods: Twenty-five consecutive patients with OVCF were enrolled in observation group and treated with 3D navigation assisted PVP using O-arm scanner and postoperatively systematic back muscle exercise, while other 25 OVCF patients in control group were treated with traditional C-arm assisted PVP and postoperatively regular back muscle exercise. Intraoperative fluoroscopy time, mean dose of radiation, mean procedure time, visual analogue score (VAS) before and 2 h, 1 month, 3 months, 6 months after operation were compared between the two groups. Technical success rate was calculated, and vertebral leakages and complications were observed. Results: Technical success rate of the two groups were both 100% (25/25). The duration of fluoroscopy and operation were shorter, the radiation dose was lower in observation group (all P0.05). Conclusion: PVP guided with 3D navigation combined with postoperative lumbar and dorsal muscle training can safely and effectively treat OVCF, shorten the operation time, reduce radiation exposure and improve the medium and long-term pain symptoms after PVP.

Augmented reality in plastic surgery: recent applications and developments / 中华整形外科杂志

Augmented reality(AR)is a technique that superimposes continuous computer-generated images onto real scenes. With the collaborative work of tracking module, registration module and display module, real-time fused images can be composed and shown. In recent years, AR has been applied in several medical fields, such as medical education, remote medical aid, navigation system, etc.Latest applications and developments of AR in plastic surgery was reviewed in this article.

Clinical efficacy of electromagnetic navigation system in distal locking of tibia intramedullary nail / 局解手术学杂志

Objective To evaluate the clinical effect of electromagnetic navigation system to locate the distal locking screw of tibia intramedullary nail. Methods From February 2010 to December 2016, 79 cases of tibia shaft fractures requiring treatment with intramedullary nailing were selected and divided into the navigation group and free hand locking group according to intramedullary nail locking methods. Forty-four cases in navigation group used an electromagnetic navigation system to lock the distal end of the intramedullary nail,while 35 cases in free hand locking group used a free-hand technique. The intraoperative X-ray exposure time,distal locking time,healing time, and the success rate of one-time distal locking were recorded compared between two groups. Results The average time of diatal locking using electromagnetic navigation technology was less than that of the free hand locking group,and the exposure time of fluoroscopy was also reduced, the differences were significant(P ＜ 0. 05). There was no difference in fracture healing time between the two groups(P ＞ 0. 05), one-time success rate of navigation group was 100％,which was higher than 37. 34％ of the free hand locking group, the difference was significant(P ＜ 0. 05). Conclusion Compared with free hand technology, the advantage of using electromagnetic navigation system to lock the distal nail of tibia intramedullary nail is high efficiency, short locking time and no radiation.

Comparison of Iso-C 3D navigation system versus X-ray fluoroscopy in minimally invasive surgery for Kümmell disease / 中华创伤骨科杂志

Objective To compare the Iso-C 3D navigation system versus the traditional X-ray fluoroscopy in minimally invasive surgery for Kümmell disease.Methods Included for the present retrospective study were 42 patients with Kümmell disease who had been treated by percutaneous kyphoplasty (PKP) or percutaneous vertebroplasty (PVP) at Department of Spine Surgery,Honghui Hospital from October 2016 to June 2018.They were 11 men and 31 women,aged from 43 to 72 years (average,57.4 years).The operation was aided by Iso-C 3D navigational system in 21 patients (observation group) and by X-ray fluoroscopy in the other 21 patients (control group).The 2 groups were compared before operation,one day and 6 months after operation in terms of visual analogue scale (VAS),Oswestry disability index (ODI),cobb angle and anterior vertebral height.Results The 2 groups were comparable because there were no significant differences between them in the preoperative general data (P ＞ 0.05).All the patients were followed up for an average of 9.6 months (from 6.0 to 18.5 months).At one day after operation for the observation andcontrol groups,the VAS scores (2.2 ±0.7 and 3.9 ± 1.5),ODI scores (15.6 ±2.8 and 26.2 ±6.9),cob angles (19.5° ± 1.7° and 20.8° ± 0.8°) and anterior vertebral heights (20.7 ± 1.4 and 18.7 ± 1.5 mm) were all significantly improved compared with those before operation (P ＜ 0.05).At 6 months after operation for the observation and control groups,the VAS scores (1.6±0.6 and 2.7±1.0),ODI (14.2±3.1 and 21.5 ±4.2),cob angles (18.6°± 1.8° and 19.0°± 1.7°) and anterior vertebral heights (19.9 ± 1.8 and 17.8 ± 1.6 mm) were not significantly different from those at one day after operation (P ＞ 0.05).The VAS,ODI,cobb angle and anterior vertebral height at one day after operation for the observation group were all significantly better than those for the control group (P ＜ 0.05).The VAS,ODI and anterior vertebral height at 6 months after operation for the observation group were significantly better than for the control group (P ＜ 0.05),but there was no significant difference between the 2 groups in the cobb angle (P ＞ 0.05).No complications were observed in the observation group but 6 cases in control group reported cement leakage.Conclusion In the PKP/PVP treatment of Kümmell disease,Iso-C 3D navigational system may be superior to traditional X-ray fluoroscopy in that it can lead to better recovery of anterior vertebral height,kyphosis correction,pain relief and quality of life.

Clinical analysis of adult spontaneous cerebrospinal fluid rhinorrhea / 临床耳鼻咽喉头颈外科杂志

OBJECTIVES@#To discuss the clinical characteristics, diagnosis and treatment of adult spontaneous cerebrospinal fluid rhinorrhea (CSFR).@*METHODS@#A retrospective study was conducted on 18 patients of CSFR. Nasal secretion was collected for biochemical analysis. Imaging examination was done for identification of the bony defect in skull base.@*RESULTS@#In all cases, the glucose concentration of nasal secretion were more than 1.7 mmol/L, and the β-2 transferrin detected by immunoelectrophoresis technique were positive. Twelve cases were found to have bony defect in skull base. For the rest 6 cases without bony defect, MRI findings of 6 cases showed sinusoidal effusion with similar signals to cerebrospinal fluid, thus predicting the location of the leak. Conservative treatment was successful in one case, and the other 17 patients underwent endoscopic sinus surgery with computer assisted navigation system (CANS). The results of all cases underwent surgery were successful by one time. No recurrence occured during the follow-up time (11 to 24 months).@*CONCLUSIONS@#The incidence of adult CSFR is low, hence it is easily to be missed and misdiagnosed. The majority of CSFR patients are middle-aged and elderly obese women, often combined with hypertension, diabetes, moderate and severe osteoporosis due to no daily exercise habits. Correct medical history collection, reasonable preoperative examination and accurate preoperative localization of bony defect are essential for surgical repairment. CANS used during operation can enable surgeons to locate the site of leakage accurately and shorten the operation time.

Real-time virtual navigation system combined with CEUS guided radiofrequency ablation therapy of neonatal or recurrent hepatocellular carcinoma lesions / 中国医学影像技术

Objective To investigate the value of real-time virtual navigation system (RVS) combined with CEUS in guiding radiofrequency ablation (RFA) therapy of neonatal or recurrent lesions of hepatocellular carcinoma (HCC).Methods Totally 111 patients with neonatal or recurrent lesions of HCC after RFA therapy were enrolled.Seventy-eight patients with 86 lesions (77 neonatal lesions and 9 recurrent lesions) underwent RFA guided by RVS combined with CEUS (RVS combined with CEUS group),and 33 patients with 38 lesions (26 neonatal lesions and 12 recurrent lesions) underwent RFA guided by CEUS alone (control group).The precise localization,inactivation rate and local recurrence rate between the two groups were compared.Results Eighty-four lesions (84/86,97.67％) in RVS combined with CEUS group and 25 lesions (25/38,65.79％) in control group were clearly showed and localized (P＜0.001).One month after RFA therapy,the tumor inactivation rate in RVS combined with CEUS group and control group was 95.35 ％ (82/86) and 76.31％ (29/38),respectively (P=0.003).The local recurrence rate in RVS combined with CEUS group was 8.14％ (7/86),while was 36.84％ (14/38) in control group (x2 =15.434,P＜0.001).Conclusion RVS combined with CEUS guidance can improve the accurate position rate and early inactivation rate of RFA therapy for neonatal or recurrent lesions of HCC.

Three-dimensional printing technique combined with computer-assisted navigation in treatment of complex maxillofacial fracture / 中华整形外科杂志

From November 2015 to January 2016, two patients with multiple maxillofacial fractures were chosen to undergo CT scanning and maxillofacial three-dimensional (3D) imaging reconstruction. The data were input to 3D printer in order to yield rapid prototyping model with the same size of patients′ maxillofacial regions. Simulated fracture surgery and reconstruction of the Ti-palate were performed on the models. The operations were conducted with the guidance of navigation system. The consistency of simulated model and real fractures was compared. The results show the complex maxillofacial fracture could make the operation more accurate and shorten the operation time. Moreover, the facial features and masticatory function of both patients were improved. The 3D printing technique combined with computer-assisted navigation could be applied to complex maxillofacial fractures surgery, in order to improve the surgical accuracy and achieve effective reconstruction.

Clinical retrospective study of navigation guided impacted maxillary supernumerary tooth extraction / 中华口腔医学杂志

Objective@#To analyze the efficiency and safety of navigation guided extraction of impacted supernumerary tooth.@*Methods@#Twenty-five cases of navigation guided supernumerary tooth extraction and 25 cases of non-navigation guided supernumerary tooth extraction (control group) were included in the study. Each group had 3 cases with one impacted supernumerary tooth and 22 cases with two impacted teeth.@*Results@#Preoperative navigation system designing time was (45.0±8.0) min in average. Navigation system installation time was (15.0±2.8) min. The average operation time was (0.64±0.08) hour in navigation group and (0.91±0.09) hour in control group.@*Conclusions@#Navigation guided extraction of impacted supernumerary tooth takes less time for operation but more time for the preoperative navigation system design.

The application and development of dynamic navigation system in implant dentistry / 口腔疾病防治

@#Dynamic surgical navigation system has been wildly used in implantology, the navigation surgical system provide preoperative trajectory planning. Moreover, the constant visualization of drilling trajectory during operation assist the operators by avoiding critical anatomic structures to achieve safer surgery. Our article focuses on the development and function of dynamic navigation system to evaluate the accuracy of dynamic surgical navigation system when used for regular implants and zygomatic implants placement. We aim to discuss the accuracy of different brand of dynamic surgical navigation systems for implants placement and to investigate the main reasons led the inaccurate outcome.

Application of a computer-assisted navigation system (CANS) in the treatment of complicated orbital fractures / 中华医学美学美容杂志

Objective To evaluate the effectiveness of computer-assisted navigation system on open reduction as treatment for complicated orbital fractures.Methods The computed tomography (CT) data for 6 patients with complicated orbital fractures were obtained before surgery and imported into the surgical planning software.After 3-dimensional (3D) construction and segmentation,data from the unaffected side were used to guide the reduction data,and surgical simulation was performed.All patients underwent open reduction under the guidance of the navigation system.The segments were then reduced to the predetermined places.CT measurements were used to evaluate navigation accuracy and bone symmetry.Results A fairly accurate match between the intraoperative anatomy and the computed tomography images was achieved through registration,with a systematic error of 1 mm difference.With guidance of the navigation system,open reduction of fractures was performed in all cases.The reduction was checked by postoperative computed tomography scans,with a good match with preoperative planning noted.The maximal deviation between the reduction and preoperative planning was less than 2 mm.The postoperative facial appearance of the patients was clearly improved.Conclusions Navigation-guided open reduction of complicated orbital fractures can be regarded as a valuable treatment option for this potentially complicated procedure.

Utility of a Computed Tomography-Based Navigation System (O-Arm) for En Bloc Partial Vertebrectomy for Lung Cancer Adjacent to the Thoracic Spine: Technical Case Report

We describe successful vertebrectomy from a posterior approach using a computed tomography (CT)-based navigation system (O-arm) in a 53-year-old man with adenocarcinoma of the posterior apex of the right lung with invasion of the adjacent rib, thoracic wall, and T2 and T3 vertebral bodies. En bloc partial vertebrectomy for lung cancer adjacent to the thoracic spine was planned using O-arm. First, laminectomy was performed from right T2 to T3, and pedicles and transverse processes of T2 to T3 were resected. O-arm was used to confirm the location of the cutting edge in the T2 to 3 right vertebral internal body, and osteotomy to the anterior cortex was performed with a chisel. Next, the patient was placed in a left decubitus position. The surgical specimen was extracted en bloc. This case shows that O-arm can be used reliably and easily in vertebrectomy from a posterior approach and can facilitate en bloc resection.

Navigated Pin-Point Approach to Osteoid Osteoma Adjacent to the Facet Joint of Spine

Osteoid osteoma (OO) is a benign osteoblastic tumor. Its curative treatment is complete removal of the nidus, where intraoperative localization of the nidus governs clinical results. However, treatment can be difficult since the lesion is often invisible over the bony surface. Accordingly, establishment of an ideal less invasive surgical strategy for spinal OO remains yet unsettled. We illustrate the efficacy of a computed tomography (CT)-based navigation system in excising OO located adjacent to the facet joint of spine. In our 2 cases, complete and pin-point removal of the nidus located close to the facet joint was successfully achieved, without excessive removal of the bone potentially leading to spinal instability and possible damage of nearby neurovascular structures. We advocate a less invasive approach to spinal OO, particularly in an environment with an available CT-based navigation system.