Augmented Reality Microsurgical Planning with a Smartphone (ARM-PS): A dissection route map in your pocket.

INTRODUCTION: Perioperative microsurgical planning increases the likelihood of successful results. Augmented reality (AR) is the addition of artificial information to allow the user to perform tasks more efficiently. The aim of our study is to report the use of AR for microsurgical planning with a smartphone (ARM-PS) as a dissection route map. PATIENTS AND METHODS: AR was used for superficial circumflex iliac artery perforator (SCIP) flap planning. Three-dimensional (3D) reconstruction images of the inguinal and lower abdomen vascular anatomy were obtained by computed tomography angiography. These 3D images were imported to a smartphone and an AR app was used to superimpose them with the camera. The drawings performed with ARM-PS were correlated with handheld Doppler and intraoperative findings. RESULTS: The correlation of ARM-PS drawings with handheld Doppler results was 100% for superficial inferior epigastric artery (SIEA) and superficial and deep branches of SCIP in 60 inguinal areas studied. Intraoperative findings matched perfectly in all 30 cases with ARM-PS drawings for the location of the mentioned vessels and lymph nodes. Flap harvest time decreased in 20% compared with our traditional timing. CONCLUSIONS: ARM-PS is an easy, noninvasive, and accurate method that provides a dissection route map, thereby standardizing flap harvesting, and shows a perfect correlation with intraoperative findings. It reduces operating time and may improve operative results, thus decreasing donor site morbidity.

Instantánea bacteriológica de la otitis media con efusión aguda / Bacteriological instant of the otitis media with acute effusion

Otitis Media es uno de los diagnósticos más frecuentes en los niños que consultan al pediatra. La Otitis Media con Efusión Aguda (OMEA) es un cuadro frecuente en los niños y su tratamiento adecuado es muy importante. Se estudió durante las temporadas de invierno de los años 1989 y 1990 la bacteriología de la OMEA en 27 niños de 3 meses a 12 años de edad en consulta ambulatoria. Se efectúa timpanocentesis bajo anestesia general en pabellón y se toma muestra de la efusión del oído medio. Se obtuvo cultivo positivo en el 77,8%de los pacientes. Los gérmenes aislados se distribuyeron con la siguiente frecuencia: Streptococo pneumoniae 25,9%, Haemophilus influenzae 18,5%, Moraxella catarrhalis 11,1%, Corynebacteium sp. 7,4%, Psudomonas maltophilia 3,7%y cultivos negativos 22,0%. No se aislaron bacterias anaerobias. Se demuestra la existencia de gérmenes que, en frecuencia, concuerdan con los informados en publicaciones extranjeras, y la aparición de la Moraxella catarrhalis como un germen importante en la etiología de la Otitis Media Aguda