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Post-traumatic enophthalmos secondary to orbital fat atrophy: a volumetric analysis.

PubMED - sex, 11/15/2019 - 09:08

Post-traumatic enophthalmos secondary to orbital fat atrophy: a volumetric analysis.

Orbit. 2019 Nov 14;:1-6

Authors: Cohen LM, Habib LA, Yoon MK

Abstract
Purpose: To investigate via volumetric analysis whether orbital fat atrophy occurs in late post-traumatic enophthalmos.Methods: An IRB-approved retrospective cohort study identified patients with diagnoses of both orbital fracture and enophthalmos with a CT orbits >3 months after injury. Exclusion criteria were surgical repair, other orbital disease or surgery, adjacent sinus disease, and an abnormal contralateral orbit. Images were analyzed using OsiriX imaging software (v.9.0.2, Pixmeo, Switzerland). Total orbital volume and orbital fat volume for the fractured and normal contralateral orbits were measured via three-dimensional volume rendering assisted region-of-interest computation. Enophthalmos was measured radiographically. Paired samples t-tests were used to compare orbital fat and total orbital volumes between the fractured and normal contralateral orbits.Results: Thirteen patients met the inclusion criteria. The numbers of patients with each fracture pattern were floor (4), medial wall (4), floor/medial wall (3), zygomaticomaxillary complex (floor+lateral wall) (1), zygomaticomaxillary complex+medial (inferior/medial/lateral walls) (1). Mean time from injury to CT scan was 21.8 ± 16.3 months. Comparing the fractured and normal contralateral orbits, there was a statistically significant decrease in orbital fat volume (mean difference 0.9 ml (14.2%), p = .0002) and increase in total orbital volume (mean difference 2.0 ml (7.0%), p = .0001). One ml orbital volume change was responsible for 0.83 mm enophthalmos.Conclusions: In addition to an increase in total orbital volume, orbital fat loss occurs with late post-traumatic enophthalmos due to unrepaired fractures. This suggests correction of bony change alone may be insufficient in some cases, and the use of custom implants may compensate for fat atrophy.

PMID: 31726012 [PubMed - as supplied by publisher]

Imaging and histomorphometric evaluation of mandible and tibia of rats treated with bisphosphonates.

PubMED - qui, 11/07/2019 - 17:02
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Imaging and histomorphometric evaluation of mandible and tibia of rats treated with bisphosphonates.

Oral Maxillofac Surg. 2019 Nov 04;:

Authors: Martelli SJR, Damian MF, Schinestsck AR, Schuch LF, Cascaes AM, Vasconcelos ACU

Abstract
OBJECTIVES: To evaluate the mandible and tibia of rats treated with bisphosphonates (BPs) by imaging and histomorphometric analysis.
STUDY DESIGN: Thirty-four rat specimens (Rattus norvegicus, Wistar strain) were distributed into 3 groups: (1) 12 rats treated with zoledronic acid; (2) 12 rats treated with clodronate; and (3) the control group, containing 10 rats that received saline. All bones were exposed to cone beam computed tomography (CBCT). The images were analyzed to determine bone density (BD), using the software OsiriX 7.0. Histological slides were prepared from the specimens and the proportion of bone volume (BV) was quantified using the software Adobe Photoshop CC.
RESULTS: There was no statistically significant difference in BD either between the drug groups or between mandible and tibia. BV between BPs and control group did not show a significant difference. However, comparing the two bones, the mandibles in the control group displayed higher BV than did the tibiae in the same group.
CONCLUSION: According to our results, we conclude that (1) BD was not altered by bone type or by type of BP administered, and (2) treatment with zoledronic acid or clodronate did not affect BV in the mandible or tibia of test groups.

PMID: 31686251 [PubMed - as supplied by publisher]

Olfactory cleft and sinus opacification differentially impact olfaction in chronic rhinosinusitis.

PubMED - sab, 10/12/2019 - 09:54
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Olfactory cleft and sinus opacification differentially impact olfaction in chronic rhinosinusitis.

Laryngoscope. 2019 Oct 11;:

Authors: Loftus C, Schlosser RJ, Smith TL, Alt JA, Ramakrishnan VR, Mattos JL, Mappus E, Storck K, Yoo F, Soler ZM

Abstract
OBJECTIVES: Prior studies have indicated that olfactory cleft (OC) opacification correlates with olfaction in patients with chronic rhinosinusitis (CRS). However, the results have been unclear in patients without polyps. The purpose of this study was to further explore the relationship between OC opacification, sinus opacification, and olfactory function in patients with CRS.
METHODS: One hundred and forty-eight patients with CRS were prospectively enrolled across five institutions. Olfactory function was evaluated using the Sniffin' Sticks tests (Burghardt, Wedel, Germany) and the 17-item Questionnaire of Olfactory Disorders (QOD-NS). Computed tomography (CT) scans for each patient were acquired and Lund-Mackay scores recorded. Opacification of the OC was determined using OsiriX MD (Pixmeo, Bernex, Switzerland) and correlated with olfaction scores.
RESULTS: A total of 148 CRS patients, 73 CRS without nasal polyps (CRSsNP) and 75 CRS with nasal polyps (CRSwNP), as well as 30 control subjects were enrolled. Overall OC opacification averaged 63.7% in CRS patients and 47.1% in control subjects (P < 0.001). In the overall cohort, OC opacification significantly correlated with threshold, discrimination, and identification (TDI) (r = -0.520; P < 0.001) and QOD-NS scores (r = 0.374; P < 0.001). CRSwNP patients demonstrated a significant correlation between OC opacification and TDI scores (r = -0.464; P < 0.001) but not the CRSsNP group (r = -0.143; P = 0.229). Lund-Mackay score correlated with TDI in both the CRSsNP (r = -0.300; P = 0.010) and CRSwNP (r = -0.271; P = 0.019) groups.
CONCLUSION: CT opacification is associated with olfactory dysfunction differentially based on nasal polyp status. Smell loss in CRSwNP correlated with both OC opacification and Lund-Mackay score, whereas CRSsNP correlated only with Lund-Mackay score, indicating different relationships between olfactory function and local inflammatory processes in these disorders.
LEVEL OF EVIDENCE: 2 Laryngoscope, 2019.

PMID: 31603563 [PubMed - as supplied by publisher]

Agreement between software programmes of body composition analyses on abdominal computed tomography scans of obese adults.

PubMED - qui, 10/03/2019 - 08:51
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Agreement between software programmes of body composition analyses on abdominal computed tomography scans of obese adults.

Arch Endocrinol Metab. 2019 Sep 30;:

Authors: Barbalho ER, Rocha IMGD, Medeiros GOC, Friedman R, Fayh APT

Abstract
OBJECTIVE: A large number of studies have used abdominal computed tomography (CT) to quantify body composition, and different software programmes have been used to perform these analyses. Thus, this comparison is important to enable researchers to know the performance of more accessible software.
SUBJECTS AND METHODS: Fifty-four abdominal CT scans of obese (BMI 30 to 39.9 kg/m2), sedentary adults (24-41 years) patients from a Brazilian single center were selected. Two software programs were compared: Slice-O-Matic (Tomovision, Canada) version 5.0 and OsiriX version 5.8.5. The body composition analysis were segmented using standard Hounsfield unit (HU) (adipose tissue: -190 to +30 and skeletal muscle: -29 to +150) and measured at the mid third lumbar vertebra (L3) level on a slice showing both transversal processes. Bland-Altman limits of agreement analyses were used to assess the level of agreement between Slice-O-Matic and OsiriX.
RESULTS: A total of fifty-four participants were evaluated, with majority women (69%), mean of age 31.3 (SD 6.5) years and obesity grade I most prevalent (74.1%). The agreement, in Bland-Altman analysis, between Slice-O-Matic and OsiriX analisys for the muscle mass tissue, visceral adipose tissue and subcutaneous adipose tissue were excellent (≥ 0.954) with P-values < 0.001.
CONCLUSION: These findings show that Slice-O-Matic and OsiriX softwares agreement in measurements of skeletal muscle and adipose tissue and sarcopenia diagnosis in obese patients, suggesting good applicability in studies with body composition in this population and clinical practice.

PMID: 31576962 [PubMed - as supplied by publisher]

The Biplanar Effect of the Medial Cuneiform Osteotomy.

PubMED - ter, 09/17/2019 - 09:45
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The Biplanar Effect of the Medial Cuneiform Osteotomy.

Foot Ankle Spec. 2019 Sep 15;:1938640019868061

Authors: Mortimer JA, Bouchard M, Acosta A, Mosca V

Abstract
Background. The "foot-CORA" (center of rotation of angulation) method confirms the medial cuneiform as the site of deformity in most forefoot/midfoot deformities and is therefore the ideal location to correct those deformities. It has been consistently observed intraoperatively by the senior author that there is a secondary, unintentional deformity created in the transverse plane when dorsiflexion and plantar flexion osteotomies of the medial cuneiform are performed to correct pronation and supination forefoot deformities, respectively. These effects may not be desirable. This biplanar effect of medial cuneiform osteotomies has been observed but not studied. The purpose of this study was to perform the 4 commonly used medial cuneiform osteotomy techniques on cadaveric feet to demonstrate their biplanar effects. Methods. Four formaldehyde preserved cadaveric feet were used to perform 4 techniques of medial cuneiform osteotomy: dorsiflexion plantar-based opening wedge, plantar flexion dorsal-based opening wedge, dorsiflexion dorsal-based closing wedge, and plantar flexion plantar-based closing wedge. Photographs and fluoroscopy were used to assess the angular changes in the sagittal and transverse planes. Angular measurements were made using OsiriX software on fluoroscopic images. Results. The medial cuneiform opening wedge osteotomies produced midfoot abduction in addition to the desired dorsiflexion and plantar flexion. The medial cuneiform closing wedge osteotomies produced midfoot adduction in addition to the desired dorsiflexion and plantar flexion. Conclusion. We confirm that intentional sagittal uniplanar osteotomies of the medial cuneiform create obligate biplanar effects. This is likely a result of tethering by ligaments and the joint capsules on the lateral border of the medial cuneiform. The obligate transverse plane effect can be used to one's advantage or result in an undesired effect if not considered during surgical planning and execution. We propose a simple treatment algorithm for selecting the appropriate medial cuneiform osteotomy for forefoot/midfoot deformities. Levels of Evidence: Level V.

PMID: 31522539 [PubMed - as supplied by publisher]

The Use of Osirix for Surgical Planning Using Cranial Measures and Region of Interest Tools: Technical Note.

PubMED - ter, 09/10/2019 - 08:47
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The Use of Osirix for Surgical Planning Using Cranial Measures and Region of Interest Tools: Technical Note.

Asian J Neurosurg. 2019 Jul-Sep;14(3):762-766

Authors: Lovato RM, Araujo JLV, Paiva ALC, Pesente FS, Yaltirik CK, Harput MV, Esteves Veiga JC

Abstract
Background: During the surgery for intrinsic brain lesions, it is important to plan the proper site of the craniotomy and to identify the relations with the gyri and superficial veins. This might be a challenge, especially in small subcortical lesions and when there is a distortion of the cortical anatomy.
Materials and Methods: Using the free computer software Osirix, we have created a 3-dimensional reconstruction of the head and cerebral showing the gyri and superficial veins. With the aid of some tools, it is possible to create a colored image of the lesion and also to calculate the distance between the areas of interest and some easily identifiable structure, making it easier to plan the site of the craniotomy identify the topography of the lesion.
Results: The reconstructions were compared to the intraoperative view. We found this technique to be useful to help identify the gyri and cortical veins and use them to find the lesions. The use of a region of interest to show better the lesion under the cortical surface and in the three-dimensional reconstruction of the head was also helpful.
Conclusions: This is a low-cost and easy technique that can be quickly learned and performed before every surgery. It helps the surgeon to plan a safe craniotomy and lesionectomy.

PMID: 31497099 [PubMed]

A new way of presenting diagnostic imaging studies in surgical planning.

PubMED - qui, 09/05/2019 - 11:09
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A new way of presenting diagnostic imaging studies in surgical planning.

Pol Przegl Chir. 2018 Nov 07;91(4):48-51

Authors: Alzubedi A, Kusz M, Kuczyńska M, Białek W, Bicki J, Rudzki S

Abstract
Technological advancement, availability and common use of diagnostic imaging slowly but consistently leads to a change in its nature from being additional studies to becoming the basis for diagnostic process and treatment planning especially in complex cases that require surgical treatment. CT angiography study presentation using the illusion called "Pepper's Ghost" in comparison to a three-dimensional printout and regular CT scan has been made to point out the relevance of research and implementation of new technologies in the diagnosis and surgical planning. Our image, despite being far from ideal and being just an illusion of a hologram, was more appealing and detailed to surgeons in comparison to a printed 3D model and standard CT angiography displayed with Osirix software. In order to change the existing methods of presenting imaging studies, it is advisable to use latest technologies, and among those currently available, ones based on virtual or mixed reality deserve special attention.

PMID: 31481641 [PubMed - in process]

Exploring the pathological role of intervertebral disc and facet joint in the development of degenerative scoliosis by biomechanical methods.

PubMED - dom, 08/25/2019 - 09:36
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Exploring the pathological role of intervertebral disc and facet joint in the development of degenerative scoliosis by biomechanical methods.

Clin Biomech (Bristol, Avon). 2019 Aug 16;70:83-88

Authors: Zheng J, Yang Y, Cheng B, Cook D

Abstract
BACKGROUND: To investigate the biomechanical changes in the development of scoliosis due to intervertebral disc and facet joint degeneration.
METHODS: We enrolled 39 cases of fresh-frozen lumbar spine specimens and underwent CT scanning and 3D reconstruction. An Osirix Dicom imaging system was to assess the degeneration of the intervertebral disc and facet joints, and mechanical loading was conducted using a spine mechanical instrument with the frequency set at plus/minus 7.5 NM, 0.005 Hz. Range of motion (ROM) and neutral zone (NZ) of 39 cadaveric lumbar spines were tested.
FINDINGS: Degeneration existed in all 39 cases of the lumbar specimens: the Cobb angle >10° in 5 cases (degenerative scoliosis (DS) group), between 3° and 10° in 9 cases (pre-degenerative scoliosis (PS) group) and <3° in 25 cases (no scoliosis (NS) group). The axial torsion (AT) range of motion (ROMAT) and the NZ of the DS and PS groups was greater than in the NS group and increased with increasing Cobb angle. A significant correlation was found between the degeneration of the intervertebral disc and the AT and the AT correlated with the Cobb angle and facet joint degeneration.
INTERPRETATION: The AT correlated with intervertebral disc and facet joint degeneration, which might be a mechanic factor in the occurrence and development of degenerative scoliosis.

PMID: 31445401 [PubMed - as supplied by publisher]

In vitro qualitative and quantitative CT assessment of iodinated aerosol nasal deposition using a 3D-printed nasal replica.

PubMED - qui, 08/22/2019 - 12:08
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In vitro qualitative and quantitative CT assessment of iodinated aerosol nasal deposition using a 3D-printed nasal replica.

Eur Radiol Exp. 2019 Aug 21;3(1):32

Authors: Sartoretti T, Mannil M, Biendl S, Froehlich JM, Alkadhi H, Zadory M

Abstract
Computed tomography can provide high-resolution details on nasal anatomy being potentially useful for the assessment of nasal spray deposition. The purpose of this technical note was to present a method based on CT imaging to assess qualitatively and quantitatively the in vitro spray deposition patterns within the sinonasal cavities of a nasal replica obtained by three-dimensional (3D) printing, using iodinated contrast agent labelled solutions with high spatial and temporal resolution. Using a third generation dual-source CT scanner in single energy mode, scans of a nasal replica were acquired following application of iodinated contrast agent labelled aerosols with an iodine concentration of 92.5 mgl/mL. Two software programmes were then utilised (Osirix MD v.9.0, Pixmeo, Geneva, Switzerland; 3mensio, Pie Medical Imaging, Bilthoven, Netherlands) to generate three-dimensional reconstructions of the scans, thus enabling the rapid detection and visualisation of administered single droplets and their voxel-by-voxel localisation. Using this approach, we achieved recovery rates between 84-98% and 89-109% (depending on the software programme) of the total applied aerosol volume.

PMID: 31432300 [PubMed - in process]