Articles: surgery.
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Objectives. To perform a preliminary cost-utility and cost-benefit of deep brain stimulation (DBS) in the treatment of dystonia, Materials and Methods. We conducted a prospective study of 26 patients undergoing DBS for the treatment of dystonia. We performed a cost-utility analysis using the Euroquol (EQ-5D) questionnaire. ⋯ There was an overall gain of 0.94 quality-adjusted life-years (QALY) with a cost of £33,980 per QALY. Conclusions. DBS for dystonia, while an expensive treatment, compares favorably to therapies that are commonly used for other conditions.
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Clinical Trial
[Sensor-based detection of skull positioning for image-guided cranial navigation under free head mobility].
Although computer- and image-guided surgical procedures are an improvement of frame-guided stereotaxy, many navigation systems still require rigid fixation of the patient's head throughout the operation. This study describes the clinical application of a technical modification that enables cranial navigation with "free head mobility" using CT and MR images as well as the calculated 3-D reconstruction models. ⋯ Based on these first test results, a high clinical potential for DRF application in cranial navigation is to be expected. The aim of DRF is to dispense with the rigid fixation of the patient's head. This increases the application scope of image-guided navigation procedures to include, for example, any bioptic or endoscopic intervention, in which rigid pin fixation of the cranium is not required or desired. For all other procedures, continuous position monitoring by DRF ensures automatic correction of imaging data with mechanical alteration of the head position.
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This case report identifies a patient with complex regional pain syndrome Type 2 (causalgia) with sympathetically maintained pain in a distal extremity associated with an anterior sacroiliac fusion with local bone graft. ⋯ Complex regional pain syndrome Type 2 with sympathetically maintained pain is a condition that can result in serious disability and can be associated with spinal procedures and sacroiliac arthrodesis. Early intervention is recommended to provide long-term resolution of the condition.
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Expert Rev Med Devices · Jul 2005
ReviewComputer-aided surgery of the paranasal sinuses and skull base.
Endoscopic sinus surgery is one of the most common surgical procedures in otolaryngology. However, the location of the orbit and intracranial contents in close proximity to the paranasal sinuses makes endoscopic sinus surgery potentially hazardous. Otolaryngologists have employed computer-aided surgery, or image-guided surgery, over the past two decades to enhance surgeon confidence, allow more thorough surgical dissections and possibly reduce the complication rate of endoscopic sinus surgery. ⋯ A number of institutional series noting surgeon experience with computer-aided surgery in the domain of paranasal sinus surgery are reviewed. Furthermore, the authors evaluate the utility of image-guidance technology beyond the paranasal sinuses and skull base, such as its use in surgery of the pituitary gland and pterygopalatine fossa, research and resident education. Finally, potential future applications of computer-aided surgery technology are discussed.
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Vet. Clin. North Am. Small Anim. Pract. · Jul 2005
ReviewRegional anesthesia and analgesia for oral and dental procedures.
Regional anesthesia and analgesia benefit the client, the patient, and the practitioner, and their use is becoming the standard for care. Familiarity with the processes involved in the generation of pain aids in understanding the benefits of preemptive and multimodal analgesia. Local anesthetic blocks should be a key component of a treatment plan, along with opioids, nonsteroidal anti-inflammatory drugs, N-methyl-D-aspartate receptor antagonists, and other therapies. Nerve blocks commonly used for dentistry and oral surgery include the infraorbital, maxillary, mental,and mandibular blocks.