Articles: surgery.
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The maxillary (or second division) nerve block is an effective method of achieving profound anesthesia of a hemimaxilla. This block can be used for procedures involving the maxillary sinus, including the maxillary sinus elevation procedure. The purpose of this study was to evaluate a computer-controlled anesthetic delivery system (Wand) for maxillary nerve block injection to attain maxillary sinus anesthesia for sinus floor elevation procedure. ⋯ The Wand appears to offer a number of advantages over the hand-held syringe when the greater palatine block technique for the maxillary nerve block is used. It is suggested that, when indicated, and with the required knowledge and respect for the associated anatomy, this technique should be considered with greater ease and more confidence.
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Ieee T Inf Technol B · Jun 2004
Comparative StudySurgical navigation by autostereoscopic image overlay of integral videography.
This paper describes an autostereoscopic image overlay technique that is integrated into a surgical navigation system to superimpose a real three-dimensional (3-D) image onto the patient via a half-silvered mirror. The images are created by employing a modified version of integral videography (IV), which is an animated extension of integral photography. IV records and reproduces 3-D images using a microconvex lens array and flat display; it can display geometrically accurate 3-D autostereoscopic images and reproduce motion parallax without the need for special devices. ⋯ Experiments demonstrated that the fast IV rendering technique and patient-image registration method produce an average registration accuracy of 1.13 mm. Experiments using a target in phantom agar showed that the system can guide a needle toward a target with an average error of 2.6 mm. Improvement in the quality of the IV display will make this system practical and its use will increase surgical accuracy and reduce invasiveness.
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Partial seizures of extratemporal origin may present unique challenges in the patient with medically refractory seizures. The efficacy of an extratemporal focal cortical resection may be less effective than an anterior temporal lobectomy for intractable epilepsy. The potential operative complications may be increased in individuals with extratemporal epilepsy because of functional cerebral cortex involvement and the need for a large cortical resection to significantly reduce seizure tendency. ⋯ Chronic intracranial EEG monitoring may be necessary to confirm the localization of the ictal onset zone before epilepsy surgery. Patients with normal neuroimaging studies and extratemporal epilepsy are unlikely to be rendered seizure-free with focal cortical resection and should be considered candidates for other alternative forms of treatment for intractable partial epilepsy. Patients with non-substrate-directed extratemporal epilepsy should undergo a preoperative evaluation and surgical treatment at a comprehensive epilepsy center with extensive experience in chronic intracranial EEG monitoring and contemporary neuroimaging procedures because of the inherently high acuity associated with the operative management clinical disorder.