(Press-News.org) Philadelphia, Pa. (August 29, 2013) – Virtual surgical planning technologies give surgeons a powerful new tool for their most challenging facial reconstruction cases, reports a paper in the September issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).
"Use of virtual surgical planning allows for complex maxillofacial reconstruction with multiple simultaneous free flaps to be preformed reliably and successfully," according to the study by Dr. Adam Saad of Louisiana State University Health Sciences Center, New Orleans, and colleagues.
Virtual Planning Helps Guide Complex Reconstructions
Dr. Saad and colleagues report their experience with maxillofacial reconstruction in patients with severe facial defects. All patients had severe destruction and distortion of the facial structure, posing difficult surgical challenges with a high risk of complications.
Virtual surgical planning begins with a high-resolution 3D CT scan of the skull and facial defect, and of the donor site from which the surgeon will obtain bone and tissue flaps for use in reconstruction. The CT data are then used to "virtually restore" the patient's preinjury anatomy—including a computer simulation showing how multiple bone-containing flaps would be placed to restore the defect.
The virtual reconstruction is used to create a "stereolithic" model of the patient's skull, including the pieces needed to perform the reconstruction. Surgeons can use the model to create custom jigs for use in performing the necessary bone cuts, as well as pre-bent surgical plates.
Dr. Saad and coauthors used the virtual surgical planning system for reconstruction in 10 patients with severe facial defects, most commonly caused by gunshot wounds or severe radiation damage after cancer treatment. The reconstructions were highly complex and demanding—for example, requiring complete reconstruction of the upper (maxilla) or lower jaw (mandible).
High-Tech Planning May Pay Off by Making Surgery More Efficient
All procedures went smoothly, with no surgical complications. The 3D model helped the surgeon understand the various components needed for the reconstruction, and how they would all fit together. Using custom-made cutting jigs and pre-bent plates allowed surgeons to work more efficiently, potentially reducing operating time.
Follow-up CT scans showed "excellent contour" of the bone flaps used for reconstruction of the facial skeleton. All bone and tissue flaps were viable at three months' follow-up. Where reconstruction of the mandible was performed, functional jaw motion was restored—in some cases, allowing the patient to resume oral feeding.
After initial experience with virtual surgical planning for simpler reconstructions, the researchers evaluated its use for the most complex maxillofacial reconstructions. "Usage of this technology should allow for more precise estimates on required bony components for reconstruction as well as enhancing our ability to make exact osteotomies to better match the contour of the facial skeleton," they write. They also propose a set of criteria for appropriate use of virtual surgical planning.
Dr. Saad and coauthors believe that the technique will be even more efficient and effective as surgeons gain familiarity with the technology. Although virtual surgical planning carries some additional costs, the researchers think this may be offset by the ability to simplify complex reconstructions. "We do feel that no price tag can be assigned to predictability and streamlining," they add.
Plastic and Reconstructive Surgery® is published by Lippincott Williams & Wilkins, part of Wolters Kluwer Health.
###
About Plastic and Reconstructive Surgery
For more than 60 years, Plastic and Reconstructive Surgery® (http://journals.lww.com/plasreconsurg/) has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. The official journal of the American Society of Plastic Surgeons, Plastic and Reconstructive Surgery® brings subscribers up-to-the-minute reports on the latest techniques and follow-up for all areas of plastic and reconstructive surgery, including breast reconstruction, experimental studies, maxillofacial reconstruction, hand and microsurgery, burn repair, and cosmetic surgery, as well as news on medico-legal issues.
About ASPS
The American Society of Plastic Surgeons (ASPS) is the world's largest organization of board-certified plastic surgeons. Representing more than 7,000 Member Surgeons, the Society is recognized as a leading authority and information source on aesthetic and reconstructive plastic surgery. ASPS comprises more than 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada. ASPS advances quality care to plastic surgery patients by encouraging high standards of training, ethics, physician practice and research in plastic surgery. You can learn more and visit the American Society of Plastic Surgeons at http://www.plasticsurgery.org or http://www.facebook.com/PlasticSurgeryASPS and http://www.twitter.com/ASPS_news.
About Wolters Kluwer Health
Wolters Kluwer Health is a leading global provider of information, business intelligence and point-of-care solutions for the healthcare industry. Serving more than 150 countries and territories worldwide, Wolters Kluwer Health's customers include professionals, institutions and students in medicine, nursing, allied health and pharmacy. Major brands include Health Language®, Lexicomp®, Lippincott Williams & Wilkins, Medicom®, Medknow, Ovid®, Pharmacy OneSource®, ProVation® Medical, and UpToDate®.
Wolters Kluwer Health is part of Wolters Kluwer, a market-leading global information services company. Wolters Kluwer had 2012 annual revenues of €3.6 billion ($4.6 billion), employs approximately 19,000 people worldwide, and maintains operations in over 40 countries across Europe, North America, Asia Pacific, and Latin America. Follow our official Twitter handle: @WKHealth.
END
An assay designed to measure normal and abnormal forms of the huntingtin protein – the mutated form of which causes Huntington's disease (HD) – was successful in detecting levels of the mutant protein in a large multicenter study of individuals at risk for the devastating neurological disorder. The report from a team of Massachusetts General Hospital (MGH) investigators – which will appear in the Sept. 24 issue of Neurology and has been released online – also found changes in levels of the mutated protein that might predict when symptoms will appear.
"Our validation ...
(SACRAMENTO, Calif.) — Glucose monitoring systems with an autocorrect feature that can detect red blood cells (hematocrit), vitamin C and other common interferents in burn patients' blood are better for monitoring care, a pilot study conducted by UC Davis researchers at the School of Medicine and College of Engineering has found. The study was published in the Journal of Burn Care Research.
Burn patients are at risk for high blood glucose levels, or hyperglycemia, due to the body's stress response. Intensive insulin therapy, which is commonly used to keep glucose under ...
Alcohol intoxication reduces communication between two areas of the brain that work together to properly interpret and respond to social signals, according to researchers at the University of Illinois at Chicago College of Medicine.
Their results were published in the September issue of Psychopharmacology.
Previous research has shown that alcohol suppresses activity in the amygdala, the area of the brain responsible for perceiving social cues such as facial expressions.
"Because emotional processing involves both the amygdala and areas of the brain located in the prefrontal ...
A recent study by UC Santa Barbara scientists analyzed whole-body fish samples taken from oil-and-gas production platforms and natural sites for heavy metal pollutants. The results showed all but four elements were relatively consistent at both types of location. The findings were published in the Bulletin of Marine Science.
The research, led by fish expert Milton S. Love, a research biologist with UCSB's Marine Science Institute, entailed collecting a total of 196 fish –– 18 kelp bass (Paralabrax clathratus), 80 kelp rockfish (Sebastes atrovirens), and 98 Pacific sanddab ...
Researchers have identified a protein that they believe may help predict breast cancer prognosis, potentially relieving thousands of women at low risk from having to undergo painful, oft-debilitating therapies, while insuring the most successful treatments for those at high risk. The research was published ahead of print in the journal Molecular and Cellular Biology.
Using bioinformatics techniques, the authors showed that the levels of expression of some 1,200 genes that are directly controlled by the enzyme, EZH2, correlates with the aggressiveness of breast cancer ...
In the search for clean, green sustainable energy sources to meet human needs for generations to come, perhaps no technology matches the ultimate potential of artificial photosynthesis. Bionic leaves that could produce energy-dense fuels from nothing more than sunlight, water and atmosphere-warming carbon dioxide, with no byproducts other than oxygen, represent an ideal alternative to fossil fuels but also pose numerous scientific challenges. A major step toward meeting at least one of these challenges has been achieved by researchers with the U.S. Department of Energy ...
SEATTLE – A team of researchers led by Janet Stanford, Ph.D., of Fred Hutchinson Cancer Research Center has discovered that mutations in the gene BTNL2, which encodes a protein involved in regulating T-cell proliferation and cytokine production – both of which impact immune function – increase the risk of developing prostate cancer.
The findings, by Stanford and colleagues from the University of Washington Genome Sciences Department and the National Human Genome Research Institute, are online ahead of the print issue of Cancer Epidemiology, Biomarkers & Prevention.
A ...
This news release is available in French. Despite all the research done on Alzheimer's, there is still no early diagnostic tool for the disease. By looking at the brain wave components of individuals with the disease, Professor Tiago H. Falk of INRS's Centre Énergie Matériaux Télécommunications has identified a promising avenue of research that may not only help diagnose the disease, but also assess its severity. This non-invasive, objective method is the subject of an article in the journal PLOS ONE.
Patients with Alzheimer's disease currently undergo neuropsychological ...
University of Alberta researchers have found that abundant materials in the Earth's crust can be used to make inexpensive and easily manufactured nanoparticle-based solar cells.
The U of A discovery, several years in the making, is an important step forward in making solar power more accessible to parts of the world that are off the traditional electricity grid or face high power costs, such as the Canadian North, said researcher Jillian Buriak, a chemistry professor and senior research officer of the National Institute for Nanotechnology, based on the U of A campus.
Buriak ...
PHILADELPHIA— A new drug target to treat depression and other mood disorders may lie in a group of GABA neurons (gamma-aminobutyric acid –the neurotransmitters which inhibit other cells) shown to contribute to symptoms like social withdrawal and increased anxiety, Penn Medicine researchers report in a new study in the Journal of Neuroscience.
Experts know that people suffering from depression and other mood disorders often react to rejection or bullying by withdrawing themselves socially more than the average person who takes it in strides, yet the biological processes ...
