Interdisciplinary management of skull base surgery

Rothweiler, René; Metzger, Marc Christian; Voss, Pit Jacob; Beck, Jürgen; Schmelzeisen, Rainer

doi:10.1016/j.jobcr.2021.09.002

Cited by 4 publications

(5 citation statements)

References 71 publications

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“…Skull base surgery has long been a challenging area of anatomy. Multiplanar reconstruction with MRI or CT imaging combined with virtual 3D planning is now increasingly used in skull base surgery to achieve accurate preoperative planning and to assist the surgeon in the actual clinic with CADIN to remove or sample lesions within safe limits that are di cult to reach without extensive surgical exposure (Rothweiler et al 2021). 2021) retrospectively analyzed data from seven patients who used a combination of mixed reality and surgical navigation to assist in oral and maxillofacial tumor surgery and evaluated the feasibility and accuracy of the protocol.…”

Section: Skull Base Surgerymentioning

confidence: 99%

“…The use of CADIN can provide an accurate and clear indication of foreign body and tumor boundaries. This allows the surgeon to perform accurate removal of foreign bodies and tumors without frequent intraoperative review of preoperative medical images, greatly improving the safety and accuracy of the procedure(Sukegawa et al 2018;Ji et al 2018;Rothweiler et al 2021).…”

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confidence: 99%

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Computer-Aided Dynamics Intraoperative Navigation in Oral Medicine: A Review

Jiang

Zhang

et al. 2023

Preprint

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Because the oral and maxillofacial areas are adjacent to important organs such as the brain and the eyes and contain a rich network of nerves and blood vessels, this poses a great challenge for surgery of the oral and maxillofacial areas. Traditional treatment protocols rely excessively on the physician's clinical experience and imagination for preoperative planning and do not provide intuitive and reliable intraoperative guidance to the physician during surgery. With the rapid development of medical imaging technology, computer-aided dynamic intraoperative navigation (CADIN) has been introduced into the field of oral and maxillofacial surgery for its ability to accurately locate key anatomical structures intraoperatively and provide the surgeon with a safe surgical boundary in real time. However, the vast majority of surgeries in oral and maxillofacial surgery are still dominated by traditional surgical methods without intraoperative guidance or computer-assisted static navigation (CASN), and CADIN techniques are not widely used. Therefore, this paper presents a systematic review of the application of CADIN technology in the field of oral and maxillofacial surgery from 2018-2023 by searching the PubMed database, discusses the problems faced in the actual clinical application of CADIN technology in the field of oral and maxillofacial surgery, and proposes solutions to improve the accuracy and application scope of CADIN technology in the future.

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Section: Skull Base Surgerymentioning

confidence: 99%

mentioning

confidence: 99%

Computer-Aided Dynamics Intraoperative Navigation in Oral Medicine: A Review

Jiang

Zhang

et al. 2023

Preprint

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“…A multidisciplinary approach is fundamental for the best outcome in treating skull base diseases. This can be coordinated through a Multidisciplinary Skull Base Board (MDT-SB), where all physicians involved in patient care, both surgeons and non-surgeons, participate [3]. It has been found that the patient care approach can differ in more than a tenth of cases after MDT-SB consultation compared to care without MDT-SB presentation [4].…”

Section: Introductionmentioning

confidence: 99%

A Multidisciplinary Skull Base Board for Tumour and Non-Tumour Diseases: Initial Experiences

Urbančič,

Battelino,

Bošnjak

et al. 2024

JPM

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The skull base is the area where various cancerous and non-cancerous diseases occur and represents the intersection of several medical fields. The key is an integrated treatment by specialists of multiple disciplines. We prospectively analysed patients with a skull base disease between August 2022 and 2023 and presented to the Multidisciplinary Skull Base Board (MDT-SB), which takes place once a month hybridly (in-person and remotely). Thirty-nine patients (median age of 58.2 years) were included, of which twelve (30.8%) had a benign tumour, twelve (30.8%) had a malignant tumour, five had an infection (12.8%), and ten (25.6%) had other diseases. For each patient, at least two otorhinolaryngologists, a neurosurgeon, and a neuroradiologist, as well as an infectious disease specialist, a paediatrician, an oculoplastic surgeon, a maxillofacial surgeon, and a pathologist were involved in 10%, 8%, 8%, 3%, and 3% of cases, respectively. In fifteen patients (38%), the MDT-SB suggested surgical treatment; in fourteen (36%), radiological follow-ups; in five (13%), non-surgical treatments; in two, conservative treatments (5%); in two (5%), surgical and conservative treatments; and in one (3%), a biopsy. Non-cancerous and cancerous diseases of the skull base in adults and children should be presented to the MDT-SB, which consists of at least an otolaryngologist, a neurosurgeon, and a neuroradiologist.

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“…The SOFF, on the other hand, is used preferably for the reconstruction of the temporomandibular joint, as the scapular tip can be used for anatomical replacement of the condylar head. Moreover, by raising the latissimus dorsi muscle, a high volume of soft tissue can be harvested alongside the SOFF [ 18 , 19 ]. The DCIA graft provides anatomically shaped bone with sufficient vertical height resembling the anatomical form of the mandibular body [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

Donor site morbidity after computer assisted surgical reconstruction of the mandible using deep circumflex iliac artery grafts: a cross sectional study

et al. 2023

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Background Computer Assisted Design and Computer Assisted Manufacturing (CAD/CAM) have revolutionized oncologic surgery of the head and neck. A multitude of benefits of this technique has been described, but there are only few reports of donor site comorbidity following CAD/CAM surgery. Methods This study investigated comorbidity of the hip following deep circumflex iliac artery (DCIA) graft raising using CAD/CAM techniques. A cross-sectional examination was performed to determine range of motion, muscle strength and nerve disturbances. Furthermore, correlations between graft volume and skin incision length with postoperative donor site morbidity were assessed using Spearman's rank correlation, linear regression and analysis of variance (ANOVA). Results Fifteen patients with a mean graft volume of 21.2 ± 5.7 cm3 and a mean incision length of 228.0 ± 30.0 mm were included. Patients reported of noticeable physical limitations in daily life activities (12.3 ± 11.9 weeks) and athletic activities (38.4 ± 40.0 weeks in mean) following surgery. Graft volume significantly correlated with the duration of the use of walking aids (R = 0.57; p = 0.033) and impairment in daily life activities (R = 0.65; p = 0.012). The length of the scar of the donor-site showed a statistically significant association with postoperative iliohypogastric nerve deficits (F = 4.4, p = 0.037). Patients with anaesthaesia of a peripheral cutaneous nerve had a larger mean scar length (280 ± 30.0 mm) than subjects with hypaesthesia (245 ± 10.1 mm) or no complaints (216 ± 27.7 mm). Conclusions Despite sophisticated planning options in modern CAD/CAM surgery, comorbidity of the donor site following iliac graft harvesting is still a problem. This study is the first to investigate comorbidity after DCIA graft raising in a patient group treated exclusively with CAD/CAM techniques. The results indicate that a minimal invasive approach in terms of small graft volumes and small skin incisions could help to reduce postoperative symptomatology. Trial registration Retrospectively registered at the German Clinical Trials Register (DRKS-ID: DRKS00029066); registration date: 23/05/2022

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Interdisciplinary management of skull base surgery

Cited by 4 publications

References 71 publications

Computer-Aided Dynamics Intraoperative Navigation in Oral Medicine: A Review

Computer-Aided Dynamics Intraoperative Navigation in Oral Medicine: A Review

A Multidisciplinary Skull Base Board for Tumour and Non-Tumour Diseases: Initial Experiences

Donor site morbidity after computer assisted surgical reconstruction of the mandible using deep circumflex iliac artery grafts: a cross sectional study

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