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Sample records for anterior skull base

  1. Minimally invasive surgery of the anterior skull base: transorbital approaches

    Science.gov (United States)

    Gassner, Holger G.; Schwan, Franziska; Schebesch, Karl-Michael

    2016-01-01

    Minimally invasive approaches are becoming increasingly popular to access the anterior skull base. With interdisciplinary cooperation, in particular endonasal endoscopic approaches have seen an impressive expansion of indications over the past decades. The more recently described transorbital approaches represent minimally invasive alternatives with a differing spectrum of access corridors. The purpose of the present paper is to discuss transorbital approaches to the anterior skull base in the light of the current literature. The transorbital approaches allow excellent exposure of areas that are difficult to reach like the anterior and posterior wall of the frontal sinus; working angles may be more favorable and the paranasal sinus system can be preserved while exposing the skull base. Because of their minimal morbidity and the cosmetically excellent results, the transorbital approaches represent an important addition to established endonasal endoscopic and open approaches to the anterior skull base. Their execution requires an interdisciplinary team approach. PMID:27453759

  2. Surgical technique for repair of complex anterior skull base defects

    Directory of Open Access Journals (Sweden)

    Kevin Reinard

    2015-01-01

    Conclusion: The layered reconstruction of large anterior cranial fossa defects resulted in postoperative CSF leak in only 5% of the patients and represents a simple and effective closure option for skull base surgeons.

  3. Anterior and middle skull base reconstruction after tumor resection

    Institute of Scientific and Technical Information of China (English)

    WANG Bo; WU Sheng-tian; LI Zhi; LIU Pi-nan

    2010-01-01

    Background Surgical management of skull base tumors is still challenging today due to its sophisticated operation procedure. Surgeons who specialize in skull base surgery are making endeavor to promote the outcome of patients with skull base tumor. A reliable skull base reconstruction after tumor resection is of paramount importance in avoiding life-threatening complications, such as cerebrospinal fluid leakage and intracranial infection. This study aimed at investigating the indication, operation approach and operation technique of anterior and middle skull base reconstruction.Methods A retrospective analysis was carried out on 44 patients who underwent anterior and middle skull base reconstruction in the Department of Neurosurgery at Beijing Tiantan Hospital between March 2005 and March 2008. Different surgical approaches were selected according to the different regions involved by the tumor. Microsurgery was carried out for tumor resection and combined endoscopic surgery was performed in some cases. According to the different locations and sizes of various defects after tumor resection, an individualized skull base soft tissue reconstruction was carried out for each case with artificial materials, pedicled flaps, free autologous tissue, and free vascularized muscle flaps, separately. A skull base bone reconstruction was carried out in some cases simultaneously.Results Soft tissue reconstruction was performed in all 44 cases with a fascia lata repair in 9 cases, a free vascularized muscle flap in 1 case, a pedicled muscle flap in 14 cases, and a pedicled periosteal flap in 20 cases. Skull base bone reconstruction was performed on 10 cases simultaneously. The materials for bone reconstruction included titanium mesh, free autogenous bone, and a Medpor implant. The result of skull base reconstruction was satisfactory in all patients. Postoperative early-stage complications occurred in 10 cases with full recovery after conventional treatment.Conclusions The specific

  4. Sandwich-like Reconstruction of Anterior Skull Base Defects

    Institute of Scientific and Technical Information of China (English)

    Wang Zheng-min; Wang De-hui

    2001-01-01

    Objective: To evaluate the safety and efficacy of new modality of anterior skull base repair,namely sandwich-like reconstruction of anterior skull base defects. Methods: A retrospective analysis of patients who underwent transcranial or transcranial-facial resections of malignant or benign aggressive tumors involving the anterior skull base was conducted in our department. We used the sandwich-like reconstruction, using pedicled pericranial flap, frontal muscle flap and free abdominal adipose tissue between them, to separate of cranial cavity and aerodigest tract and keep the frontal lobes in place following resections of anterior skull base tumors. Results: From October, 1984 to October, 1998, 116 patients underwent transcranial or transcranialfacial approach for the resection of malignant or aggressive benign tumor, and sandwich-like repairs were performed for the anterior skull base defect. 54 (46.6 % ) patients had previous operation, with a maximum of 5 surgeries. The average age of patients was 35.9 years old, ranging form 6 to 73 years old. Forty-eight (41.4%)patients had malignant neoplasmas, and sixty-eight (58.6%) patients had benign aggressive tumors. In our series, with the maximal follow-ups for as long as 14 years, NO one had early failure of the one-stage reconstruction. CSF fluid leakage was not encountered, nor was ascending bacterial meningitis observed. No immediate or delayed prolapse of dura or frontal lobes was observed. Conclusion: We conclude that the sandwich-like reconstruction, using pericranial flap, frontal muscle flap and free abdominal adipose between them, is an extremely safe and effective procedure for the repair of skull base defect, even when tumor extensively involves anterior skull base.

  5. Sandwich-like Reconstruction of Anterior Skull Base Defects

    Institute of Scientific and Technical Information of China (English)

    WangZheng-min,MD; WangDe-hui,MD

    2001-01-01

    Objective:To evaluate the safety and efficacy of new modality of anterior skull base repair,namely sandwich-like reconstruction of anterior skull base defects. Methods : A retrospective analysis of patients who underwent wanscranial or wanscranial-facial resections of malignant or benign aggressive tumors involving the anterior skull base was conducted in our department. We used the sandwich-like reconstruction, using pedicled pericranial flap, frontal muscle flap and free abdominal adipose tissue between them, to separate of cranial cavity and aerodigest tract and keep the frontal lobes in place following resections of anterior skull base tumors. Results: From October, 1984 to October, 1998, 116 patients underwent tmnscranial or tmnscranial-facial approach for the resection of malignant or aggressive benign tumor, and sandwich-like repairs were performed for the anterior skull base defect.54 (46.6%) patients had previous operation, with a maximum of 5 surgeries. The average age of patients was 35.9 years old, ranging form 6 to 73 years old. Forty-eight (41.4%) patients had malignant neoplasmas, and sixty-eight (58.6%) patients had benign aggressive tumors. In our series, with the maximal follow-ups for as long as 14 years, NO one had early failure of the one-stage reconstruction. CSF fluid leakage was not encountered, nor was ascending bacterial meningitis observed. No immediate or delayed prolapse of dura or frontal lobes was observed. Conclusion: We conclude that the sandwich-like reconstruction, using pericranial flap, frontal muscle flap and free abdominal adipose between them, is an extremely safe and effective procedure for the repair of skull base defect, even when tumor extensively involves anterior skull base.

  6. Computed tomography of the human developing anterior skull base

    NARCIS (Netherlands)

    J. van Loosen (J.); A.I.J. Klooswijk (A. I J); D. van Velzen (D.); C.D.A. Verwoerd (Carel)

    1990-01-01

    markdownabstractAbstract The ossification of the anterior skull base, especially the lamina cribrosa, has been studied by computed tomography and histopathology. Sixteen human fetuses, (referred to our laboratory for pathological examination after spontaneous abortion between 18 and 32 weeks of ge

  7. Vascularised local and free flaps in anterior skull base reconstruction.

    Science.gov (United States)

    Hoffmann, Thomas K; El Hindy, Nicolai; Müller, Oliver M; Schuler, Patrick J; Bergmann, Christoph; Hierner, Robert; Lehnerdt, Götz; Mattheis, Stefan; Wagenmann, Martin; Schipper, Jörg; Sure, Ulrich; Lang, Stephan; Hänggi, Daniel; Sandalcioglu, I Erol

    2013-03-01

    Lesions of the anterior skull base often require sufficient closure in order to prevent cerebrospinal fluid (CSF) leak, ascending infection and/or brain tissue prolapse. The transfer of devitalized autologous, allogenic or xenogeneic material is not always sufficient particularly not in larger defects or in the recurrent situation. Here the transfer of vascularised tissue seems to be more appropriate. The anterior skull base with various complex defects of 41 patients was reconstructed in an interdisciplinary setting by vascularised, autologous tissue transfer. Minor defects (chondroblastoma, metastasis, nasal fistula), were reconstructed by a local, vascularized pedicled mucosal flap of the lower turbinate (n = 3) or septum (n = 23). Patients with major defects (>2.5 cm in max. diameter, n = 15), comprising those with malignoma, meningoencephalocele, aneurysmatic bone cyst and trauma, were repaired by a "sandwich technique" with a combination of calvarian split and galea periosteum flap in 10 patients, in one case with a temporalis muscle flap, while in 4 further patients free vascularised radial forearm flaps were used for revision after multiple unsuccessful operations elsewhere. After a mean follow-up time of 30.5 months 38 of the 41 cases were successfully repaired with respect to prevention and treatment of CSF leakage or brain tissue prolapse, only 3 cases needed surgical revision. The reconstruction of the anterior skull base bearing complex lesions is feasible using vascularised, autologous local and also distal tissue transfer in a close interdisciplinary cooperation. PMID:22878359

  8. A checklist for endonasal transsphenoidal anterior skull base surgery.

    Science.gov (United States)

    Laws, Edward R; Wong, Judith M; Smith, Timothy R; de Los Reyes, Kenneth; Aglio, Linda S; Thorne, Alison J; Cote, David J; Esposito, Felice; Cappabianca, Paolo; Gawande, Atul

    2016-06-01

    OBJECT Approximately 250 million surgical procedures are performed annually worldwide, and data suggest that major complications occur in 3%-17% of them. Many of these complications can be classified as avoidable, and previous studies have demonstrated that preoperative checklists improve operating room teamwork and decrease complication rates. Although the authors' institution has instituted a general preoperative "time-out" designed to streamline communication, flatten vertical authority gradients, and decrease procedural errors, there is no specific checklist for transnasal transsphenoidal anterior skull base surgery, with or without endoscopy. Such minimally invasive cranial surgery uses a completely different conceptual approach, set-up, instrumentation, and operative procedure. Therefore, it can be associated with different types of complications as compared with open cranial surgery. The authors hypothesized that a detailed, procedure-specific, preoperative checklist would be useful to reduce errors, improve outcomes, decrease delays, and maximize both teambuilding and operational efficiency. Thus, the object of this study was to develop such a checklist for endonasal transsphenoidal anterior skull base surgery. METHODS An expert panel was convened that consisted of all members of the typical surgical team for transsphenoidal endoscopic cases: neurosurgeons, anesthesiologists, circulating nurses, scrub technicians, surgical operations managers, and technical assistants. Beginning with a general checklist, procedure-specific items were added and categorized into 4 pauses: Anesthesia Pause, Surgical Pause, Equipment Pause, and Closure Pause. RESULTS The final endonasal transsphenoidal anterior skull base surgery checklist is composed of the following 4 pauses. The Anesthesia Pause consists of patient identification, diagnosis, pertinent laboratory studies, medications, surgical preparation, patient positioning, intravenous/arterial access, fluid management

  9. Chondroblastoma with secondary aneurysmal bone cyst in the anterior skull base

    OpenAIRE

    Ming Jie Wang, MD, PhD; Bing Zhou, MD

    2016-01-01

    Chondroblastoma with secondary aneurysmal bone cyst (ABC), especially in the anterior skull base, is an extremely rare condition. A 5-year-old boy presented with a large space-occupying lesion in the anterior skull base along with a left sided-epistaxis, proptosis and decreased vision. Radical excision of the lesion was performed by an endoscopic transnasal and transethmoidal approach. The patient recovered without any recurrence during a follow-up period of up to 28 months. Here, we review t...

  10. Quality-of-Life after Anterior Skull Base Surgery: A Systematic Review.

    Science.gov (United States)

    Kirkman, Matthew A; Borg, Anouk; Al-Mousa, Alaa; Haliasos, Nikolaos; Choi, David

    2014-04-01

    Background Improved treatment and survival of patients with skull base tumors has made the assessment of quality-of-life (QoL) in this population increasingly important. This article provides a comprehensive systematic review pertaining to QoL assessment in adults undergoing anterior skull base surgery. Methods We performed a literature search using the electronic databases of Ovid Medline and Embase. Additional articles were identified through a search using the phrase anterior skull base. Further articles were sought through hand-searching relevant journals and reference lists of identified articles. Results Our search strategy identified 29 articles for inclusion in our systematic review, with considerable variation between studies in population characteristics, methodological design and quality, follow-up length, and outcome assessment. The most commonly used QoL tools were the Karnofsky Performance Status and the Anterior Skull Base Questionnaire. QoL following anterior skull base surgery appears to improve beyond preoperative levels in the months after surgery. For patients undergoing endoscopic skull base surgery, the gain in QoL appears to be greater and may manifest earlier, with no clear long-term deleterious effect on sinonasal outcomes compared with open surgery. Conclusions QoL after anterior skull base surgery in adults appears to improve within several months of surgery, but earlier and to a larger extent if the endoscopic approach is used. Given the relative paucity and heterogeneity of anterior skull base tumors, large-scale prospective multicentre studies utilizing valid and reliable multidimensional QoL tools are required. This may result in improved patient care, by understanding patients' needs better and facilitating the provision of reliable outcome data for clinical trials.

  11. Quality-of-Life after Anterior Skull Base Surgery: A Systematic Review.

    Science.gov (United States)

    Kirkman, Matthew A; Borg, Anouk; Al-Mousa, Alaa; Haliasos, Nikolaos; Choi, David

    2014-04-01

    Background Improved treatment and survival of patients with skull base tumors has made the assessment of quality-of-life (QoL) in this population increasingly important. This article provides a comprehensive systematic review pertaining to QoL assessment in adults undergoing anterior skull base surgery. Methods We performed a literature search using the electronic databases of Ovid Medline and Embase. Additional articles were identified through a search using the phrase anterior skull base. Further articles were sought through hand-searching relevant journals and reference lists of identified articles. Results Our search strategy identified 29 articles for inclusion in our systematic review, with considerable variation between studies in population characteristics, methodological design and quality, follow-up length, and outcome assessment. The most commonly used QoL tools were the Karnofsky Performance Status and the Anterior Skull Base Questionnaire. QoL following anterior skull base surgery appears to improve beyond preoperative levels in the months after surgery. For patients undergoing endoscopic skull base surgery, the gain in QoL appears to be greater and may manifest earlier, with no clear long-term deleterious effect on sinonasal outcomes compared with open surgery. Conclusions QoL after anterior skull base surgery in adults appears to improve within several months of surgery, but earlier and to a larger extent if the endoscopic approach is used. Given the relative paucity and heterogeneity of anterior skull base tumors, large-scale prospective multicentre studies utilizing valid and reliable multidimensional QoL tools are required. This may result in improved patient care, by understanding patients' needs better and facilitating the provision of reliable outcome data for clinical trials. PMID:24719794

  12. Visual outcome after fractionated stereotactic radiation therapy of benign anterior skull base tumors

    DEFF Research Database (Denmark)

    Astradsson, Arnar; Wiencke, Anne Katrine; Munck af Rosenschold, Per;

    2014-01-01

    To determine visual outcome including the occurrence of radiation induced optic neuropathy (RION) as well as tumor control after fractionated stereotactic radiation therapy (FSRT) of benign anterior skull base meningiomas or pituitary adenomas. Thirty-nine patients treated with FSRT for anterior ...

  13. Chondroblastoma with secondary aneurysmal bone cyst in the anterior skull base

    Directory of Open Access Journals (Sweden)

    Ming Jie Wang, MD, PhD

    2016-06-01

    Full Text Available Chondroblastoma with secondary aneurysmal bone cyst (ABC, especially in the anterior skull base, is an extremely rare condition. A 5-year-old boy presented with a large space-occupying lesion in the anterior skull base along with a left sided-epistaxis, proptosis and decreased vision. Radical excision of the lesion was performed by an endoscopic transnasal and transethmoidal approach. The patient recovered without any recurrence during a follow-up period of up to 28 months. Here, we review this rare case and discuss the clinical presentation and surgical treatment.

  14. Recurrent ameloblastoma in the anterior skull base: Report of 3 cases

    Institute of Scientific and Technical Information of China (English)

    CHEN Wei-liang; YANG Zhao-hui; HUANG Zhi-quan; WANG Yong-jie; LI Jin-song; ZHANG Bin

    2005-01-01

    Recurrent ameloblastoma is common following inadequate excision but rarely presents in the anterior skull base. We presented 3 patients with recurrent ameloblastoma in the anterior skull base including the frontotemporal fossa and the pterygomaxillary fossa that occurred following multiple enucleations, segmental mandibulectomy, or partial maxillectomy for ameloblastoma in the jaws. Attenborough approach was used in the exposure of the frontotemporal fossa. Attenborough plus Barbosa approach was used in the exposure of the pterygomaxillary fossa. The patients were treated by radical dissection. Microscopy confirmed that the histopathologic pattern of one case was fixed follicular and plexiform, two cases were follicular. All patients healed without serious complications. The local recurrences of the patients following the operations were found in 3 to 4 years. The present study showed that the tumors in the regions had a greater recurrence potential even when treated with radical dissection, and the original tumors were the high-risk follicular pattern.

  15. Intraosseous Metastasizing of Pineoblastoma into the Anterior Skull Base, Calvarial Bones, and Vertebrae.

    Science.gov (United States)

    Golbin, Denis; Nikitin, Konstantin V; Konovalov, Alexander N; Pitskhelauri, David I; Shishkina, Liudmila V; Golanov, Andrey V; Cherekaev, Vasily A; Kobiakov, Grigory L; Absalyamova, Oksana V; Lasunin, Nikolay; Antipina, Natalia

    2015-01-01

    Pineoblastoma is a rare malignant tumor of the central nervous system (CNS), which arises from the parenchyma of the pineal gland. It is characterized by aggressive clinical behavior and frequent metastases along the craniospinal axis. Extraneural metastases may occur due to surgical seeding of tumor cells beyond the dura and/or hematogenous spread, ventriculoperitoneal shunting, or through Batson's plexus. To our knowledge, only six documented cases of intraosseous metastases of pineoblastoma are described in the literature. A 23-year-old female patient presented with clinical and radiological symptoms of a pineal tumor causing secondary hydrocephalus. After initial surgical treatment, chemotherapy, and local radiotherapy with craniospinal irradiation, she developed multiple metastases affecting the anterior skull base, intracranial meninges, frontal bone, and finally, the entire vertebral column. The patient received surgical treatment for the anterior skull base metastasis, repeated irradiation of the neuraxis, radiosurgical and radiotherapeutic procedures, and chemotherapy. The patient survived 57 months after the primary disease manifestation and died of multiple metastases. This presented case is the first known description of metastasis of pineoblastoma in the anterior cranial base. Multiple intracranial metastases were suppressed using CyberKnife radiation treatment and chemotherapy until massive involvement of spinal column occurred. Interestingly, no signs of brain radiation necrosis after repeated radiation treatments were observed, and the patient developed only moderate neurocognitive decline. PMID:26858918

  16. Septal flip flap for anterior skull base reconstruction after endoscopic resection of sinonasal cancers: preliminary outcomes.

    Science.gov (United States)

    Battaglia, P; Turri-Zanoni, M; De Bernardi, F; Dehgani Mobaraki, P; Karligkiotis, A; Leone, F; Castelnuovo, P

    2016-06-01

    Over the past decade surgery for sinonasal malignancies encroaching into the anterior skull base (ASB) has evolved from open craniofacial resection to the use of minimally invasive transnasal endoscopic approaches. Using these techniques, ASB reconstruction is most often performed in a multilayer fashion with autologous free grafts (fascia lata or iliotibial tract) which leads to the production of abundant nasal crusting in the postoperative months and discomfort for patients. In carefully selected cases, we propose harvesting a flap from the contralateral nasal septum based on the septal branches of the anterior and posterior ethmoidal arteries (Septal Flip Flap, SFF), which can be rotated to resurface the ASB defect. The exclusion criteria for using the SFF were as follows: cases where the tumour extended to both ethmoid complexes; cases where there was nasal septum or planum spheno-ethmoidalis involvement by the disease; cases of sinonasal malignant tumour with multifocal histology. In our tertiary care referral centre, skull base reconstruction using the SFF was performed in four patients; one was affected by ethmoidal teratocarcinosarcoma, one by persistence of sinonasal undifferentiated carcinoma after radio-chemotherapy, another by olfactory cleft esthesioneuroblastoma and the fourth by ethmoidal squamous cell carcinoma. Successful skull base reconstruction was obtained in all four cases without any intra- or post-operative complications. Post-operatively, nasal crusting was significantly reduced with faster healing of the surgical cavity. No recurrences of disease have been observed after a mean follow-up of 15 months. The SFF can be considered as a safe and effective technique for ASB reconstruction with high success rates similar to those obtained with other pedicled flaps. This flap also ensured a faster healing process with reduction of nasal crusting and improvement in the quality of life of patients in the postoperative period. This technique appears

  17. Skull Base Anatomy.

    Science.gov (United States)

    Patel, Chirag R; Fernandez-Miranda, Juan C; Wang, Wei-Hsin; Wang, Eric W

    2016-02-01

    The anatomy of the skull base is complex with multiple neurovascular structures in a small space. Understanding all of the intricate relationships begins with understanding the anatomy of the sphenoid bone. The cavernous sinus contains the carotid artery and some of its branches; cranial nerves III, IV, VI, and V1; and transmits venous blood from multiple sources. The anterior skull base extends to the frontal sinus and is important to understand for sinus surgery and sinonasal malignancies. The clivus protects the brainstem and posterior cranial fossa. A thorough appreciation of the anatomy of these various areas allows for endoscopic endonasal approaches to the skull base.

  18. A prospective evaluation of short-term health-related quality of life in patients undergoing anterior skull base surgery.

    Science.gov (United States)

    Abergel, Abraham; Fliss, Dan M; Margalit, Nevo; Gil, Ziv

    2010-01-01

    We evaluated the health-related quality of life (QOL) of patients undergoing anterior skull base tumor resection. The Anterior Skull Base Surgery QOL questionnaire, a disease-specific multidimensional instrument dedicated to this population, was used to collect and prospectively analyze demographic, medical, and QOL data on 48 patients. Thirty-nine patients completed the questionnaire preoperatively and at 6 and 12 months postoperatively. Seventeen patients (44%) had malignant histology and 22 (56%) had benign tumors. The overall QOL score decreased significantly at 6 months postoperatively (p base tumor resection returns to baseline by 1 year after surgery. Histology and radiotherapy are significant predictors of health-related QOL in this population. PMID:20592855

  19. Primary step for endoscopic sinonasal tract and anterior skull base robotics

    Directory of Open Access Journals (Sweden)

    Crampette Louis

    2011-12-01

    Full Text Available Introduction: Surgeons have evolved a lot their surgical procedures in sinus surgery and are now able to resect malignant tumors. These progresses are now leading new difficulties like impairing vision (bleeding and LCR flow and necessity of multiple simultaneous tasks. With the aim of designing a new endoscope-holder, primary step was to characterize the surgeon gesture, the kinematics, and the type of man-machine interface acceptable by the surgeon. Methods: We worked on thirteen sinonasal tracts of cadaver heads. Surgical procedures were: opening all the sinuses, the carotid, the sella turcica, the lamina papyracea and the anterior skull base. We used conventional instruments which were instrumented with a force-torque sensor and a navigation system. Then we have experimentally evaluated robots with three different kinematics and two types of man-machine interfaces. Results: We collected enough position and force data as well as kinematics constraints and interface requirements to specify a robot for endoscopic sinus surgery.

  20. THIRTY YEARS IN SKULL BASE SURGERY

    Institute of Scientific and Technical Information of China (English)

    HUANG; Deliang; LIU; Liangfa

    2012-01-01

    <正>The skull base generally refers to the anterior, middle and posterior cranial fossa and structures on the outside side of these skull areas. The cranial roof and skull base are separated by a line connecting the external occipital protuberance, parietal notch and supraorbital ridge[1].The skull base supports the brain above, is connected to

  1. Fractionated stereotactic radiosurgery for patients with skull base metastases from systemic cancer involving the anterior visual pathway

    International Nuclear Information System (INIS)

    To analyze the tumor control, survival outcomes, and toxicity after stereotactic radiosurgery (SRS) for skull base metastases from systemic cancer involving the anterior visual pathway. We have analyzed 34 patients (23 females and 11 males, median age 59 years) who underwent multi-fraction SRS for a skull base metastasis compressing or in close proximity of optic nerves and chiasm. All metastases were treated with frameless LINAC-based multi-fraction SRS in 5 daily fractions of 5 Gy each. Local control, distant failure, and overall survival were estimated using the Kaplan-Meier method calculated from the time of SRS. Prognostic variables were assessed using log-rank and Cox regression analyses. At a median follow-up of 13 months (range, 2–36.5 months), twenty-five patients had died and 9 were alive. The 1-year and 2-year local control rates were 89% and 72%, and respective actuarial survival rates were 63% and 30%. Four patients recurred with a median time to progression of 12 months (range, 6–27 months), and 17 patients had new brain metastases at distant brain sites. The 1-year and 2-year distant failure rates were 50% and 77%, respectively. On multivariate analysis, a Karnofsky performance status (KPS) >70 and the absence of extracranial metastases were prognostic factors associated with lower distant failure rates and longer survival. After multi-fraction SRS, 15 (51%) out of 29 patients had a clinical improvement of their preexisting cranial deficits. No patients developed radiation-induced optic neuropathy during the follow-up. Multi-fraction SRS (5 x 5 Gy) is a safe treatment option associated with good local control and improved cranial nerve symptoms for patients with a skull base metastasis involving the anterior visual pathway

  2. Surgical Simulation of Extradural Anterior Clinoidectomy through the Trans-superior Orbital Fissure Approach Using a Dissectable Three-dimensional Skull Base Model with Artificial Cavernous Sinus

    OpenAIRE

    Mori, Kentaro; Yamamoto, Takuji; NAKAO, Yasuaki; Esaki, Takanori

    2010-01-01

    Extradural anterior clinoidectomy via the trans-superior orbital fissure (SOF) approach can provide extensive exposure of the anterior clinoid process and safe drilling under direct view. This technique requires peeling of the dura propria of the temporal lobe from the lateral wall of the SOF. Therefore, cadaveric dissection is mandatory to acquire surgical technique. However, chances for cadaveric dissection are limited. We propose modification of our three-dimensional (3-D) skull base model...

  3. Three-dimensional MR imaging of skull-base tumors

    International Nuclear Information System (INIS)

    This paper demonstrates skull base lesions and to evaluate the diagnostic value of three-dimensional (3D) MR imaging performed with 3D reconstruction of the head. MR imaging was performed at 1.0 T and a 1.5 T, M before and after application of Gd-DTPA. Twenty-one healthy volunteers and 19 patients with skull base lesions were examined with standard 2D MR imaging and 3D fast low-angle shot imaging. A 3D reconstruction mode, based on the ray-tracing model, enabled us to construct arbitrarily complex extraction schemes. All 3D-reconstructions were compared with the surgical findings. The diagnoses included 10 benign skull base lesions and nine malignant lesions of the anterior and middle skull base. Gd-DTPA proved helpful in 82% of the cases

  4. Management of osteomyelitis of the skull base

    International Nuclear Information System (INIS)

    Osteomyelitis of the skull base is the most severe form of malignant otitis externa. As a result of having treated 13 patients with skull base osteomyelitis over a 4-year period, we have developed a method of staging and monitoring this malady using gallium and technetium scanning techniques. Stage I is localized to soft tissues, stage II is limited osteomyelitis, and stage III represents extensive skull base osteomyelitis. All stages are treated with appropriate antipseudomonal antibiotics. The duration of therapy depends upon the clearing of inflammation as shown on the gallium scan. Each case must be looked at independently and not subjected to an arbitrary treatment protocol

  5. Management of osteomyelitis of the skull base

    Energy Technology Data Exchange (ETDEWEB)

    Benecke, J.E. Jr. (Otologic Medical Group, Inc., Los Angeles, CA (USA))

    1989-12-01

    Osteomyelitis of the skull base is the most severe form of malignant otitis externa. As a result of having treated 13 patients with skull base osteomyelitis over a 4-year period, we have developed a method of staging and monitoring this malady using gallium and technetium scanning techniques. Stage I is localized to soft tissues, stage II is limited osteomyelitis, and stage III represents extensive skull base osteomyelitis. All stages are treated with appropriate antipseudomonal antibiotics. The duration of therapy depends upon the clearing of inflammation as shown on the gallium scan. Each case must be looked at independently and not subjected to an arbitrary treatment protocol.

  6. Management of osteomyelitis of the skull base.

    Science.gov (United States)

    Benecke, J E

    1989-12-01

    Osteomyelitis of the skull base is the most severe form of malignant otitis externa. As a result of having treated 13 patients with skull base osteomyelitis over a 4-year period, we have developed a method of staging and monitoring this malady using gallium and technetium scanning techniques. Stage I is localized to soft tissues, stage II is limited osteomyelitis, and stage III represents extensive skull base osteomyelitis. All stages are treated with appropriate antipseudomonal antibiotics. The duration of therapy depends upon the clearing of inflammation as shown on the gallium scan. Each case must be looked at independently and not subjected to an arbitrary treatment protocol. PMID:2601534

  7. Chondroma of the skull base and maxilla

    Directory of Open Access Journals (Sweden)

    Kiralj Aleksandar

    2007-01-01

    Full Text Available Introduction. Chondromas are uncommon benign tumors of cartilaginous origin. Although chonodroma of the jaw is extremely rare, the commonly involved are the anterior portion of the maxilla, condyle and coronoid process. A chondroma is a painless, slow growing tumor causing destruction and exfoliation of teeth. On a radiograph, the tumor appears as a cyst-like radiolucent lesion, while some are sclerotic. The borders are usually ill-defined. Irregular calcifications may be seen with radiolucencies and then it is an osteochondroma. Material and Methods. We present a patient with a resected and histologically proven chondroma of the skull base and maxilla. A 65-year-old female was admitted to our clinic with swelling and breathing difficulties. MRI showed a large soft tissue mass of the skull base and maxilla. Clinicopathological and radiological features were examined by computed tomography (CT and magnetic resonance imaging (MRI. Discussion and Conclusion. Chondromyxoid fibroma (CMF is a rare, benign cartilaginous tumor that often occurs in the metaphyses of proximal tibia, proximal and distal femur and small bones of the foot. The differential diagnosis is wide and includes simple or aneyrismal bone cyst, giant cell tumor, nonossifying fibroma, fibrous dysplasia, enchondroma, chondroblastoma, eosinophilic granuloma and fibrous cortical defect. Our case demonstrates an uncommon occurrence in the maxillary sinus: CMF with nasal, pterygoid and orbital infiltration. In the diagnosis of an intracranial chondrocytic tumor, it is important to distinguish it from enchondroma and chondrosarcoma. MR provides a detailed assessment of soft tissue masses of the craniofacial region, while CT offers superior analysis of bone structure involvement. The present case underlines the importance of MR examination in the diagnosis of soft tissue masses in the craniofacial region.

  8. CT skull base & calvarium normal variant pitfalls

    OpenAIRE

    Lockwood, P

    2013-01-01

    Intended learning outcomes - To recognise the varied neurological appearances of skull based normal variants with the brain. Highlighting the importance of differentiation of normal and variant anatomy from the pitfalls of misdiagnosing a pathological condition Content of Presentation -Pictorial review of 12 common examples of neuroradiological normal variant conditions of skull base and calvarium anatomical areas of the brain, including sutures, asymmetry of bones, benign growths, thicken...

  9. Radiologic assessment of maxillofacial, mandibular, and skull base trauma

    International Nuclear Information System (INIS)

    Cranio-maxillofacial injuries affect a significant proportion of trauma patients either in isolation or concurring with other serious injuries. Contrary to maxillofacial injuries that result from a direct impact, central skull base and lateral skull base (petrous bone) fractures usually are caused by a lateral or sagittal directed force to the skull and therefore are indirect fractures. The traditional strong role of conventional images in patients with isolated trauma to the viscerocranium is decreasing. Spiral multislice CT is progressively replacing the panoramic radiograph, Waters view, and axial films for maxillofacial trauma, and is increasingly being performed in addition to conventional films to detail and classify trauma to the mandible as well. Imaging thus contributes to accurately categorizing mandibular fractures based on location, into alveolar, mandibular proper, and condylar fractures - the last are subdivided into intracapsular and extracapsular fractures. In the midface, CT facilitates attribution of trauma to the categories central, lateral, or combined centrolateral fractures. The last frequently encompass orbital trauma as well. CT is the imaging technique of choice to display the multiplicity of fragments, the degree of dislocation and rotation, or skull base involvement. Transsphenoid skull base fractures are classified into transverse and oblique types; lateral base (temporal bone) trauma is subdivided into longitudinal and transverse fractures. Supplementary MR examinations are required when a cranial nerve palsy occurs in order to recognize neural compression. Early and late complications of trauma related to the orbit, anterior cranial fossa, or lateral skull base due to infection, brain concussion, or herniation require CT to visualize the osseous prerequisites of complications, and MR to define the adjacent brain and soft tissue involvement. (orig.)

  10. A high-resolution MRI study of linear growth of the human fetal skull base

    Energy Technology Data Exchange (ETDEWEB)

    Jeffery, N. [University Coll., London (United Kingdom). Dept. of Anatomy and Development Biology

    2002-04-01

    The skull base, otherwise referred to as the basicranium or cranial base, plays a key role in the process of skull development, providing both support for the brain and an architectural component of the craniofacial complex. Consequently, the fetal skull base has been the focus of numerous studies employing various methods, including sectioning, plain radiography and CT. This paper investigates high-resolution (hr) MRI as an alternative method for looking at and quantifying the fetal skull base. The evaluation tests two basic hypotheses drawn from previous studies. These suggest that the anterior segment of the midline skull base grows more rapidly than the posterior segment and that the width of the posterior cranial fossa increases disproportionately in relation to its length. I imaged 42 formalin preserved human fetuses from museum collections with hrMRI. The T2-weighted image voxels were significantly smaller than those acquired with conventional clinical MRI. Landmarks of the fetal skull base were identified on reformatted axial and sagittal images. Bivariate plots revealed that the growth rate of the anterior skull base is almost twice that of the posterior skull base and that increases in the width of the posterior cranial fossa exceed those in its length. These findings confirm those of previous investigations and show that hrMRI offers a way forward in noninvasive quantification of fetal morphology. ----------------------------------------------------------------------------.

  11. Augmented reality-assisted skull base surgery.

    Science.gov (United States)

    Cabrilo, I; Sarrafzadeh, A; Bijlenga, P; Landis, B N; Schaller, K

    2014-12-01

    Neuronavigation is widely considered as a valuable tool during skull base surgery. Advances in neuronavigation technology, with the integration of augmented reality, present advantages over traditional point-based neuronavigation. However, this development has not yet made its way into routine surgical practice, possibly due to a lack of acquaintance with these systems. In this report, we illustrate the usefulness and easy application of augmented reality-based neuronavigation through a case example of a patient with a clivus chordoma. We also demonstrate how augmented reality can help throughout all phases of a skull base procedure, from the verification of neuronavigation accuracy to intraoperative image-guidance.

  12. Skull base development and craniosynostosis

    Energy Technology Data Exchange (ETDEWEB)

    Blaser, Susan I. [The Hospital for Sick Children and University of Toronto, Department of Diagnostic Imaging, Division of Neuroradiology, Toronto (Canada); University of Toronto, Department of Otolaryngology - Head and Neck Surgery, Toronto (Canada); Padfield, Nancy [The Hospital for Sick Children and University of Toronto, Department of Diagnostic Imaging, Division of Neuroradiology, Toronto (Canada); Chitayat, David [The Hospital for Sick Children and University of Toronto, Division of Clinical and Metabolic Genetics, Toronto (Canada); Mount Sinai Hospital and University of Toronto, Prenatal Diagnosis and Medical Genetics Program, Toronto (Canada); Forrest, Christopher R. [The Hospital for Sick Children and University of Toronto, Centre for Craniofacial Care and Research, Division of Plastic and Reconstructive Surgery, Toronto (Canada)

    2015-09-15

    Abnormal skull shape resulting in craniofacial deformity is a relatively common clinical finding, with deformity either positional (positional plagiocephaly) or related to premature ossification and fusion of the skull sutures (craniosynostosis). Growth restriction occurring at a stenosed suture is associated with exaggerated growth at the open sutures, resulting in fairly predictable craniofacial phenotypes in single-suture non-syndromic pathologies. Multi-suture syndromic subtypes are not so easy to understand without imaging. Imaging is performed to define the site and extent of craniosynostosis, to determine the presence or absence of underlying brain anomalies, and to evaluate both pre- and postoperative complications of craniosynostosis. Evidence for intracranial hypertension may be seen both pre- and postoperatively, associated with jugular foraminal stenosis, sinovenous occlusion, hydrocephalus and Chiari 1 malformations. Following clinical assessment, imaging evaluation may include radiographs, high-frequency US of the involved sutures, low-dose (20-30 mAs) CT with three-dimensional reformatted images, MRI and nuclear medicine brain imaging. Anomalous or vigorous collateral venous drainage may be mapped preoperatively with CT or MR venography or catheter angiography. (orig.)

  13. An intradural skull base chordoma presenting with acute intratumoral hemorrhage

    Directory of Open Access Journals (Sweden)

    Uda Takehiro

    2006-01-01

    Full Text Available We present a rare case of skull base chordoma of extraosseous intradural type that presented as acute intratumoral hemorrhage. Surgical removal of the tumor was accomplished using a skull base approach.

  14. Sinonasal Non-Hodgkin's Lymphoma with Skull Base Involvement

    OpenAIRE

    Dare, Amos O.; Datta, Rajiv V.; Thom R. Loree; Hicks, Wesley L.; Grand, Walter

    2001-01-01

    Non-Hodgkin's lymphoma (NHL) is a rare tumor of the skull base. As the incidence of primary central nervous system (CNS) lymphoma has increased, atypical presentations involving the skull or cranial base exclusively have been reported. In immunocompetent patients with no previous history or predisposing factors, the diagnosis of primary NHL of the skull base may be delayed. We present four cases of nasal and paranasal sinus NHL with both skull base and intracranial involvement in immunocompet...

  15. Osteoradionecrosis of the maxilla and skull base

    Energy Technology Data Exchange (ETDEWEB)

    Komisar, A.; Silver, C.; Kalnicki, S.

    1985-01-01

    Osteoradionecrosis of the maxilla and base of skull are rare phenomena, usually seen after combined therapy for malignancies of the maxillary sinus. While the mandible is most commonly affected by osteoradionecrosis, the maxilla and skull base may also be affected when preoperative or postoperative radiotherapy is combined with surgery. Contributing factors may be: high radiation dosage delivered to the treatment volume (greater than 6000 rads), loss of tissue protective effects due to surgery, decreased vascularity caused by surgery and radiation, and proximity of a contaminated field. Onset of symptoms may vary. One patient presented 25 years after postoperative radiotherapy. Major symptoms were pain, trismus, and purulent discharge. The best diagnostic modality remains the history and physical exam, as the area is readily accessible. CT scans may be helpful in diagnosis and treatment planning. Therapy should follow time honored principles of local wound care. Home irrigations and hyperbaric therapy have been helpful in encouraging early sequestration and rapid healing.

  16. Osteoradionecrosis of the maxilla and skull base

    International Nuclear Information System (INIS)

    Osteoradionecrosis of the maxilla and base of skull are rare phenomena, usually seen after combined therapy for malignancies of the maxillary sinus. While the mandible is most commonly affected by osteoradionecrosis, the maxilla and skull base may also be affected when preoperative or postoperative radiotherapy is combined with surgery. Contributing factors may be: high radiation dosage delivered to the treatment volume (greater than 6000 rads), loss of tissue protective effects due to surgery, decreased vascularity caused by surgery and radiation, and proximity of a contaminated field. Onset of symptoms may vary. One patient presented 25 years after postoperative radiotherapy. Major symptoms were pain, trismus, and purulent discharge. The best diagnostic modality remains the history and physical exam, as the area is readily accessible. CT scans may be helpful in diagnosis and treatment planning. Therapy should follow time honored principles of local wound care. Home irrigations and hyperbaric therapy have been helpful in encouraging early sequestration and rapid healing

  17. Tumors of the skull base in children: review of tumor types and management strategies.

    Science.gov (United States)

    Tsai, Eve C; Santoreneos, Stephen; Rutka, James T

    2002-05-15

    Although many treatment strategies for skull base tumors in adults have been reported, relatively little has been reported regarding such therapies in the pediatric population. Skull base tumors in children present a therapeutic challenge because of their unique pathological composition, the constraints of the maturing skull and brain, and the small size of the patients. In this review, the authors examine the pediatric skull base lesions that occur in the anterior, middle, and posterior cranial base, focusing on unique pediatric tumors such as encepahalocele, fibrous dysplasia, esthesioneuroblastoma, craniopharyngioma, juvenile nasopharyngeal angiofibroma, cholesteatoma, chordoma, chondrosarcoma, and Ewing sarcoma. They review management strategies that include radio- and chemotherapy, as well as surgical approaches with emphasis on the modifications and complications associated with the procedures as they apply in children. Evidence for the advantages and limitations of radiotherapy, chemotherapy, and surgery as it pertains to the pediatric population will be examined. With a working knowledge of skull base anatomy and special considerations of the developing craniofacial skeleton, neurosurgeons can treat skull base lesions in children with acceptable morbidity and mortality rates. Outcomes in this population may be better than those in adults, in part because of the benign histopathology that frequently affects the pediatric skull base, as well as the plasticity of the maturing nervous system.

  18. Carbon Ion Radiotherapy for Skull Base Chordoma

    OpenAIRE

    Mizoe, Jun–etsu; Hasegawa, Azusa; Takagi, Ryo; Bessho, Hiroki; Onda, Takeshi; Tsujii, Hirohiko

    2009-01-01

    Objective: To present the results of the clinical study of carbon ion radiotherapy (CIRT) for skull base and paracervical spine tumors at the National Institute of Radiological Sciences in Chiba, Japan. Methods: The study is comprised of three protocols: a pilot study, a phase I/II dose escalation study, and a phase II study. All the patients were treated by 16 fractions for 4 weeks with total doses of 48.0, 52.8, 57.6, and 60.8 Gy equivalents (GyE). Results: As a result of the dose escalatio...

  19. Skull base chondroblastoma : a case report.

    Directory of Open Access Journals (Sweden)

    Moorthy R

    2002-10-01

    Full Text Available Chondroblastoma is a rare tumor of the skull. Temporal bone is the commonest site of involvement in the skull. We present a thirty one year old man who presented with painless swelling over the left temporal bone, which was near totally excised after preoperative embolization. Management of this unusual tumor and its complications are discussed.

  20. Osteomyelitis of the base of the skull

    Energy Technology Data Exchange (ETDEWEB)

    Chandler, J.R.; Grobman, L.; Quencer, R.; Serafini, A.

    1986-03-01

    Infection in the marrow of the temporal, occipital, and sphenoid bones is an uncommon, but increasing occurrence. It is usually secondary to infections beginning in the external auditory canal and is caused almost uniformly by the gram negative Pseudomonas aeruginosa bacteria. Technetium and gallium scintigraphy help in the early detection of such infections while CT scans demonstrate dissolution of bone in well-developed cases. Headache is the predominant symptom. Dysphagia, hoarseness, and aspiration herald the inevitable march of cranial nerves. We have diagnosed and treated 17 cases of osteomyelitis of the skull base. Although the total mortality rate is 53%, it is now a curable disease. Six of our last 8 patients remain alive, although 1 is still under treatment. Treatment is medical and requires the long-term concomitant intravenous administration of an aminoglycoside and a broad spectrum semisynthetic penicillin effective against the causative organism.

  1. Transnasal endoscopy-assisted skull base surgery.

    Science.gov (United States)

    Stamm, Aldo M

    2006-09-01

    Skull base surgery (SBS), which originated in the 19th century, became refined in the 20th century in parallel with technological advancements and is now in the midst of further refinements largely driven by advances in endoscopic sinus surgery. With the development of modern SBS, lesions that were once inoperable and potentially fatal can now be eradicated successfully by means of endoscopy-assisted procedures that reduce or completely eliminate intracranial trauma, minimize postsurgical morbidity, and make full recovery possible. It is absolutely mandatory to have the appropriate instrumentation for endoscopy-assisted SBS. Among the new technologies available are advanced endoscopes, high-speed suction irrigation drills, digital video cameras, computed tomography and magnetic resonance imaging, and systems for 3-dimensional computer-assisted image-guided surgical navigation. An experienced endoscopic surgeon working with multidisciplinary teams, and using new instrumentation and techniques, can bring SBS to new levels of success in the 21st century. PMID:17040018

  2. Endoscopic skull base training using 3D printed models with pre-existing pathology.

    Science.gov (United States)

    Narayanan, Vairavan; Narayanan, Prepageran; Rajagopalan, Raman; Karuppiah, Ravindran; Rahman, Zainal Ariff Abdul; Wormald, Peter-John; Van Hasselt, Charles Andrew; Waran, Vicknes

    2015-03-01

    Endoscopic base of skull surgery has been growing in acceptance in the recent past due to improvements in visualisation and micro instrumentation as well as the surgical maturing of early endoscopic skull base practitioners. Unfortunately, these demanding procedures have a steep learning curve. A physical simulation that is able to reproduce the complex anatomy of the anterior skull base provides very useful means of learning the necessary skills in a safe and effective environment. This paper aims to assess the ease of learning endoscopic skull base exposure and drilling techniques using an anatomically accurate physical model with a pre-existing pathology (i.e., basilar invagination) created from actual patient data. Five models of a patient with platy-basia and basilar invagination were created from the original MRI and CT imaging data of a patient. The models were used as part of a training workshop for ENT surgeons with varying degrees of experience in endoscopic base of skull surgery, from trainees to experienced consultants. The surgeons were given a list of key steps to achieve in exposing and drilling the skull base using the simulation model. They were then asked to list the level of difficulty of learning these steps using the model. The participants found the models suitable for learning registration, navigation and skull base drilling techniques. All participants also found the deep structures to be accurately represented spatially as confirmed by the navigation system. These models allow structured simulation to be conducted in a workshop environment where surgeons and trainees can practice to perform complex procedures in a controlled fashion under the supervision of experts. PMID:25294050

  3. Esthetic Craniofacial Bony and Skull Base Reconstruction Using Flap Wrapping Technique.

    Science.gov (United States)

    Yano, Tomoyuki; Suesada, Nobuko; Usami, Satoshi

    2016-07-01

    For a safe and esthetic skull base reconstruction combined with repair of craniofacial bone defects, the authors introduce the flap wrapping technique in this study. This technique consists of skull base reconstruction using the vastus lateralis muscle of an anterolateral thigh (ALT) free flap, and structural craniofacial bony reconstruction using an autologous calvarial bone graft. The key to this technique is that all of the grafted autologous bone is wrapped with the vascularized fascia of the ALT free flap to protect the grafted bone from infection and exposure. Two anterior skull base tumors combined with craniofacial bony defects were included in this study. The subjects were a man and a woman, aged 18 and 64. Both patients had preoperative proton beam therapy. First, the skull base defect was filled with vastus lateralis muscle, and then structural reconstruction was performed with an autologous bone graft and a fabricated inner layer of calvarial bone, and then the grafted bone was completely wrapped in the vascularized fascia of the ALT free flap. By applying this technique, there was no intracranial infection or grafted bone exposure in these 2 patients postoperatively, even though both patients had preoperative proton beam therapy. Additionally, the vascularized fascia wrapped bone graft could provide a natural contour and prevent collapse of the craniofacial region, and this gives patients a better facial appearance even though they have had skull base surgery. PMID:27300454

  4. Chordoma of skull base presenting as nasopharyngeal mass

    Directory of Open Access Journals (Sweden)

    Sant Prakash Kataria

    2013-01-01

    Full Text Available While the nasopharynx is most commonly regarded by the otolaryngologist as a primary site of neoplastic involvement, it is also an avenue of spread of base-of-the-skull tumors presenting as bulging nasopharyngeal masses. Chordoma is a relatively rare tumor of the skull base and sacrum thought to originate from embryonic remnants of the notochord. Chordomas arising from the skull base/clivus are typically locally aggressive with lytic bone destruction. The optimal treatment may be photon/proton radiotherapy alone or combined with a gross total resection, when feasible. We report a case of intracranial chordoma presenting as nasopharyngeal mass.

  5. Transoral robotic surgery of the central skull base: preclinical investigations.

    Science.gov (United States)

    Fernandez-Nogueras, F J J; Katati, M J; Arraez Sanchez, M A; Molina Martinez, M; Sanchez Carrion, M

    2014-06-01

    In this study we explored possible applications of the da Vinci system in approaching the skull base at optic chiasm level on two cryopreserved cadavers, using an entirely transoral robotic technique (TORS). We used a standard 12 mm endoscopy and 8 mm terminals. Bone drilling was performed manually. The da Vinci system is equipped with very good illumination and 3D viewing, thus providing excellent vision and great maneuverability even in the less accessible areas of the skull. Our experience demonstrates that an entirely transoral skull base robotic approach to this complex anatomical region has many advantages as compared to traditional techniques. PMID:24077869

  6. CHONDROID SKULL BASE TUMORS (A REVIEW OF LITERATURE

    Directory of Open Access Journals (Sweden)

    T. G. Gasparyan

    2012-01-01

    Full Text Available Chondroid skull base tumors are a rare and little studied pathology; many problems of their classification, diagnosis and treatment remain to be solved. This group of neoplasms is referred to as bone tumors arising from the cartilaginous tissue of the skull base bones, particularly from the bones formed during chondral osteogenesis. The paper details the clinical picture, X-ray and morphological diagnosis of chondroid tumors. Particular attention is given to surgery and radiotherapy for this category of tumors.

  7. Osseointegrated Implant Applications in Cosmetic and Functional Skull Base Rehabilitation

    OpenAIRE

    Benscoter, Brent J.; Jaber, James J.; Kircher, Matthew L.; Marzo, Sam J.; Leonetti, John P.

    2011-01-01

    This study discusses the indications, outcomes, and complications in patients that underwent osseointegrated implantation for skull base rehabilitation. We conducted a retrospective review of eight patients with skull base defects who had undergone implantation of a facial prosthetic retention device ± bone-anchored hearing aid at a tertiary academic referral center. Descriptive analysis of applications, techniques, outcomes, and complications were reviewed. The majority of patients were male...

  8. Skull (image)

    Science.gov (United States)

    The skull is anterior to the spinal column and is the bony structure that encases the brain. Its purpose is to protect the brain and allow attachments for the facial muscles. The two regions of ... is the part of the skull that directly houses the brain and the ...

  9. Meningioma of the Posterior Skull Base

    Science.gov (United States)

    Biggs, Michael Thomas; Fagan, Paul A.; Sheehy, John P.R.; Bentivoglio, Peter J.; Doust, Bruce D.; Tonkin, John

    1991-01-01

    Combined intratemporal and cerebellopontine angle meningiomas are rejatively rare. There are unsolved problems with the stability of the skull and spine and the lower cranial nerves and there is a marked tendency for the tumor to involve the spinal cord. This article reports on five cases of combined intratemporal and cerebellopontine angle meningiomas. ImagesFigure 1p44-bFigure 2Figure 3Figure 4Figure 5 PMID:17170820

  10. Image guidance in endoscopic sinus surgery and skull base surgery

    Institute of Scientific and Technical Information of China (English)

    Mitchell R.Gore; Brent A.Senior

    2012-01-01

    Objective The objective of this study was to review the current clinical applications and impact of intraoperative imaging on endoscopic sinonasal and skull base procedures in adult and pediatric patients.Methods The PubMed database was searched for articles related to the use of image guidance in otolaryngology using the search terms "image guidance otolaryngology".This was supplemented by the authors′ experience utilizing image guidance in nearly 3000 endoscopic sinus and skull base procedures.Results The literature demonstrates that intraoperative image guidance has utility in primary and revision endoscopic sinus surgery,as well as endoscopic surgery of the skull base.Image guidance also has applications in pediatric endoscopic surgery,such as pediatric sinus surgery and repair of choanal atresia.Conclusions Intraoperative image guidance,when combined with a thorough knowledge of paranasal sinus and skull base anatomy and technical proficiency,can provide improved safety when performing otolaryngologic procedures from endoscopic sinus surgery to endoscopic skull base surgery.While not a substitute for knowledge of anatomy,the increased availability and usability of image guidance systems make them a useful tool in the armamentarium of the otolaryngologist/head and neck surgeon and neurosurgeon.

  11. [Intraoperative navigation, with focus on the skull base].

    Science.gov (United States)

    Wirtz, C R

    2016-09-01

    Intraoperative navigation systems are widely used in ENT, oral and maxillofacial, and neurosurgery. The benefits of such systems have been demonstrated in various applications, including intracranial and skull base surgery. Intraoperative shift, "brain shift" and changes in anatomy caused by the surgical procedure itself impair the accuracy of navigation and represent factors limiting its application, particularly in glioma and metastatic brain surgery. For this reason, intraoperative imaging was incorporated into neurosurgery. A specific application of navigation is thus skull base surgery, where shifts are often negligible due to the bony structures in which pathologies are embedded. Development of new systems with seamless integration into the operative workflow propagated routine use of navigation in neuro- and ENT surgery. Navigation proved especially helpful in interdisciplinary surgery with pathologies located in anatomic regions where competences of different surgical disciplines overlap, as in the skull base. While this increased radicality in tumour resection, there was a high risk of morbidity. The integration of electrophysiological function monitoring served to preserve function and reduce morbidity, and has led to less invasive and radical strategies in skull base surgery. New radiosurgical methods to adjuvantly treat possible tumour remnants have also supported this development. Systems allowing resection borders to be marked in the navigational coordinates would enable direct linking of these data to radiotherapy planning and better interpretation of follow-up imaging. Navigation is thus a valuable tool supporting interdisciplinary cooperation in skull base surgery for the benefit of patients. PMID:27566369

  12. Central skull base lymphoma in children: MR and CT features

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Hei-Kyung [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea); Cheon, Jung-Eun; Kim, In-One; Youn, Byung Jae; Jung, Ah Young; Shin, Su-Mi; Kim, Woo Sun; Yeon, Kyung Mo [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea); Seoul National University Hospital, Institute of Radiation Medicine, SNUMRC (Seoul National University Medical Research Center), Seoul (Korea)

    2008-08-15

    Central skull base tumours are rare in children. To characterize the imaging features of central skull base lymphoma in children to aid its diagnosis. The authors reviewed the CT findings (available in three patients) and MR findings (available in four patients) in four patients (three boys, one girl; age 2-12 years) with pathologically proven lymphoma (two with Burkitt lymphoma, two with B-cell lymphoma) involving the central skull base. Tumour location and extent, MRI signal intensities, noncontrast CT attenuation, patterns of enhancement, and changes in adjacent structures were evaluated. All four tumours involved the sphenoid bone. In three patients, the tumour extended to the ethmoid sinus and both cavernous sinuses. All lesions were isointense solid masses on T2-weighted images and showed avid enhancement, except for one lesion with a focal necrosis. All tumours were associated with adjacent dural thickening. Non-contrast CT showed highly attenuating masses and permeative bone destruction in the central skull base. Lymphoma involving the central skull base in children is visualized as an isointense mass on T2-weighted MRI with marked contrast enhancement and adjacent dural thickening, and as a highly attenuating mass on noncontrast CT with permeative or erosive bone destruction patterns. (orig.)

  13. SPECT/CT in the Diagnosis of Skull Base Osteomyelitis

    Energy Technology Data Exchange (ETDEWEB)

    Damle, Nishikant Avinash; Kumar, Rakesh; Kumar, Praveen; Jaganthan, Sriram; Patnecha, Manish; Bal, Chandrasekhar; Bandopadhyaya, Gurupad; Malhotra, Arun [All India Institute of Medical Sciences, New Delhi (India)

    2011-09-15

    Skull base osteomyelitis is a potentially fatal disease. We demonstrate here the utility of SPECT/CT in diagnosing this entity, which was not obvious on a planar bone scan. A {sup 99mT}c MDP bone scan with SPECT/CT was carried out on a patient with clinically suspected skull base osteomyelitis. Findings were correlated with contrast enhanced CT (CECT) and MRI. Planar images were equivocal, but SPECT/CT showed intense uptake in the body of sphenoid and petrous temporal bone as well as the atlas corresponding to irregular bone destruction on CT and MRI. These findings indicate that SPECT/CT may have an additional role beyond planar imaging in the detection of skull base osteomyelitis.

  14. A tomographic study of the skull base in primary spontaneous cerebrospinal fluid leaks

    Energy Technology Data Exchange (ETDEWEB)

    Giannetti, Alexandre Varella [Hospital das Clinicas, Service of Neurosurgery, Belo Horizonte (Brazil); Federal University of Minas Gerais, Department of Surgery, School of Medicine, Belo Horizonte (Brazil); Guimaraes, Roberto Eustaquio S. [Hospital das Clinicas, Services Otorhinolaryngology, Belo Horizonte (Brazil); Federal University of Minas Gerais, Department of Ophthalmology and Otorhinolaryngology, School of Medicine, Belo Horizonte (Brazil); Santiago, Ana Paula M.S. [Hospital das Clinicas, Services Radiology, Belo Horizonte (Brazil); Perpetuo, Francisco Otaviano L.; Machado, Marco Antonio O. [Computed Tomography Center of Minas Gerais, Belo Horizonte (Brazil)

    2012-05-15

    This study aims to evaluate the existence of anatomic abnormalities in the skull base that could contribute to the origin of primary spontaneous cerebrospinal fluid leaks (PSL). Twenty PSL patients were compared with 20 healthy individuals. The following features were measured through an analysis of computed tomography scans: the angles of the petrosal bones and skull base in both the sagittal and coronal planes; the anteroposterior and mediolateral diameters of the anterior skull base, sella, and sphenoid sinus; the depth of the olfactory fossa; the pneumatization of the sphenoid sinus; the position of the crista galli; and the state of the dorsum sellae. Body mass index (BMI) was compared. There were no differences between the two groups with respect to the angles and diameters of the anterior cranial fossa and the sphenoid sinus or the depth of the olfactory fossa. Pneumatization of the lateral recess of the sphenoid sinus was more frequent in the PSL group (55%) than in the control group (25%, p = 0.053). The dorsum sellae were eroded in 30% of the PSL patients but intact in all healthy subjects. PSL subjects showed higher sellae (1.0 versus 0.8 cm, p = 0.002). The average BMI of PSL patients was higher than that of the control group. Global alterations in the skull base of PSL patients were not found. The increase in the height of sellae and the erosion of its dorsum suggest intracranial hypertension. The higher BMI in the case group confirms the relation between obesity and PSL. (orig.)

  15. A Quantitative Analysis of Published Skull Base Endoscopy Literature.

    Science.gov (United States)

    Hardesty, Douglas A; Ponce, Francisco A; Little, Andrew S; Nakaji, Peter

    2016-02-01

    Objectives Skull base endoscopy allows for minimal access approaches to the sinonasal contents and cranial base. Advances in endoscopic technique and applications have been published rapidly in recent decades. Setting We utilized an Internet-based scholarly database (Web of Science, Thomson Reuters) to query broad-based phrases regarding skull base endoscopy literature. Participants All skull base endoscopy publications. Main Outcome Measures Standard bibliometrics outcomes. Results We identified 4,082 relevant skull base endoscopy English-language articles published between 1973 and 2014. The 50 top-cited publications (n = 51, due to articles with equal citation counts) ranged in citation count from 397 to 88. Most of the articles were clinical case series or technique descriptions. Most (96% [49/51])were published in journals specific to either neurosurgery or otolaryngology. Conclusions A relatively small number of institutions and individuals have published a large amount of the literature. Most of the publications consisted of case series and technical advances, with a lack of randomized trials. PMID:26949585

  16. Use of sodium fluorescein in skull base tumors

    Directory of Open Access Journals (Sweden)

    Carlos Eduardo da Silva

    2010-10-01

    Full Text Available Objective: The authors present this study using sodium fluorescein (SF to enhance skull base tumors by performing a quantitative digital analysis of tumor enhancement. The purpose of this study is to observe the grade of SF enhancement by the tumors.Methods: A prospective experiment within-subjects study design was performed which included six patients with skull base lesions. Digital pictures were taken before and after the SF systemic injection, using the same light source of the microsurgical field. The pictures were analyzed by computer software which calculated the wavelength (WL of the SF pre- and post-injection.Results: The group of tumors was as follows: one vestibular schwannoma, three meningiomas, one craniopharyngioma and one pituitary adenoma. The SF enhancement in all tumors was strongly positive. The digital analysis of the pictures, considering the SF WL pre- and post-injection, presented P = 0.028 (Wilcoxon T test.Conclusions: The enhancement of the tumors by SF was consistent and evident. The introductory results suggest the possibility of using SF as an adjuvant tool for the skull base surgery. Further studies should test the clinical application of the SF in skull base tumors.

  17. Resection of giant ethmoid osteoma with orbital and skull base extension followed by duraplasty

    Directory of Open Access Journals (Sweden)

    Ferekidou Eliza

    2008-10-01

    Full Text Available Abstract Background Osteomas of ethmoid sinus are rare, especially when they involve anterior skull base and orbit, and lead to ophthalmologic and neurological symptoms. Case presentation The present case describes a giant ethmoid osteoma. Patient symptoms and signs were exophthalmos and proptosis of the left eye, with progressive visual acuity impairment and visual fields defects. CT/MRI scanning demonstrated a huge osseous lesion of the left ethmoid sinus (6.5 cm × 5 cm × 2.2 cm, extending laterally in to the orbit and cranially up to the anterior skull base. Bilateral extensive polyposis was also found. Endoscopic and external techniques were combined to remove the lesion. Bilateral endoscopic polypectomy, anterior and posterior ethmoidectomy and middle meatus antrostomy were performed. Finally, the remaining part of the tumor was reached and dissected from the surrounding tissue via a minimally invasive Lynch incision around the left middle canthus. During surgery, CSF rhinorrhea was observed and leakage was grafted with fascia lata and coated with bio-glu. Postoperatively, symptoms disappeared. Eighteen months after surgery, the patient is still free of symptoms. Conclusion Before management of ethmoid osteomas with intraorbital and skull base extension, a thorough neurological, ophthalmological and imaging evaluation is required, in order to define the bounders of the tumor, carefully survey the severity of symptoms and signs, and precisely plan the optimal treatment. The endoscopic procedure can constitute an important part of surgery undertaken for giant ethmoidal osteomas. In addition, surgeons always have to take into account a possible CSF leak and they have to be prepared to resolve it.

  18. Influence of the lateral ventricles and irregular skull base on brain kinematics due to sagittal plane head rotation.

    Science.gov (United States)

    Ivarsson, J; Viano, D C; Lövsund, P

    2002-08-01

    Two-dimensional physical models of the human head were used to investigate how the lateral ventricles and irregular skull base influence kinematics in the medial brain during sagittal angular head dynamics. Silicone gel simulated the brain and was separatedfrom the surrounding skull vessel by paraffin that provided a slip interface between the gel and vessel. A humanlike skull base model (HSB) included a surrogate skull base mimicking the irregular geometry of the human. An HSBV model added an elliptical inclusion filled with liquid paraffin simulating the lateral ventricles to the HSB model. A simplified skull base model (SSBV) included ventricle substitute but approximated the anterior and middle cranial fossae by a flat and slightly angled surface. The models were exposed to 7600 rad/s2 peak angular acceleration with 6 ms pulse duration and 5 deg forced rotation. After 90 deg free rotation, the models were decelerated during 30 ms. Rigid body displacement, shear strain and principal strains were determined from high-speed video recorded trajectories of grid markers in the surrogate brains. Peak values of inferior brain surface displacement and strains were up to 10.9X (times) and 3.3X higher in SSBV than in HSBV. Peak strain was up to 2.7X higher in HSB than in HSBV. The results indicate that the irregular skull base protects nerves and vessels passing through the cranial floor by reducing brain displacement and that the intraventricular cerebrospinal fluid relieves strain in regions inferior and superior to the ventricles. The ventricles and irregular skull base are necessary in modeling head impact and understanding brain injury mechanisms. PMID:12188208

  19. Whole-transcriptome analysis of chordoma of the skull base.

    Science.gov (United States)

    Bell, Diana; Raza, Shaan M; Bell, Achim H; Fuller, Gregory N; DeMonte, Franco

    2016-10-01

    Fourteen skull base chordoma specimens and three normal specimens were microdissected from paraffin-embedded tissue. Pools of RNA from highly enriched preparations of these cell types were subjected to expression profiling using whole-transcriptome shotgun sequencing. Using strict criteria, 294 differentially expressed transcripts were found, with 28 % upregulated and 72 % downregulated. The transcripts were annotated using NCBI Entrez Gene and computationally analyzed with the Ingenuity Pathway Analysis program. From these significantly changed expressions, the analysis identified 222 cancer-related transcripts. These 294 differentially expressed genes and non-coding RNA transcripts provide here a set to specifically define skull base chordomas and to identify novel and potentially important targets for diagnosis, prognosis, and therapy of this cancer. Significance Genomic profiling to subtype skull base chordoma reveals potential candidates for specific biomarkers, with validation by IHC for selected candidates. The highly expressed developmental genes T, LMX1A, ZIC4, LHX4, and HOXA1 may be potential drivers of this disease.

  20. The use of free flaps in skull base reconstruction.

    Science.gov (United States)

    Macía, G; Picón, M; Nuñez, J; Almeida, F; Alvarez, I; Acero, J

    2016-02-01

    Skull base tumours are rare, comprising less than 1% of all tumours of the head and neck. Surgical treatment of these tumours involves the approach, the resection, and the reconstruction of the defect, which present a challenge due to the technical difficulty and anatomical complexity. A retrospective study of 17 patients with tumours involving the skull base, treated by resection and immediate reconstruction using microsurgical free flaps, is presented; 11 were men and six were women. The following types of flap were used: osteocutaneous fibula flaps, fasciocutaneous anterolateral thigh flaps, and myocutaneous latissimus dorsi flaps. The most common histology of the tumours was squamous cell carcinoma. The most frequent point of origin was the paranasal sinuses (58.8%). All of the free flaps used for reconstruction were viable. A cerebrospinal fluid fistula occurred in two patients, and in one of these cases, meningoencephalitis led to death. In conclusion, the reconstruction of large defects of the skull base after ablation requires a viable tissue that in many cases can be obtained only through the use of microvascular free flaps. The type of flap to be selected depends on the anatomical structures and size of the defect to be restored.

  1. Clinical results of proton beam therapy for skull base chordoma

    International Nuclear Information System (INIS)

    Purpose: To evaluate clinical results of proton beam therapy for patients with skull base chordoma. Methods and materials: Thirteen patients with skull base chordoma who were treated with proton beams with or without X-rays at the University of Tsukuba between 1989 and 2000 were retrospectively reviewed. A median total tumor dose of 72.0 Gy (range, 63.0-95.0 Gy) was delivered. The patients were followed for a median period of 69.3 months (range, 14.6-123.4 months). Results: The 5-year local control rate was 46.0%. Cause-specific, overall, and disease-free survival rates at 5 years were 72.2%, 66.7%, and 42.2%, respectively. The local control rate was higher, without statistical significance, for those with preoperative tumors <30 mL. Partial or subtotal tumor removal did not yield better local control rates than for patients who underwent biopsy only as the latest surgery. Conclusion: Proton beam therapy is effective for patients with skull base chordoma, especially for those with small tumors. For a patient with a tumor of <30 mL with no prior treatment, biopsy without tumor removal seems to be appropriate before proton beam therapy

  2. Surgeon's view of the skull base from the lateral approach.

    Science.gov (United States)

    Goldenberg, R A

    1984-12-01

    This paper presents the surgical anatomy of the skull base and infratemporal fossa. The information has been derived from the author's own experience in surgical and cadaver dissection, standard anatomical references, and selected experience of other skull base surgeons. Because the lateral approach has become the utilitarian method of exposure, the intricate detailed anatomy is demonstrated from this view at five levels of dissection, so the surgeon may gain a practical understanding of the surgical relationship of critical structures. Consistent anatomical landmarks can be used by the surgeon in the location of these critical structures. The styloid process, sphenoidal spine, and middle meningeal artery identify the internal carotid artery as it enters the carotid canal. The bony or fibrous septum that divides the jugular foramen into neural and vascular compartments may be used to better identify nerves IX, X, and XI. The zygomatic root is useful for location of the middle fossa dura. The lateral pterygoid plate leads directly to the foramen ovale. The increased precision of dissection permitted by use of the microscope requires an increased level of knowledge of anatomical structures in this area. It is hoped that the information presented in this paper will assist surgeons in the meticulous and thorough removal of skull base tumors and in the preservation of neural and vascular structures that are presently being sacrificed.

  3. Skull Base Osteomyelitis in the Emergency Department: A Case Report

    Directory of Open Access Journals (Sweden)

    Mustafa Burak Sayhan

    2011-01-01

    Full Text Available Skull base osteomyelitis (SBO is a rare clinical presentation and usually occurs as a complication of trauma or sinusitis. A 5-year-old child presented to the emergency department with a three-week history of fever associated with drowsiness and left parietal headache, and a week's history of swelling on the left frontoparietal soft tissue. He had suffered a penetrating scalp injury four month ago. On physical examination, there was a tender swelling with purulent stream on the lateral half of his scalp. His vital signs are within normal limits. Plain X-ray of the skull showed a lytic lesion on the left frontoparietal bone. A cranial computed tomography (CT scan demonstrated a large subgaleal abscess at the left frontoparietal region. SBO possesses a high morbidity and mortality; therefore, prompt diagnosis and appropriate treatment are mandatory to prevent further complications and to reduce morbidity and mortality significantly.

  4. Automatic analysis of a skull fracture based on image content

    Science.gov (United States)

    Shao, Hong; Zhao, Hong

    2003-09-01

    Automatic analysis based on image content is a hotspot with bright future of medical image diagnosis technology research. Analysis of the fracture of skull can help doctors diagnose. In this paper, a new approach is proposed to automatically detect the fracture of skull based on CT image content. First region growing method, whose seeds and growing rules are chosen by k-means clustering dynamically, is applied for image automatic segmentation. The segmented region boundary is found by boundary tracing. Then the shape of the boundary is analyzed, and the circularity measure is taken as description parameter. At last the rules for computer automatic diagnosis of the fracture of the skull are reasoned by entropy function. This method is used to analyze the images from the third ventricles below layer to cerebral cortex top layer. Experimental result shows that the recognition rate is 100% for the 100 images, which are chosen from medical image database randomly and are not included in the training examples. This method integrates color and shape feature, and isn't affected by image size and position. This research achieves high recognition rate and sets a basis for automatic analysis of brain image.

  5. Fractionated stereotactic conformal radiotherapy for large benign skull base meningiomas

    International Nuclear Information System (INIS)

    to assess the safety and efficacy of fractionated stereotactic radiotherapy (FSRT) for large skull base meningiomas. Fifty-two patients with large skull base meningiomas aged 34-74 years (median age 56 years) were treated with FSRT between June 2004 and August 2009. All patients received FSRT for residual or progressive meningiomas more than 4 centimeters in greatest dimension. The median GTV was 35.4 cm3 (range 24.1-94.9 cm3), and the median PTV was 47.6 cm3 (range 33.5-142.7 cm3). Treatment volumes were achieved with 5-8 noncoplanar beams shaped using a micromultileaf collimator (MLC). Treatment was delivered in 30 daily fractions over 6 weeks to a total dose of 50 Gy using 6 MV photons. Outcome was assessed prospectively. At a median follow-up of 42 months (range 9-72 months) the 3-year and 5-year progression-free survival (PFS) rates were 96% and 93%, respectively, and survival was 100%. Three patients required further debulking surgery for progressive disease. Hypopituitarism was the most commonly reported late complication, with a new hormone pituitary deficit occurring in 10 (19%) of patients. Clinically significant late neurological toxicity was observed in 3 (5.5%) patients consisting of worsening of pre-existing cranial deficits. FSRT as a high-precision technique of localized RT is suitable for the treatment of large skull base meningiomas. The local control is comparable to that reported following conventional external beam RT. Longer follow-up is required to assess long term efficacy and toxicity, particularly in terms of potential reduction of treatment-related late toxicity

  6. Olfaction in Endoscopic Sinus and Skull Base Surgery.

    Science.gov (United States)

    Thompson, Christopher F; Kern, Robert C; Conley, David B

    2015-10-01

    Olfactory dysfunction is a common complaint for patients with chronic rhinosinusitis, because smell loss decreases a patient's quality of life. Smell loss is caused by obstruction from polyps, nasal discharge, and mucosal edema, as well as inflammatory changes within the olfactory epithelium. Addressing olfaction before endoscopic sinus and skull base surgery is important in order to set postoperative expectations, because an improvement in smell is difficult to predict. Several commercially available olfactory testing measures are available and can easily be administered in clinic. During surgery, careful dissection within the olfactory cleft is recommended in order to optimize postoperative olfactory function.

  7. HelixFlex: bioinspired maneuverable instrument for skull base surgery.

    Science.gov (United States)

    Gerboni, Giada; Henselmans, Paul W J; Arkenbout, Ewout A; van Furth, Wouter R; Breedveld, Paul

    2015-12-01

    Endoscopic endonasal surgery is currently regarded as the 'gold standard' for operating on pituitary gland tumors, and is becoming more and more accepted for treatment of other skull base lesions. However, endoscopic surgical treatment of most skull base pathologies, including certain pituitary tumors, is severely impaired by current instruments lack of maneuverability. Especially, gaining access to, and visibility of, difficult-to-reach anatomical corners without interference with surrounding neurovascular structures or other instruments, is a challenge. In this context there is the need for instruments that are able to provide a stable shaft position, while both the orientation and the position of the end-effector can be independently controlled. Current instruments that allow for this level of maneuverability are usually mechanically complex, and hence less suitable for mass production. This study therefore focuses on the development of a new actuation technique that allows for the required maneuverability while reducing the construction complexity. This actuation technique, referred to as multi-actuation, integrates multiple cable routings into a single steerable structure. Multi-actuation has been successfully integrated and tested in a handheld prototype instrument called HelixFlex. HelixFlex contains a 4 degrees of freedom maneuverable 5.8 mm (diameter) tip and shows promising results concerning its maneuverability and potential rigidity.

  8. [Gross tumor volume (GTV) and clinical target volume (CTV) in radiotherapy of benign skull base tumors].

    Science.gov (United States)

    Maire, J P; Liguoro, D; San Galli, F

    2001-10-01

    Skull base tumours represent about 35 to 40% of all intracranial tumours. There are now many reports in the literature confirming the fact that about 80 to 90% of such tumours are controlled with fractionated radiotherapy. Stereotactic and 3-dimensional treatment planning techniques increase local control and central nervous system tolerance. Definition of the gross tumor volume (GTV) is generally easy with currently available medical imaging systems and computers for 3-dimensional dosimetry. The definition of the clinical target volume (CTV) is more difficult to appreciate; it is defined from the CTV plus a margin, which depends on the histology and anterior therapeutic history of the tumour. It is important to take into account the visible tumour and its possible extension pathways (adjacent bone, holes at the base of skull) and/or an anatomic region (sella turcica + adjacent cavernous sinus). It is necessary to evaluate these volumes with CT Scan and MRI to appreciate tumor extension in a 3-dimentional approach, in order to reduce the risk of marginal recurrences. The aim of this paper is to discuss volume definition as a function of tumour site and tumour type to be irradiated. PMID:11715310

  9. Papillary thyroid microcarcinoma presenting as skull base metastasis

    Institute of Scientific and Technical Information of China (English)

    YAN Bo; LIU Dian-gang; L(U) Hai-li; ZHANG Qiu-hang

    2010-01-01

    @@ Papillary thyroid carcinoma (PTC) is the most common type of well-differentiated thyroid cancer and is considered to be a relatively indolent tumor in which distant metastasis and death are rare.1 The metastasis of PTC is usually to regional lymph nodes, especially the cervical and mediastinal nodes. Metastases to the brain are rare, and constitute 0.1%-5.0% of distant metastases of papillary carcinoma.2 Skull metastasis is uncommon,and is found in 2.5%-5.8% of cases of thyroid cancer.3 Skull base metastasis of PTC is extremely rare, with only eight reported cases in the literature involving the clivus,cavernous sinus, sella turcica, and the petrous apex and ridge.4 A metastatic lesion can arise from histologically benign and silent thyroid neoplasms,5 and differential diagnosis between ectopic and metastatic thyroid cancer can be difficult,6 therefore, the management of thyroid cancer is controversial after removal of metastatic disease.Here we reported a case of papillary thyroid microcarcinoma (PTMC) that was manifested as a solitary clivus metastasis and discussed the diagnostic and therapeutic management strategies. The 73-year-old patient presented with visual impairment in the right eye,and epistaxis. The patient subsequently underwent complete total thyroidectomy after a diagnosis of papillary microcarcinoma. This finding emphasizes that clinically significant metastases can arise from thyroid papillary microcarcinoma. Total thyroidectomy and careful review of the histology are necessary to prevent delay in proper diagnosis.

  10. BASE OF SKULL ANATOMY AND DIFFERENT PATHOLOGIES IN CROSS SECTIONAL IMAGING

    OpenAIRE

    Hashem Sharifian

    2012-01-01

    Purpose: The aim of this study is to improvethe radiologic knowledge of skull base anatomy and pathologies. Content: Skull base is composed of multiple complex bones and soft tissues. So many pathologies as tumoral, infectious and traumatic can involve it. With a brief discussion of the anatomy, we review various pathologic conditions in this region.

  11. Clinicopathological and Molecular Histochemical Review of Skull Base Metastasis from Differentiated Thyroid Carcinoma

    International Nuclear Information System (INIS)

    Skull base metastasis from differentiated thyroid carcinoma including follicular thyroid carcinoma (FTC) and papillary thyroid carcinoma (PTC) is a rare clinical entity. Eighteen FTC cases and 10 PTC cases showing skull base metastasis have been reported. The most common symptom of skull base metastasis from FTC and PTC is cranial nerve dysfunction. Bone destruction and local invasion to the surrounding soft tissues are common on radiological imaging. Skull base metastases can be the initial clinical presentation of FTC and PTC in the presence of silent primary sites. The possibility of skull base metastasis from FTC and PTC should be considered in patients with the clinical symptoms of cranial nerve dysfunction and radiological findings of bone destruction. A variety of genetic alterations in thyroid tumors have been identified to have a fundamental role in their tumorigenesis. Molecular histochemical studies are useful for elucidating the histopathological features of thyroid carcinoma. Recent molecular findings may provide novel molecular-based treatment strategies for thyroid carcinoma

  12. Skull base chordomas: analysis of dose-response characteristics

    International Nuclear Information System (INIS)

    Objective: To extract dose-response characteristics from dose-volume histograms and corresponding actuarial survival statistics for 115 patients with skull base chordomas. Materials and Methods: We analyzed data for 115 patients with skull base chordoma treated with combined photon and proton conformal radiotherapy to doses in the range 66.6Gy - 79.2Gy. Data set for each patient included gender, histology, age, tumor volume, prescribed dose, overall treatment time, time to recurrence or time to last observation, target dose-volume histogram, and several dosimetric parameters (minimum/mean/median/maximum target dose, percent of the target volume receiving the prescribed dose, dose to 90% of the target volume, and the Equivalent Uniform Dose (EUD). Data were analyzed using the Kaplan-Meier survivor function estimate, the proportional hazards (Cox) model, and parametric modeling of the actuarial probability of recurrence. Parameters of dose-response characteristics were obtained using the maximum likelihood method. Results: Local failure developed in 42 (36%) of patients, with actuarial local control rates at 5 years of 59.2%. The proportional hazards model revealed significant dependence of gender on the probability of recurrence, with female patients having significantly poorer prognosis (hazard ratio of 2.3 with the p value of 0.008). The Wilcoxon and the log-rank tests of the corresponding Kaplan-Meier recurrence-free survival curves confirmed statistical significance of this effect. The Cox model with stratification by gender showed significance of tumor volume (p=0.01), the minimum target dose (p=0.02), and the EUD (p=0.02). Other parameters were not significant at the α level of significance of 0.05, including the prescribed dose (p=0.21). Parametric analysis using a combined model of tumor control probability (to account for non-uniformity of target dose distribution) and the Weibull failure time model (to account for censoring) allowed us to estimate

  13. Management of Battlefield Injuries to the Skull Base.

    Science.gov (United States)

    Stevens, Jayne R; Brennan, Joseph

    2016-10-01

    High velocity skull base injuries on the battlefield are unique in comparison to most civilian sector trauma. With more than 43,000 United States military personnel injuries during Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF), the most recent conflicts in Iraq and Afghanistan have significantly expanded the understanding of the physiology of modern battlefield trauma and how to appropriately address these injuries. The acute care principles of effective triage, airway management, and hemorrhage control in these injuries can be life saving and are reviewed here. Specific injury patterns and battlefield examples are reviewed as well, with a review of some of the lessons learned while providing care in a deployed setting. Utilization of the knowledge learned in Iraq and Afghanistan, which have improved casualty care of deployed service members, can be used both in future military conflicts and in civilian trauma care. PMID:27648400

  14. Use of a Galeopericranial Flap for the Reconstruction of Anterior Cranial Base Defects

    OpenAIRE

    Chia-Hsiang Fu; Sheng-Po Hao; Yung-Shin Hsu

    2005-01-01

    Background: To evaluate the efficacy of using a galeopericranial flap for reconstruction ofanterior cranial base defects.Methods: In Linkou Chang Gung Memorial Hospital from February 1994 to November2003, 25 patients who had tumors of the skull base underwent craniofacialresection, and a galeopericranial flap was used to reconstruct the anterior cranialbase defect. The galeopericranial flap was developed and based on atleast 1 side of the supraorbital or supratrochlear arteries and veins; it ...

  15. Factors for tumor progression in patients with skull base chordoma.

    Science.gov (United States)

    Wang, Liang; Tian, Kaibing; Wang, Ke; Ma, Junpeng; Ru, Xiaojuan; Du, Jiang; Jia, Guijun; Zhang, Liwei; Wu, Zhen; Zhang, Junting

    2016-09-01

    Skull base chordoma is a rare and fatal disease, recurrence of which is inevitable, albeit variable. We aimed to investigate the clinicopathologic features of disease progression, identify prognostic factors, and construct a nomogram for predicting progression in individual patients. Data of 229 patients with skull base chordoma treated by one institution between 2005 and 2014 were retrieved and grouped as primary and recurrent. Kaplan-Meier survival of progression was estimated, taking competing risks into account. Multivariable Cox regression was used to investigate survival predictors. The primary group consisted by 183 cases, gained more benefits on 5-year progression-free survival (PFS) (51%) and mean PFS time (66.9 months) than the recurrent group (46 cases), in which 5-year postrecurrent PFS was 14%, and mean postrecurrent PFS time was 29.5 months. In the primary group, visual deficits, pathological subtypes, extent of bone invasion, preoperative Karnofsky performance scale (KPS) score, and variation in perioperative KPS were identified as independent predictors of PFS. A nomogram to predict 3-year and 5-year PFS consisted of these factors, was well calibrated and had good discriminative ability (adjusted Harrell C statistic, 0.68). In the recurrent group, marginal resection (P = 0.018) and adjuvant radiotherapy (P = 0.043) were verified as protective factors associated with postrecurrent PFS. Factors for tumor progression demonstrated some differences between primary and recurrent cases. The nomogram appears useful for risk stratification of tumor progression in primary cases. Further studies will be necessary to identify the rapid-growth histopathological subtype as an independent predictor of rapid progression.

  16. [The Base of the Skull. Rudolf Virchow between Pathology and Anthropology].

    Science.gov (United States)

    Seemann, Sophie

    2016-01-01

    Throughout his scientific career, the pathologist and anthropologist Rudolf Virchow (1821-1902) examined countless skulls, gradually changing his perspective on this object of research. Initially, he was mainly concerned with pathologically deformed skulls. From the 1850s onwards, he gradually developed a more anthropological approach, and anthropology increasingly came to dominate his scientific interest. This article shows how different influences became central for the establishment of his specific and dynamic model of the human skull development and its successful application in anthropology. Crucial for this process were Virchow's collaboration with his teacher Robert Froriep (1804-1861) in the department of pathology of the Charité, his research on cretinism and rickets, as well as his description of the base of the skull as the center of skull development. His research work was attended by and showed a reciprocal interaction with the buildup of large skull collections. This article uses Virchow's original publications on skull pathology as well as his still preserved skull specimens from the collection of the Berlin Museum of Medical History at the Charité for an integrated text and object based analysis.

  17. [The Base of the Skull. Rudolf Virchow between Pathology and Anthropology].

    Science.gov (United States)

    Seemann, Sophie

    2016-01-01

    Throughout his scientific career, the pathologist and anthropologist Rudolf Virchow (1821-1902) examined countless skulls, gradually changing his perspective on this object of research. Initially, he was mainly concerned with pathologically deformed skulls. From the 1850s onwards, he gradually developed a more anthropological approach, and anthropology increasingly came to dominate his scientific interest. This article shows how different influences became central for the establishment of his specific and dynamic model of the human skull development and its successful application in anthropology. Crucial for this process were Virchow's collaboration with his teacher Robert Froriep (1804-1861) in the department of pathology of the Charité, his research on cretinism and rickets, as well as his description of the base of the skull as the center of skull development. His research work was attended by and showed a reciprocal interaction with the buildup of large skull collections. This article uses Virchow's original publications on skull pathology as well as his still preserved skull specimens from the collection of the Berlin Museum of Medical History at the Charité for an integrated text and object based analysis. PMID:27476256

  18. Quality of life following endonasal skull base surgery.

    Science.gov (United States)

    Pant, Harshita; Bhatki, Amol M; Snyderman, Carl H; Vescan, Allan D; Carrau, Ricardo L; Gardner, Paul; Prevedello, Daniel; Kassam, Amin B

    2010-01-01

    The importance of quality of life (QOL) outcomes following treatments for head and neck tumors are now increasingly appreciated and measured to improve medical and surgical care for these patients. An understanding of the definitions in the setting of health care and the use of appropriate QOL instruments and measures are critical to obtain meaningful information that guides decision making in various aspects of patient health care. QOL outcomes following cranial base surgery is only recently being defined. In this article, we describe the current published data on QOL outcomes following cranial base surgery and provide preliminary prospective data on QOL outcomes and sinonasal morbidity in patients who underwent endonasal cranial base surgery for management of various skull base tumors at our institution. We used a disease-specific multidimensional instrument to measure QOL outcomes in these patients. Our results show that although sinonasal morbidity is increased, this is temporary, and the vast majority of patients have a very good QOL by 4 to 6 months after endonasal approach to the cranial base. PMID:20592856

  19. Skull anatomy (image)

    Science.gov (United States)

    The skull is anterior to the spinal column and is the bony structure that encases the brain. Its purpose is to protect the brain and allow attachments for the facial muscles. The two regions of ... is the part of the skull that directly houses the brain and the ...

  20. Skull Base Aneurysmal Bone Cyst Presented with Foramen Jugular Syndrome and Multi-Osseous Involvement

    Directory of Open Access Journals (Sweden)

    Leila Aghaghazvini

    2012-01-01

    Full Text Available Aneurysmal bone cyst (ABC is an expansile bone lesion that usually involves the long bones. Skull base involvement is rare. Hereby, we describe a 17-year-old man with hoarseness, facial asymmetry, left sided sensorineural hearing loss and left jugular foramen syndrome. CT scan and MRI showed a skull base mass that was confirmed as ABC in histopathology. The case was unusual and interesting due to the clinical presentation of jugular foramen syndrome and radiological findings such as severe enhancement and multiosseous involvement.Keywords: Bone Cysts,Aneurysmal,Petrous Bone,Skull Base,Cranial Fossa,Posterior

  1. Juvenile nasopharyngeal angiofibroma with skull base invasion : intratumoral direct puncture embolization

    International Nuclear Information System (INIS)

    The purpose of this study is to demonstrate the utility and efficacy of percutaneous direct glue embolization for juvenile nasopharyngeal angiofibromas with skull base invasion. In nine cases of juvenile nasopharyngeal angiofibromas with invasion of the skull base, embolization under general anethesia was performed. Using an 18G spinal needle, direct puncture were made via the transnasal or mandibular sciatic notch. A glue-lipiodol mixture (1:1 -1:3) was injected slowly for 15 to 30 seconds under fluoroscopic control; the number of post-embolization angiography and the distribution of embolic materials was assessed on CT within 1-3 days. The mass was surgically removed 3 to 7 days after embolization. Direct glue embolization of juvenile angiofibroma with skull base invasion appears to be a simple and safe procedure. The technique could be used for other hypervascular lesions in the base of the skull or parapharyngeal space. (author). 19 refs., 1 tab., 2 figs

  2. Particle Beam Therapy for Cancer of the Skull Base, Nasal Cavity, and Paranasal Sinus

    OpenAIRE

    Fukumitsu, Nobuyoshi

    2012-01-01

    Particle beam therapy has been rapidly developed in these several decades. Proton and carbon ion beams are most frequently used in particle beam therapy. Proton and carbon ion beam radiotherapy have physical and biological advantage to the conventional photon radiotherapy. Cancers of the skull base, nasal cavity, and paranasal sinus are rare; however these diseases can receive the benefits of particle beam radiotherapy. This paper describes the clinical review of the cancer of the skull base,...

  3. Proton radiotherapy in management of pediatric base of skull tumors

    International Nuclear Information System (INIS)

    Purpose: Primary skull base tumors of the developing child are rare and present a formidable challenge to both surgeons and radiation oncologists. Gross total resection with negative margins is rarely achieved, and the risks of functional, structural, and cosmetic deficits limit the radiation dose using conventional radiation techniques. Twenty-nine children and adolescents treated with conformal proton radiotherapy (proton RT) were analyzed to assess treatment efficacy and safety. Methods and Materials: Between July 1992 and April 1999, 29 patients with mesenchymal tumors underwent fractionated proton (13 patients) or fractionated combined proton and photon (16 patients) irradiation. The age at treatment ranged from 1 to 19 years (median 12); 14 patients were male and 15 female. Tumors were grouped as malignant or benign. Twenty patients had malignant histologic findings, including chordoma (n=10), chondrosarcoma (n=3), rhabdomyosarcoma (n=4), and other sarcomas (n=3). Target doses ranged between 50.4 and 78.6 Gy/cobalt Gray equivalent (CGE), delivered at doses of 1.8-2.0 Gy/CGE per fraction. The benign histologic findings included giant cell tumors (n=6), angiofibromas (n=2), and chondroblastoma (n=1). RT doses for this group ranged from 45.0 to 71.8 Gy/CGE. Despite maximal surgical resection, 28 (97%) of 29 patients had gross disease at the time of proton RT. Follow-up after proton RT ranged from 13 to 92 months (mean 40). Results: Of the 20 patients with malignant tumors, 5 (25%) had local failure; 1 patient had failure in the surgical access route and 3 patients developed distant metastases. Seven patients had died of progressive disease at the time of analysis. Local tumor control was maintained in 6 (60%) of 10 patients with chordoma, 3 (100%) of 3 with chondrosarcoma, 4 (100%) of 4 with rhabdomyosarcoma, and 2 (66%) of 3 with other sarcomas. The actuarial 5-year local control and overall survival rate was 72% and 56%, respectively, and the overall survival

  4. WRN Cys1367Arg polymorphism is not associated with skull base chordoma

    Science.gov (United States)

    WANG, KE; WANG, LIANG; FENG, JIE; HAO, SHUYU; TIAN, KAIBING; WU, ZHEN; ZHANG, LIWEI; JIA, GUIJUN; WAN, HONG; ZHANG, JUNTING

    2014-01-01

    Skull base chordoma is a rare tumor with unknown risk factors. Werner syndrome, which is caused by a mutation in the WRN gene, is a disease of progeria, resembling the pathological process of aging. The present study aimed to provide data on the possible association between skull base chordoma and the single-nucleotide polymorphism (SNP) rs1346044 of the WRN gene. Between July, 2010 and September, 2012, a total of 65 patients with pathologically confirmed skull base chordoma and 65 control subjects were enrolled in this case-control study. The clinical data of the skull base chordoma patients were documented and the rs1346044 site in all the enrolled subjects was analyzed by sequencing and statistically compared using SPSS software. The A allele was the dominant allele of the rs1346044. The comparisons of genotype distributions and allele frequencies did not reveal any significant difference between the groups [P=0.383, 95% confidence interval (CI): 0.346–1.505]. The clinicopathological factors were assessed and no statistically significant difference was observed. In conclusion, the present study suggested that there is no association between rs1346044 SNP and skull base chordomas, at least in the population analyzed. PMID:24944800

  5. Development of skull fracture criterion based on real-world head trauma simulations using finite element head model.

    Science.gov (United States)

    Sahoo, Debasis; Deck, Caroline; Yoganandan, Narayan; Willinger, Rémy

    2016-04-01

    The objective of this study was to enhance an existing finite element (FE) head model with composite modeling and a new constitutive law for the skull. The response of the state-of-the-art FE head model was validated in the time domain using data from 15 temporo-parietal impact experiments, conducted with postmortem human surrogates. The new model predicted skull fractures observed in these tests. Further, 70 well-documented head trauma cases were reconstructed. The 15 experiments and 70 real-world head trauma cases were combined to derive skull fracture injury risk curves. The skull internal energy was found to be the best candidate to predict skull failure based on an in depth statistical analysis of different mechanical parameters (force, skull internal energy), head kinematic-based parameter, the head injury criterion (HIC), and skull fracture correlate (SFC). The proposed tolerance limit for 50% risk of skull fracture was associated with 453mJ of internal energy. Statistical analyses were extended for individual impact locations (frontal, occipital and temporo-parietal) and separate injury risk curves were obtained. The 50% risk of skull fracture for each location: frontal: 481mJ, occipital: 457mJ, temporo-parietal: 456mJ of skull internal energy.

  6. Cerebrospinal Fluid Diversion in Endoscopic Skull Base Reconstruction: An Evidence-Based Approach to the Use of Lumbar Drains.

    Science.gov (United States)

    Tien, Duc A; Stokken, Janalee K; Recinos, Pablo F; Woodard, Troy D; Sindwani, Raj

    2016-02-01

    Before the vascularized pedicled nasoseptal flap was popularized, lumbar drains (LDs) were routinely used for cerebral spinal fluid (CSF) diversion in endoscopic skull base reconstruction. LDs are not necessary in most CSF leaks encountered during skull base surgery. In this article, the use is considered of an LD in select high-risk settings in which a high-flow leak is anticipated and the patient has significant risk factors that make closure of the leak more challenging. Evidence for the use of LDs in preventing postoperative after endoscopic skull base reconstruction is reviewed and a rational framework for their use is proposed. PMID:26614832

  7. Endonasal Skull Base Tumor Removal Using Concentric Tube Continuum Robots: A Phantom Study.

    Science.gov (United States)

    Swaney, Philip J; Gilbert, Hunter B; Webster, Robert J; Russell, Paul T; Weaver, Kyle D

    2015-03-01

    Objectives The purpose of this study is to experimentally evaluate the use of concentric tube continuum robots in endonasal skull base tumor removal. This new type of surgical robot offers many advantages over existing straight and rigid surgical tools including added dexterity, the ability to scale movements, and the ability to rotate the end effector while leaving the robot fixed in space. In this study, a concentric tube continuum robot was used to remove simulated pituitary tumors from a skull phantom. Design The robot was teleoperated by experienced skull base surgeons to remove a phantom pituitary tumor within a skull. Percentage resection was measured by weight. Resection duration was timed. Setting Academic research laboratory. Main Outcome Measures Percentage removal of tumor material and procedure duration. Results Average removal percentage of 79.8 ± 5.9% and average time to complete procedure of 12.5 ± 4.1 minutes (n = 20). Conclusions The robotic system presented here for use in endonasal skull base surgery shows promise in improving the dexterity, tool motion, and end effector capabilities currently available with straight and rigid tools while remaining an effective tool for resecting the tumor. PMID:27054057

  8. Eosinophilic granuloma of the skull base: patient with unique clinical moreover, radiographic presentation.

    Directory of Open Access Journals (Sweden)

    Hosein Dalili

    2015-01-01

    Full Text Available This case report presents an eight-year-old girl having periauricular swelling and severe pain during mouth opening on the right-side temporomandibular joint (TMJ. CBCT showed extensive destruction of the base of the skull and the roof of the glenoid fossa on the right side. The findings based on CT and MRI images with and without contrast are discussed herein. This report highlights a skull base eosinophilic granuloma that mimics TMJ disorder and the importance of proper evaluation of CBCT images to make an early diagnosis.

  9. Nanofibrous Synthetic Dural Patch for Skull Base Defects: Preliminary Experience for Reconstruction after Extended Endonasal Approaches.

    Science.gov (United States)

    Zenga, Francesco; Tardivo, Valentina; Pacca, Paolo; Garzaro, Massimiliano; Garbossa, Diego; Ducati, Alessandro

    2016-03-01

    Setting One of the consequences of the widespread use of endoscopic endonasal approaches (EEA) to skull base pathologies is the management of complex skull base defects. Nowadays, the gold standard is a multilayer closure that reproduces the physiological tissue barriers. Several techniques have been described in the literature; however, skull base reconstruction after EEA still represents a matter of debate, especially after extended EEA. A watertight closure is paramount to prevent cerebrospinal fluid leak and meningitis. Design Regarding this issue, we present our experience with a new synthetic dural patch, ReDura (Medprin Biotech, La Mirada, California, United States), as a subdural inlay in three patients who underwent endoscopic endonasal removal of sellar and suprasellar lesions. Conclusions ReDura patch showed the same versatility of autologous iliotibial tract. A dural patch that easily adapts to all defects, revealed to be a useful tool for performing watertight closure, possibly in a short operative time, after endoscopic approaches.

  10. Nanofibrous Synthetic Dural Patch for Skull Base Defects: Preliminary Experience for Reconstruction after Extended Endonasal Approaches.

    Science.gov (United States)

    Zenga, Francesco; Tardivo, Valentina; Pacca, Paolo; Garzaro, Massimiliano; Garbossa, Diego; Ducati, Alessandro

    2016-03-01

    Setting One of the consequences of the widespread use of endoscopic endonasal approaches (EEA) to skull base pathologies is the management of complex skull base defects. Nowadays, the gold standard is a multilayer closure that reproduces the physiological tissue barriers. Several techniques have been described in the literature; however, skull base reconstruction after EEA still represents a matter of debate, especially after extended EEA. A watertight closure is paramount to prevent cerebrospinal fluid leak and meningitis. Design Regarding this issue, we present our experience with a new synthetic dural patch, ReDura (Medprin Biotech, La Mirada, California, United States), as a subdural inlay in three patients who underwent endoscopic endonasal removal of sellar and suprasellar lesions. Conclusions ReDura patch showed the same versatility of autologous iliotibial tract. A dural patch that easily adapts to all defects, revealed to be a useful tool for performing watertight closure, possibly in a short operative time, after endoscopic approaches. PMID:26937335

  11. Intraoperative Neurophysiological Monitoring for Endoscopic Endonasal Approaches to the Skull Base: A Technical Guide

    Directory of Open Access Journals (Sweden)

    Harminder Singh

    2016-01-01

    Full Text Available Intraoperative neurophysiological monitoring during endoscopic, endonasal approaches to the skull base is both feasible and safe. Numerous reports have recently emerged from the literature evaluating the efficacy of different neuromonitoring tests during endonasal procedures, making them relatively well-studied. The authors report on a comprehensive, multimodality approach to monitoring the functional integrity of at risk nervous system structures, including the cerebral cortex, brainstem, cranial nerves, corticospinal tract, corticobulbar tract, and the thalamocortical somatosensory system during endonasal surgery of the skull base. The modalities employed include electroencephalography, somatosensory evoked potentials, free-running and electrically triggered electromyography, transcranial electric motor evoked potentials, and auditory evoked potentials. Methodological considerations as well as benefits and limitations are discussed. The authors argue that, while individual modalities have their limitations, multimodality neuromonitoring provides a real-time, comprehensive assessment of nervous system function and allows for safer, more aggressive management of skull base tumors via the endonasal route.

  12. Readability analysis of internet-based patient information regarding skull base tumors.

    Science.gov (United States)

    Misra, Poonam; Kasabwala, Khushabu; Agarwal, Nitin; Eloy, Jean Anderson; Liu, James K

    2012-09-01

    Readability is an important consideration in assessing healthcare-related literature. In order for a source of information to be the most beneficial to patients, it should be written at a level appropriate for the audience. The National Institute of Health recommends that health literature be written at a maximum level of sixth grade. This is not uniformly found in current health literature, putting patients with lower reading levels at a disadvantage. In February 2012, healthcare-oriented education resources were retrieved from websites obtained using the Google search phrase skull base tumors. Of the first 25 consecutive, unique website hits, 18 websites were found to contain information for patients. Ten different assessment scales were utilized to assess the readability of the patient-specific web pages. Patient-oriented material found online for skull base tumors was written at a significantly higher level than the reading level of the average US patient. The average reading level of this material was found to be at a minimum of eleventh grade across all ten scales. Health related material related to skull base tumors available through the internet can be improved to reach a larger audience without sacrificing the necessary information. Revisions of this material can provide significant benefit for average patients and improve their health care. PMID:22810759

  13. Atypical post-adenoidectomy Grisel's syndrome in Crouzon child with kyphotic skull base.

    Science.gov (United States)

    Kourelis, Konstantinos; Haronis, Vasileios; Konandreas, Ioannis; Kontrafouri, Athina; Asimakopoulos, Athanasios

    2015-10-01

    Crouzon syndrome is characterized by abnormal craniofacial growth due to craniosynostosis. Skull base may also be involved in the pattern of malformations. Grisel's syndrome, an inflammation-mediated atlanto-axial instability occurs rarely in children after adenoidectomy. We report a 9-year-old female Crouzon patient, without vertebral anomalies, who developed severe torticollis few days after adenoid curettage. A deformity of the skull base alone might have induced an irregular arrangement of the craniocervical junction elements, thus increasing the susceptibility to cervical spine complications. PMID:25805067

  14. Skull base aneurysmal bone cyst presented with foramen jugular syndrome and multi-osseous involvement.

    Science.gov (United States)

    Aghaghazvini, Leila; Sedighi, Nahid; Karami, Parisa; Yeganeh, Omid

    2012-09-01

    Aneurysmal bone cyst (ABC) is an expansile bone lesion that usually involves the long bones. Skull base involvement is rare. Hereby, we describe a 17-year-old man with hoarseness, facial asymmetry, left sided sensorineural hearing loss and left jugular foramen syndrome. CT scan and MRI showed a skull base mass that was confirmed as ABC in histopathology. The case was unusual and interesting due to the clinical presentation of jugular foramen syndrome and radiological findings such as severe enhancement and multiosseous involvement.

  15. Skull-base Osteomyelitis: a Dreaded Complication after Trivial Fall and Inadequate Management

    Directory of Open Access Journals (Sweden)

    Kundan Mittal

    2015-10-01

    Full Text Available Introduction: Skull-based osteomyelitis is bony infection which generally originates from inadequately treated chronic infection, adjoining tissue infection or after trauma.Case: 11 month female child had a trivial fall while standing near a bucket. The child developed fracture of right clavicle and left orbital swelling which was inadequately treated. This resulted in in spread of infection to adjoining tissues, skull bones, sinuses and brain.Conclusion: Cranial base osteomyelitis is rare but dreaded condition which requires early diagnosis and prompt treatment to avoid mortality and morbidity in form of neurological deficits and permanent disability

  16. Surgical anatomy and utility of pedicled vascularized tissue flaps for multilayered repair of skull base defects.

    Science.gov (United States)

    Safavi-Abbasi, Sam; Komune, Noritaka; Archer, Jacob B; Sun, Hai; Theodore, Nicholas; James, Jeffrey; Little, Andrew S; Nakaji, Peter; Sughrue, Michael E; Rhoton, Albert L; Spetzler, Robert F

    2016-08-01

    OBJECT The objective of this study was to describe the surgical anatomy and technical nuances of various vascularized tissue flaps. METHODS The surgical anatomy of various tissue flaps and their vascular pedicles was studied in 5 colored silicone-injected anatomical specimens. Medical records were reviewed of 11 consecutive patients who underwent repair of extensive skull base defects with a combination of various vascularized flaps. RESULTS The supraorbital, supratrochlear, superficial temporal, greater auricular, and occipital arteries contribute to the vascular supply of the pericranium. The pericranial flap can be designed based on an axial blood supply. Laterally, various flaps are supplied by the deep or superficial temporal arteries. The nasoseptal flap is a vascular pedicled flap based on the nasoseptal artery. Patients with extensive skull base defects can undergo effective repair with dual flaps or triple flaps using these pedicled vascularized flaps. CONCLUSIONS Multiple pedicled flaps are available for reconstitution of the skull base. Knowledge of the surgical anatomy of these flaps is crucial for the skull base surgeon. These vascularized tissue flaps can be used effectively as single or combination flaps. Multilayered closure of cranial base defects with vascularized tissue can be used safely and may lead to excellent repair outcomes. PMID:26613175

  17. Fractionated external beam radiotherapy of skull base metastases with cranial nerve involvement

    Energy Technology Data Exchange (ETDEWEB)

    Droege, L.H.; Hinsche, T.; Hess, C.F.; Wolff, H.A. [University Hospital of Goettingen, Department of Radiotherapy and Radiation Oncology, Goettingen (Germany); Canis, M. [University of Goettingen, Department of Otorhinolaryngology, Head and Neck Surgery, Goettingen (Germany); Alt-Epping, B. [University of Goettingen, Department of Palliative Medicine, Goettingen (Germany)

    2014-02-15

    Skull base metastases frequently appear in a late stage of various tumor entities and cause pain and neurological disorders which strongly impair patient quality of life. This study retrospectively analyzed fractionated external beam radiotherapy (EBRT) as a palliative treatment approach with special respect to neurological outcome, feasibility and acute toxicity. A total of 30 patients with skull base metastases and cranial nerve disorders underwent EBRT with a mean total dose of 31.6 Gy. Neurological status was assessed before radiotherapy, during radiotherapy and 2 weeks afterwards categorizing orbital, parasellar, middle fossa, jugular foramen and occipital condyle involvement and associated clinical syndromes. Neurological outcome was scored as persistence of symptoms, partial response, good response and complete remission. Treatment-related toxicity and overall survival were assessed. Before EBRT 37 skull base involvement syndromes were determined with 4 patients showing more than 1 syndrome. Of the patients 81.1 % responded to radiotherapy with 10.8 % in complete remission, 48.6 % with good response and 21.6 % with partial response. Grade 1 toxicity of the skin occurred in two patients and grade 1 hematological toxicity in 1 patient under concurrent chemoradiotherapy. Median overall survival was 3.9 months with a median follow-up of 45 months. The use of EBRT for skull base metastases with symptomatic involvement of cranial nerves is marked by good therapeutic success in terms of neurological outcome, high feasibility and low toxicity rates. These findings underline EBRT as the standard therapeutic approach in the palliative setting. (orig.)

  18. Clinicopathological significance of p16, cyclin D1, Rb and MIB-1 levels in skull base chordoma and chondrosarcoma

    Institute of Scientific and Technical Information of China (English)

    Jun-qi Liu; Qiu-hang Zhang; Zhen-lin Wang

    2015-01-01

    Objective: To investigate the expression of p16, cyclin D1, retinoblastoma tumor suppressor protein (Rb) and MIB-1 in skull base chordoma and chondrosarcoma tissues, and to determine the clinicopathological significance of the above indexes in these diseases.Methods: A total of 100 skull base chordoma, 30 chondrosarcoma, and 20 normal cartilage tissue samples were analyzed by immunohistochemistry.The expression levels of p16, cyclinD1,Rb and MIB-1 proteins were assessed for potential correlation with the clinicopathological features.Results: As compared to normal cartilage specimen (control), there was decreased expression of p16, and increased expression of cyclin D1, Rb and MIB-1 proteins, in both skull base chordoma and chondrosarcoma specimens.MIB-1 LI levels were significantly increased in skull base chordoma specimens with negative expression of p16, and positive expression of cyclin D1 and Rb (P < 0.05).Significantly elevated MIB-1 LI was also detected in skull base chondrosarcoma tissues, while there was negative expression of p16, cyclin D1 and Rb (P < 0.05).In skull base chordoma, p16 negatively correlated with cyclin D1 and Rb, while cyclin D1 positively correlated with Rb.Additionally, p16, cyclin D1, Rb, or MIB-1 expression showed no correlation with age, gender, or pathological classification of patients with skull base chordoma (P > 0.05).However, p16 and MIB-1 levels correlated with the intradural invasion, and expression of p16, Rb and MIB-1 correlated with the number of tumor foci (P < 0.05).Further, the expression of p16 and MIB-1 appeared to correlate with the prognosis of patients with skull base chordoma.Conclusions: The abnormal expression of p16, cyclin D1 and Rb proteins might be associated with the tumorigenesis of skull base chordoma and chondrosarcoma.

  19. Skull Base Allergic Fungal Sinusitis with Abducens Palsy in the Third Trimester

    OpenAIRE

    Rassekh, Christopher H.; Kinsella, John B.; Calhoun, Karen H.; Maggio, William W.; Chaljub, Gregory; Gourley, William K.

    1996-01-01

    Allergic fungal sinusitis (AFS) usually follows a slow course, but bone erosion including that of the skull base can be seen. Patients may present with intracranial extension mimicking a cranial base neoplasm. We describe a 21-year-old pregnant female initially seen at 27 weeks gestation with a complete right sixth nerve paralysis. MR imaging showed an apparent nasopharyngeal neoplasm invading both temporal lobes. Further evaluation revealed typical findings of fungal sinusitis on both CT and...

  20. Arrested pneumatization of the sphenoid sinus mimicking intraosseous lesions of the skull base

    Energy Technology Data Exchange (ETDEWEB)

    Jalali, Elnaz; Tadinada, Aditya [Dept. of Oral and Maxillofacial Radiology, University of Connecticut School of Dental Medicine, Farmington (United States)

    2015-03-15

    Arrested pneumatization of the sphenoid sinus is a developmental variant that is not always well recognized and is often confused with other pathologies associated with the skull base. This report describes the case of a patient referred for cone-beam computed tomography (CBCT) imaging for dental implant therapy. CBCT demonstrated a well-defined incidental lesion in the left sphenoid sinus with soft tissue-like density and sclerotic borders with internal curvilinear opacifications. The differential diagnoses included intraosseous lipoma, arrested pneumatization of the sphenoid sinus, chondrosarcoma, chondroid chordoma, and ossifying fibroma. The radiographic diagnosis of arrested pneumatization was based on the location of the lesion, its well-defined nature, the presence of internal opacifications, and lack of expansion. Gray-scale CBCT imaging of the area demonstrated values similar to fatty tissue. This case highlighted the fact that benign developmental variants associated with the skull base share similar radiographic features with more serious pathological entities.

  1. Skull Practice.

    Science.gov (United States)

    Slesnick, Irwin L.

    1988-01-01

    Disguises a lesson about skulls with some fun to cause less fear among students. Outlines strategies, questions, and answers for use. Includes a skull mask which can be photocopied and distributed to students as a learning tool and a fun Halloween treat. Also shown is a picture of skull parts. (RT)

  2. Challenges in Linear Accelerator Radiotherapy for Chordomas and Chondrosarcomas of the Skull Base: Focus on Complications

    Energy Technology Data Exchange (ETDEWEB)

    Hauptman, Jason S., E-mail: jhauptman@mednet.ucla.edu [Division of Stereotactic and Functional Neurosurgery, Department of Neurosurgery, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA (United States); Barkhoudarian, Garni; Safaee, Michael; Gorgulho, Alessandra [Division of Stereotactic and Functional Neurosurgery, Department of Neurosurgery, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA (United States); Tenn, Steven; Agazaryan, Nzhde; Selch, Michael [Department of Radiation Oncology, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA (United States); De Salles, Antonio A.F. [Division of Stereotactic and Functional Neurosurgery, Department of Neurosurgery, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA (United States); Department of Radiation Oncology, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA (United States)

    2012-06-01

    Purpose: Intracranial chordomas and chondrosarcomas are histologically low-grade, locally invasive tumors that infiltrate the skull base. Currently, consensus therapy includes surgical resection and adjuvant radiotherapy. Radiation delivery is typically limited by the proximity of these tumors to critical skull base structures. Methods: This is a retrospective review of 13 cases of chordomas and 2 cases of chondroid chondrosarcomas of the skull based treated with linear accelerator stereotactic radiotherapy (SRT, n = 10) or stereotactic radiosurgery (SRS, n = 5). The average time to the most recent follow-up visit was 4.5 years. The tumor characteristics, treatment details, and outcomes were recorded. Each radiation plan was reviewed, and the dosage received by the brainstem, optic apparatus, and pituitary was calculated. Results: Of the 10 patients treated with SRT, 6 were found to have unchanged or decreased tumor size as determined from radiographic follow-up. Of the 5 patients treated with SRS, 3 were found to have stable or unchanged tumors at follow-up. The complications included 1 SRT patient who developed endocrinopathy, 2 patients (1 treated with SRS and the other with SRT), who developed cranial neuropathy, and 1 SRS patient who developed visual deficits. Additionally, 1 patient who received both SRS and SRT within 2 years for recurrence experienced transient medial temporal lobe radiation changes that resolved. Conclusions: Where proton beam therapy is unavailable, linear accelerator-based SRT or radiosurgery remains a safe option for adjuvant therapy of chordomas and chondrosarcomas of the skull base. The exposure of the optic apparatus, pituitary stalk, and brainstem must be considered during planning to minimize complications. If the optic apparatus is included in the 80% isodose line, it might be best to fractionate therapy. Exposure of the pituitary stalk should be kept to <30 Gy to minimize endocrine dysfunction. Brainstem exposure should be

  3. Challenges in Linear Accelerator Radiotherapy for Chordomas and Chondrosarcomas of the Skull Base: Focus on Complications

    International Nuclear Information System (INIS)

    Purpose: Intracranial chordomas and chondrosarcomas are histologically low-grade, locally invasive tumors that infiltrate the skull base. Currently, consensus therapy includes surgical resection and adjuvant radiotherapy. Radiation delivery is typically limited by the proximity of these tumors to critical skull base structures. Methods: This is a retrospective review of 13 cases of chordomas and 2 cases of chondroid chondrosarcomas of the skull based treated with linear accelerator stereotactic radiotherapy (SRT, n = 10) or stereotactic radiosurgery (SRS, n = 5). The average time to the most recent follow-up visit was 4.5 years. The tumor characteristics, treatment details, and outcomes were recorded. Each radiation plan was reviewed, and the dosage received by the brainstem, optic apparatus, and pituitary was calculated. Results: Of the 10 patients treated with SRT, 6 were found to have unchanged or decreased tumor size as determined from radiographic follow-up. Of the 5 patients treated with SRS, 3 were found to have stable or unchanged tumors at follow-up. The complications included 1 SRT patient who developed endocrinopathy, 2 patients (1 treated with SRS and the other with SRT), who developed cranial neuropathy, and 1 SRS patient who developed visual deficits. Additionally, 1 patient who received both SRS and SRT within 2 years for recurrence experienced transient medial temporal lobe radiation changes that resolved. Conclusions: Where proton beam therapy is unavailable, linear accelerator-based SRT or radiosurgery remains a safe option for adjuvant therapy of chordomas and chondrosarcomas of the skull base. The exposure of the optic apparatus, pituitary stalk, and brainstem must be considered during planning to minimize complications. If the optic apparatus is included in the 80% isodose line, it might be best to fractionate therapy. Exposure of the pituitary stalk should be kept to <30 Gy to minimize endocrine dysfunction. Brainstem exposure should be

  4. Synchronous metastatic skull base chordoma to the breast: case report and literature review

    Science.gov (United States)

    Shakir, S.I.; Pelmus, M.; Florea, A.; Boileau, J.F.; Guiot, M.C.; Di Maio, S.; Muanza, T.M.

    2016-01-01

    Clinical Scenario During routine staging work-up for a left breast mass, a 68-year-old woman complained of dysphagia and dysphonia. During further investigations, a left-sided lesion at the foramen magnum was observed on brain imaging. Both lesions were biopsied and showed a classical chordoma. Management The skull-base lesion and the breast lesion were surgically resected, and adjuvant radiotherapy was given. Summary Chordoma is a rare primary central nervous system tumour that seldom metastasizes. The lung is the most common site of metastasis. Synchronous breast metastasis from a skull-base chordoma is very rare, and a safe management option includes a maximum resection followed by adjuvant radiotherapy. PMID:27122985

  5. Role of Endoscopic Skull Base and Keyhole Surgery for Pituitary and Parasellar Tumors Impacting Vision.

    Science.gov (United States)

    Kelly, Daniel F; Griffiths, Chester F; Takasumi, Yuki; Rhee, John; Barkhoudarian, Garni; Krauss, Howard R

    2015-12-01

    Significant advances over the last 2 decades in imaging technology, instrumentation, anatomical knowledge, and reconstructive techniques have resulted in the endonasal endoscopic approach becoming an integral part of modern skull base surgery. With growing use and greater experience, surgical outcomes continue to incrementally improve across many skull base pathologies, including those tumors that impact vision and ocular motility. The importance of the learning curve and use of a multi-disciplinary approach is critical to maximizing success, minimizing complications, and enhancing quality of life in these patients. Realizing the limits of the endonasal route and reasonable use of transcranial approaches such as the supraorbital eyebrow craniotomy, it may br appropriate to consider nonsurgical therapy including various forms of radiotherapy [corrected] and medical treatment options. PMID:26576016

  6. Treatment of malignant tumors of the skull base with multi-session radiosurgery

    Directory of Open Access Journals (Sweden)

    Gagnon Gregory J

    2009-04-01

    Full Text Available Abstract Objective Malignant tumors that involve the skull base pose significant challenges to the clinician because of the proximity of critical neurovascular structures and limited effectiveness of surgical resection without major morbidity. The purpose of this study was to evaluate the efficacy and safety of multi-session radiosurgery in patients with malignancies of the skull base. Methods Clinical and radiographic data for 37 patients treated with image-guided, multi-session radiosurgery between January 2002 and December 2007 were reviewed retrospectively. Lesions were classified according to involvement with the bones of the base of the skull and proximity to the cranial nerves. Results Our cohort consisted of 37 patients. Six patients with follow-up periods less than four weeks were eliminated from statistical consideration, thus leaving the data from 31 patients to be analyzed. The median follow-up was 37 weeks. Ten patients (32% were alive at the end of the follow-up period. At last follow-up, or the time of death from systemic disease, tumor regression or stable local disease was observed in 23 lesions, representing an overall tumor control rate of 74%. For the remainder of lesions, the median time to progression was 24 weeks. The median progression-free survival was 230 weeks. The median overall survival was 39 weeks. In the absence of tumor progression, there were no cranial nerve, brainstem or vascular complications referable specifically to CyberKnife® radiosurgery. Conclusion Our experience suggests that multi-session radiosurgery for the treatment of malignant skull base tumors is comparable to other radiosurgical techniques in progression-free survival, local tumor control, and adverse effects.

  7. Teflon Granuloma of the Skull Base: A Complication of Endonasal Brain Surgery

    OpenAIRE

    Soose, Ryan J.; Snyderman, Carl H.; Amin B Kassam

    2007-01-01

    Teflon granuloma is an inflammatory giant-cell foreign-body reaction to polytetrafluoroethylene fibers or injection. Tissue augmentation with Teflon has dramatically declined over the past two decades because of its implication in granuloma formation. Nevertheless, Teflon felt is still commonly used in neurosurgical dissection and microvascular decompression. We report a patient with a Teflon granuloma of the skull base discovered 1.5 years after endonasal resection of an olfactory groove men...

  8. Teamwork in skull base surgery: An avenue for improvement in patient care

    OpenAIRE

    McLaughlin, Nancy; Ricardo L. Carrau; Daniel F. Kelly; Prevedello, Daniel M.; Kassam, Amin B.

    2013-01-01

    Background: During the past several decades, numerous centers have acquired significant expertise in the treatment of skull base pathologies. Favorable outcomes are not only due to meticulous surgical planning and execution, but they are also related to the collaborative efforts of multiple disciplines. We review the impact of teamwork on patient care, elaborate on the key processes for successful teamwork, and discuss its challenges. Methods: Pubmed and Medline databases were searched for pu...

  9. Extended Distance-based Phylogenetic Analyses Applied to 3D Homo Fossil Skull Evolution

    OpenAIRE

    Waddell, Peter J.

    2014-01-01

    This article shows how 3D geometric morphometric data can be analyzed using newly developed distance-based evolutionary tree inference methods, with extensions to planar graphs. Application of these methods to 3D representations of the skullcap (calvaria) of 13 diverse skulls in the genus Homo, ranging from Homo erectus (ergaster) at about 1.6 mya, all the way forward to modern humans, yields a remarkably clear phylogenetic tree. Various evolutionary hypotheses are tested. Results of these te...

  10. Proton and carbon ion radiotherapy for primary brain tumors and tumors of the skull base

    Energy Technology Data Exchange (ETDEWEB)

    Combs, Stephanie E.; Kessel, Kerstin; Habermehl, Daniel; Debus, Jurgen [Univ. Hospital of Heidelberg, Dept. of Radiation Oncology, Heidelberg (Germany)], e-mail: Stephanie.Combs@med.uni-heidelberg.de; Haberer, Thomas [Heidelberger Ionenstrahl Therapiezentrum (HIT), Heidelberg (Germany); Jaekel, Oliver [Univ. Hospital of Heidelberg, Dept. of Radiation Oncology, Heidelberg (Germany); Heidelberger Ionenstrahl Therapiezentrum (HIT), Heidelberg (Germany)

    2013-10-15

    To analyze clinical concepts, toxicity and treatment outcome in patients with brain and skull base tumors treated with photons and particle therapy. Material and methods: In total 260 patients with brain tumors and tumors of the skull base were treated at the Heidelberg Ion Therapy Center (HIT). Patients enrolled in and randomized within prospective clinical trials as well as bony or soft tissue tumors are not included in this analysis. Treatment was delivered as protons, carbon ions, or combinations of photons and a carbon ion boost. All patients are included in a tight follow-up program. The median follow-up time is 12 months (range 2-39 months). Results: Main histologies included meningioma (n = 107) for skull base lesions, pituitary adenomas (n = 14), low-grade gliomas (n = 51) as well as high-grade gliomas (n = 55) for brain tumors. In all patients treatment could be completed without any unexpected severe toxicities. No side effects > CTC Grade III were observed. To date, no severe late toxicities were observed, however, for endpoints such as secondary malignancies or neuro cognitive side effects follow-up time still remains too short. Local recurrences were mainly seen in the group of high-grade gliomas or atypical meningiomas; for benign skull base meningiomas, to date, no recurrences were observed during follow-up. Conclusion: The specific benefit of particle therapy will potentially reduce the risk of secondary malignancies as well as improve neuro cognitive outcome and quality of life (QOL); thus, longer follow-up will be necessary to confirm these endpoints. Indication-specific trials on meningiomas and gliomas are underway to elucidate the role of protons and carbon ions in these indications.

  11. Neurotization of oculomotor, trochlear and abducent nerves in skull base surgery

    Institute of Scientific and Technical Information of China (English)

    李世亭; 潘庆刚; 刘宁涛; 刘忠; 沈峰

    2003-01-01

    Objective To anatomically reconstruct the oculomotor nerve, trochlear nerve, and abducent nerve by skull base surgery. Methods Seventeen cranial nerves (three oculomotor nerves, eight trochlear nerves and six abducent nerves) were injured and anatomically reconstructed in thirteen skull base operations during a period from 1994 to 2000. Repair techniques included end-to-end neurosuture or fibrin glue adhesion, graft neurosuture or fibrin glue adhesion. The relationships between repair techniques and functional recovery and the related factors were analyzed.Results Functional recovery began from 3 to 8 months after surgery. During a follow-up period of 4 months to 6 years, complete recovery of function was observed in 6 trochlear nerves (75%) and 4 abducent nerves (67%), while partial functional recovery was observed in the other cranial nerves including 2 trochlear nerves, 2 abducent nerves, and 3 oculomotor nerves.Conclusions Complete or partial functional recovery could be expected after anatomical neurotization of an injured oculomotor, trochlear or abducent nerve. Our study demonstrated that, in terms of functional recovery, trochlear and abducent nerves are more responsive than oculomotor nerves, and that end-to-end reconstruction is more efficient than graft reconstruction. These results encourage us to perform reconstruction for a separated cranial nerve as often as possible during skull base surgery.

  12. [Endovascular management of skull base tumors. A practical review on literature].

    Science.gov (United States)

    Moscote-Salazar, Luis Rafael; Balderrama, Jorge; Alvis-Miranda, Hernando Raphael; Lee, Angel; Alcalá-Cerra, Gabriel

    2014-01-01

    Generally speaking, skull base tumors are very difficult-to-reach lesions. More or less, two thirds of those tumors correspond to meningiomas, which are highly vascular tumors. Tumors that are able to an embolization are juvenile nasopharyngeal angiofibromas, hemangiopericytomas, hemangioblastomas, meningiomas, metastatic lesions, paragangliomas, glomus tumors and other paragangliomas. Pre-operatory embolization of tumors arising in the skull base is a surgical strategy which allows to control probable hemorrhages secondary to the surgical resection of the tumor. The benefits of this sort of embolization have been partially demonstrated. However, there are concrete and objective results, as reduction in bleeding, time of surgery, post-operative hospital stay, and the use of blood transfusion; besides, another benefit reported is the lower morbimortality related to the surgical management of neural tissue and vascular structures. The aim of this article was to bring up to date the available information up to this moment, describe briefly the background of the pre-operative embolization of skull base tumors, and emphasize the knowledge related with the variables of this therapy, such as the types of hypervascular tumors, vascular anatomy related to this (according to type and position of the tumor), the types of embolization therapy in hypervascular tumors, as well as the materials that must be used. PMID:25078745

  13. The Brachyury Gly177Asp SNP Is not Associated with a Risk of Skull Base Chordoma in the Chinese Population

    Directory of Open Access Journals (Sweden)

    Zhen Wu

    2013-10-01

    Full Text Available A recent chordoma cancer genotyping study reveals that the rs2305089, a single nucleotide polymorphism (SNP located in brachyury gene and a key gene in the development of notochord, is significantly associated with chordoma risk. The brachyury gene is believed to be one of the key genes involved in the pathogenesis of chordoma, a rare primary bone tumor originating along the spinal column or at the base of the skull. The association between the brachyury Gly177Asp single nucleotide polymorphism (SNP and the risk of skull base chordoma in Chinese populations is currently unknown. We investigated the genotype distribution of this SNP in 65 skull-base chordoma cases and 120 healthy subjects. Comparisons of the genotype distributions and allele frequencies did not reveal any significant difference between the groups. Our data suggest that the brachyury Gly177Asp SNP is not involved in the risks of skull-base chordoma, at least in the Chinese population.

  14. Quality assurance of multiport image-guided minimally invasive surgery at the lateral skull base.

    Science.gov (United States)

    Nau-Hermes, Maria; Schmitt, Robert; Becker, Meike; El-Hakimi, Wissam; Hansen, Stefan; Klenzner, Thomas; Schipper, Jörg

    2014-01-01

    For multiport image-guided minimally invasive surgery at the lateral skull base a quality management is necessary to avoid the damage of closely spaced critical neurovascular structures. So far there is no standardized method applicable independently from the surgery. Therefore, we adapt a quality management method, the quality gates (QG), which is well established in, for example, the automotive industry and apply it to multiport image-guided minimally invasive surgery. QG divide a process into different sections. Passing between sections can only be achieved if previously defined requirements are fulfilled which secures the process chain. An interdisciplinary team of otosurgeons, computer scientists, and engineers has worked together to define the quality gates and the corresponding criteria that need to be fulfilled before passing each quality gate. In order to evaluate the defined QG and their criteria, the new surgery method was applied with a first prototype at a human skull cadaver model. We show that the QG method can ensure a safe multiport minimally invasive surgical process at the lateral skull base. Therewith, we present an approach towards the standardization of quality assurance of surgical processes. PMID:25105146

  15. Multimodal navigated skull base tumor resection using image-based vascular and cranial nerve segmentation: A prospective pilot study

    Directory of Open Access Journals (Sweden)

    Parviz Dolati

    2015-01-01

    Conclusion: Image-based preoperative vascular and neural element segmentation with 3D reconstruction is highly informative preoperatively and could increase the vigilance of neurosurgeons for preventing neurovascular injury during skull base surgeries. Additionally, the accuracy found in this study is superior to previously reported measurements. This novel preliminary study is encouraging for future validation with larger numbers of patients.

  16. Efficacy of navigation in skull base surgery using composite computer graphics of magnetic resonance and computed tomography images

    Energy Technology Data Exchange (ETDEWEB)

    Hayashi, Nakamasa; Kurimoto, Masanori; Hirashima, Yutaka; Ikeda, Hiroaki; Shibata, Takashi; Tomita, Takahiro; Endo, Shunro [Toyama Medical and Pharmaceutical Univ. (Japan)

    2001-07-01

    The efficacy of a neurosurgical navigation system using three-dimensional composite computer graphics (CGs) of magnetic resonance (MR) and computed tomography (CT) images was evaluated in skull base surgery. Three-point transformation was used for integration of MR and CT images. MR and CT image data were obtained with three skin markers placed on the patient's scalp. Volume-rendering manipulations of the data produced three-dimensional CGs of the scalp, brain, and lesions from the MR images, and the scalp and skull from the CT. Composite CGs of the scalp, skull, brain, and lesion were created by registering the three markers on the three-dimensional rendered scalp images obtained from MR imaging and CT in the system. This system was used for 14 patients with skull base lesions. Three-point transformation using three-dimensional CGs was easily performed for multimodal registration. Simulation of surgical procedures on composite CGs aided in comprehension of the skull base anatomy and selection of the optimal approaches. Intraoperative navigation aided in determination of actual spatial position in the skull base and the optimal trajectory to the tumor during surgical procedures. (author)

  17. The selection of methods and materials in skull base reconstruction%颅底重建方法及材料的选择

    Institute of Scientific and Technical Information of China (English)

    伊志强; 莫大鹏; 孔鲁; 李良; 张家涌; 张彦芳; 张建国; 鲍圣德

    2008-01-01

    Objectives To explore the necessity, principles, selection of methods and materials of skull base reconstruction. To improve the efficacy of skull base surgery and decrease the surgery related complications. Methods 14 cases (3 cases of anterior skull base reconstruction and 11 cases of lateral skull base and related middle cranial fossa reconstruction) of skull base reconstruction were retrospectively analyzed. Titanium was used to repair the bony defect in 3 cases. Results All the cases were followed-up more than six months. Cerebral spinal fluid leakage and intracranial infection occurred in 1 patient in 3 weeks after operation and was cured with Kamofsky score of 40 after six months. Facial nerve injury occurred in 1 case and recovered completely after two months. The postoperative courses were uneventful in the else 12 cases without any surgery related complications such as cerebral spinal fluid leakage, infection or necrosis of transferred tissue etc. Conclusions Skull base reconstruction is integral to the skull base surgery, and the duraplasty in watertight style is the paramount part of the reconstruction procedures. The selection of the optimal reconstruction method and materials according to the tissue, size and site of defect with concerning not only functions but also cosmetics, can improve the efficacy of skull base surgery and decrease the surgery related compliations.%目的 探讨颅底重建的必要性、原则及方法和材料的选择,提高颅底手术疗效,降低并发症.方法 回顾性分析14例颅底重建病例,其中前颅底重建3例,中颅窝及侧颅底重建11例,应用钛板修复颅底骨性缺损3例.结果 14例患者术后均随访6个月以上.1例于术后3周出现脑脊液漏、颅内感染,随访6个月时Karuofsky评分40分.1例出现面神经损伤,术后2个月痊愈.其余患者均未出现脑脊液漏、颅内外感染、移植皮瓣坏死等相关并发症.结论 颅底重建是颅底外科的重要部分,硬

  18. State-of-the-art treatment alternatives for base of skull meningiomas: complementing and controversial indications for neurosurgery, stereotactic and robotic based radiosurgery or modern fractionated radiation techniques

    International Nuclear Information System (INIS)

    For skull base meningiomas, several treatment paradigms are available: Observation with serial imaging, surgical resection, stereotactic radiosurgery, radiation therapy or some combination of both. The choice depends on several factors. In this review we evaluate different treatment options, the outcome of modern irradiation techniques as well as the clinical results available, and establish recommendations for the treatment of patients with skull-base meningiomas

  19. A Novel Augmented Reality Navigation System for Endoscopic Sinus and Skull Base Surgery: A Feasibility Study.

    Directory of Open Access Journals (Sweden)

    Liang Li

    Full Text Available To verify the reliability and clinical feasibility of a self-developed navigation system based on an augmented reality technique for endoscopic sinus and skull base surgery.In this study we performed a head phantom and cadaver experiment to determine the display effect and accuracy of our navigational system. We compared cadaver head-based simulated operations, the target registration error, operation time, and National Aeronautics and Space Administration Task Load Index scores of our navigation system to conventional navigation systems.The navigation system developed in this study has a novel display mode capable of fusing endoscopic images to three-dimensional (3-D virtual images. In the cadaver head experiment, the target registration error was 1.28 ± 0.45 mm, which met the accepted standards of a navigation system used for nasal endoscopic surgery. Compared with conventional navigation systems, the new system was more effective in terms of operation time and the mental workload of surgeons, which is especially important for less experienced surgeons.The self-developed augmented reality navigation system for endoscopic sinus and skull base surgery appears to have advantages that outweigh those of conventional navigation systems. We conclude that this navigational system will provide rhinologists with more intuitive and more detailed imaging information, thus reducing the judgment time and mental workload of surgeons when performing complex sinus and skull base surgeries. Ultimately, this new navigational system has potential to increase the quality of surgeries. In addition, the augmented reality navigational system could be of interest to junior doctors being trained in endoscopic techniques because it could speed up their learning. However, it should be noted that the navigation system serves as an adjunct to a surgeon's skills and knowledge, not as a substitute.

  20. The radiological and histopathological differential diagnosis of chordoid neoplasms in skull base

    Directory of Open Access Journals (Sweden)

    PAN Bin-cai

    2013-07-01

    Full Text Available Background Chordoid neoplasms refer to tumors appearing to have histological features of embryonic notochord, which is characterized by cords and lobules of neoplastic cells arranged within myxoid matrix. Because of radiological and histological similarities with myxoid matrix and overlapping immunohistochemical profile, chordoma, chordoid meningioma, chordoid glioma, and rare extraskeletal myxoid chondrosarcoma enter in the radiological and histological differential diagnosis at the site of skull base. However, there is always a great challenge for histopathologists to make an accurate diagnosis when encountering a chordoid neoplasm within or near the central nervous system. The aim of this study is to investigate and summarize the radiological, histological features and immunohistochemical profiles of chordoid neoplasms in skull base, and to find a judicious panel of immunostains to unquestionably help in diagnostically challenging cases. Methods A total of 23 cases of chordoid neoplasms in skull base, including 10 chordomas, 5 chordoid meningiomas, 3 chordoid gliomas and 5 extraskeletal myxoid chondrosarcomas, were collected from the First Affiliated Hospital, Sun Yat-sen University and Guangdong Tongjiang Hospital. MRI examination was performed on the patients before surgical treatment. Microscopical examination and immunohistochemical staining study using vimentin (Vim, pan-cytokeratin (PCK, epithelial membrane antigen (EMA, S?100 protein (S-100, glial fibrillary acidic protein (GFAP, D2-40, Galectin-3, CD3, CD20, Ki-67 were performed on the samples of cases. The clinicopathological data of the patients was also analyzed retrospectively. Results Most of chordomas were localized in the clivus with heterogeneous hyperintensity on T2WI scanning. The breakage of clivus was observed in most cases. Histologically, the tumor cells of chordoma exhibited bland nuclear features and some contained abundant vacuolated cytoplasm (the so

  1. Individual prefabricated titanium implants and titanium mesh in skull base reconstructive surgery. A report of cases.

    Science.gov (United States)

    Schipper, J; Ridder, G J; Spetzger, U; Teszler, C B; Fradis, M; Maier, W

    2004-05-01

    Titanium implants can be shaped by traditional hand forming, press shaping, modular construction by welding, construction on full-size models shaped from CT coordinates and, most recently, by computer-assisted design and computer-assisted manufacturing (CAD/CAM) that consist in the direct prefabrication of individual implants by milling them out of a solid block of titanium. The aim of our study was to present a set of preliminary cases of an ongoing program of reconstructive procedures of the skull base using titanium implants. The subjects underwent ablative procedures of the skull base with reconstruction either by titanium mesh or individual prefabricated CAD/CAM implants. Six patients have been operated on successfully since 2000: two received prefabricated CAD/CAM titanium plates and four others underwent reconstruction with titanium mesh. The stability of CAD/CAM plates is superior to that of mesh, thus it is more useful in reconstructing large lesions of the frontal skull base and the temporal and occipital bones. Titanium mesh was successfully used for defects smaller than 100 cm(2) or where selected viscerocranial defects are complicated in design and less reproducible by CAD/CAM. The intraoperative design, shaping and adjustment characteristic of titanium mesh can be dispensed with when CAD/CAM implants are used. The 3-D data set used in the CAD/CAM process also operates in the navigated simulation and planning of the ablation contours, the latter being of great assistance in establishing the optimal future defect. As a disadvantage, CAD/CAM technology is more expensive than titanium mesh, and the process is time-consuming as it is carried out in advance of surgery.

  2. Health-related quality of life in patients with skull base tumours.

    LENUS (Irish Health Repository)

    Kelleher, M O

    2012-02-03

    The objective of the investigation was to report on the health-related quality of life (HRQoL) of patients diagnosed with skull base tumours using the Short Form Health Survey questionnaire (SF-36). Those patients suffering with vestibular schwannoma were examined to determine the effect facial nerve function had on their quality of life. It took place at the tertiary referral centre at the Department of Clinical Neurosciences, Western General Hospital, Edinburgh. A prospective study of 70 consecutive patients was taken, who harboured the following tumours: 54 vestibular schwannomas, 13 meningiomas, two haemangioblastomas and one hypoglossal schwannoma. Patients were interviewed using the short form 36 (SF-36) questionnaire. Facial nerve function was assessed in those patients who had vestibular schwannomas. The entire cohort of live skull base patients were assessed after a median follow-up time of 38.4 months. Patients with vestibular schwannoma treated conservatively with interval MRI had a quality of life similar to t he normal population. Those who underwent surgery had a significant difference in two of the SF-36 domains. No statistically significant correlation was found at final assessment between the degree of facial nerve functioning and any of the domains of SF-36. Patients with non-vestibular tumours had an impaired HRQoL in seven of the eight domains. Patients with skull base tumours have a significant impairment of their HRQoL. A conservative policy of follow up with interval MRI for patients with small vestibular schwannomas may therefore be more appropriate to preserve their HRQoL. Facial nerve outcome has little influence on quality of life in vestibular schwannoma patients.

  3. Gorham-Stout Disease of the Skull Base With Hearing Loss: Dramatic Recovery and Antiangiogenic Therapy.

    Science.gov (United States)

    Nozawa, Akifumi; Ozeki, Michio; Kuze, Bunya; Asano, Takahiko; Matsuoka, Kentaro; Fukao, Toshiyuki

    2016-05-01

    Gorham-Stout disease (GSD) is a rare disorder of unknown etiology. We present a 6-year-old male with GSD involving the skull base who presented with recurrent cerebrospinal fluid (CSF) rhinorrhea, severe hearing loss, and facial palsy secondary to cerebellar herniation into the internal auditory canal. After 2 months of treatment with pegylated interferon (IFN) α-2b (50 μg/week), his hearing recovered dramatically. Two years later, new bone formation appeared radiologically and IFN was switched to sirolimus. One year after the switch, CSF rhinorrhea disappeared. Antiangiogenic therapy might inhibit proliferation of vascular endothelial cells in osteolytic lesions and lead to new bone formation.

  4. Detection of brain lesions at the skull base using diffusion-weighted imaging with readout-segmented echo-planar imaging and generalized autocalibrating partially parallel acquisitions

    Directory of Open Access Journals (Sweden)

    Xiao-Er Wei

    2011-01-01

    Full Text Available Objective: To analyze the value of readout-segmented echo-planar imaging (rs-EPI with parallel imaging and a two-dimensional (2D navigator-based reacquisition technique in the detection of brain lesions at the skull base. Materials and Methods: A total of 54 patients (male 37, female 17 with suspected skull-base intracranial lesions underwent magnetic resonance imaging (MRI, including pre-T1 weighted imaging, T2-weighted imaging, Fluid Attenuated Inversion Recovery (FLAIR, standard single shot echo-planar imaging diffusion weighted imaging (ss-EPI DWI and rs-EPI DWI, post-contrast T1-weighted. The total number of lesions and the number of lesions at different sites on all MRI sequences were used as reference measures. Then differences in detecting lesions and image quality between standard ss-EPI DWI and rs-EPI DWI were analyzed. Results: There was a significant difference in the total number of lesions detected by rs-EPI DWI and standard ss-EPI DWI (P = 0.01. But this difference was mainly due to an improved ability of rs-EPI DWI to detect lesions located in the anterior cranial fossa, compared to ss-EPI DWI (P=0.02; the ability of ss-EPI and rs-EPI DWI to detect lesions in the middle cranial fossa and posterior cranial fossa was not significantly different (P = 0.471, P = 0.486, respectively. For image quality, rs-EPI images were significantly better than standard ss-EPI DWI images (P<0.001. Conclusion: The rs-EPI DWI technique is a useful tool for the detection and evaluation of lesions located at the skull base.

  5. Applied Anatomy of the Neurovascular Structures of the Base of the Skull

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    Rosso, María Victoria

    2011-12-01

    Full Text Available Variations of the anatomy of the vascular system or various pathological processes like intracranial aneurysms could cause neurological symptoms, due to their proximity to cranial nerves. The aim of this study is to describe the link between vessels and cranial nerves, to associate with neurological clinic.24 anatomical pieces were used, 10 of them with repletion of the vascular tree with coloured latex and 12 skulls, observed with magnifying glasses, and through surgical microscope. Images database was used to elaborate this study. The neurovascular relations observed during the dissection including, in cephalocaudal sense, the followings:a. Optic nerve [II] with internal carotid artery and ophthalmic artery.b. Oculomotor nerve [III] with posterior cerebral artery, superior cerebellar artery and posterior communicating artery.c. Trochlear nerve [IV] with superior cerebellar artery.d. Trigeminal nerve [V] with superior cerebellar arterye. Facial nerve [VII] with anterior- inferior cerebellar artery.f. Glossopharyngeal nerve [IX] with posterior- inferior cerebellar artery.The close neurovascular links can explain various neurological manifestations and understand different neurosurgical approaches.The knowledge of the neurovascular relations provides students a useful tool to understand the clinic. In addition, it improves physicians’ daily practice.

  6. CT evaluation of Chamberlain's, McGregor's, and McRae's skull-base lines

    International Nuclear Information System (INIS)

    Aim: To evaluate the mean distance from the odontoid process of C2 to the standard skull-base lines (Chamberlain's, McGregor's, and McRae's lines) on computed tomography (CT) imaging. To compare these measurements to previously documented plain radiograph and magnetic resonance imaging (MRI) measurements. Materials and methods: Reformatted midline sagittal CT images of 150 adults were retrospectively evaluated. The shortest perpendicular distance was measured from the Chamberlain's, McGregor's and McRae's baselines for each subject to the odontoid tip. Statistical analysis was performed to compare the CT data with the previously obtained MRI and plain film data. Results: The mean position of the odontoid process was 1.4 mm below Chamberlain's line (median 1.2 mm, SD 2.4 mm), 0.8 mm (median 0.9 mm, SD 3 mm) below McGregor's line and 5 mm (median 5 mm, SD 1.8 mm) below McRae's line. There is no significant difference between male and female results (p > 0.05) or between these CT and previous MRI measurements (p > 0.05). Conclusion: These results provide the mean and range of normal distance from the odontoid process to the most frequently used skull-base lines on the current population on CT

  7. Trigemino-cardiac reflex during skull-base neurosurgeries: a case report

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Khajavi

    2013-11-01

    Full Text Available Background: The Trigemino-cardiac reflex (TCR has been studied as a phenomenon including; bradycardia, arterial hypotension, apnea and gastric hypermotility during manipulation of the peripheral or central parts of the trigeminal nerve.Case presentation: We report a case of a 26-year-old man undergoing surgery for a skull base extra axial tumor in right petrous bone suspected to metastasis of a previous renal cell carcinoma which had been treated four years ago. The patient presented with continuous and unilateral headache and difficulty in swallowing, sensory neural hearing loss, nasal speech and tongue deviation to left side. He underwent general anesthesia with standard monitoring and total intravenous anesthetic technique. The first episode of sudden onset bradycardia and hypotension related to surgical manipulation was detected intraoperatively in which the heart rate spontaneously returned to normal level once the surgical manipulation stopped. However, it repeated several times by beginning of tumor resection and manipulation in the region of trigeminal nerve. The intensity of bradycardia in subsequent episodes of TCR was relatively crescendo and had no fatigability. Finally, it was treated by administration of a single dose of atropine (0.5mg/IV and did not happen again.Conclusion: The risk of TCR should be considered in any neurosurgical intervention involving trigeminal nerve and its branches, especially at the skull base surgeries. The vigilance of the medical team and continuous intraoperative hemodynamic monitoring alerts the surgeons to interrupt surgical maneuvers upon the TCR occurrence, immediately.

  8. Role of MR imaging in evaluation of neoplastic lesions of the skull base

    International Nuclear Information System (INIS)

    Twenty-five patients with known neoplasms and clinical evidence of involvement of the skull base were evaluated by CT (General Electric 9800) and MR imaging (General Electric Signa, 1.5 T). The studies were evaluated independently for evidence and extent of the disease. Fourteen lesions were considered to be extensive and these were equally well demonstrated by both MR imaging and CT. MR imaging offered superior visualization of the relationship of the tumor mass to the vascular structures. In six patients, the CT scan was considered to show the extent of bone disease better than the MR image did. In five equivocal cases, all located with the sphenoid bone, MR images showed abnormal signal arising from the clivus. This was evident on T1-weighted images as decreased intensity of the clivus on the sagittal view indicating replacement of bone marrow. The authors' experience indicates that the majority of the lesions of the skull base are equally well evaluated by both modalities. However, MR imaging is superior in assessment of the lesions arising from the sphenoid bone

  9. Study on Effect of Vitamin D on Skull Growth of Children with Small Anterior Fontanel%维生素D对前囟门偏小儿童头颅生长的影响研究

    Institute of Scientific and Technical Information of China (English)

    任淑红

    2012-01-01

    目的 观察维生素D对前囟门偏小儿童头颅生长的影响. 方法 选择2009年3-8月诊治的于出生后第42 d健康体检婴儿115例作为观察对象,根据前囟门斜径长度分为两组,前囟门偏小组(≤1.5 crn)45例、前囟门正常组(1.5~2.5 cm)70例,均给予维生素D预防佝偻病,跟踪观察两组的前囟门闭合时间以及头围变化情况,组间结果进行比较分析. 结果 两组的前囟门闭合时间比较,差异有统计学意义(P<0.05);而两组在1、2、3岁时的头围比较,差异无统计学意义(P>0.05). 结论 维生素D对前囟门偏小儿童头颅生长无不良影响,无论前囟门大小均应服用维生素D进行佝偻病的预防.%Objective To observe the influence of vitamin D on the skull growth of children with small anterior fontanel. Methods One hundred and fifteen healthy infants aged 42 days hospitalized in the Children's Hospital of Baoding City from March to August in 2009 were selected as the objects of the study. They were divided into two groups according to the fontanelle inclined length, 45 cases of the small anterior fontanel group (≤1.5 cm) and 70 cases of the normal anterior fontanel group (1.5 -2.5 cm). All infants were treated with vitamin D to prevent rickets. We followed - up and observed the closure time of their anterior fontanels and the head circumferences at the ages of 1, 2 and 3 years, and the results were compared between the two groups. Results There were statistically significant differences in the closure time of the anterior fontanel between the two groups (P0.05). Conclusions Vitamin D has no adverse effect on the skull growth of children with small anterior fontanel. It is necessary to take vitamin D for rickets prevention whatever the size of anterior fontanel.

  10. Is orthopantomography reliable for TMJ diagnosis? An experimental study on a dry skull.

    Science.gov (United States)

    Ruf, S; Pancherz, H

    1995-01-01

    The accuracy of orthopantomography in reproducing the temporomandibular joint area was analyzed on a dry skull. The results based on this study of a single skull revealed that the radiographic image of the temporomandibular joint did not correspond to the anatomic condylar and fossa components or to their actual relationship. To a large extent, changes in skull position affected the radiographic temporomandibular joint image, simulating anterior condylar flattening, osteophytes, narrowing of joint space, and left/right condylar asymmetry. Orthopantomography may have questionable reliability for temporomandibular joint diagnostic purposes.

  11. A cone-beam CT based technique to augment the 3D virtual skull model with a detailed dental surface.

    Science.gov (United States)

    Swennen, G R J; Mommaerts, M Y; Abeloos, J; De Clercq, C; Lamoral, P; Neyt, N; Casselman, J; Schutyser, F

    2009-01-01

    Cone-beam computed tomography (CBCT) is used for maxillofacial imaging. 3D virtual planning of orthognathic and facial orthomorphic surgery requires detailed visualisation of the interocclusal relationship. This study aimed to introduce and evaluate the use of a double CBCT scan procedure with a modified wax bite wafer to augment the 3D virtual skull model with a detailed dental surface. The impressions of the dental arches and the wax bite wafer were scanned for ten patient separately using a high resolution standardized CBCT scanning protocol. Surface-based rigid registration using ICP (iterative closest points) was used to fit the virtual models on the wax bite wafer. Automatic rigid point-based registration of the wax bite wafer on the patient scan was performed to implement the digital virtual dental arches into the patient's skull model. Probability error histograms showed errors of 3D virtual augmented model of the skull with detailed dental surface.

  12. Atlas and feature based 3D pathway visualization enhancement for skull base pre-operative fast planning from head CT

    Science.gov (United States)

    Aghdasi, Nava; Li, Yangming; Berens, Angelique; Moe, Kris S.; Bly, Randall A.; Hannaford, Blake

    2015-03-01

    Minimally invasive neuroendoscopic surgery provides an alternative to open craniotomy for many skull base lesions. These techniques provides a great benefit to the patient through shorter ICU stays, decreased post-operative pain and quicker return to baseline function. However, density of critical neurovascular structures at the skull base makes planning for these procedures highly complex. Furthermore, additional surgical portals are often used to improve visualization and instrument access, which adds to the complexity of pre-operative planning. Surgical approach planning is currently limited and typically involves review of 2D axial, coronal, and sagittal CT and MRI images. In addition, skull base surgeons manually change the visualization effect to review all possible approaches to the target lesion and achieve an optimal surgical plan. This cumbersome process relies heavily on surgeon experience and it does not allow for 3D visualization. In this paper, we describe a rapid pre-operative planning system for skull base surgery using the following two novel concepts: importance-based highlight and mobile portal. With this innovation, critical areas in the 3D CT model are highlighted based on segmentation results. Mobile portals allow surgeons to review multiple potential entry portals in real-time with improved visualization of critical structures located inside the pathway. To achieve this we used the following methods: (1) novel bone-only atlases were manually generated, (2) orbits and the center of the skull serve as features to quickly pre-align the patient's scan with the atlas, (3) deformable registration technique was used for fine alignment, (4) surgical importance was assigned to each voxel according to a surgical dictionary, and (5) pre-defined transfer function was applied to the processed data to highlight important structures. The proposed idea was fully implemented as independent planning software and additional data are used for verification and

  13. Properties and architecture of the sperm whale skull amphitheatre.

    Science.gov (United States)

    Alam, Parvez; Amini, Shahrouz; Tadayon, Maryam; Miserez, Ali; Chinsamy, Anusuya

    2016-02-01

    The sperm whale skull amphitheatre cradles an enormous two-tonne spermaceti organ. The amphitheatre separates this organ from the cranium and the cervical vertebrae that lie in close proximity to the base of the skull. Here, we elucidate that this skull amphitheatre is an elastic, flexible, triple-layered structure with mechanical properties that are conjointly guided by bone histology and the characteristics of pore space. We contend that the amphitheatre will flex elastically to equilibrate forces transmitted via the spermaceti organ that arise through diving. We find that collisions from sperm whale aggression do not cause the amphitheatre to bend, but rather localise stress to the base of the amphitheatre on its anterior face. We consider, therefore, that the uniquely thin and extended construction of the amphitheatre, has relevance as an energy absorptive structure in diving.

  14. Systemic therapy for selected skull base sarcomas: Chondrosarcoma, chordoma, giant cell tumour and solitary fibrous tumour/hemangiopericytoma.

    Science.gov (United States)

    Colia, Vittoria; Provenzano, Salvatore; Hindi, Nadia; Casali, Paolo G; Stacchiotti, Silvia

    2016-01-01

    This review highlights the data currently available on the activity of systemic therapy in chondrosarcoma, chordoma, giant cell tumour of the bone (GCTB) and solitary fibrous tumour, i.e., four rare sarcomas amongst mesenchymal malignancy arising from the skull base.

  15. Meningitis caused by Enterococcus casseliflavus with refractory cerebrospinai fluid leakage following endoscopic endonasal removal of skull base chondrosarcoma

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    To the Editor:Meningitis caused by Enterococcus casseliflavus (E.casseliflavus) is extremely rare.Here we report an unusual case of meningitis caused by E.casseliflavus coexisting with refractory cerebrospinal fluid (CSF) leakage following endoscopic endonasal resection of skull base chondrosarcoma.

  16. Systemic therapy for selected skull base sarcomas: Chondrosarcoma, chordoma, giant cell tumour and solitary fibrous tumour/hemangiopericytoma.

    Science.gov (United States)

    Colia, Vittoria; Provenzano, Salvatore; Hindi, Nadia; Casali, Paolo G; Stacchiotti, Silvia

    2016-01-01

    This review highlights the data currently available on the activity of systemic therapy in chondrosarcoma, chordoma, giant cell tumour of the bone (GCTB) and solitary fibrous tumour, i.e., four rare sarcomas amongst mesenchymal malignancy arising from the skull base. PMID:27330421

  17. Trautmann's triangle anatomy with application to posterior transpetrosal and other related skull base procedures.

    Science.gov (United States)

    Tubbs, R Shane; Griessenauer, Christoph; Loukas, Marios; Ansari, Shaheryar F; Fritsch, Michael H; Cohen-Gadol, Aaron A

    2014-10-01

    Trautmann's triangle (TT) faces the cerebellopontine angle and is exposed during posterior transpetrosal approaches. However, reports on the morphometric analysis of this structure are lacking in the literature. The goal was to better understand this important operative corridor. TT was exposed from an external approach (transmastoid) in ten cadavers (20 sides) and from an internal approach on 20 dry adult temporal bones. Measurements included calculation of the area of TT and the distance of the endolymphatic sac from the anterior border of the sigmoid sinus. The area range of TT was 45-210 mm(2) (mean 151 mm(2); SD 37 mm(2)). Three types of triangles were identified based on area. Type I triangles had areas less than 75 mm(2), Type II areas were 75-149 mm(2), and Type III areas were 150 mm(2) and greater. These types were observed in 37.5%, 35%, and 27.5% of sides, respectively. The distance from the jugular bulb's anterior border to the posterior border of the posterior semicircular canal ranged from 6 to 11 mm (mean 8.5 mm). The endolymphatic sac was located in the inferior portion of TT and traveled anterior to the sigmoid sinus. The horizontal distance from the anterior edge of the sigmoid sinus to the posterior edge of the endolymphatic sac ranged from 0 to 13.5 mm (mean 9 mm). Additional anatomic knowledge regarding TT may improve neurosurgical procedures in this region by avoiding intrusion into the endolymphatic sac and sigmoid sinus.

  18. Primary step for endoscopic sinonasal tract and anterior skull base robotics

    OpenAIRE

    Crampette Louis; Garrel Renaud; Herman Benoît; Tempier Olivier; Poignet Philippe; Sobral Rafaël; Dombre Etienne; Trévillot Vincent

    2011-01-01

    Introduction: Surgeons have evolved a lot their surgical procedures in sinus surgery and are now able to resect malignant tumors. These progresses are now leading new difficulties like impairing vision (bleeding and LCR flow) and necessity of multiple simultaneous tasks. With the aim of designing a new endoscope-holder, primary step was to characterize the surgeon gesture, the kinematics, and the type of man-machine interface acceptable by the surgeon. Methods: We worked on thirteen sinonasal...

  19. Primary step for endoscopic sinonasal tract and anterior skull base robotics

    OpenAIRE

    Trévillot, Vincent; Dombre, Etienne; Poignet, Philippe; Sobral, Rafaël; Tempier, Olivier; Herman, Benoît; Garrel, Renaud; Crampette, Louis; The International Conference of the European SKILLS Project

    2011-01-01

    Introduction: Surgeons have evolved a lot their surgical procedures in sinus surgery and are now able to resect malignant tumors. These progresses are now leading new difficulties like impairing vision (bleeding and LCR flow) and necessity of multiple simultaneous tasks. With the aim of designing a new endoscope-holder, primary step was to characterize the surgeon gesture, the kinematics, and the type of man-machine interface acceptable by the surgeon. Methods: We worked on thirteen sinona...

  20. Effect of skull flexural properties on brain response during dynamic head loading - biomed 2013.

    Science.gov (United States)

    Harrigan, T P; Roberts, J C; Ward, E E; Carneal, C M; Merkle, A C

    2013-01-01

    The skull-brain complex is typically modeled as an integrated structure, similar to a fluid-filled shell. Under dynamic loads, the interaction of the skull and the underlying brain, cerebrospinal fluid, and other tissue produces the pressure and strain histories that are the basis for many theories meant to describe the genesis of traumatic brain injury. In addition, local bone strains are of interest for predicting skull fracture in blunt trauma. However, the role of skull flexure in the intracranial pressure response to blunt trauma is complex. Since the relative time scales for pressure and flexural wave transmission across the skull are not easily separated, it is difficult to separate out the relative roles of the mechanical components in this system. This study uses a finite element model of the head, which is validated for pressure transmission to the brain, to assess the influence of skull table flexural stiffness on pressure in the brain and on strain within the skull. In a Human Head Finite Element Model, the skull component was modified by attaching shell elements to the inner and outer surfaces of the existing solid elements that modeled the skull. The shell elements were given the properties of bone, and the existing solid elements were decreased so that the overall stiffness along the surface of the skull was unchanged, but the skull table bending stiffness increased by a factor of 2.4. Blunt impact loads were applied to the frontal bone centrally, using LS-Dyna. The intracranial pressure predictions and the strain predictions in the skull were compared for models with and without surface shell elements, showing that the pressures in the mid-anterior and mid-posterior of the brain were very similar, but the strains in the skull under the loads and adjacent to the loads were decreased 15% with stiffer flexural properties. Pressure equilibration to nearly hydrostatic distributions occurred, indicating that the important frequency components for typical

  1. Automatic Sex Determination of Skulls Based on a Statistical Shape Model

    Directory of Open Access Journals (Sweden)

    Li Luo

    2013-01-01

    Full Text Available Sex determination from skeletons is an important research subject in forensic medicine. Previous skeletal sex assessments are through subjective visual analysis by anthropologists or metric analysis of sexually dimorphic features. In this work, we present an automatic sex determination method for 3D digital skulls, in which a statistical shape model for skulls is constructed, which projects the high-dimensional skull data into a low-dimensional shape space, and Fisher discriminant analysis is used to classify skulls in the shape space. This method combines the advantages of metrical and morphological methods. It is easy to use without professional qualification and tedious manual measurement. With a group of Chinese skulls including 127 males and 81 females, we choose 92 males and 58 females to establish the discriminant model and validate the model with the other skulls. The correct rate is 95.7% and 91.4% for females and males, respectively. Leave-one-out test also shows that the method has a high accuracy.

  2. Active raster scanning with carbon ions. Reirradiation in patients with recurrent skull base chordomas and chondrosarcomas

    Energy Technology Data Exchange (ETDEWEB)

    Uhl, Matthias; Welzel, Thomas; Oelmann, Jan; Habl, Gregor; Hauswald, Henrik; Jensen, Alexandra; Debus, Juergen; Herfarth, Klaus [University of Heidelberg, Department of Radiation Oncology, Heidelberg (Germany); Ellerbrock, Malte [Heidelberg Ion Therapy Center (HIT), Heidelberg (Germany)

    2014-07-15

    To evaluate the safety and efficacy of reirradiation with carbon ions in patients with relapse of skull base chordoma and chondrosarcoma. Reirradiation with carbon ions was performed on 25 patients with locally recurrent skull base chordoma (n = 20) or chondrosarcoma (n = 5). The median time between the last radiation exposure and the reirradiation with carbon ions was 7 years. In the past, 23 patients had been irradiated once, two patients twice. Reirradiation was delivered using the active raster scanning method. The total median dose was 51.0 GyE carbon ions in a weekly regimen of five to six fractions of 3 GyE. Local progression-free survival (LPFS) was evaluated using the Kaplan-Meier method; toxicity was evaluated using the NCI Common Terminology Criteria for Adverse Events (CTCAE v.4.03). The treatment could be finished in all patients without interruption. In 80 % of patients, symptom control was achieved after therapy. The 2-year-LPFS probability was 79.3 %. A PTV volume of < 100 ml or a total dose of > 51 GyE was associated with a superior local control rate. The therapy was associated with low acute toxicity. One patient developed grade 2 mucositis during therapy. Furthermore, 12 % of patients had tympanic effusion with mild hypacusis (grade 2), while 20 % developed an asymptomatic temporal lobe reaction after treatment (grade 1). Only one patient showed a grade 3 osteoradionecrosis. Reirradiation with carbon ions is a safe and effective method in patients with relapsed chordoma and chondrosarcoma of the skull base. (orig.) [German] Evaluierung der Sicherheit und Wirksamkeit einer Re-Bestrahlung mittels Kohlenstoffionen bei Patienten mit Lokalrezidiv eines Chordoms und Chondrosarkoms der Schaedelbasis. Bei 25 Patienten mit einem Lokalrezidiv eines Chordoms (n = 20) oder Chondrosarkoms (n = 5) der Schaedelbasis erfolgte eine Re-Bestrahlung mittels Kohlenstoffionen. Die mediane Zeit zwischen letzter Bestrahlung und Re-Bestrahlung mit Kohlenstoffionen

  3. Anterior ethmoidal artery emerging anterior to bulla ethmoidalis: An abnormal anatomical variation in Waardenburg's syndrome

    OpenAIRE

    Wong, Danny K. C.; Shao, Angus; Campbell, Raewyn; Douglas, Richard

    2014-01-01

    In endoscopic sinus surgery, the anterior ethmoidal artery (AEA) is usually identified as it traverses obliquely across the fovea ethmoidalis, posterior to the bulla ethmoidalis and anterior to or within the ground lamella's attachment to the skull base. Injury to the AEA may result in hemorrhage, retraction of the AEA into the orbit, and a retrobulbar hematoma. The resulting increase in intraorbital pressure may threaten vision. Waardenburg's syndrome (WS) is a rare congenital, autosomal dom...

  4. 显微手术切除颅底沟通性脊索瘤%Microsurgical treatment of communicative skull base chordoma

    Institute of Scientific and Technical Information of China (English)

    魏伟; 刘兵; 孙庚林

    2009-01-01

    Objective To investigate the appropriate surgical approaches and microsurgical resection of communicative skull base chordoma. Methods Twenty two cases of communicative skull base chordomas were microsurgically treated from 1995 to 2005 and followed up. The tumors were removed with extended anterior skull base approach in eight cases, with modified Weber-Ferguson (transmaxillary) approach in eight cases, and with transmandibular approach in six cases. Some cases were resected with combined approaches including pterional approach in 3 eases, subtemporal-zygomatie approach in 1 case, and suboccipital-retromastoid approach in 2 cases. Results Total, subtotal and partial removal of the tumors were achieved in 10 cases, 7 and 5 cases respectively. No patients died and had severe nervous system dysfunction after surgery. However, one had CSF rhinorrhea, one with infection, three with cranial never dysfunction. Twenty patients were followed-up with average 3.4 years, 12 returned to normal or partial works, 5 took care by oneself, 1 needed help, 2 died from tumor recurrence. Conclusion The treatment of communicative skull base chordoma is a challenge to neurosurgeon. The key point is the total removal of the tumor with the microsurgical technique and the appropriate approach depend on the location of the tumor. Moreover, skull base reconstruction is also important to avoid the cerebrospinal fluid leak and infection.%目的 探讨不同颅面入路治疗颅底沟通性脊索瘤的入路选择和显微手术方法.方法 手术治疗并经病理证实的颅底沟通性脊索瘤22例.采用颅面入路或联合入路显微手术切除,包括扩大的前颅底入路8例,改良Weber-Ferguson入路8例,下颌入路6例.其中部分向颅内生长明显的沟通性肿瘤,联合经颅手术,包括翼点入路3例,颞颧入路1例,枕下乙状窦后入路2例.对患者预后进行长期随访.结果 肿瘤全切除10例,次全切除7例,大部切除4例,部分切除1例.肿

  5. Radiosurgery for skull base meningiomas: a study on 230 cases in Iranian Gamma Knife Center

    Directory of Open Access Journals (Sweden)

    Ali Bitara M

    2010-06-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Meningiomas are among the most common tumors of the brain. Skull base meningiomas comprise s major part of brain meningiomas. They are difficult to treat because of proximity to major vital neuro-vascular structures which makes their surgical resection hazardous and fraught with a high rate of complications. Radiosurgery is considered as an alternative efficient way to treat them, which targets the tumor and its supplying vasculature. The standard treatment consists of tumor eradication and its supplying vessels through homogeneous dose of 201 rays of cobalt 60 source."n"nMethods: In a case-series study, we report 230 meningiomas referred to Iraninan Gamma Knife Center, treated by radiosurgery with type C Gamma Knife. Radio-surgery was performed at a mean dose of 15 Gy and 50% isodose."n"nResults: Two hundred and thirty of all meningioma cases refered to our institute were skull base lesions. Eighty (35% were new case and the rest were previously treated microsurgically one or more times. None of the patients died after treatment and the most common post-operative complications were headache (30 patients and peri-tumoral edema (12 patients."n"nConclusion: Tumoral control is defined as reduced tumor volume

  6. Dose–Volume Relationships Associated With Temporal Lobe Radiation Necrosis After Skull Base Proton Beam Therapy

    Energy Technology Data Exchange (ETDEWEB)

    McDonald, Mark W., E-mail: markmcdonaldmd@gmail.com [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana (United States); Indiana University Health Proton Therapy Center, Bloomington, Indiana (United States); Linton, Okechukwu R. [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana (United States); Calley, Cynthia S.J. [Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana (United States)

    2015-02-01

    Purpose: We evaluated patient and treatment parameters correlated with development of temporal lobe radiation necrosis. Methods and Materials: This was a retrospective analysis of a cohort of 66 patients treated for skull base chordoma, chondrosarcoma, adenoid cystic carcinoma, or sinonasal malignancies between 2005 and 2012, who had at least 6 months of clinical and radiographic follow-up. The median radiation dose was 75.6 Gy (relative biological effectiveness [RBE]). Analyzed factors included gender, age, hypertension, diabetes, smoking status, use of chemotherapy, and the absolute dose:volume data for both the right and left temporal lobes, considered separately. A generalized estimating equation (GEE) regression analysis evaluated potential predictors of radiation necrosis, and the median effective concentration (EC50) model estimated dose–volume parameters associated with radiation necrosis. Results: Median follow-up time was 31 months (range 6-96 months) and was 34 months in patients who were alive. The Kaplan-Meier estimate of overall survival at 3 years was 84.9%. The 3-year estimate of any grade temporal lobe radiation necrosis was 12.4%, and for grade 2 or higher radiation necrosis was 5.7%. On multivariate GEE, only dose–volume relationships were associated with the risk of radiation necrosis. In the EC50 model, all dose levels from 10 to 70 Gy (RBE) were highly correlated with radiation necrosis, with a 15% 3-year risk of any-grade temporal lobe radiation necrosis when the absolute volume of a temporal lobe receiving 60 Gy (RBE) (aV60) exceeded 5.5 cm{sup 3}, or aV70 > 1.7 cm{sup 3}. Conclusions: Dose–volume parameters are highly correlated with the risk of developing temporal lobe radiation necrosis. In this study the risk of radiation necrosis increased sharply when the temporal lobe aV60 exceeded 5.5 cm{sup 3} or aV70 > 1.7 cm{sup 3}. Treatment planning goals should include constraints on the volume of temporal lobes receiving

  7. Radiation-Induced Middle Ear and Mastoid Opacification in Skull Base Tumors Treated With Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Walker, Gary V. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Ahmed, Salmaan [Department of Radiology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Allen, Pamela [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Gidley, Paul W. [Department of Head and Neck Surgery, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Woo, Shiao Y. [Department of Radiation Oncology, University of Louisville, Louisville, KY (United States); DeMonte, Franco [Department of Neurosurgery, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Chang, Eric L. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Mahajan, Anita, E-mail: amahajan@mdanderson.org [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)

    2011-12-01

    Purpose: To assess the incidence of middle ear (ME) pathology in patients treated with radiotherapy (RT) for skull base tumors. Methods and Materials: A retrospective analysis of 61 patients treated with RT between 2003 and 2008 for skull base tumors was conducted. Clinical outcomes and demographics were reviewed. Dose-volume histogram analysis was performed on the eustachian canal (EC), ME, mastoid air cells, vestibular apparatus, cochlea, internal auditory canal, lateral and posterior nasopharynx, and temporal lobes to relate doses to symptoms and radiographic change. Otomastoid opacification was rated 0 (none), 1 (mild), 2 (moderate), and 3 (severe) by a neuroradiologist blinded to clinical outcomes and doses. Results: The median prescribed dose was 50.4 Gy (range, 14-74 Gy). The ME mean dose was 14 Gy and 34 Gy for Grade 0-1 and 2-3 opacification, respectively (p < 0.0001). The mean mastoid dose was 10 Gy and 26 Gy for Grade 0-1 and 2-3, respectively (p < 0.0001). The mean EC dose was 17 Gy and 32 Gy for Grade 0-1 and 2-3, respectively (p = 0.0001). Otomastoid opacification resolved in 17 of 40 patients (42.5%), at a mean of 17 months after RT (range, 2-45 months). Otomastoid opacification persisted in 23 of 40 patients (57.5%), with a mean follow-up of 23 months (range, 2-55 months). Multivariate analysis showed that mastoid dose >30 Gy (odds ratio = 28.0, p < 0.001) and posterior nasopharynx dose of >30 Gy (odds ratio = 4.9, p = 0.009) were associated with Grade 2-3 effusions, whereas other factors including dose to EC and ME were not significant. Conclusions: A mean RT dose >30 Gy to the mastoid air cells or posterior nasopharynx is associated with increased risk of moderate to severe otomastoid opacification, which persisted in more than half of patients at 2-year follow-up.

  8. Comparison of Scientific Calipers and Computer-Enabled CT Review for the Measurement of Skull Base and Craniomaxillofacial Dimensions

    OpenAIRE

    Citardi, Martin J; Herrmann, Brian; Hollenbeak, Chris S.; Stack, Brendan C.; Cooper, Margaret; Bucholz, Richard D.

    2001-01-01

    Traditionally, cadaveric studies and plain-film cephalometrics provided information about craniomaxillofacial proportions and measurements; however, advances in computer technology now permit software-based review of computed tomography (CT)-based models. Distances between standardized anatomic points were measured on five dried human skulls with standard scientific calipers (Geneva Gauge, Albany, NY) and through computer workstation (StealthStation 2.6.4, Medtronic Surgical Navigation Techno...

  9. A skull-based multiple dipole phantom for EEG and MEG studies

    Energy Technology Data Exchange (ETDEWEB)

    Spencer, M.E.; Leahy, R.M. [University of Southern California, Los Angeles, CA (United States); Mosher, J.C. [Los Alamos National Lab., NM (United States)

    1996-07-01

    A versatile phantom for use in evaluating forward and inverse methods for MEG and EEG has been designed and is currently being constructed. The phantom consists of three major components: (i) a 32-element cur- rent dipole array, (ii) a PC-controlled dipole driver with 32 isolated channels allowing independent control of each dipole, (iii) spherical and human-skull mounts in which the dipole array is placed. Materials were selected throughout the phantom to produce minimal field distortions and artifacts to enable acquisition of high quality EEG and MEG data. The dipoles are made from a rigid narrow (0.84 mm) stainless steel coax cable. The dipole drivers can be configured as either current or voltage sources, are independently programmable and fully isolated, and are capable of producing arbitrary bipolar waveforms up to a 200 Hz bandwidth. The spherical mount is a single shell sphere filled with conductive gelatin. The human skull mount has three shells: ``brain`` (conducting gelatin), ``skull`` (the skull is impregnated with a low conductivity conducting gelatin), and ``scalp`` (a thin layer of rubber latex mixed with NaCl to achieve a conductivity matched to the brain). The conductivities will be adjusted to achieve approximately an 80:1:80 ratio. Data collected to date from the spherical phantom shows excellent agreement between measured surface potentials and that predicted from theory (27 of the 32 dipoles give better than 99.9% rms fit) and negligible leakage between dipoles. We are currently completing construction of the skull mount.

  10. Chordoma versus chondrosarcoma of the central skull base: MR and CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Guk Myeong; Han, Moon Hee; Chang, Kee Hyun; Kim, Hong Dae; Yeon, Kyung Mo [Seoul National Univ. (Korea, Republic of). Coll. of Medicine; Yu, In Kyu [Uulji Hospital, Seoul (Korea, Republic of); Kim, Sam Soo [Boramae Hospital, Seoul (Korea, Republic of)

    1998-02-01

    It is known that due to both their imaging and pathologic features, the accurate differentiation of chondrosarcoma from chordoma is difficult. Through an analysis of MR and CT finding, this study aims to determine the differential points between these two tumors. In 21 patients, CT and MR imaging studies of chordoma (n=12) and chondrosarcoma (n=9) at the base of the skull were retrospectively reviewed. Diagnosis had been established by histologic examination of surgically removed specimens. Eleven of the chordomas were subclassified as conventional and one as chondroid ; eight chondrosarcoma were conventional and one was myxoid. Four chordoma patients underwent CT and MR ; in six, only MR was in one, only CT was performed. All scans were retrospectively evaluated for the location (midline/off-midline), direction of extension, margin and shape, bony destruction and calcification, MR signal intensity and enhancement patterns of the tumors. Degree of calcification was graded from I to II. Although MR and CT findings were similar in both types of tumor, location and degree of calcification may be features which usefully distinguish chordoma from chondrosarcoma. (author). 17 refs., 2 tabs., 5 figs.

  11. Association between cervical spine and skull-base fractures and blunt cerebrovascular injury

    Energy Technology Data Exchange (ETDEWEB)

    Buch, Karen; Nguyen, Thanh; Norbash, Alex; Mian, Asim [Boston University School of Medicine, Department of Radiology, Boston Medical Center, Boston, MA (United States); Mahoney, Eric; Burke, Peter [Boston University School of Medicine, Department of Surgery, Boston Medical Center, Boston, MA (United States); Libby, Brandon; Calner, Paul [Boston University School of Medicine, Department of Emergency Medicine, Boston Medical Center, Boston, MA (United States)

    2016-02-15

    Blunt cerebrovascular injuries (BCVI) are associated with high morbidity and mortality and can lead to neurological deficits. The established criteria for patients undergoing CT angiography (CTA) for BCVI are broad, and can expose patients to radiation unnecessarily. This study aimed to examine the prevalence of BCVI in patients on CTA and determine presentations associated with the highest rates of BCVI. With IRB approval, patients were selected for CTA screening for BCVI according to a predefined set of criteria at our hospital between 2007 and 2010. Patients were identified from our institution's trauma database. CTAs were retrospectively reviewed for BCVI including vasospasm and dissection. Electronic medical records were reviewed for clinical presentation and hospital course. Of 432 patients, vasospasm (n = 10) and/or dissection (n = 36) were found in 46 patients (10.6 %). BCVI was associated with cervical spine and/or skull-base fracture in 40/46 patients (87 %, P < 0.0001). Significant correlations were seen between dissection and fracture in 31/36 patients (86.2 %, p < 0.0001) and between BCVI and both neurological deficits and fractures (27/44, P < 0.0001). BCVI was significantly associated with cervical and/or skullbase fractures and neurological deficits with coexistent fractures. Patients with these injuries should be prioritized for rapid CTA evaluation for BCVI. (orig.)

  12. Neuropsychological function in adults after high dose fractionated radiation therapy of skull base tumors

    International Nuclear Information System (INIS)

    Purpose: To evaluate the long term effects of high dose fractionated radiation therapy on brain functioning prospectively in adults without primary brain tumors. Methods and Materials: Seventeen patients with histologically confirmed chordomas and low grade chondrosarcomas of the skull base were evaluated with neuropsychological measures of intelligence, language, memory, attention, motor function and mood following surgical resection/biopsy of the tumor prior to irradiation, and then at about 6 months, 2 years and 4 years following completion of treatment. None received chemotherapy. Results: In the patients without tumor recurrence or radiation necrosis, there were no indications of adverse effects on cognitive functioning in the post-acute through the late stages after brain irradiation. Even in patients who received doses of radiation up to 66 Cobalt Gy equivalent through nondiseased (temporal lobe) brain tissue, memory and cognitive functioning remained stable for up to 5 years after treatment. A mild decline in psycho-motor speed was seen in more than half of the patients, and motor slowing was related to higher radiation doses in midline and temporal lobe brain structures. Conclusion: Results suggest that in adults, tolerance for focused radiation is relatively high in cortical brain structures

  13. Association between cervical spine and skull-base fractures and blunt cerebrovascular injury

    International Nuclear Information System (INIS)

    Blunt cerebrovascular injuries (BCVI) are associated with high morbidity and mortality and can lead to neurological deficits. The established criteria for patients undergoing CT angiography (CTA) for BCVI are broad, and can expose patients to radiation unnecessarily. This study aimed to examine the prevalence of BCVI in patients on CTA and determine presentations associated with the highest rates of BCVI. With IRB approval, patients were selected for CTA screening for BCVI according to a predefined set of criteria at our hospital between 2007 and 2010. Patients were identified from our institution's trauma database. CTAs were retrospectively reviewed for BCVI including vasospasm and dissection. Electronic medical records were reviewed for clinical presentation and hospital course. Of 432 patients, vasospasm (n = 10) and/or dissection (n = 36) were found in 46 patients (10.6 %). BCVI was associated with cervical spine and/or skull-base fracture in 40/46 patients (87 %, P < 0.0001). Significant correlations were seen between dissection and fracture in 31/36 patients (86.2 %, p < 0.0001) and between BCVI and both neurological deficits and fractures (27/44, P < 0.0001). BCVI was significantly associated with cervical and/or skullbase fractures and neurological deficits with coexistent fractures. Patients with these injuries should be prioritized for rapid CTA evaluation for BCVI. (orig.)

  14. MR Imaging with Gadolinium-DTPA in skull-base tumors

    International Nuclear Information System (INIS)

    Twenty-five patients were investigated by MR imaging in order to evaluate the diagnostic value of Gadolinium (Gd)-DTPA in skull-base tumors. The patients were studied with standard acquisition techniques (T1, mixed and T2-weighted images) without contrast medium. The images obtained after intravenous injection of Gd-DTPA. The contrastographic results in the different types of acquisition were evaluated. Thanks to the extra-ordinary increase in contrast resolution it provides, Gd-DTPA allowed the precise evaluation of the lesion and of its perfect spatial definition in all cases. Our experience demonstrated that Gd-DTPA considerably increases the sensitivity of the technique in this anatomical region. On the contrary, as regards the nature of the lesion, the signal did not significantly very after the iv injection of Gd-DTPA in the various kinds of lesion. In addition to the important diagnostic advantages of Gd-DTPA, its excellent tollerability and the absence of side-effects must be stressed

  15. Radiosurgery with photons or protons for benign and malignant tumours of the skull base: a review

    Directory of Open Access Journals (Sweden)

    Amichetti Maurizio

    2012-12-01

    Full Text Available Abstract Stereotactic radiosurgery (SRS is an important treatment option for intracranial lesions. Many studies have shown the effectiveness of photon-SRS for the treatment of skull base (SB tumours; however, limited data are available for proton-SRS. Several photon-SRS techniques, including Gamma Knife, modified linear accelerators (Linac and CyberKnife, have been developed and several studies have compared treatment plan characteristics between protons and photons. The principles of classical radiobiology are similar for protons and photons even though they differ in terms of physical properties and interaction with matter resulting in different dose distributions. Protons have special characteristics that allow normal tissues to be spared better than with the use of photons, although their potential clinical superiority remains to be demonstrated. A critical analysis of the fundamental radiobiological principles, dosimetric characteristics, clinical results, and toxicity of proton- and photon-SRS for SB tumours is provided and discussed with an attempt of defining the advantages and limits of each radiosurgical technique.

  16. Endoscopic Transnasal Approach for Urgent Decompression of the Craniocervical Junction in Acute Skull Base Osteomyelitis.

    Science.gov (United States)

    Burns, Terry C; Mindea, Stefan A; Pendharkar, Arjun V; Lapustea, Nicolae B; Irime, Ioana; Nayak, Jayakar V

    2015-07-01

    Ventral epidural abscess with osteomyelitis at the craniocervical junction is a rare occurrence that typically mandates spinal cord decompression via a transoral approach. However, given the potential for morbidity with transoral surgery, especially in the setting of immunosuppression, together with the advent of extended endonasal techniques, the transnasal approach could be attractive for selected patients. We present two cases of ventral epidural abscess and osteomyelitis at the craniocervical junction involving C1/C2 that were successfully treated via the endoscopic transnasal approach. Both were treated in staged procedures involving posterior cervical fusion followed by endoscopic transnasal resection of the ventral C1 arch and odontoid process for decompression of the ventral spinal cord and medulla. Dural repairs were successfully performed using multilayered, onlay techniques where required. Both patients tolerated surgery exceedingly well, had brief postoperative hospital stays, and recovered uneventfully to their neurologic baselines. Postoperative magnetic resonance imaging confirmed complete decompression of the foramen magnum and upper C-spine. These cases illustrate the advantages and low morbidity of the endonasal endoscopic approach to the craniocervical junction in the setting of frank skull base infection and immunosuppression, representing to our knowledge a unique application of this technique to osteomyelitis and epidural abscess at the craniocervical junction. PMID:26251807

  17. Fractionated stereotactic radiation therapy improves cranial neuropathies in patients with skull base meningiomas: a retrospective cohort study

    International Nuclear Information System (INIS)

    Skull base meningiomas commonly present with cranial neuropathies. Fractionated stereotactic radiation therapy (FSRT) has been used to treat these tumors with excellent local control, but rates of improvement in cranial neuropathies have not been well defined. We review the experience at Thomas Jefferson University using FSRT in the management of these patients with a focus on symptom outcomes. We identified 225 cases of skull base meningiomas treated with FSRT at Thomas Jefferson University from 1994 through 2009. The target volume was the enhancing tumor, treated to a standard prescription dose of 54 Gy. Symptoms at the time of RT were classified based on the cranial nerve affected. Logistic regression was performed to determine predictors of symptom improvement after FSRT. The median follow-up time was 4.4 years. In 92% of cases, patients were symptomatic at the time of RT; the most common were impaired visual field/acuity (58%) or extraocular movements (34%). After FSRT, durable improvement of at least one symptom occurred in 57% of cases, including 40% of visual acuity/visual field deficits, and 40% of diplopia/ptosis deficits. Of all symptomatic patients, 27% experienced improvement of at least one symptom within 2 months of the end of RT. FSRT is very effective in achieving improvement of cranial neuropathies from skull base meningiomas, particularly visual symptoms. Over half of treated patients experience a durable improvement of at least one symptom, frequently within 2 months from the end of RT

  18. Detection of brain lesions at the skull base using diffusion-weighted imaging with readout-segmented echo-planar imaging and generalized autocalibrating partially parallel acquisitions

    OpenAIRE

    Xiao-Er Wei; Wen-Bin Li; Ming-Hua Li; Yue-Hua Li; Dan Wang; Yu-Zhen Zhang; Li-Xin Jin

    2011-01-01

    Objective: To analyze the value of readout-segmented echo-planar imaging (rs-EPI) with parallel imaging and a two-dimensional (2D) navigator-based reacquisition technique in the detection of brain lesions at the skull base. Materials and Methods: A total of 54 patients (male 37, female 17) with suspected skull-base intracranial lesions underwent magnetic resonance imaging (MRI), including pre-T1 weighted imaging, T2-weighted imaging, Fluid Attenuated Inversion Recovery (FLAIR), standard singl...

  19. Efficacy of Navigation in Skull Base Surgery using Composite Computer Graphics of Magnetic Resonance and Computed Tomography Images

    OpenAIRE

    Hayashi, Nakamasa; Kurimoto, Masanori; Hirashima, Yutaka; Ikeda, Hiroaki; Shibata, Takashi; Tomita, Takahiro; Endo, Shunro

    2001-01-01

    The efficacy of a neurosurgical navigation system using three-dimensional composite computer graphics (CGs) of magnetic resonance (MR) and computed tomography (CT) images was evaluated in skull base surgery. Three-point transformation was used for integration of MR and CT images. MR and CT image data were obtained with three skin markers placed on the patient's scalp. Volume-rendering manipulations of the data produced three-dimensional CGs of the scalp, brain, and lesions from the MR images,...

  20. Chondroblastoma-like chondroma of soft tissue: report of the first case in the base of skull.

    Science.gov (United States)

    Raparia, Kirtee; Lin, Jerry W; Donovan, Donald; Vrabec, Jeffrey T; Zhai, Qihui Jim; Ayala, Alberto A; Ro, Jae Y

    2013-06-01

    Chondroblastoma-like chondroma (CLC) of soft tissue is a rare benign neoplasm that usually involves the soft tissues of the hand. This report describes the first case of CLC of soft tissue arising in the base of the skull. A 33-year-old man was seen with a slow growing mass in the right parotid region of his face. The noncontrast computed tomographic scans showed an 8.5-cm mass with calcifications involving the right masticator space and extending through the bone into the middle cranial fossa. The radiologic differential diagnosis included osteosarcoma, leiomyosarcoma, chondrosarcoma, and giant cell tumor. During surgery, the large lateral skull base tumor appeared to involve the middle and infratemporal fossae and eroded the surrounding bone. Although the tumor was removed piecemeal, total excision was performed. On microscopic examination, the tumor displayed lobules of mature hyaline cartilage with numerous chondroblasts, coarse calcifications including chicken wire calcifications, and scattered osteoclasts. No atypia, mitoses, necrosis, or osteoid formation was seen. The tumor was diagnosed as chondroma with chondroblastoma features of the soft tissue. His postoperative clinical course was uneventful; however, after 7 months, he had a local recurrence identified on follow-up magnetic resonance imaging. He underwent repeat surgical excision of the tumor, which showed similar histology as the previous excision. This large skull based tumor eroding the bone, which clinically and radiologically mimicked a malignant process, was an unusual presentation of a benign cartilaginous neoplasm. Pathologists should be aware that CLC may occur in the base of the skull and this lesion should be differentiated from the other benign or malignant tumors arising in this area. These lesions have a potential for local recurrence; hence, a close follow-up is recommended.

  1. Base of the skull morphology and Class III malocclusion in patients with unilateral cleft lip and palate

    Directory of Open Access Journals (Sweden)

    Mariana Maciel Tinano

    2015-02-01

    Full Text Available OBJECTIVE: The aim of the present study was to determine the morphological differences in the base of the skull of individuals with cleft lip and palate and Class III malocclusion in comparison to control groups with Class I and Class III malocclusion. METHODS: A total of 89 individuals (males and females aged between 5 and 27 years old (Class I, n = 32; Class III, n = 29; and Class III individuals with unilateral cleft lip and palate, n = 28 attending PUC-MG Dental Center and Cleft Lip/Palate Care Center of Baleia Hospital and PUC-MG (CENTRARE were selected. Linear and angular measurements of the base of the skull, maxilla and mandible were performed and assessed by a single calibrated examiner by means of cephalometric radiographs. Statistical analysis involved ANCOVA and Bonferroni correction. RESULTS: No significant differences with regard to the base of the skull were found between the control group (Class I and individuals with cleft lip and palate (P > 0.017. The cleft lip/palate group differed from the Class III group only with regard to CI.Sp.Ba (P = 0.015. Individuals with cleft lip and palate had a significantly shorter maxillary length (Co-A in comparison to the control group (P < 0.001. No significant differences were found in the mandible (Co-Gn of the control group and individuals with cleft lip and palate (P = 1.000. CONCLUSION: The present findings suggest that there are no significant differences in the base of the skull of individuals Class I or Class III and individuals with cleft lip and palate and Class III malocclusion.

  2. Stereotactic Ablative Radiosurgery for Locally-Advanced or Recurrent Skull Base Malignancies with Prior External Beam Radiation Therapy

    Directory of Open Access Journals (Sweden)

    Karen Mann Xu

    2015-03-01

    Full Text Available Purpose: Stereotactic ablative radiotherapy (SABR is an attractive modality to treat malignancies invading the skull base as it can deliver a highly conformal dose with minimal toxicity. However, variation exists in the prescribed dose and fractionation. The purpose of our study is to examine the local control, survival and toxicities in SABR for the treatment of malignant skull base tumors. Methods and Materials: A total of 31 patients and 40 locally-advanced or recurrent head and neck malignancies involving the skull base treated with a common SABR regimen which delivers a radiation dose of 44 Gy in 5 fractions from January 1st, 2004 to December 31st, 2013 were retrospectively reviewed. The local control rate (LC, progression-free survival rate (PFS, overall survival rate (OS and toxicities were reported.Results: The median follow-up time of all patients was 11.4 months (range: 0.6-67.2 months. The median tumor volume was 27 cm3 (range: 2.4-205 cm3. All patients received prior EBRT with a median radiation dose of 64 Gy (range: 24-75.6 Gy delivered in 12 to 42 fractions. 20 patients had surgeries prior to SABR. 19 patients received chemotherapy. Specifically, 8 patients received concurrent cetuximab (ErbituxTM with SABR. The median time-to-progression (TTP was 3.3 months (range: 0-16.9 months. For the 29 patients (93.5% who died, the median time from the end of first SABR to death was 10.3 months (range: 0.5-41.4 months. The estimated 1-year overall survival (OS rate was 35%. The estimated 2-year OS rate was 12%. Treatment was well-tolerated without grade 4 or 5 treatment-related toxicities.Conclusions: SABR has been shown to achieve low toxicities in locally-advanced or recurrent, previously irradiated head and neck malignancies invading the skull base.

  3. Usefulness of Choline-PET for the detection of residual hemangiopericytoma in the skull base: comparison with FDG-PET

    Directory of Open Access Journals (Sweden)

    Ito Shin

    2012-02-01

    Full Text Available Abstract Background Choline is a new PET tracer that is useful for the detection of malignant tumor. Choline is a precursor of the biosynthesis of phosphatidylcholine, a major phospholipid in the cell membrane of eukaryotic cells. Malignant tumors have an elevated level of phosphatidylcholine in cell membrane. Thus, choline is a marker of tumor malignancy. Method The patient was a 51-year-old man with repeated recurrent hemangiopericytoma in the skull base. We performed Choline-PET in this patient after various treatments and compared findings with those of FDG-PET. Results Choline accumulated in this tumor, but FDG did not accumulate. We diagnosed this tumor as residual hemangiopericytoma and performed the resection of the residual tumor. FDG-PET is not appropriate for skull base tumor detection because uptake in the brain is very strong. Conclusion We emphasize the usefulness of Choline-PET for the detection of residual hemangiopericytoma in the skull base after various treatments, compared with FDG-PET.

  4. High-resolution Whole-Genome Analysis of Skull Base Chordomas Implicates FHIT Loss in Chordoma Pathogenesis

    Directory of Open Access Journals (Sweden)

    Roberto Jose Diaz

    2012-09-01

    Full Text Available Chordoma is a rare tumor arising in the sacrum, clivus, or vertebrae. It is often not completely resectable and shows a high incidence of recurrence and progression with shortened patient survival and impaired quality of life. Chemotherapeutic options are limited to investigational therapies at present. Therefore, adjuvant therapy for control of tumor recurrence and progression is of great interest, especially in skull base lesions where complete tumor resection is often not possible because of the proximity of cranial nerves. To understand the extent of genetic instability and associated chromosomal and gene losses or gains in skull base chordoma, we undertook whole-genome single-nucleotide polymorphism microarray analysis of flash frozen surgical chordoma specimens, 21 from the clivus and 1 from C1 to C2 vertebrae. We confirm the presence of a deletion at 9p involving CDKN2A, CDKN2B, and MTAP but at a much lower rate (22% than previously reported for sacral chordoma. At a similar frequency (21%, we found aneuploidy of chromosome 3. Tissue microarray immunohistochemistry demonstrated absent or reduced fragile histidine triad (FHIT protein expression in 98% of sacral chordomas and 67%of skull base chordomas. Our data suggest that chromosome 3 aneuploidy and epigenetic regulation of FHIT contribute to loss of the FHIT tumor suppressor in chordoma. The finding that FHIT is lost in a majority of chordomas provides new insight into chordoma pathogenesis and points to a potential new therapeutic target for this challenging neoplasm.

  5. Magnetic resonance (MR) imaging of chordoma and chondroma in the skull base; Differential diagnosis by IR sequence

    Energy Technology Data Exchange (ETDEWEB)

    Tashiro, Takahiko; Inoue, Yuichi; Nemoto, Yutaka (Osaka City Univ. (Japan). Faculty of Medicine) (and others)

    1992-05-01

    Differential diagnosis of chordoma and chondroma in the skull base is sometimes difficult. We retrospectively reviewed the MR images of 14 patients with skull base tumors (nine chordomas, four chondromas and one chondrosarcoma). MR imaging was performed with a 0.5 Tesla system (Picker International). Inversion recovery (IR) (2500-2100/600-500/40), T1-weighted spin echo (SE) (800-600/40), and T2-weighted SE (2500-1800/120) images were obtained. On IR images, seven of eight chordomas showed heterogeneous low signal intensity, and one chordoma and all chondromas showed markedly low signal intensity similar to that of CSF. Calcified or ossified portions of the chondromas were demonstrated as areas of moderately low intensity on IR images. Chondrosarcoma showed moderately low intensity similar to that of chordoma. T1-weighted SE images of chordoma and chondroma showed no difference in signal intensity. On T2-weighted SE images, six of nine chordomas and all chondromas showed markedly high signal intensity. Three chordomas and one chondrosarcoma showed moderately high signal intensity. In the diagnosis of skull base tumors, the IR sequence seems to be useful for differentiating chondroma from chordoma. (author).

  6. Advanced therapeutic strategy for radiation-induced osteosarcoma in the skull base: a case report and review

    International Nuclear Information System (INIS)

    A review of patients with skull base osteosarcoma secondary to radiation (radiation-induced osteosarcoma: RIOS) of the pituitary tumor shows the mean survival of approximately 7 months (2 weeks – 16 months). This warning prognosis seems to stem from two factors, 1) the anatomical complexity of the skull base for total resection of the tumor, and 2) standard adjuvant therapies for the tumor yet to be established. Contrary to the general belief, the authors report an unusually long survival of a 75-year-old woman with a history of osteosarcoma that developed in the same sequence 20 years after pituitary tumor radiation. On her recent admission, she complained of frontal headaches and MRI studies showed a tumor in the sphenoid sinus. Endoscopic trans-nasal tumor removal allowed for histological diagnosis of an osteosarcoma. However, further rapid tumor growth necessitated a radical tumor resection followed by a combined chemotherapy with ifosfamide, cisplatin, and etoposide (ICE). Despite temporary suppression of the tumor growth, the chemotherapy was discontinued due to severe pancytopenia that occurred after three courses of treatment. Shortly after the discontinuation of ICE therapy, the tumor size increased again rapidly, requiring a novel radiation therapy, Cyber-knife treatment. Following this radiation, the tumor growth was arrested, and the patient remains healthy without neurological symptoms over 24 months. The outcome of Cyber-knife in this case suggests that this specific therapy must be considered for the unresectable skull base RIOS

  7. Advanced therapeutic strategy for radiation-induced osteosarcoma in the skull base: a case report and review

    Directory of Open Access Journals (Sweden)

    Yamada Shoko Merrit

    2012-08-01

    Full Text Available Abstract A review of patients with skull base osteosarcoma secondary to radiation (radiation-induced osteosarcoma: RIOS of the pituitary tumor shows the mean survival of approximately 7 months (2 weeks – 16 months. This warning prognosis seems to stem from two factors, 1 the anatomical complexity of the skull base for total resection of the tumor, and 2 standard adjuvant therapies for the tumor yet to be established. Contrary to the general belief, the authors report an unusually long survival of a 75-year-old woman with a history of osteosarcoma that developed in the same sequence 20 years after pituitary tumor radiation. On her recent admission, she complained of frontal headaches and MRI studies showed a tumor in the sphenoid sinus. Endoscopic trans-nasal tumor removal allowed for histological diagnosis of an osteosarcoma. However, further rapid tumor growth necessitated a radical tumor resection followed by a combined chemotherapy with ifosfamide, cisplatin, and etoposide (ICE. Despite temporary suppression of the tumor growth, the chemotherapy was discontinued due to severe pancytopenia that occurred after three courses of treatment. Shortly after the discontinuation of ICE therapy, the tumor size increased again rapidly, requiring a novel radiation therapy, Cyber-knife treatment. Following this radiation, the tumor growth was arrested, and the patient remains healthy without neurological symptoms over 24 months. The outcome of Cyber-knife in this case suggests that this specific therapy must be considered for the unresectable skull base RIOS.

  8. Compensation of skull motion and breathing motion in CT using data-based and image-based metrics, respectively

    Science.gov (United States)

    Bruder, H.; Rohkohl, C.; Stierstorfer, K.; Flohr, T.

    2016-03-01

    We present a novel reconstruction for motion correction of non-cardiac organs. With non-cooperative patients or in emergency case, breathing motion or motion of the skull may compromise image quality. Our algorithm is based on the optimization of either motion artefact metrics or data-driven metrics. This approach was successfully applied in cardiac CTA [1]. While motion correction of the coronary vessels requires a local motion model, global motion models are sufficient for organs like the lung or the skull. The parameter vector for the global affine motion is estimated iteratively, using the open source optimization library NLOPT. The image is updated using motion compensated reconstruction in each of the iterations. Evaluation of the metric value, e.g. the image entropy, provides information for the next iteration loop. After reaching the fixed point of the iteration, the final motion parameters are used for a motion-compensated full quality reconstruction. In head imaging the motion model is based on translation and rotation, in thoracic imaging the rotation is replaced by non-isotropic scaling in all three dimensions. We demonstrate the efficiency of the method in thoracic imaging by evaluating PET-CT data from free-breathing patients. In neuro imaging, data from stroke patients showing skull tremor were analyzed. It was shown that motion artefacts can be largely reduced and spatial resolution was restored. In head imaging, similar results can be obtained using motion artefact metrics or data-driven metrics. In case of image-based metrics, the entropy of the image proved to be superior. Breathing motion could also be significantly reduced using entropy metric. However, in this case data driven metrics cannot be applied because the line integrals associated to the ROI of the lung have to be computed using the local ROI mechanism [2] It was shown that the lung signal is corrupted by signals originating from the complement of the lung. Thus a meaningful

  9. Gross tumor volume (GTV) and clinical target volume (CTV) for radiation therapy of benign skull base tumours; Volume tumoral macroscopique (GTV) et volume-cible anatomoclinique (CTV) dans la radiotherapie des tumeurs benignes de la base du crane

    Energy Technology Data Exchange (ETDEWEB)

    Maire, J.P. [Centre Hospitalier Universitaire de Bordeaux, Hopital Saint Andre, Service d' Oncologie Radiotherapie, 33 - Bordeaux (France); Liguoro, D.; San Galli, F. [Centre Hospitalier Universitaire de Bordeaux, Hopital Saint Andre, Service de Neurochirurgie A, 33 - Bordeaux (France)

    2001-10-01

    Skull base tumours represent a out 35 to 40% of all intracranial tumours. There are now many reports in the literature confirming the fact that about 80 to 90% of such tumours are controlled with fractionated radiotherapy. Stereotactic and 3-dimensional treatment planning techniques increase local control and central nervous system tolerance. Definition of the gross tumor volume (GTV) is generally easy with currently available medical imaging systems and computers for 3-dimensional dosimetry. The definition of the clinical target volume (CTV) is more difficult to appreciate: it is defined from the CTV plus a margin, which depends on the histology and anterior therapeutic history of the tumour. It is important to take into account the visible tumour and its possible extension pathways (adjacent bone, holes at the base of skull) and/or an anatomic region (sella turcica + adjacent cavernous sinus). It is necessary to evaluate these volumes with CT Scan and MRI to appreciate tumor extension in a 3-dimensional approach, in order to reduce the risk of marginal recurrences. The aim of this paper is to discuss volume definition as a function of tumour site and tumour type to be irradiated. (authors)

  10. Influence of MRI abnormality in skull base bone on prognosis of nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Purpose. To evaluate the influence of skull base bone (SBB) abnormality showed by MRI on prognosis of nasopharyngeal carcinoma (NPC). Patients and methods. From March 1993 to December 1998, 122 NPC patients received prime radiotherapy treatment. All of them were proved pathologically and checked by magnetic resonance imaging (MRI). Every patient received radiation through conjoint facio-cervical field and conventional dose-fractionation schedules. The total dose to the primary tumor was 60 5 Gy (median, 70 Gy). The Kaplan Meier method, the Log-rank test and the Cox regression model were used to evaluate the significance of prognostic factors on NPC patient survival. Results. The overall median survival period was 50 (6 2) months, and the 1, 3 and 5 year-survival rates were, respectively, 99.2%, 87.9%, and 73.3%. The 1, 3, and 5 year-survival rates of abnormality and normality of the SBB on MRI were 98.9%, 87.2%, 71.9%, and 100.0%, 89.8%, 77.0%, respectively (P 0.4233). Gender, age, head pain, SBB abnormality, cranial nerve palsy, cervical lymphadenopathy and primary tumor extent were analyzed with the Cox regression model and SBB abnormality on MRI did not prove to have statistical significance (P = 0.6934). According to the analysis of regrouping, patients with SBB abnormalities ≥ sites have a worse prognosis (P = 0.0427). Then. the above seven factors are analyzed by Cox regression model and the result had statistical significance (P = 0.0385). Conclusion. The SBB abnormality on MRI is of no obvious influence on prognosis of NPC. However, when SBB abnormality sites were ≥ 2, there is obvious statistical significance on the prognosis. (author)

  11. Improved methods for chronic light-based motor mapping in mice: automated movement tracking with accelerometers, and chronic EEG recording in a bilateral thin-skull preparation.

    Directory of Open Access Journals (Sweden)

    Gergely eSilasi

    2013-07-01

    Full Text Available Optogenetic stimulation of the mouse cortex can be used to generate motor maps that are similar to maps derived from electrode-based stimulation. Here we present a refined set of procedures for repeated light-based motor mapping in ChR2-expressing mice implanted with a bilateral thinned-skull chronic window and a chronically implanted EEG electrode. Light stimulation is delivered sequentially to over 400 points across the cortex, and evoked movements are quantified on-line with a 3-axis accelerometer attached to each forelimb. Bilateral maps of forelimb movement amplitude and movement direction were generated at weekly intervals after recovery from cranial window implantation. We found that light pulses of ~2 mW produced well-defined maps that were centered approximately 0.7 mm anterior and 1.6 mm lateral from bregma. Map borders were defined by sites where light stimulation evoked EEG deflections, but not movements. Motor maps were similar in size and location between mice, and maps were stable over weeks in terms of the number of responsive sites, and the direction of evoked movements. We suggest that our method may be used to chronically assess evoked motor output in mice, and may be combined with other imaging tools to assess cortical reorganization or sensory-motor integration.

  12. Applied Anatomy of the Neurovascular Structures of the Base of the Skull

    OpenAIRE

    Rosso, María Victoria; Pawluk, Gustavo; Pappolla, Agustin; Ferraro, Fernando Martin; Dorman, Matías; Bakken, Sofía María

    2011-01-01

    Variations of the anatomy of the vascular system or various pathological processes like intracranial aneurysms could cause neurological symptoms, due to their proximity to cranial nerves. The aim of this study is to describe the link between vessels and cranial nerves, to associate with neurological clinic.24 anatomical pieces were used, 10 of them with repletion of the vascular tree with coloured latex and 12 skulls, observed with magnifying glasses, and through surgical microscope. Images d...

  13. Fetal skull analysis in ultrasound images based on iterative randomized Hough transform

    Science.gov (United States)

    Shen, Yufei; Yu, Jinhua; Shen, Yuzhong; Wang, Yuanyuan

    2009-02-01

    Analysis of ultrasound fetal head images is a daily routine for medical professionals in obstetrics. The contours of fetal skulls often appear discontinuous and irregular in clinical ultrasound images, making it difficult to measure the fetal head size automatically. In addition, the presence of heavy noise in ultrasound images is another challenge for computer aided automatic fetal head detection. In this paper, we first utilize the stick method to suppress the noise and compute an adaptive threshold for fetal skull segmentation. Morphological thinning is then performed to obtain a skeleton image, which is used as an input to the Hough transform. Finally, automatic fetal skull detection is realized by Iterative Randomized Hough Transform (IRHT). The elliptic eccentricity is used in the IRHT to reduce the number of invalid accumulations in the parameter space, improving the detection accuracy. Furthermore, the target region is adaptively adjusted in the IRHT. To evaluate the performance of IRHT, we also developed a simulation user interface for comparing results produced by the conventional randomized Hough transform (RHT) and the IRHT. Experimental results showed that the proposed method is effective for automatic fetal head detection in ultrasound images.

  14. Feasibility of combined operation and perioperative intensity-modulated brachytherapy of advanced/recurrent malignancies involving the skull base

    Energy Technology Data Exchange (ETDEWEB)

    Strege, R.J.; Eichmann, T.; Mehdorn, H.M. [University Hospital Schleswig-Holstein, Kiel (Germany). Dept. of Neurosurgery; Kovacs, G.; Niehoff, P. [University Hospital Schleswig-Holstein, Kiel (Germany). Interdisciplinary Brachytherapy Center; Maune, S. [University Hospital Schleswig-Holstein, Kiel (Germany). Dept. of Otolaryngology; Holland, D. [University Hospital Schleswig-Holstein, Kiel (Germany). Dept. of Ophthalmology

    2005-02-01

    Purpose: To assess the technical feasibility and toxicity of combined operation and perioperative intensity-modulated fractionated interstitial brachytherapy (IMBT) in advanced-stage malignancies involving the skull base with the goal of preserving the patients' senses of sight. Patients and Methods: This series consisted of 18 consecutive cases: ten patients with paranasal sinus carcinomas, five with sarcomas, two with primitive neuroectodermal tumors (PNETs), and one with parotid gland carcinoma. After, in most cases, subtotal surgical resection (R1-R2: carried out so that the patients' senses of sight were preserved), two to twelve (mean five) afterloading plastic tubes were placed into the tumor bed. IMBT was performed with an iridium-192 stepping source in pulsed-dose-rate/high-dose-rate (PDR/HDR) afterloading technique. The total IMBT dose, ranging from 10 to 30 Gy, was administered in a fractionated manner (3-5 Gy/day, 5 days/week). Results: Perioperative fractionated IMBT was performed in 15 out of 18 patients and was well tolerated. Complications that partially prevented or delayed IMBT in some cases included cerebrospinal fluid leakage (twice), meningitis (twice), frontal brain syndrome (twice), afterloading tube displacement (twice), seizure (once), and general morbidity (once). No surgery- or radiation-induced injuries to the cranial nerves or eyes occurred. Median survival times were 33 months after diagnosis and 16 months after combined operation and IMBT. Conclusion: Perioperative fractionated IMBT after extensive but vision-preserving tumor resection seems to be a safe and well-tolerated treatment of advanced/recurrent malignancies involving the skull base. These preliminary state suggest that combined operation and perioperative fractionated IMBT is a palliative therapeutic option in the management of fatal malignancies involving the base of the skull, a strategy which leaves the patients' visual acuity intact. (orig.)

  15. Radiosurgery of small skull-base lesions. No advantage for intensity-modulated stereotactic radiosurgery versus conformal arc technique

    Energy Technology Data Exchange (ETDEWEB)

    Ernst-Stecken, A.; Sauer, R.; Grabenbauer, G. [Dept. of Radiation Therapy and Novalis Shaped Beam Surgery Center, Univ. of Erlangen-Nuremberg, Erlangen (Germany); Lambrecht, U.; Mueller, R. [Dept. of Radiation Therapy and Novalis Shaped Beam Surgery Center, Univ. of Erlangen-Nuremberg, Erlangen (Germany); Div. of Medical Physics, Dept. of Radiation Therapy, Univ. of Erlangen-Nuremberg, Erlangen (Germany); Ganslandt, O.; Fahlbusch, R. [Dept. of Neurosurgery, Univ. of Erlangen-Nuremberg, Erlangen (Germany)

    2005-05-01

    Background and purpose: intensity-modulated stereotactic radiotherapy (IMSRT) has shown the ability to conform the dose to concavities and to better avoid critical organs for large tumors. Given the availability of an electronically driven micro-multileaf collimator, both intensity-modulated stereotactic radiosurgery (IMSRS) and dynamic conformal arc (DCA) technique (DCA) can be performed at the Novalis Shaped Beam Surgery Center, University of Erlangen-Nuremberg, Germany, since 12/2002. This study evaluates both techniques in small skull-base tumors treated with radiosurgery. Material and methods: between 12/2002 and 04/2004, a total of 109 radiosurgical procedures were performed in 77 patients, equally distributed between patients with acoustic neuroma (AN), pituitary adenoma (PA) and meningeoma (M). Six index patients (n = 2 AN, n = 1 PA, n = 3 M) routinely planned for dynamic arc stereotactic radiosurgery were replanned using the IMSRS approach (BrainScan, BrainLAB, Heimstetten, Germany). The RTOG radiosurgery quality assurance guidelines, isodose volumes, doses to organs at risk (OAR), and dose delivery criteria were compared. Results: DCA was superior to IMSRS for homogeneity and coverage. IMSRS could keep the high-dose-irradiated volumes (90% isodose volume) lower than DCA in the PA and AN with very small volumes, but all other lower dose volumes were larger for IMSRS. Dose maxima to OAR were higher for IMSRS. Treatment delivery time for IMSRS would clearly exceed treatment time for DCA by a factor of 2-3. The integral absorbed dose to the brain was much higher in the IMSRS than in the DCA approach (factor 2-3). Conclusion: RTOG radiosurgery guidelines were best met by the DCA rather than IMSRS approach for the treatment of small skull-base lesions. The IMSRS approach will increase the time for planning, dose delivery and integral dose to the brain. Thus, IMSRT techniques are recommended for fractionated stereotactic radiotherapy to larger volumes rather

  16. Carotid canal dehiscence in the human skull

    Energy Technology Data Exchange (ETDEWEB)

    Pastor Vazquez, J.F.; Gil Verona, J.A. [Department of Anatomy, Faculty of Medicine, University of Valladolid, Ramon y Cajal, 7, E-47005 Valladolid (Spain); Garcia Porrero, M. [Department of Radiology, Faculty of Medicine, University of Valladolid (Spain)

    1999-06-01

    Abnormalities of the floor of the carotid canal have been studied in 538 skulls. These abnormalities range from a fissure to total absence of the floor. This variation may be caused by abnormalities of the internal carotid artery or deficiencies in ossification of the skull base. CT suggests that these changes should be taken into account by surgeons working on the skull base. (orig.) With 4 figs., 8 refs.

  17. Three-dimensional fracture visualisation of multidetector CT of the skull base in trauma patients: comparison of three reconstruction algorithms

    International Nuclear Information System (INIS)

    The purpose of this study was to retrospectively assess the detection rate of skull-base fractures for three different three-dimensional (3D) reconstruction methods of cranial CT examinations in trauma patients. A total of 130 cranial CT examinations of patients with previous head trauma were subjected to 3D reconstruction of the skull base, using solid (SVR) and transparent (TVR) volume-rendering technique and maximum intensity projection (MIP). Three radiologists independently evaluated all reconstructions as well as standard high-resolution multiplanar reformations (HR-MPRs). Mean fracture detection rates for all readers reading rotating reconstructions were 39, 36, 61 and 64% for SVR, TVR, MIP and HR-MPR respectively. Although not significantly different from HR-MPR with respect to sensitivity (P = 0.9), MIP visualised 18% of fractures that were not reported in HR-MPR. Because of the relatively low detection rate using HR-MPRs alone, we recommend reading MIP reconstructions in addition to the obligatory HR-MPRs to improve fracture detection. (orig.)

  18. Neuropsychological outcome after fractionated stereotactic radiotherapy (FSRT) for base of skull meningiomas: a prospective 1-year follow-up

    International Nuclear Information System (INIS)

    Purpose: The purpose of this study was to evaluate the cognitive outcome after fractionated stereotactic radiotherapy (FSRT) in patients with base of skull meningiomas. Methods and material: A total of 40 patients with base of skull meningiomas were neuro psychologically evaluated before, after the first fraction (1.8 Gy), at the end of FSRT (n=37), 6 weeks (n=24), 6 (n=18) and 12 months (n=14) after FSRT. A comprehensive test battery including assessment of general intelligence, attention and memory functions was used. Alternate forms were used and current mood state was controlled. Results: After the first fraction a transient decline in memory function and simultaneous improvements in attention functions were observed. No cognitive deteriorations were seen during further follow-up, but increases in attention and memory functions were observed. Mood state improved after the first fraction, at the end of radiotherapy and 6 weeks after radiotherapy. Conclusion: The present data support the conclusion that the probability for the development of permanent cognitive dysfunctions appears to be very low after FSRT. The transient memory impairments on day 1 are interpreted as most likely related to an increase of a preexisting peritumoral edema, whereas the significant acute improvements in attention functions are interpreted as practice effects. An analysis of localization specific effects of radiation failed to show clear hemisphere specific cognitive changes

  19. Embolization of a giant pediatric, posttraumatic, skull base internal carotid artery aneurysm with a liquid embolic agent.

    Science.gov (United States)

    Reig, Adam S; Simon, Scott; Mericle, Robert A

    2009-11-01

    Many treatments for posttraumatic, skull base aneurysms have been described. Eight months after an all-terrain-vehicle accident, this 12-year-old girl presented with right-side Horner syndrome caused by a 33 x 19-mm internal carotid artery aneurysm at the C-1 level. We chose to treat the aneurysm with a new liquid embolic agent for wide-necked, side-wall aneurysms (Onyx HD 500). We felt this treatment would result in less morbidity than surgery and was less likely to occlude the parent artery than placement of a covered stent, especially in a smaller artery in a pediatric patient. Liquid embolic agents also appear to be associated with a lower chance of recanalization and lower cost compared with stent-assisted coil embolization. After the patient was treated with loading doses of aspirin, clopidogrel bisulfate, and heparin, 99% of the aneurysm was embolized with 9 cc of the liquid embolic agent. There were no complications, and the patient remained neurologically stable. Follow-up angiography revealed durable aneurysm occlusion after 1 year. The cost of Onyx was less than the cost of coils required for coil embolization of similarly sized intracranial aneurysms at our institution. Liquid embolic agents can provide a safe, efficacious, and cost-effective approach to treatment of select giant, posttraumatic, skull base aneurysms in pediatric patients.

  20. Analytical study of the artifacts appeared in the base of skull on the Artronix 1110 Neuro CAT System

    International Nuclear Information System (INIS)

    There are many kind of artifacts in the CT images of the skull base views. The streaking is one of the artifacts which radiate from the tip of sharp edged bone as pyramidal bone. But there are some different type of artifacts in the skull base region. Among these the radiated artifacts in the infratentorial region are usually demonstrated in the picture with Artronix Neuro-CT-1110. However in some pictures there are few of these artifacts. The difference of these two type of the pictures is due to the volume of air filled nasal cavity. The images which contained very small spaces of nasal cavity were looked beautiful with very few artifacts. So those artifacts might be due to the effects of the airfilled nasal cavity. The phantome was made to investigate the effects of the longitudinal distance of the airfilled cavity. The artifact begins to appear from the distance of 4 cm, and within 4 cm there are very few artifacts. The air gaps of nasopharynx and mastoid cells are all the causes of this kind of artifacts. In order to avoid these artifacts it is needed to make the adequate angle of the O-M line to eliminate the nasal cavity before taking the position for CT images. (author)

  1. Radiological and acetomorphine analysis of the symmetry and direction of evolution of skulls from some historic populations

    International Nuclear Information System (INIS)

    Introduction: Asymmetry is a common phenomenon in nature. It is typical for the human body and for the skull as its part. Knowledge of asymmetry and normal anatomy, especially of variability which does not represent pathology but distinguishes individuals is the basis for correct interpretation of radiological findings concerning the skull both in research and diagnostic examinations widely performed in surgery, neurology, neurosurgery, internal medicine, or pediatrics. Analysis of fluctuating asymmetry reveals the influence of stress factors on human development and the ability of the organism to defend itself against stress.The aim of this work was to analyse the asymmetry of skulls from some historic populations and to describe changes in their anatomy over the ages. Material and methods: The material consisted of three skull groups: one contemporary with 82 skulls and two mediaeval (52 skulls from Cedynia and 77 skulls from Grodek on Bug). Direct measurements were done and the skull was X-rayed in the Posterior-Anterior and skull-base projections. Images were scanned and calibrated with MicroStation 95 Academic Edition software. Helmert's transformation with first-order polynomial was done to attain a suitable geometry. Vectorisation of axes and areas was performed on reference material. Using tools for measurement of vector elements, the distance between bilateral points of both sides of the skull were obtained. Data were analysed statistically. Results: The results of measurements were used to study the directional and fluctuating asymmetry. It was found that asymmetry of the skull was present in both historic populations. The following conclusions were drawn: changes in the distribution of directional and fluctuating asymmetry for individual dimensions have taken place over the ages. A high level of directional asymmetry in the facial part and fluctuating asymmetry in the calvaria is typical for contemporary skulls. The reverse is true for relations in the

  2. Aneurysmal Bone Cyst of the Skull Base in a 17-Year-Old Boy Who Was Referred with Unusual Presentation

    Directory of Open Access Journals (Sweden)

    Leila Aghaghazvini

    2011-05-01

    Full Text Available Aneurismal Bone Cyst (ABC is an osteolytic lesion"ncommonly observed in the first and second decades of"nlife more in females. They typically involve the long"nbones. Skull base involvement is rare. We describe"na 17-year-old boy with ABC of the skull base with"nforamen Jugular symptoms. Our case presented with a"nhistory of hoarseness for 2 years and facial asymmetry"nand left sided hearing loss from 5 months ago with no"nhistory of trauma or surgery. On physical examination,"nhe had left-sided sensorineural hearing loss with left"njugular foramen syndrome. The exam was otyherwise"nunremarkable. On MRI sequences an iso signal"nAbstracts"nIran J Radiol 2011, 8 (Supp.1 S61"nlobulated well defied mass containing few high signal"nareas in T1W and heterogeneous high signal (T2W"nand Flair was noted arising from the jugular foramen"nextending to the inferior cerebello-pontine angle"nwhich showed severe enhancement containing low"nsignal areas. No fluid-fluid level or enhancing septa was"nnoted. On CT scan a lytic expansile mass was detected"non the left side of foramen magnum and clivus with"ninvolvement of petrous apex and the internal auditory"ncanal. According to MRI findings, glomus jugular,"nschwannomas and meningiomas, but based on CT"nscan and MRI findings giant cell tumor and based on"nthe patient;s age ABC were our differential diagnosis."nThe lesion was only resected (without radiotherapy"nand histopathology confirmed an ABC. No recurrence"nwas observed after 6 months. Our case was interesting"nbecause of its rarity; not only the clinical jugular"nforamen syndrome but also the unusual radiological"npresentations such as severe enhancement, lack of"nfluid level and multi osseous involvement."nKeywords: Aneurysmal Bone Cyst, Foramen Jugular,"nPetros, Skull bBase, Clivus

  3. Measure, Then Show: Grasping Human Evolution Through an Inquiry-Based, Data-driven Hominin Skulls Lab.

    Science.gov (United States)

    Bayer, Chris N; Luberda, Michael

    2016-01-01

    Incomprehension and denial of the theory of evolution among high school students has been observed to also occur when teachers are not equipped to deliver a compelling case also for human evolution based on fossil evidence. This paper assesses the outcomes of a novel inquiry-based paleoanthropology lab teaching human evolution to high-school students. The inquiry-based Be a Paleoanthropologist for a Day lab placed a dozen hominin skulls into the hands of high-school students. Upon measuring three variables of human evolution, students explain what they have observed and discuss findings. In the 2013/14 school year, 11 biology classes in 7 schools in the Greater New Orleans area participated in this lab. The interviewed teacher cohort unanimously agreed that the lab featuring hominin skull replicas and stimulating student inquiry was a pedagogically excellent method of delivering the subject of human evolution. First, the lab's learning path of transforming facts to data, information to knowledge, and knowledge to acceptance empowered students to themselves execute part of the science that underpins our understanding of deep time hominin evolution. Second, although challenging, the hands-on format of the lab was accessible to high-school students, most of whom were readily able to engage the lab's scientific process. Third, the lab's exciting and compelling pedagogy unlocked higher order thinking skills, effectively activating the cognitive, psychomotor and affected learning domains as defined in Bloom's taxonomy. Lastly, the lab afforded students a formative experience with a high degree of retention and epistemic depth. Further study is warranted to gauge the degree of these effects. PMID:27513927

  4. A dual resolution measurement based Monte Carlo simulation technique for detailed dose analysis of small volume organs in the skull base region

    Science.gov (United States)

    Yeh, Chi-Yuan; Tung, Chuan-Jung; Chao, Tsi-Chain; Lin, Mu-Han; Lee, Chung-Chi

    2014-11-01

    The purpose of this study was to examine dose distribution of a skull base tumor and surrounding critical structures in response to high dose intensity-modulated radiosurgery (IMRS) with Monte Carlo (MC) simulation using a dual resolution sandwich phantom. The measurement-based Monte Carlo (MBMC) method (Lin et al., 2009) was adopted for the study. The major components of the MBMC technique involve (1) the BEAMnrc code for beam transport through the treatment head of a Varian 21EX linear accelerator, (2) the DOSXYZnrc code for patient dose simulation and (3) an EPID-measured efficiency map which describes non-uniform fluence distribution of the IMRS treatment beam. For the simulated case, five isocentric 6 MV photon beams were designed to deliver a total dose of 1200 cGy in two fractions to the skull base tumor. A sandwich phantom for the MBMC simulation was created based on the patient's CT scan of a skull base tumor [gross tumor volume (GTV)=8.4 cm3] near the right 8th cranial nerve. The phantom, consisted of a 1.2-cm thick skull base region, had a voxel resolution of 0.05×0.05×0.1 cm3 and was sandwiched in between 0.05×0.05×0.3 cm3 slices of a head phantom. A coarser 0.2×0.2×0.3 cm3 single resolution (SR) phantom was also created for comparison with the sandwich phantom. A particle history of 3×108 for each beam was used for simulations of both the SR and the sandwich phantoms to achieve a statistical uncertainty of <2%. Our study showed that the planning target volume (PTV) receiving at least 95% of the prescribed dose (VPTV95) was 96.9%, 96.7% and 99.9% for the TPS, SR, and sandwich phantom, respectively. The maximum and mean doses to large organs such as the PTV, brain stem, and parotid gland for the TPS, SR and sandwich MC simulations did not show any significant difference; however, significant dose differences were observed for very small structures like the right 8th cranial nerve, right cochlea, right malleus and right semicircular canal. Dose

  5. A Bullet Entered through the Open Mouth and Ended Up in the Parapharyngeal Space and Skull Base

    Directory of Open Access Journals (Sweden)

    Saileswar Goswami

    2015-01-01

    Full Text Available Shot from a revolver from a close range, a bullet pierced the chest of a policeman and entered through the open mouth of a young male person standing behind. The entry wound was found in the cheek mucosa adjacent to the left lower third molar. After hitting and fracturing the body and the ramus of the mandible, the bullet was deflected and was finally lodged in the parapharyngeal space and skull base, anterolateral to the transverse process of the atlas. The great vessels of the neck were not injured. The patient’s condition was very critical but his life could be saved. The bullet was approached through a modified Blair’s incision and was found to be lying over the carotid sheath. It was removed safely and the patient recovered completely.

  6. Image-guided, intensity-modulated radiation therapy (IG-IMRT) for skull base chordoma and chondrosarcoma: preliminary outcomes

    Science.gov (United States)

    Sahgal, Arjun; Chan, Michael W.; Atenafu, Eshetu G.; Masson-Cote, Laurence; Bahl, Gaurav; Yu, Eugene; Millar, Barbara-Ann; Chung, Caroline; Catton, Charles; O'Sullivan, Brian; Irish, Jonathan C.; Gilbert, Ralph; Zadeh, Gelareh; Cusimano, Michael; Gentili, Fred; Laperriere, Normand J.

    2015-01-01

    Background We report our preliminary outcomes following high-dose image-guided intensity modulated radiotherapy (IG-IMRT) for skull base chordoma and chondrosarcoma. Methods Forty-two consecutive IG-IMRT patients, with either skull base chordoma (n = 24) or chondrosarcoma (n = 18) treated between August 2001 and December 2012 were reviewed. The median follow-up was 36 months (range, 3–90 mo) in the chordoma cohort, and 67 months (range, 15–125) in the chondrosarcoma cohort. Initial surgery included biopsy (7% of patients), subtotal resection (57% of patients), and gross total resection (36% of patients). The median IG-IMRT total doses in the chondrosarcoma and chordoma cohorts were 70 Gy and 76 Gy, respectively, delivered with 2 Gy/fraction. Results For the chordoma and chondrosarcoma cohorts, the 5-year overall survival and local control rates were 85.6% and 65.3%, and 87.8% and 88.1%, respectively. In total, 10 patients progressed locally: 8 were chordoma patients and 2 chondrosarcoma patients. Both chondrosarcoma failures were in higher-grade tumors (grades 2 and 3). None of the 8 patients with grade 1 chondrosarcoma failed, with a median follow-up of 77 months (range, 34–125). There were 8 radiation-induced late effects—the most significant was a radiation-induced secondary malignancy occurring 6.7 years following IG-IMRT. Gross total resection and age were predictors of local control in the chordoma and chondrosarcoma patients, respectively. Conclusions We report favorable survival, local control and adverse event rates following high dose IG-IMRT. Further follow-up is needed to confirm long-term efficacy. PMID:25543126

  7. A panoramic view of the skull base: systematic review of open and endoscopic endonasal approaches to four tumors.

    Science.gov (United States)

    Graffeo, Christopher S; Dietrich, August R; Grobelny, Bartosz; Zhang, Meng; Goldberg, Judith D; Golfinos, John G; Lebowitz, Richard; Kleinberg, David; Placantonakis, Dimitris G

    2014-08-01

    Endoscopic endonasal surgery has been established as the safest approach to pituitary tumors, yet its role in other common skull base lesions has not been established. To answer this question, we carried out a systematic review of reported series of open and endoscopic endonasal approaches to four major skull base tumors: olfactory groove meningiomas (OGM), tuberculum sellae meningiomas (TSM), craniopharyngiomas (CRA), and clival chordomas (CHO). Data from 162 studies containing 5,701 patients were combined and compared for differences in perioperative mortality, gross total resection (GTR), cerebrospinal fluid (CSF) leak, neurological morbidity, post-operative visual function, post-operative anosmia, post-operative diabetes insipidus (DI), and post-operative obesity/hyperphagia. Weighted average rates for each outcome were calculated using relative study size. Our findings indicate similar rates of GTR and perioperative mortality between open and endoscopic approaches for all tumor types. CSF leak was increased after endoscopic surgery. Visual function symptoms were more likely to improve after endoscopic surgery for TSM, CRA, and CHO. Post-operative DI and obesity/hyperphagia were significantly increased after open resection in CRA. Recurrence rates per 1,000 patient-years of follow-up were higher in endoscopy for OGM, TSM, and CHO. Trends for open and endoscopic surgery suggested modest improvement in all outcomes over time. Our observations suggest that endonasal endoscopy is a safe alternative to craniotomy and may be preferred for certain tumor types. However, endoscopic surgery is associated with higher rates of CSF leak, and possibly increased recurrence rates. Prospective study with long-term follow-up is required to verify these preliminary observations.

  8. Detecting plasma Epstein-Barr virus DNA to diagnose postradiation nasopharyngeal skull base lesions in nasopharyngeal carcinoma patients: a prospective study

    Institute of Scientific and Technical Information of China (English)

    Fa-Ya Liang; Wei Sun; Ping Han; Xing Lu; Ying-Ni Lian; Xiao-Ming Huang

    2012-01-01

    The diagnosis of postradiation nasopharyngeal skull base lesions in petients with nasopharyngeal carcinoma (NPC) is still a tough problem in clinical practice.An early and accurate diagnosis is important for subsequent management.We prospectively evaluated the diagnostic value of plasma Epstein-Barr virus (EBV) DNA in detecting postradiation nasopharyngeal skull base lesions in NPC patients.From July 2006 to September 2010,90 patients with postradiation NPC (34 women and 56 men; median age:42years) met the selection criteria and were recruited in this study.All postradiation nasopharyngeal skull base lesions were found in the latest magnetic resonance imaging (MRI) examinations before endoscopic surgery,and the nasopharyngeal cavity was normal under flexible nasopharyngoscopy.Plasma EBV DNA detection was performed within 2 weeks before endoscopic surgery.A total of 90 endoscopic operations were successfully performed without any postoperative complications. Recurrences confirmed by postoperative pathology were found in 30 patients.The specificity,positive and negative predictive values of plasma EBV DNA detection were better than those of MRI.In addition,combining plasma EBV DNA detection with MRI improved the specificity and positive predictive values of MRI.Plasma EBV DNA detection followed by MRI would help to diagnose recurrence whereas MRI was unable.These results indicate that plasma EBV DNA is an effective and feasible biomarker for detecting postradiation nasopharyngeal skull base lesions in NPC patients.

  9. NUMERICAL SIMULATION OF INDUCTION SKULL MELTING PROCESS FOR TITANIUM-ALUMINIUM BASE ALLOY

    Institute of Scientific and Technical Information of China (English)

    Z.Y. Chen; L.J. Xu; F.T. Kong; Q. Shu; Y.Y. Chen

    2004-01-01

    The mathematics model for temperature field of water-cooling copper crucible induction skull melting process was established. The program for simulating temperature field of melting process was developed with finite element method. The temperature field of the melting process for Ti-47Al-2Cr-2Nb alloy was calculated. During melting period, the temperature is raised gradually along radius augmentation direction. The elements of the charge near the crucible wall are molten first. The center elements of the charge are molten last. The melting time of the center element is just that of all the charge melting. The melting time of Ti-47Al-2Cr-2Nb alloy is 15min. In which, the charge was heated by low power 80kW for 9min and by high power 300kW for 6min. When melting Ti-47Al-2Cr-2Nb alloy,the loading power is nearly direct proportion to melt temperature. Increasing loading power may raise melt temperature. The best melting power of Ti-47Al-2Cr-2Nb alloy is 305-310kW. This is identical with the melting test and has guidance sense to the melting process of actual titanium alloy.

  10. Electrophysiological Monitoring in Patients With Tumors of the Skull Base Treated by Carbon-12 Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Carozzo, Simone [Department of Neuroscience, Ophthalmology, and Genetics, University of Genova, Genova (Italy); Schardt, Dieter [Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt (Germany); Narici, Livio [Department of Physics, University of Rome Tor Vergata, Rome (Italy); Combs, Stephanie E.; Debus, Jürgen [Department of Radiation Oncology, University of Heidelberg, Heidelberg (Germany); Sannita, Walter G., E-mail: wgs@dism.unige.it [Department of Neuroscience, Ophthalmology, and Genetics, University of Genova, Genova (Italy); Department of Psychiatry, State University of New York, Stony Brook, New York (United States)

    2013-03-15

    Purpose: To report the results of short-term electrophysiologic monitoring of patients undergoing {sup 12}C therapy for the treatment of skull chordomas and chondrosarcomas unsuitable for radical surgery. Methods and Materials: Conventional electroencephalogram (EEG) and retinal and cortical electrophysiologic responses to contrast stimuli were recorded from 30 patients undergoing carbon ion radiation therapy, within a few hours before the first treatment and after completion of therapy. Methodologies and procedures were compliant with the guidelines of the International Federation for Clinical Neurophysiology and International Society for Clinical Electrophysiology of Vision. Results: At baseline, clinical signs were reported in 56.6% of subjects. Electrophysiologic test results were abnormal in 76.7% (EEG), 78.6% (cortical evoked potentials), and 92.8% (electroretinogram) of cases, without correlation with neurologic signs, tumor location, or therapy plan. Results on EEG, but not electroretinograms and cortical responses, were more often abnormal in patients with reported clinical signs. Abnormal EEG results and retinal/cortical responses improved after therapy in 40% (EEG), 62.5% (cortical potentials), and 70% (electroretinogram) of cases. Results on EEG worsened after therapy in one-third of patients whose recordings were normal at baseline. Conclusions: The percentages of subjects whose EEG results improved or worsened after therapy and the improvement of retinal/cortical responses in the majority of patients are indicative of a limited or negligible (and possibly transient) acute central nervous system toxicity of carbon ion therapy, with a significant beneficial effect on the visual pathways. Research on large samples would validate electrophysiologic procedures as a possible independent test for central nervous system toxicity and allow investigation of the correlation with clinical signs; repeated testing over time after therapy would demonstrate, and may

  11. CASE REPORT: Assimilation of Atlas in Indian Dry Skulls

    Directory of Open Access Journals (Sweden)

    Surekha D Jadhav

    2012-01-01

    Full Text Available Background: A congenital fusion of the atlas to the base of the occiput is defined as assimilation of atlas. It may produce narrowingof foramen magnum which may compress the spinal cord or brain stem. Rarely, it also results in vertebral artery compression, leading todizziness, seizures and syncope. Multiple variations of partial assimilation have been reported and may involve any aspect of atlantooccipital articulation. Therefore the knowledge of such anomaly is essential for orthopedic, anesthetist, and clinician.Aims and Objectives: Aim of the present study was to find the incidence of assimilation of atlas in Indian dry adult skulls of unknown sex and age for which 150 skulls were examined. Results: Only in one skull, we observed fusion of atlas vertebra with occipital bone. The posterior arch and two superior facets of atlashad completely fused with the occipital condyles. The anterior arch had incompletely fused with occipital bone, showing nonunion inthe midline. Only right transverse process was fused with occipital bone. Conclusions: Assimilation of atlas may cause orthopedic problems and occasionally it produces neurological effects especially when the lumen of foramen magnum is reduced. Therefore, improved knowledge on the fusion of the atlas with the occipital bone is important in clinical practice as it shows multiple variations and combinations.

  12. Radiation therapy for chordoma and chondrosarcoma of the skull base and the cervical spine. Prognostic factors and patterns of failure

    Energy Technology Data Exchange (ETDEWEB)

    Noel, G.; Jauffret, E.; Mammar, H.; Ferrand, R. [Centre de Protontherapie d' Orsay, Orsay (France); Habrand, J.L.; Crevoisier, R. de; Haie-Meder, C.; Beaudre, A. [Inst. Gustave Roussy, Villejuif (France); Dederke, S.; Hasboun, D.; Boisserie, G. [Groupe Pitie Salpetriere, AP-HP, Paris (France); Pontvert, D.; Gaboriaud, G. [Inst. Curie, Paris (France); Guedea, F.; Petriz, L. [Catalan Inst. of Oncology, Barcelona (Spain); Mazeron, J.J. [Centre de Protontherapie d' Orsay, Orsay (France); Groupe Pitie Salpetriere, AP-HP, Paris (France)

    2003-04-01

    Background: Prospective analysis of local tumor control, survival and treatment complications in 67 consecutive patients treated with fractionated photon and proton radiation for chordoma or chondrosarcoma of the base of the skull and the cervical spine. Patients and Methods: Between December 1995 and January 2000, 67 patients with a median age of 52 years (range: 14-85 years), were treated at the Centre de Protontherapie d'Orsay (CPO), France, using the 201-MeV proton beam, 49 for chordoma and 18 for chondrosarcoma. Irradiation combined high-energy photons and protons. Photons represented two thirds of the total dose and protons one third. The median total dose delivered within gross tumor volume (GTV) was 67 cobalt gray equivalents (CGE; range: 60-70 CGE). Results: Within a median follow-up of 29 months (range: 4-71 months), the 3-year local control rates were 71% and 85% for chordomas and chondrosarcomas, respectively, and the 3-year overall survival rates 88% and 75%, respectively. 14 tumors (21.5%) failed locally (eight within the GTV, four within the clinical target volume [CTV], and two without further assessment). Seven patients died from their tumor and another one from a nonrelated condition (pulmonary embolism). The maximum tumor diameter and, similarly, the GTV were larger in relapsing patients, compared with the rest of the population: 56 mm vs 44 mm (p = 0.024) and 50 ml vs 22 ml (p = 0.0083), respectively. In univariate analysis, age {<=} 52 years at the time of radiotherapy (p = 0.002), maximum diameter < 45 mm (p = 0.02), and GTV < 28 ml (p = 0.02) impacted positively on local control. On multivariate analysis, only age was an independent prognostic factor of local control. Conclusion: In chordomas and chondrosarcomas of the skull base and cervical spine, combined photon and proton radiation therapy offers excellent chances of cure. In two thirds of the cases, relapses are located in the GTV. Maximum diameter, GTV, and age are prognostic

  13. Value of free-run electromyographic monitoring of lower cranial nerves in endoscopic endonasal approach to skull base surgeries.

    Science.gov (United States)

    Thirumala, Parthasarathy D; Mohanraj, Santhosh Kumar; Habeych, Miguel; Wichman, Kelley; Chang, Yue-Fang; Gardner, Paul; Snyderman, Carl; Crammond, Donald J; Balzer, Jeffrey

    2012-08-01

    Objective The main objective of this study was to evaluate the value of free-run electromyography (f-EMG) monitoring of cranial nerves (CNs) VII, IX, X, XI, and XII in skull base surgeries performed using endoscopic endonasal approach (EEA) to reduce iatrogenic CN deficits. Design We retrospectively identified 73 patients out of 990 patients who had EEA in our institution who had at least one CN monitored. In each CN group, we classified patients who had significant (SG) f-EMG activity as group I and those who did not as group II. Results We monitored a total of 342 CNs. A total of 62 nerves had SG f-EMG activity including CN VII = 18, CN IX = 16, CN X = 13, CN XI = 5, and CN XII = 10. No nerve deficit was found in the nerves that had significant activity during procedure. A total of five nerve deficits including (CN IX = 1, CN X = 2, CN XII = 2) were observed in the group that did not display SG f-EMG activity during surgery. Conclusions f-EMG seems highly sensitive to surgical manipulations and in locating CNs. It seems to have limited value in predicting postoperative neurological deficits. Future studies to evaluate the EMG of lower CNs during EEA procedures need to be done with both f-EMG and triggered EMG.

  14. Value of Free-Run Electromyographic Monitoring of Extraocular Cranial Nerves during Expanded Endonasal Surgery (EES) of the Skull Base.

    Science.gov (United States)

    Thirumala, Parthasarathy D; Mohanraj, Santhosh Kumar; Habeych, Miguel; Wichman, Kelley; Chang, Yue-Fang; Gardner, Paul; Snyderman, Carl; Crammond, Donald J; Balzer, Jeffrey

    2013-06-01

    Objective To evaluate the value of free-run electromyography (f-EMG) monitoring of extraocular cranial nerves (EOCN) III, IV, and VI during expanded endonasal surgery (EES) of the skull base in reducing iatrogenic cranial nerve (CN) deficits. Design We retrospectively identified 200 patients out of 990 who had at least one EOCN monitored during EES. We further separated patients into groups according to the specific CN monitored. In each CN group, we classified patients who had significant (SG) f-EMG activity as Group I and those who did not as Group II. Results A total of 696 EOCNs were monitored. The number of muscles supplied by EOCNs that had SG f-EMG activity was 88, including CN III = 46, CN IV = 21, and CN VI = 21. There were two deficits involving CN VI in patients who had SG f-EMG activity during surgery. There were 14 deficits observed, including CN III = 3, CN IV = 2, and CN VI = 9 in patients who did not have SG f-EMG activity during surgery. Conclusions f-EMG monitoring of EOCN during EES can be useful in identifying the location of the nerve. It seems to have limited value in predicting postoperative neurological deficits. Future studies to evaluate the EMG of EOCN during EES need to be done with both f-EMG and triggered EMG.

  15. Allogeneic cartilage used for skull base plasty in children with primary intranasal encephalomeningocele associated with cerebrospinal fluid rhinorrhea.

    Science.gov (United States)

    Parízek, J; Mĕrićka, P; Nĕmecek, S; Nĕmecková, J; Zemánková, M; Sercl, M; Häringová, M

    1996-03-01

    Three children with primary intranasal encephalomeningocele associated with cerebrospinal fluid rhinorrhea were operated on at the Department of Neurosurgery, Hradec Králové. In two children, aged 4 and 9.5 years, freeze-dried allogeneic costal cartilage was glued into the skull base defect. This plugging was covered up with deep frozen allogeneic fascia lata. In the third child, an only 1-year-old boy, after transection of the neck of the encephalomeningocele freeze-dried allogeneic dura mater was glued on extradurally and deep-frozen allogeneic fascia lata applied intradurally. The cerebrospinal fluid rhinorrhea ceased immediately after surgery. Spontaneous atrophy of the intranasal portion of the encephalomeningocele was demonstrated respectively 11, 1, and 7 years postoperatively on computed tomography. To evaluate cartilage healing histologically, the extracted allogeneic cartilage used for orbital roof plasty after 4 months was examined. The extent of spotty regressions represented about 7% of the tissue volume. It is stressed that, once diagnosed, intranasal encephalomeningocele associated with cerebrospinal fluid rhinorrhea should be operated on for prevention of meningitis as soon as possible. PMID:8697455

  16. Randomised trial of proton vs. carbon ion radiation therapy in patients with chordoma of the skull base, clinical phase III study HIT-1-Study

    Directory of Open Access Journals (Sweden)

    Jensen Alexandra D

    2010-11-01

    Full Text Available Abstract Background Chordomas of the skull base are relative rare lesions of the bones. Surgical resection is the primary treatment standard, though complete resection is nearly impossible due to close proximity to critical and hence also dose limiting organs for radiation therapy. Level of recurrence after surgery alone is comparatively high, so adjuvant radiation therapy is very important for the improvement of local control rates. Proton therapy is the gold standard in the treatment of skull base chordomas. However, high-LET beams such as carbon ions theoretically offer biologic advantages by enhanced biologic effectiveness in slow-growing tumors. Methods/design This clinical study is a prospective randomised phase III trial. The trial will be carried out at Heidelberger Ionenstrahl-Therapie centre (HIT and is a monocentric study. Patients with skull base chordoma will be randomised to either proton or carbon ion radiation therapy. As a standard, patients will undergo non-invasive, rigid immobilization and target volume delineation will be carried out based on CT and MRI data. The biologically isoeffective target dose to the PTV in carbon ion treatment (accelerated dose will be 63 Gy E ± 5% and 72 Gy E ± 5% (standard dose in proton therapy respectively. Local-progression free survival (LPFS will be analysed as primary end point. Toxicity and overall survival are the secondary end points. Additional examined parameters are patterns of recurrence, prognostic factors and plan quality analysis. Discussion Up until now it was impossible to compare two different particle therapies, i.e. protons and carbon ions directly at the same facility. The aim of this study is to find out, whether the biological advantages of carbon ion therapy can also be clinically confirmed and translated into the better local control rates in the treatment of skull base chordomas. Trial registration ClinicalTrials.gov identifier: NCT01182779

  17. A dual resolution measurement based Monte Carlo simulation technique for detailed dose analysis of small volume organs in the skull base region

    International Nuclear Information System (INIS)

    The purpose of this study was to examine dose distribution of a skull base tumor and surrounding critical structures in response to high dose intensity-modulated radiosurgery (IMRS) with Monte Carlo (MC) simulation using a dual resolution sandwich phantom. The measurement-based Monte Carlo (MBMC) method (Lin et al., 2009) was adopted for the study. The major components of the MBMC technique involve (1) the BEAMnrc code for beam transport through the treatment head of a Varian 21EX linear accelerator, (2) the DOSXYZnrc code for patient dose simulation and (3) an EPID-measured efficiency map which describes non-uniform fluence distribution of the IMRS treatment beam. For the simulated case, five isocentric 6 MV photon beams were designed to deliver a total dose of 1200 cGy in two fractions to the skull base tumor. A sandwich phantom for the MBMC simulation was created based on the patient's CT scan of a skull base tumor [gross tumor volume (GTV)=8.4 cm3] near the right 8th cranial nerve. The phantom, consisted of a 1.2-cm thick skull base region, had a voxel resolution of 0.05×0.05×0.1 cm3 and was sandwiched in between 0.05×0.05×0.3 cm3 slices of a head phantom. A coarser 0.2×0.2×0.3 cm3 single resolution (SR) phantom was also created for comparison with the sandwich phantom. A particle history of 3×108 for each beam was used for simulations of both the SR and the sandwich phantoms to achieve a statistical uncertainty of <2%. Our study showed that the planning target volume (PTV) receiving at least 95% of the prescribed dose (VPTV95) was 96.9%, 96.7% and 99.9% for the TPS, SR, and sandwich phantom, respectively. The maximum and mean doses to large organs such as the PTV, brain stem, and parotid gland for the TPS, SR and sandwich MC simulations did not show any significant difference; however, significant dose differences were observed for very small structures like the right 8th cranial nerve, right cochlea, right malleus and right semicircular canal

  18. Fractionated stereotactic radiotherapy of benign skull-base tumors: a dosimetric comparison of volumetric modulated arc therapy with Rapidarc® versus non-coplanar dynamic arcs

    OpenAIRE

    Martin, Fanny; Magnier, Florian; Berger, Lucie; Miroir, Jessica; Chautard, Emmanuel; Verrelle, Pierre; Lapeyre, Michel; Biau, Julian

    2016-01-01

    Background Benign tumors of the skull base are a challenge when delivering radiotherapy. An appropriate choice of radiation technique may significantly improve the patient’s outcomes. Our study aimed to compare the dosimetric results of fractionated stereotactic radiotherapy between non-coplanar dynamic arcs and coplanar volumetric modulated arctherapy (Rapidarc®). Methods Thirteen patients treated with Novalis TX® were analysed: six vestibular schwannomas, four pituitary adenomas and three m...

  19. CT and MRI of intrinsic space-occupying lesions of the bony skull base; CT und MRT bei intrinsischen raumfordernden Laesionen der knoechernen Schaedelbasis

    Energy Technology Data Exchange (ETDEWEB)

    Koesling, S.; Brandt, S. [Martin-Luther-Universitaet Halle-Wittenberg, Universitaetsklinik und Poliklinik fuer Diagnostische Radiologie, Halle (Germany); Neumann, K. [Martin-Luther-Universitaet Halle-Wittenberg, Universitaetsklinik und Poliklinik fuer Hals-, Nasen-, Ohrenheilkunde, Kopf- und Halschirurgie, Halle (Germany)

    2009-07-15

    Intrinsic bony lesions of the skull base are diseases which arise within the bones forming the skull base. Mainly they are bone tumours and tumour-like lesions. With the exception of osteomas of the paranasal sinuses and exostoses of the external auditory canal, these lesions occur rarely. This article gives an overview of the appearance of the most common primary bony skull base masses in CT and MRI. From the authors' point of view these are fibrous dysplasia, chordomas, chondrosarcomas, Langerhans cell histiocytosis and multiple myelomas, which must be differentiated from pseudolesions. The possibilities of CT and MRI in making a specific diagnosis, differential diagnosis and the kind of making the final diagnosis are described. (orig.) [German] Unter intrinsischen Laesionen der knoechernen Schaedelbasis versteht man Erkrankungen, die von den die Schaedelbasis bildenden Knochen ausgehen. In erster Linie handelt es sich um Knochentumoren und tumoraehnliche Laesionen. Mit wenigen Ausnahmen (Nasennebenhoehlenosteome, Exostosen des aeusseren Gehoergangs) sind sie selten. Dieser Beitrag gibt einen Ueberblick ueber das CT- und MRT-Erscheinungsbild der aus Sicht der Autoren unter diesem Aspekt noch am haeufigsten anzutreffenden raumfordernden Laesionen. Dazu zaehlen die fibroese Dysplasie, Chordome, Chondrosarkome, die Langerhans-Zell-Histiozytose und das multiple Myelom. Abgrenzt werden muessen Pseudotumoren. Artdiagnostische Zuordnungsmoeglichkeiten durch CT und/oder MRT, Differenzialdiagnosen und Diagnosesicherung werden dargelegt. (orig.)

  20. Skull base osteomyelitis in otitis externa: The utility of triphasic and single photon emission computed tomography/computed tomography bone scintigraphy

    International Nuclear Information System (INIS)

    Skull base osteomyelitis (SBO) refers to infection that has spread beyond the external auditory canal to the base of the skull in advanced stages of otitis externa. Clinically, it may be difficult to differentiate SBO from severe otitis externa without bony involvement. This study was performed to determine the role of three phase bone scintigraphy (TPBS) and single photon emission tomography/computed tomography (SPECT/CT) in detecting SBO. We retrospectively analyzed records of 20 patients (14 M, 6 F) with otitis externa and suspected SBO. TPBS and SPECT/CT of the skull were performed. Findings were correlated with clinical, laboratory and diagnostic CT scan findings. All patients were diabetic with elevated erythrocyte sedimentation rate. A total of 18 patients had bilateral and two unilateral symptoms. Cranial nerves were involved in eight patients and microbiological culture of ear discharge fluid positive in seven. Early images showed increased temporal vascularity in nine patients and increased soft-tissue uptake in 10, while delayed images showed increased bone uptake in 19/20 patients. Localized abnormal tracer uptake was shown by SPECT/CT in the mastoid temporal (15), petrous (11), sphenoid (3) and zygomatic (1) and showed destructive changes in five. Thus, TPBS was found positive for SBO in 10/20 patients and changed the management in four. Our study suggests that TPBS with SPECT/CT is a useful non-invasive investigation for detection of SBO in otitis externa

  1. MRI-detected skull-base invasion. Prognostic value and therapeutic implication in intensity-modulated radiotherapy treatment for nasopharyngeal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Cheng, Yi-Kan; Jiang, Ning; Yue, Dan; Tang, Ling-Long; Zhang, Fan; Lin, Li; Liu, Xu; Chen, Lei; Ma, Jun [Sun Yat-sen University Cancer Center, Department of Radiation Oncology, Guangzhou (China); Liu, Li-Zhi [Sun Yat-sen University Cancer Center, Department of Radiology, Guangzhou (China)

    2014-10-15

    With advances in imaging and radiotherapy, the prognostic value of skull-base invasion in nasopharyngeal carcinoma (NPC) needs to be reassessed. We aimed to define a classification system and evaluate the prognostic value of the classification of magnetic resonance imaging (MRI)-detected skull-base invasion in NPC treated with intensity-modulated radiotherapy (IMRT). We retrospectively reviewed 749 patients who underwent MRI and were subsequently histologically diagnosed with nondisseminated NPC and treated with IMRT. MRI-detected skull-base invasion was not found to be an independent prognostic factor for overall survival (OS), distant metastasis-free survival (DMFS), local relapse-free survival (LRFS), or disease-free survival (DFS; p > 0.05 for all). Skull-base invasion was classified according to the incidence of each site (type I sites inside pharyngobasilar fascia and clivus vs. type II sites outside pharyngobasilar fascia). The 5-year OS, DMFS, LRFS, and DFS rates in the classification of skull-base invasion in NPC were 83 vs. 67 %, 85 vs.75 %, 95 vs. 88 %, and 76 vs. 62 %, respectively (p < 0.05 for all). Multivariate analysis indicated the classification of skull-base invasion was an independent prognostic factor. MRI-detected skull-base invasion is not an independent prognostic factor in patients with NPC treated with IMRT. However, classification according to the site of invasion has prognostic value. Therefore, patients with various subclassifications of stage T3 disease may receive treatment with different intensities; however, further studies are warranted to prove this. (orig.) [German] Aufgrund der Fortschritte der bildgebenden Verfahren und der Strahlentherapie muss der prognostische Wert der Invasion des nasopharyngealen Karzinoms (NPC) in die Schaedelbasis erneut bewertet werden. Unser Ziel ist die Definition eines Klassifikationssystems und die Untersuchung des prognostischen Werts der Klassifikation der MRT-ermittelten Invasion des mit

  2. Skull Base Clear Cell Carcinoma, Metastasis of Renal Primary Tumor: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Ilson Sepúlveda

    2013-08-01

    Full Text Available We report on a patient who presented with cranial nerve VI bilateral paresis, absence of pharyngeal reflex, dysarthria, right tongue deviation, and right facial paralysis. Imaging studies showed an expansive process in the cranial base with clivus and petrous apex osteolysis. A biopsy confirmed the presence of clear cell adenocarcinoma and suspicion of renal tumor metastases. Abdominal imaging studies revealed a mass in the right kidney. Consequently, radiotherapy was performed, and the patient was enrolled in a palliative care and pain control program.

  3. Spot Scanning Proton Therapy for Malignancies of the Base of Skull: Treatment Planning, Acute Toxicities, and Preliminary Clinical Outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Grosshans, David R., E-mail: dgrossha@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Zhu, X. Ronald; Melancon, Adam [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Allen, Pamela K. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Poenisch, Falk; Palmer, Matthew [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); McAleer, Mary Frances; McGovern, Susan L. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Gillin, Michael [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); DeMonte, Franco [Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Chang, Eric L. [Department of Radiation Oncology, University of Southern California Keck School of Medicine, Los Angeles, California (United States); Brown, Paul D.; Mahajan, Anita [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2014-11-01

    Purpose: To describe treatment planning techniques and early clinical outcomes in patients treated with spot scanning proton therapy for chordoma or chondrosarcoma of the skull base. Methods and Materials: From June 2010 through August 2011, 15 patients were treated with spot scanning proton therapy for chordoma (n=10) or chondrosarcoma (n=5) at a single institution. Toxicity was prospectively evaluated and scored weekly and at all follow-up visits according to Common Terminology Criteria for Adverse Events, version 3.0. Treatment planning techniques and dosimetric data were recorded and compared with those of passive scattering plans created with clinically applicable dose constraints. Results: Ten patients were treated with single-field-optimized scanning beam plans and 5 with multifield-optimized intensity modulated proton therapy. All but 2 patients received a simultaneous integrated boost as well. The mean prescribed radiation doses were 69.8 Gy (relative biological effectiveness [RBE]; range, 68-70 Gy [RBE]) for chordoma and 68.4 Gy (RBE) (range, 66-70) for chondrosarcoma. In comparison with passive scattering plans, spot scanning plans demonstrated improved high-dose conformality and sparing of temporal lobes and brainstem. Clinically, the most common acute toxicities included fatigue (grade 2 for 2 patients, grade 1 for 8 patients) and nausea (grade 2 for 2 patients, grade 1 for 6 patients). No toxicities of grades 3 to 5 were recorded. At a median follow-up time of 27 months (range, 13-42 months), 1 patient had experienced local recurrence and a second developed distant metastatic disease. Two patients had magnetic resonance imaging-documented temporal lobe changes, and a third patient developed facial numbness. No other subacute or late effects were recorded. Conclusions: In comparison to passive scattering, treatment plans for spot scanning proton therapy displayed improved high-dose conformality. Clinically, the treatment was well tolerated, and

  4. Aspects of achondroplasia in the skulls of dwarf transgenic mice: a cephalometric study.

    Science.gov (United States)

    Bloom, Melissa Wadler; Murakami, Shunichi; Cody, Dianna; Montufar-Solis, Dina; Duke, Pauline Jackie

    2006-03-01

    Achondroplasia, the most common short-limbed dwarfism in humans, results from a single nucleotide substitution in the gene for fibroblast growth factor receptor 3 (FGFR3). FGFR3 regulates bone growth in part via the mitogen-activated protein kinase pathway (MAPK). To examine the role of this pathway in chondrocyte differentiation, a transgenic mouse was generated that expresses a constitutively active mutant of MEK1 in chondrocytes and exhibits dwarfing characteristics typical of human achondroplasia, i.e., shortened axial and appendicular skeletons, mid-facial hypoplasia, and dome-shaped cranium. In this study, cephalometrics of the MEK1 mutant skulls were assessed to determine if the MEK1 mice are a good model of achondroplasia. Skull length, arc of the cranial vault, and area, maximum and minimum diameters of the brain case were measured on digitized radiographs of skulls of MEK1 and control mice. Cranial base and nasal bone length and foramen magnum diameter were measured on midsagittal micro-CT sections. Data were normalized by dividing by the cube root of each animal's weight. Transgenic mice exhibited a domed skull, deficient midface, and (relatively) prognathic mandible and had a shorter cranial base and nasal bone than the wild-type. Skull length was significantly less in transgenic mice, but cranial arc was significantly greater. The brain case was larger and more circular and minimum diameter of the brain case was significantly greater in transgenic mice. The foramen magnum was displaced anteriorly but not narrowed. MEK1 mouse cephalometrics confirm these mice as a model for achondroplasia, demonstrating that the MAP kinase signaling pathway is involved in FGF signaling in skeletal development. PMID:16463380

  5. Interparietal bones in Nigerian skulls.

    OpenAIRE

    Saxena, S. K.; Chowdhary, D S; Jain, S P

    1986-01-01

    The study was conducted on 40 adult Nigerian skulls which were examined for the presence of interparietal and pre-interparietal bones. Only one interparietal bone was found (2.5% of the present series) while a single pre-interparietal bone was found in four skulls (10%) and multiple pre-interparietal bones in one skull (2.5%).

  6. CT evaluation of Chamberlain's, McGregor's, and McRae's skull-base lines

    Energy Technology Data Exchange (ETDEWEB)

    Cronin, C.G. [Department of Radiology, University College Hospital, Galway (Ireland)], E-mail: carmelcronin2000@hotmail.com; Lohan, D.G.; Mhuircheartigh, J.N.; Meehan, C.P.; Murphy, J.; Roche, C. [Department of Radiology, University College Hospital, Galway (Ireland)

    2009-01-15

    Aim: To evaluate the mean distance from the odontoid process of C2 to the standard skull-base lines (Chamberlain's, McGregor's, and McRae's lines) on computed tomography (CT) imaging. To compare these measurements to previously documented plain radiograph and magnetic resonance imaging (MRI) measurements. Materials and methods: Reformatted midline sagittal CT images of 150 adults were retrospectively evaluated. The shortest perpendicular distance was measured from the Chamberlain's, McGregor's and McRae's baselines for each subject to the odontoid tip. Statistical analysis was performed to compare the CT data with the previously obtained MRI and plain film data. Results: The mean position of the odontoid process was 1.4 mm below Chamberlain's line (median 1.2 mm, SD 2.4 mm), 0.8 mm (median 0.9 mm, SD 3 mm) below McGregor's line and 5 mm (median 5 mm, SD 1.8 mm) below McRae's line. There is no significant difference between male and female results (p > 0.05) or between these CT and previous MRI measurements (p > 0.05). Conclusion: These results provide the mean and range of normal distance from the odontoid process to the most frequently used skull-base lines on the current population on CT.

  7. MSCT versus CBCT: evaluation of high-resolution acquisition modes for dento-maxillary and skull-base imaging

    Energy Technology Data Exchange (ETDEWEB)

    Dillenseger, Jean-Philippe; Goetz, Christian [Hopitaux Universitaires de Strasbourg, Imagerie Preclinique-UF6237, Pole d' imagerie, Strasbourg (France); Universite de Strasbourg, Icube, equipe MMB, CNRS, Strasbourg (France); Universite de Strasbourg, Federation de Medecine Translationnelle de Strasbourg, Faculte de Medecine, Strasbourg (France); Matern, Jean-Francois [Hopitaux Universitaires de Strasbourg, Imagerie Preclinique-UF6237, Pole d' imagerie, Strasbourg (France); Universite de Strasbourg, Federation de Medecine Translationnelle de Strasbourg, Faculte de Medecine, Strasbourg (France); Gros, Catherine-Isabelle; Bornert, Fabien [Universite de Strasbourg, Federation de Medecine Translationnelle de Strasbourg, Faculte de Medecine, Strasbourg (France); Universite de Strasbourg, Faculte de Chirurgie Dentaire, Strasbourg (France); Le Minor, Jean-Marie [Universite de Strasbourg, Icube, equipe MMB, CNRS, Strasbourg (France); Universite de Strasbourg, Federation de Medecine Translationnelle de Strasbourg, Faculte de Medecine, Strasbourg (France); Universite de Strasbourg, Institut d' Anatomie Normale, Strasbourg (France); Constantinesco, Andre [Hopitaux Universitaires de Strasbourg, Imagerie Preclinique-UF6237, Pole d' imagerie, Strasbourg (France); Choquet, Philippe [Hopitaux Universitaires de Strasbourg, Imagerie Preclinique-UF6237, Pole d' imagerie, Strasbourg (France); Universite de Strasbourg, Icube, equipe MMB, CNRS, Strasbourg (France); Universite de Strasbourg, Federation de Medecine Translationnelle de Strasbourg, Faculte de Medecine, Strasbourg (France); Hopital de Hautepierre, Imagerie Preclinique, Biophysique et Medecine Nucleaire, Strasbourg Cedex (France)

    2014-09-24

    Our aim was to conduct a quantitative and qualitative evaluation of high-resolution skull-bone imaging for dentistry and otolaryngology using different architectures of recent X-ray computed tomography systems. Three multi-slice computed tomography (MSCT) systems and one Cone-beam computed tomography (CBCT) system were used in this study. All apparatuses were tested with installed acquisition modes and proprietary reconstruction software enabling high-resolution bone imaging. Quantitative analyses were performed with small fields of view with the preclinical vmCT phantom, which permits to measure spatial resolution, geometrical accuracy, linearity and homogeneity. Ten operators performed visual qualitative analyses on the vmCT phantom images, and on dry human skull images. Quantitative analysis showed no significant differences between protocols in terms of linearity and geometric accuracy. All MSCT systems present a better homogeneity than the CBCT. Both quantitative and visual analyses demonstrate that CBCT acquisitions are not better than the collimated helical MSCT mode. Our results demonstrate that current high-resolution MSCT protocols could exceed the performance of a previous generation CBCT system for spatial resolution and image homogeneity. (orig.)

  8. Fractionated stereotactic radiotherapy for skull base tumors: analysis of treatment accuracy using a stereotactic mask fixation system

    Directory of Open Access Journals (Sweden)

    Montagnoli Roberto

    2010-01-01

    Full Text Available Abstract Background To assess the accuracy of fractionated stereotactic radiotherapy (FSRT using a stereotactic mask fixation system. Patients and Methods Sixteen patients treated with FSRT were involved in the study. A commercial stereotactic mask fixation system (BrainLAB AG was used for patient immobilization. Serial CT scans obtained before and during FSRT were used to assess the accuracy of patient immobilization by comparing the isocenter position. Daily portal imaging were acquired to establish day to day patient position variation. Displacement errors along the different directions were calculated as combination of systematic and random errors. Results The mean isocenter displacements based on localization and verification CT imaging were 0.1 mm (SD 0.3 mm in the lateral direction, 0.1 mm (SD 0.4 mm in the anteroposterior, and 0.3 mm (SD 0.4 mm in craniocaudal direction. The mean 3D displacement was 0.5 mm (SD 0.4 mm, being maximum 1.4 mm. No significant differences were found during the treatment (P = 0.4. The overall isocenter displacement as calculated by 456 anterior and lateral portal images were 0.3 mm (SD 0.9 mm in the mediolateral direction, -0.2 mm (SD 1 mm in the anteroposterior direction, and 0.2 mm (SD 1.1 mm in the craniocaudal direction. The largest displacement of 2.7 mm was seen in the cranio-caudal direction, with 95% of displacements Conclusions The results indicate that the setup error of the presented mask system evaluated by CT verification scans and portal imaging are minimal. Reproducibility of the isocenter position is in the best range of positioning reproducibility reported for other stereotactic systems.

  9. Experience of complex deformity of skull base by surgical treatment%复杂颅底凹陷畸形的手术治疗体会

    Institute of Scientific and Technical Information of China (English)

    程飞

    2012-01-01

    目的 探讨复杂颅底凹陷的外科手术治疗效果.方法 对郑州市第三人民医院2005年11月-2011年3月收治的22例复杂颅底凹陷的患者,根据不同的临床表现和影像学特征采取不同的手术方法.结果 两组患者治疗前与治疗后3个月比较疗效均有明显改善.治疗后3个月经影像检查显示脊髓前、后方减压良好,枕颈植骨均已融合.两组患者手术前后SAC的测量结果比较差异有统计学意义(P<0.05).结论 颅底凹陷畸形是枕骨大孔区、寰枕区畸形较复杂的一种,应当根据不同临床症状、体征及影像学的表现采用不同手术方式.%Objective To explore the experience of complex skull base surgical treatment. Methods The hospital in November 2005 to March 2011 treated 22 patients with complex skull base, depending on the clinical and imaging features to adopt different surgical methods. Results The two groups of patients before treatment and 3 months after treatment compared the efficacy showed significant improvement. 3 months after the treatment period before imaging shows the spinal cord posterior decompression good pillow neck bone have been integrated. Two groups of patients before and after SAC measurements the difference was statistically significant ( P < 0. 05 ) . Conclusions The base of the skull deformity is a foramen magnum, atlanto - occipital region of a more complex deformity, should be based on different clinical symptoms, signs and imaging performance to choose different surgical methods.

  10. Neurosurgical considerations of cranial base surgery.

    Science.gov (United States)

    Chenelle, A G; Shaffrey, M E; Delashaw, J B; Jane, J A

    1995-07-01

    Several craniotomies have been described that allow extensive resection of skull base and low-lying cranial tumors that involve little disfigurement to the patient. These techniques should be of interest to plastic surgeons as they may be called to aid their neurosurgical colleagues in exposing the anterior skull base or may be involved in combined procedures to resect tumors that involve the face, sinuses, orbit, and cranial vault. PMID:7554716

  11. Functional structure of the skull in hominoidea.

    Science.gov (United States)

    Preuschoft, H; Witzel, U

    2004-01-01

    Finite elements stress analysis (FESA) was used to investigate the flow of compressive forces which occur if a homogenous, three-dimensional body representing the skull is loaded by simulated bite forces against the tooth row. Model 1 represents the snout alone. Bite forces are applied simultaneously, but increase rearward. Stresses in the model concentrate along the anterior contour and the lower surface of the model, leaving unstressed a nasal opening and a wide naso-oral connection. Model 2 represents the facial region, as far as the temporomandibular joint. The orbits and the nasal cavity are assumed to be present a priori. Model 3 applies reactions to the bite forces in the temporal fossa, corresponding to the origins of the masticatory muscles. Regions of the model under compressive stress correspond closely to the arrangement of bony material in a hominoid skull. If only the stress-bearing finite elements on each section are combined, and the stress-free parts neglected, the resulting three-dimensional shape is surprisingly similar to a hominoid skull. If bite forces are applied to parts of the tooth row only, the stress patterns are lower, asymmetrical and do not spread into all regions that are stress-bearing in simultaneous biting on all teeth. In model 2, the highest stresses occur at the tooth roots and along the forehead on top of the nasal roof. There are no marked stress concentrations on top of the orbits. The resulting shape resembles that of an orang-utan. In model 3, the highest stresses also occur at the tooth roots, but the circles of force mostly close below the brain case, so that the stress concentration in the forehead region remains much less marked. In this model, however, the stress concentrations are very similar to hollow brow ridges. The entire resulting shape resembles that of gorilla or chimpanzee skulls. A typical gracile australopithecine skull (STS-5) also shows clear similarities to the patterns of stress flow in our models

  12. Cave crawling in zebra Finch skulls

    DEFF Research Database (Denmark)

    Larsen, Ole Næsbye; Salomon, Rasmus; Jensen, Kenneth Kragh;

    2014-01-01

    The middle ears of birds are acoustically coupled through an air-filled interaural canal, often illustrated and modelled as a simple tube. It allows sound to propagate through the skull from one ear to the other and considerably enhance the cues for directional hearing by interaction with the...... by anatomical adaptations during evolution. A closer inspection of the zebra finch cranium using micro-CT scanning reveals that not only is IAC trabeculated and irregularly shaped but it also communicates with a set of highly complex, air-filled canals in the skull extending to the base of the beak...

  13. 内镜下颅底手术体会%Clinical experience with nasendoscopic surgery in nose-skull base area

    Institute of Scientific and Technical Information of China (English)

    包小庆; 谢宏武

    2011-01-01

    Objective To summarize the clinical experience with nasendoscopic surgery in nose-skull base area and explore appropriate surgical technique for various kinds lesion in this area based on a retrospective clinical analysis. Methods Included in this study were 15 patients with various kinds of nose-skull base disease, all being treated by nasendoscopic surgery during the period from Jul., 2003 to Aug., 2011. A retrospective study was carried out among them, with their clinical data analyzed carefully to sum up our experience with this kind of surgery. Results All these operations were carried out under nasal endoscope successfully. Among them, 7 with pituitary adenoma were seen with their disordered endocrine symptoms and impaired vision function improved following the surgery, 3 with traumatic cerebrospinal rhinorrhea were cured successfully without symptoms reoccurred after die operation, and 5 with traumatic optic neuropathy had improved visual function at various degrees respectively after transnasal endoscopic optic canal decompression. Among these cases with traumatic optic neuropathy, one was complicated with cerebrospinal rhinorrhea following the operation but the lesion was cured with conservative treating procedures after the primary surgery. Conclusions Transnasal endoscopic surgery holds many advantages for the treatment of lesions involving the area of nose-skull base, such as minimal invasive during the operation, quicker recovery course following the operation and fewer chance with possible operative complications. It is very important to identify the surgical anatomical landmarks exactly during the operation and to reconstruct the tissue defects in skull base properly for ensuring the safety and efficacy of the surgery.%目的 总结内镜下颅底手术的方法和临床经验.方法 回顾性分析2003年7月~2011年8月在鼻内镜下完成的鼻颅底区域手术15例临床资料,探讨鼻颅底手术的相关技术与

  14. [Force-based local navigation in robot-assisted implantation bed anlage in the lateral skull base. An experimental study].

    Science.gov (United States)

    Plinkert, P K; Federspil, P A; Plinkert, B; Henrich, D

    2002-03-01

    Excellent precision, miss of retiring, reproducibility are main characteristics of robots in the operating theatre. Because of these facts their use for surgery in the lateral scull base is of great interest. In recent experiments we determined process parameters for robot assisted reaming of a cochlea implant bed and for a mastoidectomy. These results suggested that optimizing parameters for thrilling with the robot is needed. Therefore we implemented a suitable reaming curve from the geometrical data of the implant and a force controlled process control for robot assisted reaming at the lateral scull base. Experiments were performed with an industrial robot on animal and human scull base specimen. Because of online force detection and feedback of sensory data the reaming with the robot was controlled. With increasing force values above a defined limit feed rates were automatically regulated. Furthermore we were able to detect contact of the thrill to dura mater by analyzing the force values. With the new computer program the desired implant bed was exactly prepared. Our examinations showed a successful reaming of an implant bed in the lateral scull base with a robot. Because of a force controlled reaming process locale navigation is possible and enables careful thrilling with a robot.

  15. [Apical petrositis, osteomyelitis of the base of the skull bones and of the first cervical vertebra in a 5 year-old children following chicken pox].

    Science.gov (United States)

    Bogomil'sky, M R; Polunin, M M; Zelikovich, E I; Soldatsky, Yu L; Burova, O V

    2016-01-01

    This publication was designed to describe a rare case of development of apicalpetrositis in a child presenting with acute otitis mediafollowing chicken pox experienced in the preceding period. We carried out the study with the use of computed tomography (CT) that demonstrated destruction of the temporal bone, bones of the base of the skull and of the first cervical vertebra. The treatment strategy chosen for the management of this condition that included antibiotic therapy and expectant observation proved justified and can be recommended as an algorithm of choice taking into consideration the difficulty of surgical approach to the apex of the petrous pyramid. However, this approach is associated with the high risk of disability arising from the potential injury to the craniocerebral nerves. PMID:26977573

  16. Evaluation of a System for High-Accuracy 3D Image-Based Registration of Endoscopic Video to C-Arm Cone-Beam CT for Image-Guided Skull Base Surgery

    OpenAIRE

    Mirota, Daniel J.; Uneri, Ali; Schafer, Sebastian; Nithiananthan, Sajendra; Reh, Douglas D.; Ishii, Masaru; Gallia, Gary L.; TAYLOR, RUSSELL H.; Hager, Gregory D.; Siewerdsen, Jeffrey H.

    2013-01-01

    The safety of endoscopic skull base surgery can be enhanced by accurate navigation in preoperative computed tomography (CT) or, more recently, intraoperative cone-beam CT (CBCT). The ability to register real-time endoscopic video with CBCT offers an additional advantage by rendering information directly within the visual scene to account for intraoperative anatomical change. However, tracker localization error (~ 1–2 mm) limits the accuracy with which video and tomographic images can be regis...

  17. Positron Emission Tomography/Computed Tomography Imaging of Residual Skull Base Chordoma Before Radiotherapy Using Fluoromisonidazole and Fluorodeoxyglucose: Potential Consequences for Dose Painting

    Energy Technology Data Exchange (ETDEWEB)

    Mammar, Hamid, E-mail: hamid.mammar@unice.fr [Radiation Oncology Department, Antoine Lacassagne Center, Nice (France); CNRS-UMR 6543, Institute of Developmental Biology and Cancer, University of Nice Sophia Antipolis, Nice (France); Kerrou, Khaldoun; Nataf, Valerie [Department of Nuclear Medicine and Radiopharmacy, Tenon Hospital, and University Pierre et Marie Curie, Paris (France); Pontvert, Dominique [Proton Therapy Center of Orsay, Curie Institute, Paris (France); Clemenceau, Stephane [Department of Neurosurgery, Pitie-Salpetriere Hospital, Paris (France); Lot, Guillaume [Department of Neurosurgery, Adolph De Rothschild Foundation, Paris (France); George, Bernard [Department of Neurosurgery, Lariboisiere Hospital, Paris (France); Polivka, Marc [Department of Pathology, Lariboisiere Hospital, Paris (France); Mokhtari, Karima [Department of Pathology, Pitie-Salpetriere Hospital, Paris (France); Ferrand, Regis; Feuvret, Loiec; Habrand, Jean-louis [Proton Therapy Center of Orsay, Curie Institute, Paris (France); Pouyssegur, Jacques; Mazure, Nathalie [CNRS-UMR 6543, Institute of Developmental Biology and Cancer, University of Nice Sophia Antipolis, Nice (France); Talbot, Jean-Noeel [Department of Nuclear Medicine and Radiopharmacy, Tenon Hospital, and University Pierre et Marie Curie, Paris (France)

    2012-11-01

    Purpose: To detect the presence of hypoxic tissue, which is known to increase the radioresistant phenotype, by its uptake of fluoromisonidazole (18F) (FMISO) using hybrid positron emission tomography/computed tomography (PET/CT) imaging, and to compare it with the glucose-avid tumor tissue imaged with fluorodeoxyglucose (18F) (FDG), in residual postsurgical skull base chordoma scheduled for radiotherapy. Patients and Methods: Seven patients with incompletely resected skull base chordomas were planned for high-dose radiotherapy (dose {>=}70 Gy). All 7 patients underwent FDG and FMISO PET/CT. Images were analyzed qualitatively by visual examination and semiquantitatively by computing the ratio of the maximal standardized uptake value (SUVmax) of the tumor and cerebellum (T/C R), with delineation of lesions on conventional imaging. Results: Of the eight lesion sites imaged with FDG PET/CT, only one was visible, whereas seven of nine lesions were visible on FMISO PET/CT. The median SUVmax in the tumor area was 2.8 g/mL (minimum 2.1; maximum 3.5) for FDG and 0.83 g/mL (minimum 0.3; maximum 1.2) for FMISO. The T/C R values ranged between 0.30 and 0.63 for FDG (median, 0.41) and between 0.75 and 2.20 for FMISO (median,1.59). FMISO T/C R >1 in six lesions suggested the presence of hypoxic tissue. There was no correlation between FMISO and FDG uptake in individual chordomas (r = 0.18, p = 0.7). Conclusion: FMISO PET/CT enables imaging of the hypoxic component in residual chordomas. In the future, it could help to better define boosted volumes for irradiation and to overcome the radioresistance of these lesions. No relationship was founded between hypoxia and glucose metabolism in these tumors after initial surgery.

  18. Superficial peroneal neurocutaneous flap based on an anterior tibial artery perforator for forefoot reconstruction.

    Science.gov (United States)

    Wang, Chun-Yang; Chai, Yi-Min; Wen, Gen; Han, Pei; Cheng, Liang

    2015-06-01

    The distally based superficial peroneal neurocutaneous (SPNC) island flap has been widely used for foot reconstruction. It is based on the descending branch of the peroneal artery perforator. However, damage to the perimalleolar vascularization or anatomic variations of the descending branch often causes flap necrosis. Because septocutaneous perforators from the anterior tibial artery participate in the vascular network of superficial peroneal nerve in the distal lower leg, a modified SPNC flap is designed based on the anterior tibial artery perforator. Seven patients with soft tissue defect over the forefoot were treated by this modified technique. Six patients had accompanied injuries at the lateral perimalleolar region, and 1 patient had an anatomic variation of the descending branch of the peroneal artery perforator. The size of defect ranged from 12 × 5 to 15 × 9 cm. All 7 flaps survived completely without complications. The size of the flaps ranged from 13 × 6 to 16 × 10 cm. No severe venous congestion occurred. The mean follow-up was 9.4 months (range, 6-14 months). All patients were satisfied with the texture and color of the flaps. Two patients complained about the thickness of the flaps, but did not want further operation. The donor sites healed uneventfully and no painful neuroma occurred. In conclusion, the modified SPNC flap based on an anterior tibial artery perforator is a feasible salvage procedure when the traditional design is unreliable. It can provide sufficient and superior coverage for large forefoot defect. PMID:25969973

  19. [The skull of Combe Capelle].

    Science.gov (United States)

    Hoffmann, Almut; Wegner, Dietrich

    2002-12-01

    Since the end of World War II two of the most important anthropological artefacts of the Museum für Vor- und Frühgeschichte in Berlin, the skulls and skeletons of Le Moustier and Combe Capelle, were believed to be missing or destroyed, respectively. The postcrania were severely damaged during a fire after the museum was bombed in February 1945, while the skulls were brought to the Soviet Union in 1945. In 1965, the skull of the Neanderthal man from Le Moustier and the chain of the grave of Combe Capelle were found amongst the art objects returned by the Soviet Union into the German Democratic Republic in 1958. However, the Combe Capelle skull was still missing. In the end of 2001 this skull could be found and identified in a store-house of the museum. Now, one the oldest known representatives of Homo sapiens sapiens is again available for scientific research and public exhibitions. PMID:12529957

  20. The plastered skulls from the Pre-Pottery Neolithic B site of Yiftahel (Israel)--a computed tomography-based analysis.

    Science.gov (United States)

    Slon, Viviane; Sarig, Rachel; Hershkovitz, Israel; Khalaily, Hamoudi; Milevski, Ianir

    2014-01-01

    Three plastered skulls, dating to the Pre-Pottery Neolithic B, were found at the site of Yiftahel, in the Lower Galilee (Israel). The skulls underwent refitting and restoration processes, details of which are described herein. All three belong to adults, of which two appear to be males and one appears to be a female. Virtual cross-sections were studied and a density analysis of the plaster was performed using computed tomography scans. These were utilized to yield information regarding the modeling process. Similarities and differences between the Yiftahel and other plastered skulls from the Levant are examined. The possible role of skull plastering within a society undergoing a shift from a hunting-gathering way of life to a food producing strategy is discussed. PMID:24586625

  1. Fractionated stereotactic radiotherapy of benign skull-base tumors: a dosimetric comparison of volumetric modulated arc therapy with Rapidarc® versus non-coplanar dynamic arcs

    International Nuclear Information System (INIS)

    Benign tumors of the skull base are a challenge when delivering radiotherapy. An appropriate choice of radiation technique may significantly improve the patient’s outcomes. Our study aimed to compare the dosimetric results of fractionated stereotactic radiotherapy between non-coplanar dynamic arcs and coplanar volumetric modulated arctherapy (Rapidarc®). Thirteen patients treated with Novalis TX® were analysed: six vestibular schwannomas, four pituitary adenomas and three meningioma. Two treatment plans were created for each case: dynamic arcs (4–5 non coplanar arcs) and Rapidarc® (2 coplanar arcs). All tumors were >3 cm and accessible to both techniques. Patients had a stereotactic facemask (Brainlab) and were daily repositioned by Exactrac®. GTV and CTV were contoured according to tumor type. A 1-mm margin was added to the CTV to obtain PTV. Radiation doses were 52.2–54 Gy, using 1.8 Gy per fraction. Treatment time was faster with Rapidarc®. The mean PTV V95 % was 98.8 for Rapidarc® and 95.9 % for DA (p = 0.09). Homogeneity index was better with Rapidarc®: 0.06 vs. 0.09 (p = 0.01). Higher conformity index values were obtained with Rapidarc®: 75.2 vs. 67.9 % (p = 0.04). The volume of healthy brain that received a high dose (V90 %) was 0.7 % using Rapidarc® vs. 1.4 % with dynamic arcs (p = 0.05). Rapidarc® and dynamic arcs gave, respectively, a mean D40 % of 10.5 vs. 18.1 Gy (p = 0.005) for the hippocampus and a Dmean of 25.4 vs. 35.3 Gy (p = 0.008) for the ipsilateral cochlea. Low-dose delivery with Rapidarc® and dynamic arcs were, respectively, 184 vs. 166 cm3 for V20 Gy (p = 0.14) and 1265 vs. 1056 cm3 for V5 Gy (p = 0.67). Fractionated stereotactic radiotherapy using Rapidarc® for large benign tumors of the skull base provided target volume coverage that was at least equal to that of dynamics arcs, with better conformity and homogeneity and faster treatment time. Rapidarc® also offered better sparing of the ipsilateral cochlea and hippocampus

  2. Predicting and Preventing Skull Overheating in Non Invasive Brain HIFU Treatment Protocols

    International Nuclear Information System (INIS)

    Ultrasound brain therapy is currently limited by the strong phase and amplitude aberrations induced by the heterogeneities of the skull. However the development of aberration correction techniques has made it possible to correct the beam distortion induced by the skull and to produce a sharp focus in the brain. Moreover, using the density of the skull bone that can be obtained with high-resolution CT scans, the corrections needed to produce this sharp focus can be calculated using ultrasound propagation models. We propose here a model for computing the temperature elevation in the skull during High Intensity Focused Ultrasound (HIFU) transcranial therapy. Based on CT scans, the wave propagation through the skull is computed with 3D finite differences wave propagation software. The acoustic simulation is combined with a 3D thermal diffusion code and the temperature elevation inside the skull is computed. Finally, the simulation is validated experimentally by measuring the temperature elevation in several locations of the skull

  3. Cervicoplastia anterior Anterior cervicoplasty

    Directory of Open Access Journals (Sweden)

    Lucas Gomes Patrocínio

    2004-10-01

    Full Text Available Muitos pacientes buscam correção estética da frouxidão da pele do pescoço, depósito de gordura na região submentoneana ou bandas de platisma. Em grande parte dos casos a ação medial, via cervicoplastia anterior é necessária. OBJETIVO: Demonstrar a casuística e avaliar os resultados e complicações com a técnica de cervicoplastia anterior no Serviço de Otorrinolaringologia da Universidade Federal de Uberlândia. FORMA DE ESTUDO: Relato de série. PACIENTES E MÉTODOS: Quarenta e dois pacientes, entre 39 e 65 anos de idade, sendo 40 (95,2% do sexo feminino e 2 (4,8% do masculino, foram submetidos a cervicoplastia anterior. Retrospectivamente foram avaliados resultados e complicações. RESULTADOS: Destes, 34 apresentaram resultados satisfatórios, 4 apresentaram déficit estético notado somente pelo cirurgião, 3 apresentaram déficit estético notado somente pelo paciente e 1 apresentou déficit estético necessitando cirurgia revisional. Ao estudo fotográfico, todos os pacientes apresentaram melhora do perfil cervical, redução das bandas de platisma e da frouxidão da pele, estabilização da musculatura cervical e acentuação do ângulo cervicomental, em graus variados. Houve complicação em 2 casos (discreto serohematoma e cicatriz um pouco alargada. CONCLUSÃO: A cervicoplastia, associada ou não à tração lateral pela ritidoplastia, é uma técnica que produz resultados satisfatórios na grande maioria dos casos.Many patients look for aesthetic correction of the laxity of neck skin, submandibular fat deposit or platisma bands. In a large part of the cases, medial action, through anterior cervicoplasty is necessary. AIM: To demonstrate the casuistic and to evaluate the results and complications with anterior cervicoplasty technique in the Otorhinolaryngology Service of the Federal University of Uberlândia. STUDY DESIGN: Serie report. PATIENTS AND METHODS: Forty-two patients, between 39 and 65 years of age, being 40 (95

  4. 颅底脊索瘤影像特征及治疗进展%Imaging characteristics and treatment progress of skull base chordoma

    Institute of Scientific and Technical Information of China (English)

    覃相志; 雷进

    2015-01-01

    脊索瘤是局部呈侵袭性生长的罕见肿瘤,起源于胚胎残余的脊索,<1/3发生于颅底。手术是颅底脊索瘤的首选治疗方案,术后常结合放射治疗,但由于其解剖位置、生物学特性、预后不良等使脊索瘤治疗相对棘手。近年来随着神经影像学技术和微创神经外科的发展,脊索瘤的诊断和预后在一定程度上得到改善。%Chordoma,originated from the spinal cord of embryonic residual,is a rare tumor whose growth is invasive lo-cally.Around one third of the cases start from the base of skull.Surgery is used as a first treatment plan for chordoma, often combined with postoperative radiotherapy,because of its anatomical location,biological characterstics and undesir-able prognosis,the treatment is relatively difficult.In recent years,with the development of neuroimaging techniques and minimally invasive neurosurgery,the diagnosis and the prognosis are improved to a certain extent.

  5. Endoscopic combined “transseptal/transnasal” approach for pituitary adenoma: reconstruction of skull base using pedicled nasoseptal flap in 91 consecutive cases

    Directory of Open Access Journals (Sweden)

    Yasunori Fujimoto

    2015-07-01

    Full Text Available Objective The purpose of this study was to describe the endoscopic combined “transseptal/transnasal” approach with a pedicled nasoseptal flap for pituitary adenoma and skull base reconstruction, especially with respect to cerebrospinal fluid (CSF fistula.Method Ninety-one consecutive patients with pituitary adenomas were retrospectively reviewed. All patients underwent the endoscopic combined “transseptal/transnasal” approach by the single team including the otorhinolaryngologists and neurosurgeons. Postoperative complications related to the flap were analyzed.Results Intra- and postoperative CSF fistulae were observed in 36 (40% and 4 (4.4% patients, respectively. Among the 4 patients, lumbar drainage and bed rest healed the CSF fistula in 3 patients and reoperation for revision was necessary in one patient. Other flap-related complications included nasal bleeding in 3 patients (3.3%.Conclusion The endoscopic combined “transseptal/transnasal” approach is most suitable for a two-surgeon technique and a pedicled nasoseptal flap is a reliable technique for preventing postoperative CSF fistula in pituitary surgery.

  6. The diagnostic value of high resolution spiral CT in fracture of the skull base%高分辨率螺旋 CT 对颅底骨折的诊断价值

    Institute of Scientific and Technical Information of China (English)

    徐柱荣

    2014-01-01

    目的:探讨高分辨率螺旋CT扫描对颅底骨折的诊断价值。方法对57例临床疑有颅底骨折的患者先行常规CT扫描,然后行高分辨率螺旋CT扫描,并对结果进行对比分析。结果57例患者中高分辨率螺旋CT扫描检出颅底骨折45例,常规CT扫描检出10例,两者比较差异具有统计学意义( P<0.01)。结论螺旋CT高分辨率检查技术显著提高颅底骨折的检出率,对临床治疗有重要的指导意义,应作为常规检查方法。%Objective To explore the diagnosis value of high resolution spiral CT scan in fracture of the skull base .Methods Fifty-seven patients with clinically suspected skull base fracture received conventional CT scan -ning first, then received high resolution spiral CT scanning , and the result analysis were compared .Results In 57 patients, 45 cases of fracture of the skull base were detected by high resolution spiral CT scan , 10 cases were detec-ted by conventional CT scanning , showing significant difference between two methods ( P<0.01 ) .Conclusion Spi-ral CT high-resolution technique significantly increase the detection rate of the fracture of the skull base , and has im-portant guiding significance to the clinical treatment , should be used as a routine examination method .

  7. Association of Anterior and Lateral Extraprostatic Extensions with Base-Positive Resection Margins in Prostate Cancer

    Science.gov (United States)

    Abalajon, Mark Joseph; Jang, Won Sik; Kwon, Jong Kyou; Yoon, Cheol Yong; Lee, Joo Yong; Cho, Kang Su; Ham, Won Sik

    2016-01-01

    Introduction Positive surgical margins (PSM) detected in the radical prostatectomy specimen increase the risk of biochemical recurrence (BCR). Still, with formidable number of patients never experiencing BCR in their life, the reason for this inconsistency has been attributed to the artifacts and to the spontaneous regression of micrometastatic site. To investigate the origin of margin positive cancers, we have looked into the influence of extraprostatic extension location on the resection margin positive site and its implications on BCR risk. Materials & Methods The clinical information and follow-up data of 612 patients who had extraprostatic extension and positive surgical margin at the time of robot assisted radical prostatectomy (RARP) in the single center between 2005 and 2014 were modeled using Fine and Gray’s competing risk regression analysis for BCR. Extraprostatic extensions were divided into categories according to location as apex, base, anterior, posterior, lateral, and posterolateral. Extraprostatic extensions were defined as presence of tumor beyond the borders of the gland in the posterior and posterolateral regions. Tumor admixed with periprostatic fat was additionally considered as having extraprostatic extension if capsule was vague in the anterior, apex, and base regions. Positive surgical margins were defined as the presence of tumor cells at the inked margin on the inspection under microscopy. Association of these classifications with the site of PSM was evaluated by Cohen’s Kappa analysis for concordance and logistic regression for the odds of apical and base PSMs. Results Median follow-up duration was 36.5 months (interquartile range[IQR] 20.1–36.5). Apex involvement was found in 158 (25.8%) patients and base in 110 (18.0%) patients. PSMs generally were found to be associated with increased risk of BCR regardless of location, with BCR risk highest for base PSM (HR 1.94, 95% CI 1.40–2.68, p<0.001) after adjusting for age, initial

  8. Diameters and form of skull base foramen ovale measured by three-dimensional spiral CT thin-slice scan in healthy adults

    Institute of Scientific and Technical Information of China (English)

    Xiaohua Chen; Fengxian Deng; Shuhang Wei; Tingsong Fang

    2006-01-01

    BACKGROUND: The accurate measurements of various data of the bone diameters of foramen ovale of living person can change the methods of puncturing trigeminal gasserian ganglion via foramen ovale for treating trifacial neuralgia from the experience of puncture operator only to puncture by taking the objective data of measurement as the evidence, which is good for improving the accuracy of puncturing trigeminal ganglion and reducing side effects.OBJECTiVE: To observe the forms of foramen ovales in healthy adults displayed by volume rendering and multi-planar reconstruction after three-dimensional spiral CT thin-slice scan of skull base, and measure the longitudinal diameter and transverse diameter.DESTGN: A repetitive observation and measurement.SETTINGS: Department of Neurosurgery and Department of Medical Imaging, Foshan Hospital of Traditional Chinese Medicine.PARTICTPANTS: Fifty healthy adults (100 sides), who were examined with three-dimensional spiral CT scan,were randomly selected from the Department of Medical Imaging, Foshan Hospital of Traditional Chinese Medicine from January 2005 to January 2006, including 26 males and 24 females, aged 25-68 years with an average of 48 years old. They were all informed and agreed with the examination.METHODS: The subjects were examined with the Philips 16-slice spiral CT-Mx 8000 IDT CT apparatus (Philips Company, Holland), the scanning ranged from 2 cm below the canthomeatal line to the level of suprasellar cistern. The width of collimator was 0.75 mm, pitch was 0.663; tube current was 350 mA, voltage was 120 kV,resolution was 512×512 matrix; slice thickness of reconstruction was 1 mm, and interval was 0.5 mm. After the three-dimensional spiral CT thin-slice scan of skull base, the image post-processing techniques including volume rendering and multi-planar reconstruction were applied to observe the forms of foramen ovales, and measure the size, longitudinal diameter and transverse diameter of the foramen ovales. The

  9. On-Board Imaging Validation of Optically Guided Stereotactic Radiosurgery Positioning System for Conventionally Fractionated Radiotherapy for Paranasal Sinus and Skull Base Cancer

    International Nuclear Information System (INIS)

    Purpose: To evaluate the positioning accuracy of an optical positioning system for stereotactic radiosurgery in a pilot experience of optically guided, conventionally fractionated, radiotherapy for paranasal sinus and skull base tumors. Methods and Materials: Before each daily radiotherapy session, the positioning of 28 patients was set up using an optical positioning system. After this initial setup, the patients underwent standard on-board imaging that included daily orthogonal kilovoltage images and weekly cone beam computed tomography scans. Daily translational shifts were made after comparing the on-board images with the treatment planning computed tomography scans. These daily translational shifts represented the daily positional error in the optical tracking system and were recorded during the treatment course. For 13 patients treated with smaller fields, a three-degree of freedom (3DOF) head positioner was used for more accurate setup. Results: The mean positional error for the optically guided system in patients with and without the 3DOF head positioner was 1.4 ± 1.1 mm and 3.9 ± 1.6 mm, respectively (p <.0001). The mean positional error drifted 0.11 mm/wk upward during the treatment course for patients using the 3DOF head positioner (p = .057). No positional drift was observed in the patients without the 3DOF head positioner. Conclusion: Our initial clinical experience with optically guided head-and-neck fractionated radiotherapy was promising and demonstrated clinical feasibility. The optically guided setup was especially useful when used in conjunction with the 3DOF head positioner and when it was recalibrated to the shifts using the weekly portal images.

  10. Mastoid emissary in Indian skulls.

    Science.gov (United States)

    Piasecki, K; Wysocki, J

    1998-01-01

    Two hundred and eleven Indian skulls originating from medieval times, South of Peru, were studied in respect to variability of the mastoid emissary. Occurrence and localisation of the external orifice of the mastoid emissary were studied in three distinct and well-separated populations, living in the three different places: Villa el Salvador, Tablada de Lurin and Paracas. Most of the skulls presented considerable degree of artificial deformation. External orifice of the mastoid emissary was multiple in most of the skulls, especially in Villa el Salvador and Paracas populations. Mastoid emissaries in Indian were situated generally higher than in European, especially regarding the Paracas population. Significant sex differences were present in this material, regarded as a whole (summarized results for the three populations), what is in agreement with previous observations on European skulls. It indicates that even in cases of relatively deep deformation, some characteristic features of sex dimorphism of the human skull are noticeable. Additionally, the three studied populations, which were well separated from each other and lived alone, differed significantly regarding localization of the mastoid emissaries. PMID:9857576

  11. Case of pycnodysostosis. Observation of skull by CT scan

    Energy Technology Data Exchange (ETDEWEB)

    Anegawa, Shigetaka; Bekki, Yoshiaki; Furukawa, Yasuhiro; Yokota, Seishi; Torigoe, Ryuichiro

    1987-07-01

    A 13-year-old boy was presented to the Department of Neurosurgery, Saiseikai Fukuoka General Hospital for further examinations concerning abnormal findings in the skull radiogram taken when he struck his head. His physical features showed some characteristics the same as those of pycnodysostosis as follows - proportionate dwarfism, prominent forehead, short spoon-shaped fingers, bilateral exophthalmos. A skull radiogram revealed widely open cranial sutures with no healing of the fracture and craniotomy which was performed for an acute epidural hematoma 6 years ago. Furthermore, the mandible was hypoplastic with a virtural loss of mandibular angle. CT of the soft tissues showed somewhat dilated cortical sulci and ventricles without any structural abnormalities in the brain. CT of bone algorythum revealed specific characteristics of this disease. The paranasal sinuses were quite hypoplastic. Especially in the maxillary sinuses, frontal sinussus and mastoid air cells, none of developments of sinuses were noted, even though the middle and internal ear seemed to be normal. Moreover, the ethomoid and sphenoid sinuses were noted, although their developments were poor. The appearance of skull base was normal, including the inlets and outlets of cranial nerves or vessels and synchondroses. However, the density of the skull base, especially in the diploe, was higher than normal in Hansfield number. Furthermore, detailed measurements of skull base demonstrated that the skull base itself was also dwarfish. In our study, the development of sinuses in bones with intramembranous ossification are worse than that with endochondral ossification. Furthermore, sutures or synchondroses in the skull base were well-developed than those of the convex. So, it is considered that pycnodysostosis must be the neighboring entity of diseases such as achondroplastic dwarfism or cleidocranial dysplasia. (J.P.N.).

  12. ANATOMIC STUDY OF LOCALIZATION OF FORAMEN OVALE, CAROTID CANAL, JUGULAR FORAMEN USING HENLE’S SPINE AS SURFACE LANDMARK IN SOUTH INDIAN ADULT SKULLS

    Directory of Open Access Journals (Sweden)

    Yogitha Ravindranath

    2016-07-01

    Full Text Available BACKGROUND Henle’s Spine (HS is a small bony prominence, anterior to the supramastoid pit, at the postero-superior margin of the external acoustic meatus. Localization of cranial structures using this anatomical landmark is of immense surgical importance to identify and avoid surgical morbidities. AIMS Considering the limited number of research articles describing its anatomy in South Indian skulls, present study was conducted to estimate the location and the difference between the right and left sides of the skull base foramen by using HS as surface landmark, which can act as a guide to various approaches of the skull base surgeries. SETTING AND DESIGN Cross-sectional observational study. MATERIALS AND METHODS Twenty nine (58 sides adult South Indian skulls with prominent HS were studied. Following distances on both right and left sides of the skulls were measured from tip of HS to anterior margin and posterior margin of foramen ovale (HS–AMFO, HS-PMFO; posterolateral and medial jugular foramen (HS-PLJF, HS-PMJF; lateral and medial margin of carotid canal (HS-LMCC, HS-MMCC using digital calliper of 0.01 mm accuracy. STATISTICAL ANALYSIS Data was analysed using SPSS version 16. Mean, Standard deviation was calculated. Side differences were estimated using paired ‘t’ test. RESULTS The mean distance from HS-AMFO was 35.96±2.05 mm, HS-PMFO was 42.57±2.38 mm; HS-PLJF 22.82±2.12 mm, HS-PMJF was 34.08±2.48 mm; HS-LMCC was 26.68±1.95 mm, HS-MMCC was 32.27±2.22 mm. There was a significant difference noted between right and left sides (p<0.05 of Henle’s spine to posterolateral margin of jugular foramen. CONCLUSION Henle’s spine can be used as a reliable landmark to locate the deeper structures of skull base. However, the possibility of side difference among the population should be kept in mind prior to surgery

  13. The development of the skull of the Egyptian Cobra Naja h. haje (Squamata: Serpentes: Elapidae.

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    Eraqi R Khannoon

    Full Text Available The study of craniofacial development is important in understanding the ontogenetic processes behind morphological diversity. A complete morphological description of the embryonic skull development of the Egyptian cobra, Naja h. haje, is lacking and there has been little comparative discussion of skull development either among elapid snakes or between them and other snakes.We present a description of skull development through a full sequence of developmental stages of the Egyptian cobra, and compare it to other snakes. Associated soft tissues of the head are noted where relevant. The first visible ossification centres are in the supratemporal, prearticular and surangular, with slight ossification visible in parts of the maxilla, prefrontal, and dentary. Epiotic centres of ossification are present in the supraoccipital, and the body of the supraoccipital forms from the tectum posterior not the tectum synoticum. The venom glands are visible as distinct bodies as early at stage 5 and enlarge later to extend from the otic capsule to the maxilla level with the anterior margin of the eye. The gland becomes more prominent shortly before hatching, concomitant with the development of the fangs. The tongue shows incipient forking at stage 5, and becomes fully bifid at stage 6.We present the first detailed staging series of cranial development for the Egyptian cobra, Naja h. haje. This is one of the first studies since the classical works of G. de Beer and W. Parker that provides a detailed description of cranial development in an advanced snake species. It allows us to correct errors and misinterpretations in previous accounts which were based on a small sample of specimens of uncertain age. Our results highlight potentially significant variation in supraoccipital formation among squamates and the need for further research in this area.

  14. Virtual Human Skull Model: A Three Dimensional Reconstruction Method Based on CT Serial Images%基于CT断层影像的颅骨解剖结构三维重建

    Institute of Scientific and Technical Information of China (English)

    吴辉群; 吴兴; 严培培; 耿兴云; 张远鹏; 蒋葵; 韩笑; 吕广明; 董建成

    2011-01-01

    Objective : To make three dimensional reconstruction of skull with Mimics8. 01 based on CT cranial serial images to provide models for anatomical study and research. Methods : Mimics software was used to make automated threshold segmentation of hone tissue in CT cranial images. After skull reconstruction, the hyoid bone was split automatically. While to other skull bones, in three different panels of CT images under Mimics, locating line comhined with anatomical knowledge of skull bone relations were used to detect the locating point between two neighboring bones. Then, the separate region of bones was manually marked in different colors designed before. The main neurocranium and facial cranium structures were reconstructed and observed in computer. Results:The skull composed bones such as frontal, temporal, occipital, parietal, sphenoid, ethmoid, nasal, lacrimal, maxilla, mandible, jaw, hyoid bones were successfully segmented with different colors and constructed, which could be observed arbitrarily in computer in single or combination form. Conclusions :Virtual skull model can be reconstructed based on CT cranial serial images, which provides basis for digital skull anatomy teaching and cranial surgical navigation.%目的:基于CT颅脑断面连续影像,利用Mimics 8.01软件对颅骨进行三维重建,为解剖学教学和研究提供模型.方法:利用Mimics软件对CT颅脑影像中的骨组织进行自动阈值分割后,对重建出的颅骨进行自动分割,分割出舌骨结构.对于其他颅骨结构,在Mimics软件中的三个方位CT图像中,利用定位线结合解剖学中的颅骨毗邻关系,找出区分毗邻颅骨之间的定位点.然后,根据事先规划的不同结构的分割颜色,人工描出相应的颅骨所在区域.随后,对分割出的各个颜色区域进行三维重建,重建出主要的脑颅骨和面颅骨结构,并分别在计算机上对上述结构进行观察.结果:成功对颅骨的结构分别以不同颜色进行分

  15. Carotid-anterior cerebral artery anastomosis on MR angiography: a university hospital-based study

    Energy Technology Data Exchange (ETDEWEB)

    Uchino, Akira; Saito, Naoko; Okada, Yoshitaka; Inoue, Kaiji [Saitama Medical University International Medical Center, Department of Diagnostic Radiology, Hidaka, Saitama (Japan)

    2012-01-15

    Rarely in the anterior circulation, an anastomosis of the carotid and anterior cerebral arteries occurs when an anomalous branch arises from the ophthalmic segment of the internal carotid artery and anastomoses with the A1-A2 junction of the anterior communicating artery. Right-side predominance is known. To our knowledge, the incidence of carotid-anterior cerebral artery anastomosis has not been reported, so we researched cases in our institution records to determine incidence and investigated characteristic features of the condition on magnetic resonance (MR) angiography. To isolate such cases, we retrospectively reviewed cranial MR angiographic images of 3,491 consecutive patients in our institution. We found three cases with carotid-anterior cerebral artery anastomosis (two men, one woman), representing an incidence of 0.086%. The anastomosis was on the right in all three cases. A normal A1 segment of the anterior cerebral artery (ACA) was present in two cases but could not be identified in the remaining case on MR angiographic images that included source images. Two of the three patients demonstrated associated arterial variations in their carotid systems. On MR angiography, we observed a 0.086% incidence of carotid-anterior cerebral artery anastomosis in our institution and reaffirmed the right-side predominance of this anomaly. We found a high frequency of other associated arterial variations in the carotid system. (orig.)

  16. CT of the skull base

    International Nuclear Information System (INIS)

    For the middle ear only the crus longus incudis and the stapedius still requires conventional tomography. This substitution of CT for classical tomography, welcome in itself is limited by financial considerations. However, when CT is necessary it should be done before tomography thus possibly limiting both expense and radiation dose. (orig./AJ)

  17. A small skull from Flores dated to the 20th century

    DEFF Research Database (Denmark)

    Villa, Chiara; Persson, Liselott; Alexandersen, Verner;

    2012-01-01

    A human skull with mandible from the Ngada District on the island of Flores, Indonesia, is described in order to contribute to the knowledge of variation in cranial architecture, which is important in interpretations of evolutionary cerebralisation. The skull was excavated in 1924 and sent...... to the National Museum in Copenhagen. The "Copenhagen Flores" (CF) male skull is radiocarbon-dated and of modern age. The cranium is small, but larger than e.g. Liang Bua skull (LB1) in every measurement. The (CT-scan based) cranial capacity of 1258 ml is normal for modern humans, but somewhat lower than values...

  18. Fourier analysis of the forehead shape of skull and sex determination by use of computer.

    Science.gov (United States)

    Inoue, M

    1990-09-01

    The forehead shape of the skull was quantified with the Fourier analysis method by using 100 male and 100 female radiographic lateral views of the skull, and sex difference in the forehead shape was studied. Furthermore to predict the sex of cranial specimens, an automated sexing computer system based on the quantification was created. The effectiveness of the system was evaluated by checking 56 male and 56 female specimens of skulls. This system was proved to discriminate male and female skulls from forehead shapes with 85% accuracy.

  19. Skull development in the muscular dystrophic mouse

    DEFF Research Database (Denmark)

    Vilmann, H; Kirkeby, S; Moss, M L

    1989-01-01

    Roentgencephalometric tracings of skulls of 7-week-old normal and muscular dystrophic mice were compared. A marked size reduction of the dystrophic skulls relative to the normal ones was observed. However, the visceral parts of the dystrophic skull were more reduced in size than the neural parts...

  20. Pitfalls of voxel-based amyloid PET analyses for diagnosis of Alzheimer's disease. Artifacts due to non-specific uptake in the white matter and the skull

    International Nuclear Information System (INIS)

    Two methods are commonly used in brain image voxel-based analyses widely used for dementia work-ups: 3-dimensional stereotactic surface projections (3D-SSP) and statistical parametric mapping (SPM). The methods calculate the Z-scores of the cortical voxels that represent the significance of differences compared to a database of brain images with normal findings, and visualize them as surface brain maps. The methods are considered useful in amyloid positron emission tomography (PET) analyses to detect small amounts of amyloid-β deposits in early-stage Alzheimer's disease (AD), but are not fully validated. We analyzed the 11C-labeled 2-(2-[2-dimethylaminothiazol-5-yl]ethenyl)-6-(2-[fluoro]ethoxy)benzoxazole (BF-227) amyloid PET imaging of 56 subjects (20 individuals with mild cognitive impairment [MCl], 19 AD patients, and 17 non-demented [ND] volunteers) with 3D-SSP and the easy Z-score imaging system (eZIS) that is an SPM-based method. To clarify these methods' limitations, we visually compared Z-score maps output from the two methods and investigated the causes of discrepancies between them. Discrepancies were found in 27 subjects (9 MCl, 13 AD, and 5 ND). Relatively high white matter uptake was considered to cause higher Z-scores on 3D-SSP in 4 subjects (1 MCl and 3 ND). Meanwhile, in 17 subjects (6 MCl, 9 AD, and 2 ND), Z-score overestimation on eZIS corresponded with high skull uptake and disappeared after removing the skull uptake ('scalping'). Our results suggest that non-specific uptakes in the white matter and skull account for errors in voxel-based amyloid PET analyses. Thus, diagnoses based on 3D-SSP data require checking white matter uptake, and 'scalping' is recommended before eZIS analysis. (author)

  1. Benchmarking of a treatment planning system for spot scanning proton therapy: Comparison and analysis of robustness to setup errors of photon IMRT and proton SFUD treatment plans of base of skull meningioma

    Energy Technology Data Exchange (ETDEWEB)

    Harding, R., E-mail: ruth.harding2@wales.nhs.uk [St James’s Institute of Oncology, Medical Physics and Engineering, Leeds LS9 7TF, United Kingdomand Abertawe Bro Morgannwg University Health Board, Medical Physics and Clinical Engineering, Swansea SA2 8QA (United Kingdom); Trnková, P.; Lomax, A. J. [Paul Scherrer Institute, Centre for Proton Therapy, Villigen 5232 (Switzerland); Weston, S. J.; Lilley, J.; Thompson, C. M.; Cosgrove, V. P. [St James’s Institute of Oncology, Medical Physics and Engineering, Leeds LS9 7TF (United Kingdom); Short, S. C. [Leeds Institute of Molecular Medicine, Oncology and Clinical Research, Leeds LS9 7TF, United Kingdomand St James’s Institute of Oncology, Oncology, Leeds LS9 7TF (United Kingdom); Loughrey, C. [St James’s Institute of Oncology, Oncology, Leeds LS9 7TF (United Kingdom); Thwaites, D. I. [St James’s Institute of Oncology, Medical Physics and Engineering, Leeds LS9 7TF, United Kingdomand Institute of Medical Physics, School of Physics, University of Sydney, Sydney NSW 2006 (Australia)

    2014-11-01

    Purpose: Base of skull meningioma can be treated with both intensity modulated radiation therapy (IMRT) and spot scanned proton therapy (PT). One of the main benefits of PT is better sparing of organs at risk, but due to the physical and dosimetric characteristics of protons, spot scanned PT can be more sensitive to the uncertainties encountered in the treatment process compared with photon treatment. Therefore, robustness analysis should be part of a comprehensive comparison between these two treatment methods in order to quantify and understand the sensitivity of the treatment techniques to uncertainties. The aim of this work was to benchmark a spot scanning treatment planning system for planning of base of skull meningioma and to compare the created plans and analyze their robustness to setup errors against the IMRT technique. Methods: Plans were produced for three base of skull meningioma cases: IMRT planned with a commercial TPS [Monaco (Elekta AB, Sweden)]; single field uniform dose (SFUD) spot scanning PT produced with an in-house TPS (PSI-plan); and SFUD spot scanning PT plan created with a commercial TPS [XiO (Elekta AB, Sweden)]. A tool for evaluating robustness to random setup errors was created and, for each plan, both a dosimetric evaluation and a robustness analysis to setup errors were performed. Results: It was possible to create clinically acceptable treatment plans for spot scanning proton therapy of meningioma with a commercially available TPS. However, since each treatment planning system uses different methods, this comparison showed different dosimetric results as well as different sensitivities to setup uncertainties. The results confirmed the necessity of an analysis tool for assessing plan robustness to provide a fair comparison of photon and proton plans. Conclusions: Robustness analysis is a critical part of plan evaluation when comparing IMRT plans with spot scanned proton therapy plans.

  2. The hot skull: Malignant or feminine

    International Nuclear Information System (INIS)

    Diffusely increased uptake in the calvarium on bone scintigraphy (a hot skull) is often present in patients with bone metastases and metabolic diseases. Excluding these known facts the prevalence of the hot skull and its relation with malignancy and, more specifically, with breast carcinoma have been studied in 673 patients. In women, the hot skull is clearly related to malignancy and to a lesser extent to breast carcinoma. However, another remarkable feature of the hot skull is its predominance in women in general (compared to men) and, therefore, the data suggest that the hot skull can also represent a normal variant of the female skull. We conclude that the hot skull has no clinical value in screening protocols. (orig.)

  3. Symbolic shape descriptors for classifying craniosynostosis deformations from skull imaging.

    Science.gov (United States)

    Lin, H; Ruiz-Correa, S; Shapiro, L G; Hing, A; Cunningham, M L; Speltz, M; Sze, R

    2005-01-01

    Craniosynostosis is a serious condition of childhood, caused by the early fusion of the sutures of the skull. The resulting abnormal skull development can lead to severe deformities, increased intra-cranial pressure, as well as vision, hearing and breathing problems. In this work we develop a novel approach to accurately classify deformations caused by metopic and isolated sagittal synostosis. Our method combines a novel set of symbolic shape descriptors and off-the-shelf classification tools to model morphological variations that characterize the synostotic skull. We demonstrate the efficacy of our methodology in a series of large-scale classification experiments that contrast the performance of our proposed symbolic descriptors to those of traditional numeric descriptors, such as clinical severity indices, Fourier-based descriptors and cranial image quantifications. PMID:17281714

  4. Efficacy of TachoSil, a Fibrin-Based Hemostat, for Anterior Lumbar Spine Surgery

    Science.gov (United States)

    Watanabe, Jo; Orita, Sumihisa; Yamauchi, Kazuyo; Eguchi, Yawara; Aoki, Yasuchika; Nakamura, Junichi; Suzuki, Miyako; Inage, Kazuhide; Sato, Jun; Shiga, Yasuhiro; Abe, Koki; Fujimoto, Kazuki; Kanamoto, Hirohito; Hanaoka, Eiji; Takahashi, Kazuhisa

    2016-01-01

    Study Design Retrospective case series. Purpose To examine the efficacy of TachoSil for vessel injury in 6 patients who underwent anterior lumbar fusion surgery (ALF). Overview of Literature ALF for the lumbar spine has a high rate of success, although intraoperative concerns and iatrogenic complications are known, and injury of a major vessel is sometimes a complication. The efficacy of TachoSil, a fibrin-based hemostat, has been reported for several types of surgery; however, use of TachoSil for ALF surgery has not been described. Here, we report on the efficacy of TachoSil in 6 patients, who underwent ALF after vascular surgeons having difficulty in repairing vessels. Methods Two man and 4 women with average age of 50.8±10.9 (mean±standard deviation) were diagnosed with a vertebral tumor (2 patients), L4 degenerative spondylolisthesis (2 patients), and L5 spondylolytic spondylolisthesis (2 patients) and underwent ALF. The blood vessels injured included the common iliac vein in 2 patients and a branch of a segmental artery from the aorta in 4 patients. We consulted a vascular surgeon to suture or repair the vessels during surgery, and although the vascular surgeon attempted to address the injuries, suturing or repair was not possible in these cases. For this reason, we used TachoSil to repair the injury in the vessels walls or to stop the bleeding. Results Time to pressure hemostasis using TachoSil was 34±12 minutes, and total blood loss was 1,488±1,711 mL. Nevertheless, all vessel injuries were controlled by the use of TachoSil. Conclusions We recommend the use of TachoSil for vessel injuries that vascular surgeons cannot suture or repair during ALF surgery. PMID:27790323

  5. Early surgery of ruptured anterior circulation aneurysm based on multislice helical computerised tomography angiography.

    Science.gov (United States)

    Hui, Ma; Dong, Wang Xiao; Ciceri, E; Marras, C; Tao, Sun; Chun, Xia He; Zheng, Li Zong; Fang, Li Guo

    2007-12-01

    The purpose of this study is to evaluate the utility of three-dimensional computed tomographic angiography (3D-CTA) as the primary diagnostic investigation in patients with spontaneous subarachnoid haemorrhage (SAH) from anterior circulation aneurysms, and to correlate the results with digital subtraction angiography (DSA) and intraoperative findings. From May 2005 to May 2007 a total of 38 consecutive patients admitted for SAH, suspicious for ruptured anterior circulation cerebral aneurysm, underwent 3D-CTA. Inclusion criteria were a SAH confirmed by a non-contrast head computed tomographic scan or by lumbar puncture. Exclusion criteria were: previous DSA, severe contrast medium allergy and severe renal failure. All patients underwent early surgical clipping of the aneurysm. The mean time between SAH onset and surgery was 43.6 h (range, 14-74 h). The 3D-CTA was performed in all cases; and in 13 out of 38 patients (34%) represented the only preoperative exam. In all patients that underwent surgery with the sole 3D-CTA, the images collected allowed a good visualisation of the morphology of aneurysms and of the anatomical relationship with the vascular structures. 3D-CTA allows accurate diagnosis with an excellent visualisation of ruptured aneurysms of the anterior circulation. Our results suggest that, in selected cases, ruptured anterior circulation aneurysms could be successfully treated on the basis of 3D-CTA alone. PMID:18175079

  6. Asymmetric index analysis on the orthodontic-orthognathic treatment of facial asymmetry patients in skull positioning posterior-anterior radiographs%正畸正颌联合治疗颜面不对称患者头颅定位后前位片的非对称性分析

    Institute of Scientific and Technical Information of China (English)

    刘奕; 陈燕; 包扬

    2014-01-01

    目的:分析正畸正颌联合治疗的颜面不对称患者头颅定位后前位片测量指标的非对称性。方法选取不同程度颜面不对称患者45例,对所有患者治疗前后头颅定位后前位片进行测量,采用单样本t检验将治疗前测量指标的非对称率与个别正常人群的非对称率进行比较,通过相关系数的分析,归纳出颜面不对称患者倾向于采用正畸正颌联合治疗的测量指标,并得出其参考值。同时通过配对t检验比较治疗前后测量指标非对称率的差异。结果有14项指标治疗前的非对称率与个别正常人群的非对称率相比差异有统计学意义(P<0.05)。45例患者中与Me[X]具有较高直线相关关系的指标为Ag[X]。28例患者以下颌骨体部不对称为主,15例患者以下颌升支不对称为主,2例患者同时存在下颌体部和下颌升支的不对称。Me[X]等15项测量指标治疗前后差异均有统计学意义(P<0.05)。结论颜面部的不对称主要集中在面下1/3,以下颌体部不对称为主要表现。当与Me[X]具有高度直线相关关系的指标Ag[X]的非对称率大于参考值下限11.31%,Go[X]的非对称率大于参考值下限9.79%,且Me[X]大于参考值下限5.2mm时,该患者的治疗方案更倾向于正畸正颌联合治疗。%Objective To analyze the asymmetry of measurements in facial asymmetry patients with skull positioning posterior-anterior radiographs after orthodontic-orthognathic treatment. Methods Posterior-anterior cephalometric radio-graphy and cephalometric analysis were performed in forty-five patients with different degrees of facial asymmetry. A single sample t-test was conducted to compare the asymmetry of measurements before treatment and individual normal occlusion. The measurement and reference values in facial asymmetry patients who underwent orthodontic-orthognathic treatment were summated by analyzing the correlation coefficient. The paired t

  7. Hallazgos en el macizo facial y la base del cráneo de pacientes pediátricos con histiocitosis de células de Langerhans Craniofacial and skull base findings in Langerhans cell histiocytosis in pediatric patients

    Directory of Open Access Journals (Sweden)

    Daniel Forlino

    2013-03-01

    Full Text Available La histiocitosis de células de Langerhans (HCL es una entidad poco frecuente, con una incidencia anual de 2,6 a 5,4 por millón de niños en la población general. Tiene manifestaciones óseas (lesiones osteolíticas solitarias o múltiples en huesos planos, largos e irregulares o multisistémicas. Se describen los hallazgos imagenológicos de una serie retrospectiva de 17 pacientes pediátricos, de 1 a 12 años de edad, con histiocitosis de células de Langerhans en el macizo facial y la base del cráneo. Las manifestaciones incluyeron lesiones osteolíticas y masa de partes blandas, que ocupaban las cavidades adyacentes, como la órbita, los senos paranasales, la caja timpánica y la mastoides. En el maxilar inferior puede provocar reabsorción del reborde alveolar con apariencia de dientes flotantes. La complejidad anatómica del área de estudio requiere su valoración mediante tomografía computada (TC y resonancia magnética (RM con contraste. La histiocitosis de células de Langerhans debe considerarse dentro de los diagnósticos diferenciales de las lesiones del macizo facial y la base del cráneo, especialmente en pacientes pediátricos.Langerhans cell histiocytosis (CLH is an uncommon entity, of unknown etiology, with an incidence of 2.6 at 5.4 per 1,000,000 children/year in the general population. It may have bone manifestations (solitary or multiple osteolytic lesions in flat, long and irregular bones or multiorgan manifestations. We report the radiological findings in retrospective series of 17 pediatric patients aged 1 to 12 years old, with CLH in craniofacial and skull base. Radiological findings included osteolytic and soft tissue lesions occupying the orbit, sinuses, tympanic cavity and mastoid. In the mandible, reabsorption of the alveolar ridge with the appearance of floating teeth was observed. The anatomical complexity of the area studied required evaluation by CT and MRI with contrast. LCH disease should be considered in

  8. Comparative histology of some craniofacial sutures and skull-base synchondroses in non-avian dinosaurs and their extant phylogenetic bracket.

    Science.gov (United States)

    Bailleul, Alida M; Horner, John R

    2016-08-01

    Sutures and synchondroses, the fibrous and cartilaginous articulations found in the skulls of vertebrates, have been studied for many biological applications at the morphological scale. However, little is known about these articulations at the microscopic scale in non-mammalian vertebrates, including extant archosaurs (birds and crocodilians). The major goals of this paper were to: (i) document the microstructure of some sutures and synchondroses through ontogeny in archosaurs; (ii) compare these microstructures with previously published sutural histology (i.e. that of mammals); and (iii) document how these articulations with different morphological degrees of closure (open or obliterated) appear histologically. This was performed with histological analyses of skulls of emus, American alligators, a fossil crocodilian and ornithischian dinosaurs (hadrosaurids, pachycephalosaurids and ceratopsids). Emus and mammals possess a sutural periosteum until sutural fusion, but it disappears rapidly during ontogeny in American alligators. This study identified seven types of sutural mineralized tissues in extant and extinct archosaurs and grouped them into four categories: periosteal tissues; acellular tissues; fibrous tissues; and intratendinous tissues. Due to the presence of a periosteum in their sutures, emus and mammals possess periosteal tissues at their sutural borders. The mineralized sutural tissues of crocodilians and ornithischian dinosaurs are more variable and can also develop via a form of necrosis for acellular tissues and metaplasia for fibrous and intratendinous tissues. It was hypothesized that non-avian dinosaurs, like the American alligator, lacked a sutural periosteum and that their primary mode of ossification involved the direct mineralization of craniofacial sutures (instead of intramembranous ossification found in mammals and birds). However, we keep in mind that a bird-like sutural microstructure might have arisen within non-avian saurichians. While

  9. Comparative histology of some craniofacial sutures and skull-base synchondroses in non-avian dinosaurs and their extant phylogenetic bracket.

    Science.gov (United States)

    Bailleul, Alida M; Horner, John R

    2016-08-01

    Sutures and synchondroses, the fibrous and cartilaginous articulations found in the skulls of vertebrates, have been studied for many biological applications at the morphological scale. However, little is known about these articulations at the microscopic scale in non-mammalian vertebrates, including extant archosaurs (birds and crocodilians). The major goals of this paper were to: (i) document the microstructure of some sutures and synchondroses through ontogeny in archosaurs; (ii) compare these microstructures with previously published sutural histology (i.e. that of mammals); and (iii) document how these articulations with different morphological degrees of closure (open or obliterated) appear histologically. This was performed with histological analyses of skulls of emus, American alligators, a fossil crocodilian and ornithischian dinosaurs (hadrosaurids, pachycephalosaurids and ceratopsids). Emus and mammals possess a sutural periosteum until sutural fusion, but it disappears rapidly during ontogeny in American alligators. This study identified seven types of sutural mineralized tissues in extant and extinct archosaurs and grouped them into four categories: periosteal tissues; acellular tissues; fibrous tissues; and intratendinous tissues. Due to the presence of a periosteum in their sutures, emus and mammals possess periosteal tissues at their sutural borders. The mineralized sutural tissues of crocodilians and ornithischian dinosaurs are more variable and can also develop via a form of necrosis for acellular tissues and metaplasia for fibrous and intratendinous tissues. It was hypothesized that non-avian dinosaurs, like the American alligator, lacked a sutural periosteum and that their primary mode of ossification involved the direct mineralization of craniofacial sutures (instead of intramembranous ossification found in mammals and birds). However, we keep in mind that a bird-like sutural microstructure might have arisen within non-avian saurichians. While

  10. Analysis of six Vietnamese trophy skulls.

    Science.gov (United States)

    Sledzik, P S; Ousley, S

    1991-03-01

    This report presents morphologic, metric, and contextual information on six documented trophy skull specimens confiscated from U.S. servicemen during the Vietnam War. Additional information on the history and occurrence of trophy skull collecting is provided. This sample, consisting mostly of young Vietnamese males, exhibits graffiti, painting, and other evidence of postmortem decorative modification. Identification of trophy skulls is important to medicolegal and anthropological researchers in distinguishing trophy remains from archaeological and forensic specimens.

  11. Ulnar nerve stability-based surgery for cubital tunnel syndrome via a small incision: a comparison with classic anterior nerve transposition

    OpenAIRE

    Kang, Ho-Jung; Koh, Il-Hyun; Chun, Yong-Min; Oh, Won-Taek; Chung, Kwang-Ho; Choi, Yun-Rak

    2015-01-01

    Objective The purpose of this study was to compare the clinical outcomes of ulnar nerve stability-based surgery via a small incision with those of classic anterior transposition of the ulnar nerve for cubital tunnel syndrome. Methods From March 2008 to December 2013, 107 patients with cubital tunnel syndrome underwent simple decompression or anterior transposition via a small incision, according to an ulnar nerve stability-based decision based on an assessment of intraoperative ulnar nerve st...

  12. The caroticoclinoid foramen formation in the human skull and its clinical correlations

    Directory of Open Access Journals (Sweden)

    Freire AR

    2010-09-01

    Full Text Available Numerous structures of the skull are well defined in literature. But there are some inconstant structures, which when present may be located in the sphenoid bone by the junction of the anterior and middle clinoid processes. The aim of this study was to evaluate the characteristics of caroticoclinoid foramen in Brazilian human skull. This case report shows a female dry human skull with 2 caroticoclinoid foramina. The largest diameter of this structure was found 5.5 mm on the right side and 5.4 mm on the left. Although being an uncommon foramen, the knowledge is important because it is located in the sphenoid bone, an important region for neurosurgery.

  13. Aspergillus Osteomyelitis of the Skull.

    Science.gov (United States)

    Nicholson, Simon; King, Richard; Chumas, Paul; Russell, John; Liddington, Mark

    2016-07-01

    Osteomyelitis of the craniofacial skeleton is rare, with fungal pathogens least commonly implicated. The authors present 2 patients of osteomyelitis of the skull caused by Aspergillus spp. and discuss the diagnosis, clinicopathological course, and management strategies.Late recurrence seen in this type of infection warrants long-term follow-up and a high index of suspicion for the clinical signs associated with recurrence.Such patients would benefit from their surgical debridement being planned and managed via a specialist craniofacial unit, so as to utilize the most aesthetically sensitive approach and the experience of specialists from several surgical disciplines. PMID:27391523

  14. Skull melting of synthetic minerals

    Energy Technology Data Exchange (ETDEWEB)

    Scott, S.D.; Hull, D.E.; Herrick, C.C.

    1977-12-01

    Direct high-frequency induction melting of dielectric materials in a water-cooled cage has been developed in the LASL synthetic minerals program. Molten material is contained in a skull, i.e., sintered shell, of its own composition so the traditional problems associated with refractory melt contamination are essentially eliminated. Preliminary analyses of power input, cage design, and coil geometry are discussed. Initial experimental results on the preparation of polycrystalline ingots, single crystals, and glasses are presented along with possible applications of this technique.

  15. Results of microsurgical removal of 147 central skull base meningiomas%147例颅底中央区脑膜瘤的显微手术疗效分析

    Institute of Scientific and Technical Information of China (English)

    刘庆; 杨军; 闫长祥; 孙炜; 张宏伟; 任铭; 孟庆虎; 于春江

    2008-01-01

    Objective To investigate the strategy and techniques of microsurgical treatment for central skull base meningioma. Methods A retrospective review was performed in 147 central skull base meningiomas, which were admitted consecutively from April 2004 to December 2007, and were removed via subfrontal approach, pterional approach, suboccipital retrosigmoid approach, subtemperal transtentorial approach, presigrnoid supra- and infratentorial approach and far lateral approach depending on the position and the extension of the tumors. Results The tumors were totally resected ( Simpson Ⅰ , Ⅱ ) in one-stage in 112 cases. The function of cranial nerves was improved in 30 cases. There were new functional deficits or deterioration of cranial nerves in 25 cases. There was no operative mortality. Contusion Despite of the challenges encountered in treating complex central skull base meniugiomas, precise preoperative evaluation, tailored surgical approaches according to tumor extension and microsurgical techniques can serve two purposes: total resection and minimal morbidity.%目的 探讨颅底中央区脑膜瘤的手术治疗策略和方法.方法 收集147例颅底中央区脑膜瘤患者,根据肿瘤部位和生长方向不同,分别选择额下入路、翼点人路、枕下乙状窦后入路、颞下经小脑幕入路、乙状窦前幕上下联合入路、远外侧入路等予以显微手术切除,对手术方法和疗效进行回顾性分析总结.结果 Simpson Ⅰ、Ⅱ级切除112例,Ⅲ级32例,Ⅳ级3例.1例术后颅内感染.30例脑神经功能较术前改善,25例脑神经功能障碍较术前加重或出现新的神经功能损害.结论 个体化的手术方案,显微手术操作能提高颅底中央区脑膜瘤的全切除率和手术疗效.

  16. Estimation of the skull insertion loss using an optoacoustic point source

    Science.gov (United States)

    Estrada, Héctor; Rebling, Johannes; Turner, Jake; Kneipp, Moritz; Shoham, Shy; Razansky, Daniel

    2016-03-01

    The acoustically-mismatched skull bone poses significant challenges for the application of ultrasonic and optical techniques in neuroimaging, still typically requiring invasive approaches using craniotomy or skull thinning. Optoacoustic imaging partially circumvents the acoustic distortions due to the skull because the induced wave is transmitted only once as opposed to the round trip in pulse-echo ultrasonography. To this end, the mouse brain has been successfully imaged transcranially by optoacoustic scanning microscopy. Yet, the skull may adversely affect the lateral and axial resolution of transcranial brain images. In order to accurately characterize the complex behavior of the optoacoustic signal as it traverses through the skull, one needs to consider the ultrawideband nature of the optoacoustic signals. Here the insertion loss of murine skull has been measured by means of a hybrid optoacoustic-ultrasound scanning microscope having a spherically focused PVDF transducer and pulsed laser excitation at 532 nm of a 20 μm diameter absorbing microsphere acting as an optoacoustic point source. Accurate modeling of the acoustic transmission through the skull is further performed using a Fourier-domain expansion of a solid-plate model, based on the simultaneously acquired pulse-echo ultrasound image providing precise information about the skull's position and its orientation relative to the optoacoustic source. Good qualitative agreement has been found between the a solid-plate model and experimental measurements. The presented strategy might pave the way for modeling skull effects and deriving efficient correction schemes to account for acoustic distortions introduced by an adult murine skull, thus improving the spatial resolution, effective penetration depth and overall image quality of transcranial optoacoustic brain microscopy.

  17. Applied anatomy of repairing skull base defect by temporal fascia (muscles) flaps%颞筋膜(肌)瓣转位重建颅底的应用解剖及修复组织缺损的作用

    Institute of Scientific and Technical Information of China (English)

    闫长祥; 于春江; 王忠诚; 刘海; 张忠

    2004-01-01

    AIM: To illustrate anatomical property, blood supply and nerve distribution of temporal fascia(muscles) flaps and explore their effects in repairing tissue defect, so as to provide an anatomical basis for skull base rebuilding.METHODS: Totally 20 wet skull samples from 10 patients were fixed with latex mixed of red and blue dyestuff into veins and arteries. After making frontal-temporal-crest incision, anatomy of each layer was photographed and measured.RESULTS: The layers from the surface to the deep were skin, hypodermic tissue, superficial temporal fascia(STF), deep temporal fascia(DTF), temporal muscle(TM) and periosteum. STF, DTF and TM had their own blood supplies.CONCLUSION: Different types of temporal fascia flaps, temporal muscle flaps and temporal fascia muscle flaps can be made for skull base rebuilding and tissue defect repair according to blood supplies.%目的:分析说明颞筋膜(肌)瓣的解剖位置、血供及神经分布,探讨其在修复组织缺损中的作用,并为进行颅底重建提供解剖学依据.方法:应用10例(20侧)成人头部湿标本,动、静脉系统分别灌注混有红、蓝色染料的乳胶;额颞顶联合切口,逐层解剖、拍照、测量.结果:该区层次由浅入深为:皮肤、皮下组织、颞浅筋膜、颞深筋膜、颞肌和骨膜.颞浅筋膜、颞深筋膜和颞肌均有各自的血液供应.结论:根据其血供可制成不同类型的颞筋膜瓣、颞肌瓣、颞筋膜肌瓣进行颅底重建及组织缺损的修复.

  18. Breaking symmetry: the marine environment, prey size, and the evolution of asymmetry in cetacean skulls.

    Science.gov (United States)

    MacLeod, C D; Reidenberg, J S; Weller, M; Santos, M B; Herman, J; Goold, J; Pierce, G J

    2007-06-01

    Skulls of odontocetes (toothed whales, including dolphins and porpoises) are typified by directional asymmetry, particularly in elements associated with the airway. Generally, it is assumed this asymmetry is related to biosonar production. However, skull asymmetry may actually be a by-product of selection pressure for an asymmetrically positioned larynx. The odontocete larynx traverses the pharynx and is held permanently in place by a ring of muscle. This allows prey swallowing while remaining underwater without risking water entering the lungs and causing injury or death. However, protrusion of the larynx through the pharynx causes a restriction around which prey must pass to reach the stomach. The larynx and associated hyoid apparatus has, therefore, been shifted to the left to provide a larger right piriform sinus (lateral pharyngeal food channel) for swallowing larger prey items. This asymmetry is reflected in the skull, particularly the dorsal openings of the nares. It is hypothesized that there is a relationship between prey size and skull asymmetry. This relationship was examined in 13 species of odontocete cetaceans from the northeast Atlantic, including four narrow-gaped genera (Mesoplodon, Ziphius, Hyperoodon, and Kogia) and eight wide-gaped genera (Phocoena, Delphinus, Stenella, Lagenorhynchus, Tursiops, Grampus, Globicephala, and Orcinus). Skulls were examined from 183 specimens to assess asymmetry of the anterior choanae. Stomach contents were examined from 294 specimens to assess prey size. Results show there is a significant positive relationship between maximum relative prey size consumed and average asymmetry relative to skull size in odontocete species (wide-gape species: R2 = 0.642, P = 0.006; narrow-gape species: R2 = 0.909, P = 0.031). This finding provides support for the hypothesis that the directional asymmetry found in odontocete skulls is related to an aquatic adaptation enabling swallowing large, whole prey while maintaining respiratory

  19. Skull thickness in patients with clefts

    DEFF Research Database (Denmark)

    Arntsen, T; Kjaer, I; Sonnesen, L;

    2010-01-01

    The purpose was to analyze skull thickness in incomplete cleft lip (CL), cleft palate (CP), and combined cleft lip and palate (UCLP).......The purpose was to analyze skull thickness in incomplete cleft lip (CL), cleft palate (CP), and combined cleft lip and palate (UCLP)....

  20. The evolutionary significance of the Wajak skulls

    NARCIS (Netherlands)

    Storm, P.

    1995-01-01

    Ever since their description by Dubois (1920, 1922) the Wajak skulls Java) have played an important role in the discussions on the evolution of modern humans in Australasia. Because of the robust morphology of the skull, Wajak Man was seen as a link between Pleistocene hominids from Java (Solo) and

  1. Ontogenetic study of the skull in modern humans and the common chimpanzees: neotenic hypothesis reconsidered with a tridimensional Procrustes analysis.

    Science.gov (United States)

    Penin, Xavier; Berge, Christine; Baylac, Michel

    2002-05-01

    primarily the function of encephalization, but less so other parts of the skull. Our results, based on the discriminant function, reveal that additional structural traits (corresponding to the nonallometric part of the shape which is specific to humans) are rather situated in the other part of the skull. They mainly concern the equilibrium of the head related to bipedalism, and the respiratory and masticatory functions. Thus, the reduced prognathism, the flexed cranial base (forward position of the foramen magnum which is brought closer to the palate), the reduced anterior portion of the face, the reduced glabella, and the prominent nose mainly correspond to functional innovations which have nothing to do with a neotenic process in human evolution. The statistical analysis used here gives us the possibility to point out that some traits, which have been classically described as paedomorphic because they superficially resemble juvenile traits, are in reality independent of growth. PMID:11953945

  2. 三叉-心脏反射在颅底肿瘤患者手术中的临床特征%Clinical analysis of trigemino-cardiac reflex during surgery for patients with skull base tumors

    Institute of Scientific and Technical Information of China (English)

    何悦; 周大彪; 王会文; 韩如泉

    2013-01-01

    Objective To investigate the clinical features,risky factors and outcome of the trigemino-cardiac reflex (TCR) during surgery for skull base tumors.Methods Two hundred and sixty-two neurosurgical patients with skull base tumors underwent general anesthesia and open surgery from October 2009 to December 2011 in department of neurosurgery of Beijing Tiantan Hospital.The occurrence of TCR and the type of tumor,the surgical approach as well as the postoperative complication relative to TCR was evaluated retrospectively.Results Seventeen patients occurred TCR events intraoperatively (6.5%).There were 8 men and 9 women with an average age of 40.5 years.Eleven of them (64.7%) underwent schwannoma surgery.Regarding with the surgical procedure,the suboccipital retrosigmoidal approach and the middle fossa transtentorial approach were most commonly associated with TCR in this series (88.2%).The heart rate and blood pressure returned to the patient's normal baseline level after cessation of the surgical manipulation.There was no TCR-relative complication in cardiovascular system.The postoperative course is uneventful in all 17 patients.Conclusions TCR may occur during surgery for skull base tumor,especially when performing schwannoma surgery and suboccipital retrosigmoidal or middle fossa transtentorial approach.Accurate recognition and management of TCR during skull base surgery often carry on favorable outcome.%目的 探讨颅底肿瘤手术中发生的三叉-心脏反射(TCR)的临床特征、相关因素和预后.方法 回顾2009年10月至2011年12月首都医科大学附属北京天坛医院神经外科262例颅底肿瘤患者在全身麻醉下开颅手术中发生的TCR,并分析与TCR相关的肿瘤类型和手术入路以及术后并发症.结果 17例患者术中发生TCR(占6.5%).其中男8例,女9例,平均年龄40.5岁.肿瘤类型以神经鞘瘤最多,共11例(64.7%);手术入路以枕下乙状窦后入路最多见,其次为中颅

  3. 鼻咽癌颅底侵犯冠状位CT扫描应用价值分析%Analysis on value of CT coronal scan in diagnosis of invasion of skull base in nasopharyngeal carcinoma

    Institute of Scientific and Technical Information of China (English)

    骆忠华

    2012-01-01

    OBJECTIVE To discuss the clinical value of CT coronal scan in diagnosis of invasion of skull base in nasopharyn-geal carcinoma (NPC). METHODS 233 patients with NPC were given CT coronal and axial scan, then compared the results of the two positions. RESULTS In the 233 cases of NPC, CT coronal scan showed bone invasion in 4 cases in 16 cases that had not been recognized by axial scan. By CT coronal scan, the invasion of skull base was confirmed in 4 and excluded in 6 of 10 cases in which the invasion was uncertain by axial scan. Wider and deeper invasions were recognized in 23 cases (12.3%) by coronal scan, though obvious invasion had been diagnosed after axial scan. Accordant invasion was displayed in 35 cases (18.8%) by CT coronal and axial scan. By CT coronal scan, the invasion of skull base was in 21 patients witch had not been showed destruction of bone. And there was destruction of bone in 21 cases by axial scan, only 12 cases could be recognized in coronal scan, and with different locations. CONCLUSION CT scan is valuable for invasion of skull base in NPC, combining CT axial with coronal scan can improve diagnostic accuracy.%目的 探讨冠状位CT扫描在鼻咽癌颅底侵犯诊断中的应用价值.方法 对233例鼻咽癌患者进行轴位及冠状位CT扫描,比较两种体位对鼻咽癌颅底侵犯的检出情况.结果 轴位扫描所见肿瘤侵袭、转移灶中173例经冠状位扫描证实;轴位扫描无骨质侵袭及转移者16例中,经冠状位扫描见4例骨质破坏;轴位扫描所见10例难以确定是否骨质破坏者,经冠状位扫描证实4例骨质破坏,6例正常;另外,冠状位扫描显示了21例轴位扫描未发现的骨质破坏;同时有21例患者轴位扫描可见骨质破坏,但冠状位仅显示12例,且位置不同.结论 CT扫描在鼻咽癌颅底侵犯影像诊断中具有重要意义,但单纯轴位扫描具有一定局限性,联合应用轴位与冠状位的扫描,可提高诊断准确率.

  4. MRI、增强CT和PET-CT鼻咽癌颅底侵犯诊断价值的对比分析%Comparison of diagnostic value of PET using 18-fluoro-2-deoxyglucose, CT and MRI in detecting skull base invasion of nasopharyngeal carcinomas

    Institute of Scientific and Technical Information of China (English)

    Xiumei Ma; Ming Ye; Taifu Liu; Li Li; Liyan Dai

    2009-01-01

    Objective: We compared positron emission tomography (PET) using 18-fiuoro-2-deoxyglucose (FDG), enhanced computed tomography (CT) and magnetic resonance imaging (MRI) in detecting skull base invasion of nasopharyngeal car-cinomas (NPC) and to evaluate the value of these three methods in determining the existence of skull base invasion of naso-pharyngeal carcinomas. Methods: The images of enhanced CT, MRI and PET-CT scans, performed at intervals ≤ 20 days on 57 NPC patients from 7 2004 to February 2007, were selected and reviewed. The endpoints of the comparison were sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of Enhanced CT, MRI and PET-CT, based on histopathologic findings or clinical imaging follow-up for at least 6 months. Results: For detecting skull base invasion of NPC, the sensitivity of enhanced CT, MRI and PET-CT were 68.18%, 84.09%, 97.67% respectively; sped-ficity were 76.92%, 69.23%, 57.14% respectively; accuracy were 70.18%, 80.7%, 87.72% respectively; PPV were 90.9%,90.24%, 87.5% respectively; NPV were 41.67%, 56.25%, 88.89% respectively. Conclusion: PET-CT has obvious advan-tages in sensitivity over CT (P < 0.05) and MRI, better than the two methods in accuracy and NPV and 5 be more valuable for new patients in detecting skull base invasion of NPC patients.

  5. An accessory skull suture mimicking a skull fracture.

    Science.gov (United States)

    Wiedijk, J E F; Soerdjbalie-Maikoe, V; Maat, G J R; Maes, A; van Rijn, R R; de Boer, H H

    2016-03-01

    This paper describes an investigation of the sudden and unexpected death of a five-and-a-half-month-old boy. As in every Dutch case of sudden unexpected death in infancy (SUDI), a multidisciplinary diagnostic approach was used. This included post-mortem radiography, showing a linear discontinuity of the parietal bone. Originally this was interpreted as a skull fracture, but autopsy indicated no signs of mechanical trauma. Instead the defect was defined as a unilateral accessory suture of the parietal bone. The initial erroneous diagnosis had severe adverse consequences and thus every health care professional or forensic specialist dealing with paediatric mechanical traumas should be cautious of this rare anomaly. PMID:26860068

  6. Statistical skull models from 3D X-ray images

    CERN Document Server

    Berar, M; Bailly, G; Payan, Y; Berar, Maxime; Desvignes, Michel; Payan, Yohan

    2006-01-01

    We present 2 statistical models of the skull and mandible built upon an elastic registration method of 3D meshes. The aim of this work is to relate degrees of freedom of skull anatomy, as static relations are of main interest for anthropology and legal medicine. Statistical models can effectively provide reconstructions together with statistical precision. In our applications, patient-specific meshes of the skull and the mandible are high-density meshes, extracted from 3D CT scans. All our patient-specific meshes are registrated in a subject-shared reference system using our 3D-to-3D elastic matching algorithm. Registration is based upon the minimization of a distance between the high density mesh and a shared low density mesh, defined on the vertexes, in a multi resolution approach. A Principal Component analysis is performed on the normalised registrated data to build a statistical linear model of the skull and mandible shape variation. The accuracy of the reconstruction is under the millimetre in the shape...

  7. Study of optimize scanning program of double helical CT in reducing skull base artifacts in images%优化扫描方案减轻双排螺旋CT颅底伪影的研究

    Institute of Scientific and Technical Information of China (English)

    何新华; 胡永胜; 杨越; 胡鹏程; 王自勇; 付璇; 慕鹏

    2014-01-01

    目的:优化扫描方案,减少颅底伪影,改善图像质量。方法双排螺旋CT头颅平扫病例60例,随机分为3组,每组20例。 A、B组采用常规序列扫描,A组层厚为8 mm (4.0 mm ×2),B组层厚为4 mm(4.0 mm ×2)。 C组采用2段螺旋扫描程序,扫描参数为颅底3 mm (1.5 mm ×2)+颅脑幕上5 mm(2.5 mm ×2)。观察和评价后、中颅窝图像有无伪影、伪影形态、位置、严重程度等。结果除A组1例外,A、B两组后颅窝均有不同程度的放射状伪影和交叉伪影,中颅窝部分病例有不同程度伪影。 B组Ⅱ级伪影的总数多于A组(29/16),Ш级伪影2例,显示B组4 mm层厚不能减轻颅底伪影,且有加重伪影程度的可能。 C组中部分病例后颅窝、中颅窝未见明显伪影,Ⅱ级伪影的例数为5例。与A、B组比较, C组可显著减轻颅底伪影,差异有统计学意义(P<0.05)。结论颅底3 mm (1.5 mm ×2)+颅脑幕上5 mm(2.5 mm ×2)螺旋扫描法,可显著减轻颅底伪影,改善图像质量,清晰显示颅底组织结构,具有临床应用价值。%Objective To optimize the scanning programs in order to reduce the skull base artifacts and improve images quality . Methods Sixty cases of brain performed with double helical CT were randomly divided into three groups with 20 in each.Group A and B u-sing routine sequential program ,the thickness was 8mm (4.0 mm ×2) in group A and was 4mm (4.0 mm ×2) in group B.Group C using two segments helical scan,the thickness for the base of the skull (Base) was 3mm (1.5 mm ×2),and for cerebrum (above brain curtain) was 5 mm (2.5 mm ×2).The artifacts shape,location,severity at posterior fossa,and middle cranial fossa images were observed and evalua-ted.Results In group A and B ,almost all cases had varying severity of radial and cross artifacts at posterior fossa ,and had different degrees of artifacts at middle cranial fossa in

  8. Comparison of Anterior Segment Measurements with Scheimpflug/Placido Photography-Based Topography System and IOLMaster Partial Coherence Interferometry in Patients with Cataracts

    OpenAIRE

    Jinhai Huang; Na Liao; Giacomo Savini; Fangjun Bao; Ye Yu; Weicong Lu; Qingjie Hu; Qinmei Wang

    2014-01-01

    Purpose. To assess the consistency of anterior segment measurements obtained using a Sirius Scheimpflug/Placido photography-based topography system (CSO, Italy) and IOLMaster partial coherence interferometry (Carl Zeiss Meditec, Germany) in eyes with cataracts. Methods. A total of 90 eyes of 90 patients were included in this prospective study. The anterior chamber depth (ACD), keratometry (K), corneal astigmatism axis, and white to white (WTW) values were randomly measured three times with Si...

  9. Asymmetric activation of the anterior cerebral cortex in recipients of IRECA: preliminary evidence for the energetic effects of an intention-based treatment modality on human neurophysiology.

    OpenAIRE

    Pike, C.; Vernon, D.; Hald, L.

    2014-01-01

    Objectives: Neurophysiologic studies of mindfulness link the health benefits of meditation to activation of the left-anterior cerebral cortex. The similarity and functional importance of intention and attentional stance in meditative and biofield therapeutic practices suggest that modulation of recipient anterior asymmetric activation may mediate the energetic effects of intention-based biofield treatments as well. The aim of the current study was to test this hypothesis by using a treatment ...

  10. Preoperative MR imaging-based volume measurements of the hippocampal formation and anterior temporal lobe in epileptic patients

    International Nuclear Information System (INIS)

    MR-based volume measurements of the anterior temporal lobe and hippocampal formation were performed in 36 patients who subsequently underwent surgery for medically refractory temporal lobe epilepsy. Seizure lateralization was based on standard clinical and electroencephalographic criteria. No surgical pathologic specimens contained structural lesions; epilepsy in these patients was therefore presumably due to mesial sclerosis. The right-minus-left hippocampal formation volume difference was greater than 0 in all 20 patients operated on the left side and less than 0 in all 16 patients operated on the right side. This difference completely separated the two surgical groups, while the same measurement in a group of 35 normal controls fell between the two surgical groups. Measurements of the anterior temporal to be showed a similar trend but incompletely separated controls, right- and left-sided epileptics. These results suggest that in a significant percentage of cases, MR-based volume measurements correctly identify the unilateral hippocampal atrophy that is known to occur in cases of mesial temporal sclerosis

  11. Characteristics of gunshot wounds in the skull.

    Science.gov (United States)

    Quatrehomme, G; Işcan, M Y

    1999-05-01

    The analysis of trauma to the skeleton is an important aspect of forensic case work, but most pathology references devote limited attention to this topic. This paper describes various aspects of gunshot wounds, including entrance and exit patterns, angle and path, range of fire and velocity, and caliber of the bullet, based on observations of a series of known cases. Skeletal remains of 21 victims of gunshot wounds were studied. In most cases, there was documentation of the investigation, autopsy, and victim's identity. Each case was analyzed in terms of wound location, shape, size and exit/entry surface area ratio, beveling, and direction of shooting Skull entry wounds were most often round or oval. Unusual shapes were observed in bones like the mandible and mastoid process, but were also found to be triangular, nearly rectangular or irregular. Tunneling was observed in the mastoid process. The expected internal beveling was obvious in all but one skull. External beveling of an entry wound was only observed in one case (parietal bone). Exit wounds were roughly round, oval, square, and rectangular and were always more irregular than entry wounds. External beveling of exit wounds was observed in most vault bones, but there was none in the orbit, maxilla, greater wing of the sphenoid, temporal, or left occipital bone. Tangential gunshot wounds were seen in a mastoid process, zygomatic process, mandibular ramus and condyle, and occipital condyle. Most of the exit to entry surface area ratios (cm2) varied from 1.4 to 2.0. In four cases the ratio indicated that entrances were larger than exists. In conclusion, understanding of gunshot wound characteristics is an important matter to interpret distance, velocity, direction and sometimes caliber size. Assessment of this nature of gunshot wounds helps reconstruct events surrounding the death. PMID:10408112

  12. Does lumbar spinal degeneration begin with the anterior structures? A study of the observed epidemiology in a community-based population

    Directory of Open Access Journals (Sweden)

    Jarvik Jeffrey G

    2011-09-01

    Full Text Available Abstract Background- Prior studies that have concluded that disk degeneration uniformly precedes facet degeneration have been based on convenience samples of individuals with low back pain. We conducted a study to examine whether the view that spinal degeneration begins with the anterior spinal structures is supported by epidemiologic observations of degeneration in a community-based population. Methods- 361 participants from the Framingham Heart Study were included in this study. The prevalences of anterior vertebral structure degeneration (disk height loss and posterior vertebral structure degeneration (facet joint osteoarthritis were characterized by CT imaging. The cohort was divided into the structural subgroups of participants with 1 no degeneration, 2 isolated anterior degeneration (without posterior degeneration, 3 combined anterior and posterior degeneration, and 4 isolated posterior degeneration (without anterior structure degeneration. We determined the prevalence of each degeneration pattern by age group Results- As the prevalence of the no degeneration and isolated anterior degeneration patterns decreased with increasing age group, the prevalence of the combined anterior/posterior degeneration pattern increased. 22% of individuals demonstrated isolated posterior degeneration, without an increase in prevalence by age group. Isolated posterior degeneration was most common at the L5-S1 and L4-L5 spinal levels. In multivariate analyses, disk height loss was independently associated with facet joint osteoarthritis, as were increased age (years, female sex, and increased BMI (kg/m2, but not smoking. Conclusions- The observed epidemiology of lumbar spinal degeneration in the community-based population is consistent with an ordered progression beginning in the anterior structures, for the majority of individuals. However, some individuals demonstrate atypical patterns of degeneration, beginning in the posterior joints. Increased age and BMI

  13. Broadband acoustic properties of a murine skull

    Science.gov (United States)

    Estrada, Héctor; Rebling, Johannes; Turner, Jake; Razansky, Daniel

    2016-03-01

    It has been well recognized that the presence of a skull imposes harsh restrictions on the use of ultrasound and optoacoustic techniques in the study, treatment and modulation of the brain function. We propose a rigorous modeling and experimental methodology for estimating the insertion loss and the elastic constants of the skull over a wide range of frequencies and incidence angles. A point-source-like excitation of ultrawideband acoustic radiation was induced via the absorption of nanosecond duration laser pulses by a 20 μm diameter microsphere. The acoustic waves transmitted through the skull are recorded by a broadband, spherically focused ultrasound transducer. A coregistered pulse-echo ultrasound scan is subsequently performed to provide accurate skull geometry to be fed into an acoustic transmission model represented in an angular spectrum domain. The modeling predictions were validated by measurements taken from a glass cover-slip and ex vivo adult mouse skulls. The flexible semi-analytical formulation of the model allows for seamless extension to other transducer geometries and diverse experimental scenarios involving broadband acoustic transmission through locally flat solid structures. It is anticipated that accurate quantification and modeling of the skull transmission effects would ultimately allow for skull aberration correction in a broad variety of applications employing transcranial detection or transmission of high frequency ultrasound.

  14. The Nondestructive Determination of the Aluminum Content in Pressed Skulls of Aluminum Dross

    Science.gov (United States)

    Kevorkijan, Varuzan; Škapin, Srečo Davor; Kovačec, Uroš

    2013-02-01

    prediction of the amount of free aluminum in pressed skulls w Al, based on nondestructive measurement of the density ρ of the pressed skulls. The pressed skulls density is measured by a fully automatic gas displacement pyknometer with a working volume large enough to enable the insertion of the whole pressed skull sample. An additional integral part of this methodology is the set of experimentally determined linear graphs w Al- ρ, plotted in advance for all classes of pressed skulls existing in the plant, from the experimentally collected data on pressed skulls density and aluminum recovery by melting. After selecting the proper graph w Al- ρ, which is usually performed on an aluminum alloy basis, the pyknometric measured density of the pressed skulls can be routinely related to the aluminum content sought, within a relative error of ±5%.

  15. Relationship between the anterior forebrain mesocircuit and the default mode network in the structural bases of disorders of consciousness

    Directory of Open Access Journals (Sweden)

    Nicholas D. Lant

    2016-01-01

    Full Text Available The specific neural bases of disorders of consciousness (DOC are still not well understood. Some studies have suggested that functional and structural impairments in the default mode network may play a role in explaining these disorders. In contrast, others have proposed that dysfunctions in the anterior forebrain mesocircuit involving striatum, globus pallidus, and thalamus may be the main underlying mechanism. Here, we provide the first report of structural integrity of fiber tracts connecting the nodes of the mesocircuit and the default mode network in 8 patients with DOC. We found evidence of significant damage to subcortico-cortical and cortico-cortical fibers, which were more severe in vegetative state patients and correlated with clinical severity as determined by Coma Recovery Scale—Revised (CRS-R scores. In contrast, fiber tracts interconnecting subcortical nodes were not significantly impaired. Lastly, we found significant damage in all fiber tracts connecting the precuneus with cortical and subcortical areas. Our results suggest a strong relationship between the default mode network – and most importantly the precuneus – and the anterior forebrain mesocircuit in the neural basis of the DOC.

  16. Functional Imaging of Human Vestibular Cortex Activity Elicited by Skull Tap and Auditory Tone Burst

    Science.gov (United States)

    Noohi, F.; Kinnaird, C.; Wood, S.; Bloomberg, J.; Mulavara, A.; Seidler, R.

    2016-01-01

    The current study characterizes brain activation in response to two modes of vestibular stimulation: skull tap and auditory tone burst. The auditory tone burst has been used in previous studies to elicit either the vestibulo-spinal reflex (saccular-mediated colic Vestibular Evoked Myogenic Potentials (cVEMP)), or the ocular muscle response (utricle-mediated ocular VEMP (oVEMP)). Some researchers have reported that air-conducted skull tap elicits both saccular and utricle-mediated VEMPs, while being faster and less irritating for the subjects. However, it is not clear whether the skull tap and auditory tone burst elicit the same pattern of cortical activity. Both forms of stimulation target the otolith response, which provides a measurement of vestibular function independent from semicircular canals. This is of high importance for studying otolith-specific deficits, including gait and balance problems that astronauts experience upon returning to earth. Previous imaging studies have documented activity in the anterior and posterior insula, superior temporal gyrus, inferior parietal lobule, inferior frontal gyrus, and the anterior cingulate cortex in response to different modes of vestibular stimulation. Here we hypothesized that skull taps elicit similar patterns of cortical activity as the auditory tone bursts, and previous vestibular imaging studies. Subjects wore bilateral MR compatible skull tappers and headphones inside the 3T GE scanner, while lying in the supine position, with eyes closed. Subjects received both forms of the stimulation in a counterbalanced fashion. Pneumatically powered skull tappers were placed bilaterally on the cheekbones. The vibration of the cheekbone was transmitted to the vestibular system, resulting in the vestibular cortical response. Auditory tone bursts were also delivered for comparison. To validate our stimulation method, we measured the ocular VEMP outside of the scanner. This measurement showed that both skull tap and auditory

  17. Prediction and near-field observation of skull-guided acoustic waves

    OpenAIRE

    Estrada, Héctor; Rebling, Johannes; Razansky, Daniel

    2016-01-01

    Ultrasound waves propagating in water or soft biological tissue are strongly reflected when encountering the skull, which limits the use of ultrasound-based techniques in transcranial imaging and therapeutic applications. Current knowledge on the acoustic properties of the cranial bone is restricted to far-field observations, leaving its near-field properties unexplored. We report on the existence of skull-guided acoustic waves, which was herein confirmed by near-field measurements of optoaco...

  18. Skull fracture and the diagnosis of abuse.

    OpenAIRE

    Hobbs, C J

    1984-01-01

    Eighty nine children under 2 years of age with skull fracture were studied retrospectively--29 children with definite non-accidental injury serially recorded by the Departments of Paediatrics and Forensic Medicine, and 60 children consecutively admitted to hospital with skull fractures after accidents. There were 20 deaths including 19 among abused children. Multiple injuries and an inadequate history assisted in diagnosing abuse. Fracture characteristics found considerably more often in abus...

  19. The 'lamellated' skull in β-thalassaemia

    International Nuclear Information System (INIS)

    The skull in homozygous β-thalassaemia may present several abnormalities, such as osteopenia, widening of the diploic space, and a 'hair-on-end' appearance. In some cases it presents also a particular stratified appearance caused by a variable number of osseous lamellae, parallel with the inner table. This 'lamellated skull' was observed in 16 out of 150 patients affected by the disease (10.6%). (orig./GDG)

  20. 导航技术在颅底-颞下区肿瘤手术中的应用%Application of computer-aided design and navigation technology in skull base and infratemporal fossa tumor surgery

    Institute of Scientific and Technical Information of China (English)

    郭玉兴; 彭歆; 刘筱菁; 张雷; 俞光岩; 郭传殡

    2013-01-01

    Objective To evaluate the application of computer-aided design and navigation technology in skull base and infratemporal fossa tumor surgery and to analyze its advantages and disadvantages.Methods Twenty-nine cases with tumor of skull base and infratemporal fossa were treated with computer-aided design and navigation surgery.The Parameters of age,gender,primary or recurrent tumor,tumor nature and surgical approach were recorded.Results En bloc resection was performed in 20 cases and subtotal resection in 9 cases.The margin status was negative margin in 8 cases,near-tumor margin in 17 cases and positive resection margin in 4 cases.Postoperative complication rate was 14% (4/29).During the follow-up period,2 benign cases recurred.In the malignant group,there were 7 cases of recurrence,2 cases of metastasis and 3 deaths.The 5-year overall survival and progression-free survival rate were 69% and 40% respectively.Conclusions Navigation technology can enhance the confidence of the surgeons and operation safety in handling malignant tumors in skull base and infratemporal fossa.%目的 评价计算机辅助设计导航技术在颅底-颞下区肿瘤手术中的应用价值.方法 对29例颅底-颞下区肿瘤患者行计算机辅助手术方案设计及术中导航.记录患者的年龄、性别、肿瘤原发或复发、肿瘤性质及手术入路.应用SPSS 13.0软件计算生存率.结果 肿瘤完全切除20例、近全切除7例、次全切除2例;切除方式:整块切除20例、分块切除9例;切缘状态:阴性切缘8例、近肿瘤切除17例、阳性切缘4例.术后并发症发生率为14%(4/29).随访期内良性肿瘤复发2例.恶性肿瘤复发7例、转移2例、死亡3例,恶性肿瘤5年总生存率和无进展生存率分别为69%和40%.结论 计算机辅助设计导航技术可提高颅底-颞下区外科操作的手术安全性.

  1. Dental development of the Taung skull from computerized tomography.

    Science.gov (United States)

    Conroy, G C; Vannier, M W

    Just over 60 years ago, Dart's description and analysis of the Taung child's skull triggered an intellectual revolution about human origins. Recently, several authors have suggested that one of the most significant hominid-like traits of australopithecines, delayed maturation, may not after all be valid. This is a radical departure from Mann's classic study of australopithecine maturation and palaeodemography based on dental eruption patterns. The resolution of this debate has important implications for the history of the biological and social evolution of the human species. In view of the controversies generated by recent studies, and particularly because the Taung skull is the type specimen of Australopithecus africanus, we have investigated the relevant anatomy of the Taung 'child' using computerized tomography. We conclude that the Taung 'child' shows some important dental maturational affinities with great apes, although as Dart noted, other hominid-like features are clearly present. PMID:3116435

  2. Synthesis of Refractory Materials by Skull Melting Technique

    Science.gov (United States)

    Osiko, Vyacheslav V.; Borik, Mikhail A.; Lomonova, Elena E.

    This chapter discusses methods of growing refractory oxide single crystals and synthesis of refractory glasses by skull melting technique in a cold crucible. It shows the advantages of radiofrequency (RF) heating of dielectric materials in a cold crucible and points out some specific problems regarding the process of growing crystals by directional crystallization from the melt and by pulling on a seed from the melt. The distinctive features of the method of directional crystallization from the melt are discussed in detail on the example of technology of materials based on zirconia, i.e., cubic single crystals and partly stabilized single crystals. It is shown that the size and quality of crystals are functions of the process conditions, such as thermal conditions under crystallization, growth rate, and chemical composition. We provide an overview of research on the structure, phase composition, and physicochemical properties of crystals based on zirconia. The optical, mechanical, and electric properties of these crystals make them suitable for a number of technical and industrial applications in optics, electronics, materials processing, and medicine. In this chapter, we also consider some problems regarding the synthesis of refractory glasses by skull melting technique. The physicochemical and optical properties of glasses are given and their practical applications in technology are discussed. We note that one of the better developed and most promising applications of skull melting technique is the immobilization of liquid and solid waste (also radioactive waste) into solid-state materials by vitrification.

  3. Imaging of cerebellopontine angle lesions: an update. Part 2: intra-axial lesions, skull base lesions that may invade the CPA region, and non-enhancing extra-axial lesions

    Energy Technology Data Exchange (ETDEWEB)

    Bonneville, Fabrice; Chiras, Jacques [Pitie-Salpetriere Hospital, Department of Neuroradiology, Paris (France); Savatovsky, Julien [Adolphe de Rothschild Foundation, Department of Radiology, Paris (France)

    2007-11-15

    Computed tomography (CT) and magnetic resonance (MR) imaging reliably demonstrate typical features of vestibular schwannomas or meningiomas in the vast majority of mass lesions responsible for cerebellopontine angle (CPA) syndrome. However, a large variety of unusual lesions can also be encountered in the CPA. Covering the entire spectrum of lesions potentially found in the CPA, these articles explain the pertinent neuroimaging features that radiologists need to know to make clinically relevant diagnoses in these cases, including data from diffusion- and perfusion-weighted imaging or MR spectroscopy, when available. A diagnostic algorithm based on the lesion's site of origin, shape and margins, density, signal intensity and contrast material uptake is also proposed. Non-enhancing extra-axial CPA masses are cystic (epidermoid cyst, arachnoid cyst, neurenteric cyst) or contain fat (dermoid cyst, lipoma). Tumours can also extend into the CPA by extension from the skull base (paraganglioma, chondromatous tumours, chordoma, cholesterol granuloma, endolymphatic sac tumour). Finally, brain stem or ventricular tumours can present with a significant exophytic component in the CPA that may be difficult to differentiate from an extra-axial lesion (lymphoma, hemangioblastoma, choroid plexus papilloma, ependymoma, glioma, medulloblastoma, dysembryoplastic neuroepithelial tumour). (orig.)

  4. All the Information the Neonate and Infant Skull

    Directory of Open Access Journals (Sweden)

    M. Bajoghli

    2008-01-01

    Full Text Available The art of skull interpretation slowly being lost and trainees in radiology see few plane film of skull. However, skull radiography still provides significant information that is helpful in finding pathologic conditions. Abnormality of skull may be reflected as variation in density, size and shape of the skull, as well as skull defect. Skull dysplasia may manifest as decreased calvarial density (hypophosphatasia, osteogenesis imferfecta, or increased calvarial density (osteopetrosis, or facial increase in density (frontometaphyseal dysplasia. Diffusely decreased or increased clavarial density is more associated with process that affects entire skull. Decrease density of cranial vault at birth seen more in torch and fetal alcoholic. Macrocephaly may be due to skeletal sysplasia, or hydrocephalus. The aim of this review is to evaluate plane film of skull in neonate and infants.

  5. Functional relationship between skull form and feeding mechanics in Sphenodon, and implications for diapsid skull development.

    Directory of Open Access Journals (Sweden)

    Neil Curtis

    Full Text Available The vertebrate skull evolved to protect the brain and sense organs, but with the appearance of jaws and associated forces there was a remarkable structural diversification. This suggests that the evolution of skull form may be linked to these forces, but an important area of debate is whether bone in the skull is minimised with respect to these forces, or whether skulls are mechanically "over-designed" and constrained by phylogeny and development. Mechanical analysis of diapsid reptile skulls could shed light on this longstanding debate. Compared to those of mammals, the skulls of many extant and extinct diapsids comprise an open framework of fenestrae (window-like openings separated by bony struts (e.g., lizards, tuatara, dinosaurs and crocodiles, a cranial form thought to be strongly linked to feeding forces. We investigated this link by utilising the powerful engineering approach of multibody dynamics analysis to predict the physiological forces acting on the skull of the diapsid reptile Sphenodon. We then ran a series of structural finite element analyses to assess the correlation between bone strain and skull form. With comprehensive loading we found that the distribution of peak von Mises strains was particularly uniform throughout the skull, although specific regions were dominated by tensile strains while others were dominated by compressive strains. Our analyses suggest that the frame-like skulls of diapsid reptiles are probably optimally formed (mechanically ideal: sufficient strength with the minimal amount of bone with respect to functional forces; they are efficient in terms of having minimal bone volume, minimal weight, and also minimal energy demands in maintenance.

  6. Solitary skull metastasis as the first symptom of hepatocellular carcinoma: case report and literature review

    Directory of Open Access Journals (Sweden)

    Guo X

    2014-04-01

    in the calvaria site were more frequent than those that occurred in the skull base and facial skeleton. This may be worthy of further investigation in the future.Keywords: hepatocellular carcinoma, skull metastasis, bone metastasis, positron emission tomography

  7. Design and Manufacturing of a Custom Skull Implant

    Directory of Open Access Journals (Sweden)

    Juan F.I. Saldarriaga

    2011-01-01

    Full Text Available Problem statement: Cranioplasty is defined as a neurosurgical procedure to cover an injured bone in the skull. This procedure is carried out in order to protect and restore intracranial structures and to restore the appearance and psychological stability of the patient. Advances in medical imaging, such as MRI and CT, have allowed the 3D reconstruction of anatomical structures for several medical applications, including the design of custom-made implants. This study describes the methodology used to design a custom-made cranial implant for a 13-year-old patient who suffered a lesion in the left frontoparietal region of the skull caused by a fall. Approach: The design of the implant was based on the 3D reconstruction of the skull of the patient, obtained by a CT scan, using Rapid Form® 2006. Once the preliminary design was completed, 3D models of the injured region of the skull and of the implant were fabricated in a Rapid Prototyping (RP machine using Fused Deposition Modeling Technology (FDM with the purpose of functionally and dimensionally validating the implant. Subsequently, the implant was fabricated using a 1.2-mm-thick Titanium Alloy (Ti6Al4V plate. Results: The prosthesis was successfully implanted. The surgical time was 85% shorter than that for the same type of surgery in which standard commercial implants and titanium meshes are used. This decrease in surgery time is primarily the result of eliminating the need for trial and error procedures to achieve a good fit for the implant. Finally, the appearance of the patient was restored, allowing the patient to safely perform daily activities. Conclusion: The use of 3D reconstruction techniques from medical images reduces the possibility of errors during surgery, improves fit and provides better implant stability. The use of 3D models designed in RP proved to be an effective practice in the design process.

  8. Skull shapes of the Lissodelphininae: radiation, adaptation and asymmetry.

    Science.gov (United States)

    Galatius, Anders; Goodall, R Natalie P

    2016-06-01

    Within Delphinidae, the sub-family Lissodelphininae consists of 8 Southern Ocean species and 2 North Pacific species. Lissodelphininae is a result of recent phylogenetic revisions based on molecular methods. Thus, morphological radiation within the taxon has not been investigated previously. The sub-family consists of ecologically diverse groups such as (1) the Cephalorhynchus genus of 4 small species inhabiting coastal and shelf waters, (2) the robust species in the Lagenorhynchus genus with the coastal La. australis, the offshore La. cruciger, the pelagic species La. obscurus and La. obliquidens, and (3) the morphologically aberrant genus Lissodelphis. Here, the shapes of 164 skulls from adults of all 10 species were compared using 3-dimensional geometric morphometrics. The Lissodelphininae skulls were supplemented by samples of Lagenorhynchus albirostris and Delphinus delphis to obtain a context for the variation found within the subfamily. Principal components analysis was used to map the most important components of shape variation on phylogeny. The first component of shape variation described an elongation of the rostrum, lateral and dorsoventral compression of the neurocranium and smaller temporal fossa. The two Lissodelphis species were on the high extreme of this spectrum, while Lagenorhynchus australis, La. cruciger and Cephalorhynchus heavisidii were at the low extreme. Along the second component, La. cruciger was isolated from the other species by its expanded neurocranium and concave facial profile. Shape variation supports the gross phylogenetic relationships proposed by recent molecular studies. However, despite the great diversity of ecology and external morphology within the subfamily, shape variation of the feeding apparatus was modest, indicating a similar mode of feeding across the subfamily. All 10 species were similar in their pattern of skull asymmetry, but interestingly, two species using narrowband high frequency clicks (La. cruciger and C

  9. Creating physical 3D stereolithograph models of brain and skull.

    Directory of Open Access Journals (Sweden)

    Daniel J Kelley

    Full Text Available The human brain and skull are three dimensional (3D anatomical structures with complex surfaces. However, medical images are often two dimensional (2D and provide incomplete visualization of structural morphology. To overcome this loss in dimension, we developed and validated a freely available, semi-automated pathway to build 3D virtual reality (VR and hand-held, stereolithograph models. To evaluate whether surface visualization in 3D was more informative than in 2D, undergraduate students (n = 50 used the Gillespie scale to rate 3D VR and physical models of both a living patient-volunteer's brain and the skull of Phineas Gage, a historically famous railroad worker whose misfortune with a projectile tamping iron provided the first evidence of a structure-function relationship in brain. Using our processing pathway, we successfully fabricated human brain and skull replicas and validated that the stereolithograph model preserved the scale of the VR model. Based on the Gillespie ratings, students indicated that the biological utility and quality of visual information at the surface of VR and stereolithograph models were greater than the 2D images from which they were derived. The method we developed is useful to create VR and stereolithograph 3D models from medical images and can be used to model hard or soft tissue in living or preserved specimens. Compared to 2D images, VR and stereolithograph models provide an extra dimension that enhances both the quality of visual information and utility of surface visualization in neuroscience and medicine.

  10. Volumetric modulated arc therapy versus step-and-shoot intensity modulated radiation therapy in the treatment of large nerve perineural spread to the skull base: a comparative dosimetric planning study

    Energy Technology Data Exchange (ETDEWEB)

    Gorayski, Peter; Fitzgerald, Rhys; Barry, Tamara [Department of Radiation Oncology, Princess Alexandra Hospital, Woolloongabba, Queensland (Australia); Burmeister, Elizabeth [Nursing Practice Development Unit, Princess Alexandra Hospital and Research Centre for Clinical and Community Practice Innovation, Griffith University, Brisbane, Queensland (Australia); Foote, Matthew [Department of Radiation Oncology, Princess Alexandra Hospital, Woolloongabba, Queensland (Australia); Diamantina Institute, University of Queensland, Brisbane, Queensland (Australia)

    2014-06-15

    Cutaneous squamous cell carcinoma with large nerve perineural (LNPN) infiltration of the base of skull is a radiotherapeutic challenge given the complex target volumes to nearby organs at risk (OAR). A comparative planning study was undertaken to evaluate dosimetric differences between volumetric modulated arc therapy (VMAT) versus intensity modulated radiation therapy (IMRT) in the treatment of LNPN. Five consecutive patients previously treated with IMRT for LNPN were selected. VMAT plans were generated for each case using the same planning target volumes (PTV), dose prescriptions and OAR constraints as IMRT. Comparative parameters used to assess target volume coverage, conformity and homogeneity included V95 of the PTV (volume encompassed by the 95% isodose), conformity index (CI) and homogeneity index (HI). In addition, OAR maximum point doses, V20, V30, non-target tissue (NTT) point max doses, NTT volume above reference dose, monitor units (MU) were compared. IMRT and VMAT plans generated were comparable for CI (P = 0.12) and HI (P = 0.89). VMAT plans achieved better V95 (P = < 0.001) and reduced V20 and V30 by 652 cubic centimetres (cc) (28.5%) and 425.7 cc (29.1%), respectively. VMAT increased MU delivered by 18% without a corresponding increase in NTT dose. Compared with IMRT plans for LNPN, VMAT achieved comparable HI and CI.

  11. Volumetric modulated arc therapy versus step-and-shoot intensity modulated radiation therapy in the treatment of large nerve perineural spread to the skull base: a comparative dosimetric planning study

    International Nuclear Information System (INIS)

    Cutaneous squamous cell carcinoma with large nerve perineural (LNPN) infiltration of the base of skull is a radiotherapeutic challenge given the complex target volumes to nearby organs at risk (OAR). A comparative planning study was undertaken to evaluate dosimetric differences between volumetric modulated arc therapy (VMAT) versus intensity modulated radiation therapy (IMRT) in the treatment of LNPN. Five consecutive patients previously treated with IMRT for LNPN were selected. VMAT plans were generated for each case using the same planning target volumes (PTV), dose prescriptions and OAR constraints as IMRT. Comparative parameters used to assess target volume coverage, conformity and homogeneity included V95 of the PTV (volume encompassed by the 95% isodose), conformity index (CI) and homogeneity index (HI). In addition, OAR maximum point doses, V20, V30, non-target tissue (NTT) point max doses, NTT volume above reference dose, monitor units (MU) were compared. IMRT and VMAT plans generated were comparable for CI (P = 0.12) and HI (P = 0.89). VMAT plans achieved better V95 (P = < 0.001) and reduced V20 and V30 by 652 cubic centimetres (cc) (28.5%) and 425.7 cc (29.1%), respectively. VMAT increased MU delivered by 18% without a corresponding increase in NTT dose. Compared with IMRT plans for LNPN, VMAT achieved comparable HI and CI

  12. [Injury by skull osteolytic secundary syphilis].

    Science.gov (United States)

    Alessandro, Lucas; Camporro, Julieta Piar; Arakaki, Naomi; Orellana, Nora; Mora, Claudia Andrea

    2016-04-01

    Bone involvement of syphilis can be observed in tertiary and congenital syphilis. It is infrequent during the secondary stage. The skull is the most affected bone in secondary syphilis, and its most frequent form of presentation is proliferative osteitis. If the skull is affected, headache is usual and can be as intense as in meningitis. Osteolyitic lesions may be seen in complimentary imaging studies, with a moth eaten aspect. These lesions raise concern over a number of differential diagnoses, among which are infectious, inflammatory and neoplastic diseases. The definitive diagnosis is made by bone biopsy of the compromised bone. Molecular techniques in the affected tissues increases diagnostic performance. There is no standardized treatment protocol for syphilis since there are no guidelines available. We report a case of a 19 year old female, presenting with a unique osteolytic lesion in the skull due to secondary syphilis. PMID:27315003

  13. Cloverleaf skull associated with unusual skeletal anomalies

    International Nuclear Information System (INIS)

    A male infant which cloverleaf skull and multiple other birth defects born to unrelated, healthy, young parents is presented. Radiologic findings in addition to the cloverleaf skull configuration included short, wide clavicles, winged scapulae, unusual shapes of ribs with abnormal spacing between them and with prominent costovertebral junctions, and widely separated ischia. Ulnae appeared angular with probable fusion to the midportion of the radial bones bilaterally. There was polydactyly of the hands and feet with grossly abnormal metacarpal and metatarsal bones. Skeletal maturation was normal. Computed tomography of the skull showed dilated lateral and third ventricles as well as agenesis of the corpus callosum. The mother denies any teratogenic exposure during the pregnancy. The findings in this infant do not seem to fit into any previously described syndrome. (orig.)

  14. The first fossil skull of Alligator sinensis from the Pleistocene, Taiwan, with a paleogeographic implication of the species

    Science.gov (United States)

    Hsi-yin, Shan; Yen-nien, Cheng; Xiao-chun, Wu

    2013-06-01

    A nearly complete fossil skull of Alligatoridae from the Pleistocene, Penghu Channel, east of Taiwan, is reported. It can be referred to the most latest clade of Alligatorinae, which includes Alligator sinensis, Alligator mississippiensis and Alligator mefferdi, on the basis of the following features: the splenial is excluded from the mandibular symphysis; the anterior tip of the splenial passes dorsal to the Meckelian groove; and the mandible is gently curved between the fourth alveoli and the mid dentary. It differs from A. mississippiensis and A. mefferdi mainly in the following characters: the breadth between the supratemporal fenestrae is approximately equal to the interorbital width, the snout is about half the length of the skull; and the anterior part of the snout is subtriangular in dorsal view. These features suggest that the Penghu alligator is most probably referable to A. sinensis. This is the only fossil skull of A. sinensis known. The discovery of the skull in Penghu Channel not only provides the first solid fossil evidence to indicate that the geological distribution of A. sinensis extended farther southeast than the historical/archeological range of the species but also adds new information on the biodiversity of the Penghu fauna.

  15. Automation and robotization of the set-up and treatment for patients treated for a brain and base of the skull tumor; Automatisation et robotisation du placement et de la mise en place des patients irradies pour une tumeur de l'encephale et de la base du crane

    Energy Technology Data Exchange (ETDEWEB)

    Noel, G.; Ferrand, R.; Feuvret, L.; Meyroneinc, S.; Mazeron, J.J. [Centre de Protontherapie d' Orsay, 91 (France); Boisserie, G.; Mazeron, J.J. [Groupe Hospitalier la Pitie-Salpetriere, Service des Tumeurs, 75 - Paris (France)

    2003-11-01

    Progresses of the three-dimensional imageries and of the software of planning systems makes that the radiotherapy of the tumours of brain and the base of skull is increasingly precise. The set-up of the patients and the positioning of the beams are key acts whose realization can become extremely tiresome if the requirement of precision increases. This precision very often rests still on the visual comparison of digital images. In the near future, the development of the automated systems controlled by robots should allow a noticeable improvement of the precision, safety and speed of the patient set-up. (author)

  16. Adaptation of proton total dose with respect to dosimetric parameters within the frame of treatment of skull base or upper cervical spine chordomas; Adaptation de la dose totale de protons en fonction des parametres dosimetriques dans le cadre du traitement des chordomes de la base du crane et du rachis cervical haut

    Energy Technology Data Exchange (ETDEWEB)

    Hemery, C.G.; Mazeron, J.J.; Feuvret, L. [Groupe hospitalier Pitie-Salpetriere (AP-HP), 75 - Paris (France); Calugaru, V.; Bolle, S.; Habrand, J.L.; Datcharty, J.; Alapetite, C.; Dendale, R.; Feuvret, L. [Institut Curie-Centre de protontherapie d' Orsay, 91 (France); Habrand, J.L.; Datcharty, J. [Institut Gustave-Roussy, 94 - Villejuif (France); Noel, G. [Centre Paul-Strauss, 67 - Strasbourg (France)

    2010-10-15

    The authors report the study of the feasibility of a photon-proton irradiation protocol with a dose adaptation with respect to dosimetric factors for patients suffering form a skull base and upper cervical spine chordoma. Sixty patients have been treated between May 2006 and June 2008 with a combination of high energy photons and protons. As five tumours have locally relapsed and one at distance, the authors comment the local control rates, the number of attained cranial nerves, the value of the macroscopic tumour volume, the survival rate without relapse in terms of multifactorial of uni-factorial analysis. Short communication

  17. Factors associated with the prevalence of anterior open bite among preschool children: A population-based study in Brazil

    Directory of Open Access Journals (Sweden)

    Daniella Borges Machado

    2014-10-01

    Full Text Available INTRODUCTION: The aim of this study was to identify factors associated with the prevalence of anterior open bite among five-year-old Brazilian children. METHODS: A cross-sectional study was undertaken using data from the National Survey of Oral Health (SB Brazil 2010. The outcome variable was anterior open bite classified as present or absent. The independent variables were classified by individual, sociodemographic and clinical factors. Data were analyzed through bivariate and multivariate analysis using SPSS statistical software (version 18.0 with a 95% level of significance. RESULTS: The prevalence of anterior open bite was 12.1%. Multivariate analysis showed that preschool children living in Southern Brazil had an increased chance of 1.8 more times of having anterior open bite (CI 95%: 1.16 - 3.02. Children identified with alterations in overjet had 14.6 times greater chances of having anterior open bite (CI 95%: 8.98 - 24.03. CONCLUSION: There was a significant association between anterior open bite and the region of Brazil where the children lived, the presence of altered overjet and the prevalence of posterior crossbite.

  18. Using evidence-based algorithms to improve clinical decision making: the case of a first-time anterior shoulder dislocation.

    Science.gov (United States)

    Federer, Andrew E; Taylor, Dean C; Mather, Richard C

    2013-09-01

    Decision making in health care has evolved substantially over the last century. Up until the late 1970s, medical decision making was predominantly intuitive and anecdotal. It was based on trial and error and involved high levels of problem solving. The 1980s gave way to empirical medicine, which was evidence based probabilistic, and involved pattern recognition and less problem solving. Although this represented a major advance in the quality of medical decision making, limitations existed. The advantages of the gold standard of the randomized controlled clinical trial (RCT) are well-known and this technique is irreplaceable in its ability to answer critical clinical questions. However, the RCT does have drawbacks. RCTs are expensive and can only capture a snapshot in time. As treatments change and new technologies emerge, new expensive clinical trials must be undertaken to reevaluate them. Furthermore, in order to best evaluate a single intervention, other factors must be controlled. In addition, the study population may not match that of another organization or provider. Although evidence-based medicine has provided powerful data for clinicians, effectively and efficiently tailoring it to the individual has not yet evolved. We are now in a period of transition from this evidence-based era to one dominated by the personalization and customization of care. It will be fueled by policy decisions to shift financial responsibility to the patient, creating a powerful and sophisticated consumer, unlike any patient we have known before. The challenge will be to apply medical evidence and personal preferences to medical decisions and deliver it efficiently in the increasingly busy clinical setting. In this article, we provide a robust review of the concepts of customized care and some of techniques to deliver it. We will illustrate this through a personalized decision model for the treatment decision after a first-time anterior shoulder dislocation. PMID:23924748

  19. Free tissue transfer for skull base reconstruction of advanced oncological defects%游离组织瓣修复晚期颅底肿瘤术后组织缺损

    Institute of Scientific and Technical Information of China (English)

    张彬; 万经海; 张永侠; 安常明; 徐震纲; 唐平章

    2010-01-01

    Objective To analyze the results and the indications of free flaps in the skull base reconstruction. Methods A retrospective review was performed of 25 free flaps reconstructions for skull base tumor ablation defects between March of 1999 and March of 2009. There were 9 latissimus dorsi flaps, 6 rectus abdominis flaps, 4 deep inferior epigastric artery perforator flaps, 3 anterolateral thigh flaps, 2 radial forearm flaps and 1 fibular flap. The defects were classified as cranial bone(100%), dura (40%) , brain (12%) , sino-nasal cavity (52%) , mucosa (56%) and skin (80%). Results Twenty-three of 25 (92% ) free flaps survived. One total flap failure and 1 partial flap failure occurred. Five patients ( 20% ) had central nervous system related postoperative complications which including 1 mortality, 2 central nerve system infection and 2 cerebrospinal fluid fistula. Conclusions Free flaps transfer is a reliable reconstruction technique for cranial base surgery. This provides a solution to the select advances disease otherwise surgical contraindications. Free flap is the choice for reconstruction of advanced oncological defects, especially when skin and mucosa are violated.%目的 总结游离皮瓣在晚期颅底肿瘤术后组织缺损中修复的效果及适应证.方法 回顾性分析中国医学科学院肿瘤医院头颈外科1999年3月-2009年3月颅底手术后组织缺损修复的游离皮瓣共25例,其中背阔肌肌皮瓣9例,腹直肌肌皮瓣6例,腹壁下动脉穿支皮瓣4例,股前外侧皮瓣3例,前臂皮瓣2例,腓骨骨肌皮瓣1例.颅底缺损类型分别为颅骨25例次,脑膜10例次,脑组织3例次,鼻腔鼻窦13例次,黏膜14例次,皮肤20例次.结果 23例(92%)游离皮瓣全部成活,1例皮瓣坏死,1例部分坏死.5例(20%)患者出现术后中枢神经系统并发症,其中脑疝死亡1例,颅内感染2例和脑脊液漏2例.结论 游离组织瓣修复技术可靠,适用于晚期颅底复发肿瘤,同时涉及皮肤或黏膜手术缺损的修复.

  20. Fitting a temporomandibular joint prosthesis to the skull

    NARCIS (Netherlands)

    van Loon, JP; de Bont, LGM; Stegenga, B; Verkerke, GJ

    2000-01-01

    Fitting a temporomandibular joint (TMJ) prosthesis to the skull by using stock prostheses seems to be an appropriate method. However, fitting the skull with one stock part requires many differently shaped parts. Therefore, we fitted the skull with two connected stock parts. The aim of the study was

  1. Skull X-Rays for Head Injury

    OpenAIRE

    J Gordon Millichap

    2005-01-01

    The effect of abolishing skull X-rays on the rate of admission, use of computer tomography (CT), radiation dose per head injury, and detection of intracranial injuries was determined in patients, aged 1 to 14 years, presenting to the ED at Royal Hospital for Sick Children, Edinburgh, UK.

  2. Sex-diagnosis of human skulls

    NARCIS (Netherlands)

    Looze, de Ellen M.A.

    1996-01-01

    For 41 human skulls from the 19th century in the collection of the Zoological Museum Amsterdam the discriminant function score was calculated using a set of twelve variables in order to arrive at a best-as-possible sex-diagnosis. The function used was developed by Van Vark & Pasveer (1994). This led

  3. MODIFIED TRANSCRANIAL APPROACH FOR RESECTION OF TUMORS INVOLVING THE ANTERIOR CRANIAL FOSSA

    Institute of Scientific and Technical Information of China (English)

    赵素萍; 陶正德; 肖健云

    2001-01-01

    Objective: To introduce the method of a modified transcranial approach for resection of paranasal sinuses tumors involving the anterior skull base and to address our experience with the approach. Patients and Methods: Ten cases were operated by the approach. Among them, 4 suffered from benign meningeomas, 6 with malignant tumors included one chondrosarcoma, two malignant meningeomas, two olfactory neuroblastomas, and one squamous sarcoma. Of the patients, 4 cases had primary tumor and 6 cases had recurrent tumors. Result: All of the ten cases underwent operation and no postopertion complication occurred. 7 cases have survived for one to four years without tumor recurrence. 3 cases with malignant tumor died of tumor relapse in one to two years. Conclusion: This method significantly has helped to reduce the persistence and recurrence of the disease.

  4. The oldest anatomical handmade skull of the world c. 1508: 'the ugliness of growing old' attributed to Leonardo da Vinci.

    Science.gov (United States)

    Missinne, Stefaan J

    2014-06-01

    The author discusses a previously unknown early sixteenth-century renaissance handmade anatomical miniature skull. The small, naturalistic skull made from an agate (calcedonia) stone mixture (mistioni) shows remarkable osteologic details. Dr. Saban was the first to link the skull to Leonardo. The three-dimensional perspective of and the search for the senso comune are discussed. Anatomical errors both in the drawings of Leonardo and this skull are presented. The article ends with the issue of physiognomy, his grotesque faces, the Perspective Communis and his experimenting c. 1508 with the stone mixture and the human skull. Evidence, including the Italian scale based on Crazie and Braccia, chemical analysis leading to a mine in Volterra and Leonardo's search for the soul in the skull are presented. Written references in the inventory of Salai (1524), the inventory of the Villa Riposo (Raffaello Borghini 1584) and Don Ambrogio Mazenta (1635) are reviewed. The author attributes the skull c. 1508 to Leonardo da Vinci.

  5. Transfer of children with isolated linear skull fractures: is it worth the cost?

    Science.gov (United States)

    White, Ian K; Pestereva, Ecaterina; Shaikh, Kashif A; Fulkerson, Daniel H

    2016-05-01

    OBJECTIVE Children with skull fractures are often transferred to hospitals with pediatric neurosurgical capabilities. Historical data suggest that a small percentage of patients with an isolated skull fracture will clinically decline. However, recent papers have suggested that the risk of decline in certain patients is low. There are few data regarding the financial costs associated with transporting patients at low risk for requiring specialty care. In this study, the clinical outcomes and financial costs of transferring of a population of children with isolated skull fractures to a Level 1 pediatric trauma center over a 9-year period were analyzed. METHODS A retrospective review of all children treated for head injury at Riley Hospital for Children (Indianapolis, Indiana) between 2005 and 2013 was performed. Patients with a skull fracture were identified based on ICD-9 codes. Patients with intracranial hematoma, brain parenchymal injury, or multisystem trauma were excluded. Children transferred to Riley Hospital from an outside facility were identified. The clinical and radiographic outcomes were recorded. A cost analysis was performed on patients who were transferred with an isolated, linear, nondisplaced skull fracture. RESULTS Between 2005 and 2013, a total of 619 pediatric patients with isolated skull fractures were transferred. Of these, 438 (70.8%) patients had a linear, nondisplaced skull fracture. Of these 438 patients, 399 (91.1%) were transferred by ambulance and 39 (8.9%) by helicopter. Based on the current ambulance and helicopter fees, a total of $1,834,727 (an average of $4188.90 per patient) was spent on transfer fees alone. No patient required neurosurgical intervention. All patients recovered with symptomatic treatment; no patient suffered late decline or epilepsy. CONCLUSIONS This study found that nearly $2 million was spent solely on transfer fees for 438 pediatric patients with isolated linear skull fractures over a 9-year period. All patients

  6. Brain atrophy and neuropsychological outcome after treatment of ruptured anterior cerebral artery aneurysms: a voxel-based morphometric study

    Energy Technology Data Exchange (ETDEWEB)

    Bendel, Paula; Koskenkorva, Paeivi; Vanninen, Ritva [Kuopio University Hospital and University of Kuopio, Department of Clinical Radiology, Kuopio (Finland); Koivisto, Timo; Aeikiae, Marja [Kuopio University Hospital and University of Kuopio, Department of Neurosurgery, Kuopio (Finland); Niskanen, Eini [Kuopio University Hospital and University of Kuopio, Department of Neurology, Kuopio (Finland); Kuopio University Hospital and University of Kuopio, Department of Physics, Kuopio (Finland); Koenoenen, Mervi [Kuopio University Hospital and University of Kuopio, Department of Clinical Radiology, Kuopio (Finland); Kuopio University Hospital and University of Kuopio, Department of Clinical Neurophysiology, Kuopio (Finland); Haenninen, Tuomo [Kuopio University Hospital and University of Kuopio, Department of Neurology, Kuopio (Finland)

    2009-11-15

    Cognitive impairment after aneurysmal subarachnoid hemorrhage (aSAH) is frequently detected. Here, we describe the pattern of cerebral (gray matter) atrophy and its clinical relevance after treatment of aSAH caused by a ruptured anterior cerebral artery (ACA) aneurysm. Thirty-seven aSAH patients with ACA aneurysm (17 surgical, 20 endovascular treatment) and a good or moderate clinical outcome (Glasgow Outcome Scale V or IV) and 30 controls underwent brain MRI. Voxel-based morphometric analysis was applied to compare the patients and controls. Patients also underwent a detailed neuropsychological assessment. The comparisons between controls and either all patients (n=37) or the subgroup of surgically treated patients (n=17) revealed bilateral cortical atrophy in the frontal lobes, mainly in the basal areas. The brainstem, bilateral thalamic and hypothalamic areas, and ipsilateral caudate nucleus were also involved. Small areas of atrophy were detected in temporal lobes. The hippocampus and parahippocampal gyrus showed atrophy ipsilateral to the surgical approach. In the subgroup of endovascularly treated patients (n = 15), small areas of atrophy were detected in the bilateral orbitofrontal cortex and in the thalamic region. Twenty patients (54%) showed cognitive deficits in neuropsychological assessment. Group analysis after aSAH and treatment of the ruptured ACA aneurysm revealed gray matter atrophy, principally involving the frontobasal cortical areas and hippocampus ipsilateral to the surgical approach. Areas of reduced gray matter were more pronounced after surgical than endovascular treatment. Together with possible focal cortical infarctions and brain retraction deficits in individual patients, this finding may explain the neuropsychological disturbances commonly detected after treatment of ruptured ACA aneurysms. (orig.)

  7. Brain atrophy and neuropsychological outcome after treatment of ruptured anterior cerebral artery aneurysms: a voxel-based morphometric study

    International Nuclear Information System (INIS)

    Cognitive impairment after aneurysmal subarachnoid hemorrhage (aSAH) is frequently detected. Here, we describe the pattern of cerebral (gray matter) atrophy and its clinical relevance after treatment of aSAH caused by a ruptured anterior cerebral artery (ACA) aneurysm. Thirty-seven aSAH patients with ACA aneurysm (17 surgical, 20 endovascular treatment) and a good or moderate clinical outcome (Glasgow Outcome Scale V or IV) and 30 controls underwent brain MRI. Voxel-based morphometric analysis was applied to compare the patients and controls. Patients also underwent a detailed neuropsychological assessment. The comparisons between controls and either all patients (n=37) or the subgroup of surgically treated patients (n=17) revealed bilateral cortical atrophy in the frontal lobes, mainly in the basal areas. The brainstem, bilateral thalamic and hypothalamic areas, and ipsilateral caudate nucleus were also involved. Small areas of atrophy were detected in temporal lobes. The hippocampus and parahippocampal gyrus showed atrophy ipsilateral to the surgical approach. In the subgroup of endovascularly treated patients (n = 15), small areas of atrophy were detected in the bilateral orbitofrontal cortex and in the thalamic region. Twenty patients (54%) showed cognitive deficits in neuropsychological assessment. Group analysis after aSAH and treatment of the ruptured ACA aneurysm revealed gray matter atrophy, principally involving the frontobasal cortical areas and hippocampus ipsilateral to the surgical approach. Areas of reduced gray matter were more pronounced after surgical than endovascular treatment. Together with possible focal cortical infarctions and brain retraction deficits in individual patients, this finding may explain the neuropsychological disturbances commonly detected after treatment of ruptured ACA aneurysms. (orig.)

  8. A morphological analysis of the skull size and shape of Kerivoulinae (Chiroptera: Vespertilionidae) from Vietnam.

    Science.gov (United States)

    Nguyen, Son Truong; Motokawa, Masaharu; Oshida, Tatsuo; Endo, Hideki

    2016-02-01

    Southeast Asia is a region of high biodiversity, containing species of plants and animals that are yet to be discovered. In this region, bats of the subfamily Kerivoulinae are widespread and diverse with six species recorded in Vietnam. However, the taxonomy of the Kerivoulinae in Asia is complicated. In our study, we used diagnostic characters and multivariate analysis to determine morphological differences between the genera Kerivoula and Phoniscus. We showed that the two genera are distinguishable by the size of second upper incisors, the shape of skull, nasal sinus, canines, second upper and lower premolars. In addition, the two genera can be osteometrically separated by measurements of the braincase height, interorbital width and shape of anterior palatal emargination. Our data clearly revealed the morphological variations in the skull shape of Kerivoula hardwickii in Vietnam. This suggests a possible separation into three morphotypes, representing cryptic species supported by statistical differences with wide variation in skull shape, size and teeth. These results demonstrated Kerivoula hardwickii can be separated three subspecies, and the result will serve as the basis for the future assessment and classification of this group in Southeast Asia. PMID:26346743

  9. The Role of Skull Modeling in EEG Source Imaging for Patients with Refractory Temporal Lobe Epilepsy.

    Science.gov (United States)

    Montes-Restrepo, Victoria; Carrette, Evelien; Strobbe, Gregor; Gadeyne, Stefanie; Vandenberghe, Stefaan; Boon, Paul; Vonck, Kristl; Mierlo, Pieter van

    2016-07-01

    We investigated the influence of different skull modeling approaches on EEG source imaging (ESI), using data of six patients with refractory temporal lobe epilepsy who later underwent successful epilepsy surgery. Four realistic head models with different skull compartments, based on finite difference methods, were constructed for each patient: (i) Three models had skulls with compact and spongy bone compartments as well as air-filled cavities, segmented from either computed tomography (CT), magnetic resonance imaging (MRI) or a CT-template and (ii) one model included a MRI-based skull with a single compact bone compartment. In all patients we performed ESI of single and averaged spikes marked in the clinical 27-channel EEG by the epileptologist. To analyze at which time point the dipole estimations were closer to the resected zone, ESI was performed at two time instants: the half-rising phase and peak of the spike. The estimated sources for each model were validated against the resected area, as indicated by the postoperative MRI. Our results showed that single spike analysis was highly influenced by the signal-to-noise ratio (SNR), yielding estimations with smaller distances to the resected volume at the peak of the spike. Although averaging reduced the SNR effects, it did not always result in dipole estimations lying closer to the resection. The proposed skull modeling approaches did not lead to significant differences in the localization of the irritative zone from clinical EEG data with low spatial sampling density. Furthermore, we showed that a simple skull model (MRI-based) resulted in similar accuracy in dipole estimation compared to more complex head models (based on CT- or CT-template). Therefore, all the considered head models can be used in the presurgical evaluation of patients with temporal lobe epilepsy to localize the irritative zone from low-density clinical EEG recordings. PMID:26936594

  10. Ecomorphology of the eyes and skull in zooplanktivorous labrid fishes

    Science.gov (United States)

    Schmitz, L.; Wainwright, P. C.

    2011-06-01

    Zooplanktivory is one of the most distinct trophic niches in coral reef fishes, and a number of skull traits are widely recognized as being adaptations for feeding in midwater on small planktonic prey. Previous studies have concluded that zooplanktivores have larger eyes for sharper visual acuity, reduced mouth structures to match small prey sizes, and longer gill rakers to help retain captured prey. We tested these three traditional hypotheses plus two novel adaptive hypotheses in labrids, a clade of very diverse coral reef fishes that show multiple independent evolutionary origins of zooplanktivory. Using phylogenetic comparative methods with a data set from 21 species, we failed to find larger eyes in three independent transitions to zooplanktivory. Instead, an impression of large eyes may be caused by a size reduction of the anterior facial region. However, two zooplanktivores ( Clepticus parrae and Halichoeres pictus) possess several features interpreted as adaptations to zooplankton feeding, namely large lens diameters relative to eye axial length, round pupil shape, and long gill rakers. The third zooplanktivore in our analysis, Cirrhilabrus solorensis, lacks all above features. It remains unclear whether Cirrhilabrus shows optical specializations for capturing planktonic prey. Our results support the prediction that increased visual acuity is adaptive for zooplanktivory, but in labrids increases in eye size are apparently not part of the evolutionary response.

  11. Carcinoma cervix with fat attenuating skull metastases

    Institute of Scientific and Technical Information of China (English)

    Anuradha Kapali; Atmakuri Sateesh Kumar; Mukunda Malathi; S D Shamsundar

    2016-01-01

    Skeletal metastasis in carcinoma cervix occurs in about 0.8-23% of cases. These lesions are usually radiographically lytic. Very few cases of metastases to the skull have been identiifed, about 5 cases to the best of our knowledge. We present a case of adenosquamous cell carcinoma of cervix with fat attenuating skull metastases in a 38-year-old lady that is not reported till date. The lesion was lytic, expansile and with negative attenuation of -15 to -30 Hounsifeld units corresponding to fat.Metastases must be included in the differentials of scalp lesions. A history of recent onset of swelling and associated lytic areas in calvarium on contrast enhanced computed tomography with multiplicity can give a clue to metastatic nature of disease.

  12. Geographic variation and sexual dimorphism in the skull of the dusky dolphin, Lagenorhynchus obscurus (Gray, 1828)

    OpenAIRE

    Van Waerebeek, K.

    1993-01-01

    Variation in skulls of 415 dusky dolphins, Lagenorhynchus obscures, was studied based on 37 standard cranial measurements and meristic variables and 28 nonmetrical characters (NMC) by using both bivariate and multivariate analyses. Geographic variation was analysed in mature skulls from central Peru (N=189), Chile (N=22), New Zealand (N=47) and southwestern Africa (N=40). Advanced fusion in the frontal-supraoccipital suture is the most reliable (95% efficiency) cranial criterion of sexual mat...

  13. Prediction and near-field observation of skull-guided acoustic waves

    CERN Document Server

    Estrada, Héctor; Razansky, Daniel

    2016-01-01

    Ultrasound waves propagating in water or soft biological tissue are strongly reflected when encountering the skull, which limits the use of ultrasound-based techniques in transcranial imaging and therapeutic applications. Current knowledge on the acoustic properties of the cranial bone is restricted to far-field observations, leaving its near-field properties unexplored. We report on the existence of skull-guided acoustic waves, which was herein confirmed by near-field measurements of optoacoustically-induced responses in ex-vivo murine skulls immersed in water. Dispersion of the guided waves was found to reasonably agree with the prediction of a multilayered flat plate model. It is generally anticipated that our findings may facilitate and broaden the application of ultrasound-mediated techniques in brain diagnostics and therapy.

  14. Skull removal in MR images using a modified artificial bee colony optimization algorithm.

    Science.gov (United States)

    Taherdangkoo, Mohammad

    2014-01-01

    Removal of the skull from brain Magnetic Resonance (MR) images is an important preprocessing step required for other image analysis techniques such as brain tissue segmentation. In this paper, we propose a new algorithm based on the Artificial Bee Colony (ABC) optimization algorithm to remove the skull region from brain MR images. We modify the ABC algorithm using a different strategy for initializing the coordinates of scout bees and their direction of search. Moreover, we impose an additional constraint to the ABC algorithm to avoid the creation of discontinuous regions. We found that our algorithm successfully removed all bony skull from a sample of de-identified MR brain images acquired from different model scanners. The obtained results of the proposed algorithm compared with those of previously introduced well known optimization algorithms such as Particle Swarm Optimization (PSO) and Ant Colony Optimization (ACO) demonstrate the superior results and computational performance of our algorithm, suggesting its potential for clinical applications. PMID:25059256

  15. Osteoma of the skull base and sinuses

    NARCIS (Netherlands)

    C. Georgalas; J. Goudakos; W.J. Fokkens

    2011-01-01

    Osteomata of the frontal and ethmoid sinuses have traditionally been surgically removed via external approaches. However, endoscopic techniques have increasingly been used for the surgical management of selected cases. Advances in visualization and instrumentation, as well as the excellent access pr

  16. AUTONOMOUS CT REPLACEMENT METHOD FOR THE SKULL PROSTHESIS MODELLING

    Directory of Open Access Journals (Sweden)

    Marcelo Rudek

    2015-12-01

    Full Text Available The geometric modeling of prosthesis is a complex task from medical and engineering viewpoint. A method based on CT replacement is proposed in order to circumvent the related problems with the missing information to modeling. The method is based on digital image processing and swarm intelligence algorithm. In this approach, a missing region on the defective skull is represented by curvature descriptors. The main function of the descriptors is to simplify the skull’s contour geometry; and they are defined from the Cubic Bezier Curves using a meta-heuristic process for parameter’s estimation. The Artificial Bee Colony (ABC optimization technique is applied in order to evaluate the best solution. The descriptors from a defective CT slice image are the searching parameters in medical image databases, and a similar image, i.e. with similar descriptors, can be retrieval and used to replace the defective slice. Thus, a prosthesis piece is automatically modeled with information extracted from distinct skulls with similar anatomical characteristics.

  17. Novel Simulation Framework of Three-Dimensional Skull Bio-Metric Measurement

    Directory of Open Access Journals (Sweden)

    Shihab A. Hameed

    2009-11-01

    Full Text Available Previously, most of the researcher was suffering from simulate any three dimension applications for biometrics application, likewise, various applications of forensics and cosmetology has not been easy to be simulated. Three dimensional figures have approved the fact that, it has been more reliable than two dimensional figures in most of the applications used to be implemented for the purposes above. The reason behind this reliability was the features that extract from the three dimensional applications more close to the reality. The goal of this paper is to study and evaluate how far three-dimensional skull biometric is reliable in term of the accurate measurements, capability and applicability. As it mentions above, it was hard to evaluate or simulate an application use three-dimensional skull in biometric, however, Canfield Imaging Systems provide a new suitable environment to simulate a new three-dimensional skull biometric. The second goal of this paper is to assess how good the new threedimensional image system is. This paper will also go through the recognition and verification based on a different biometric application. Subsequently this paper will study the reliability and dependability of using skull biometric. The simulation based on the three-dimensional Skull recognition using threedimensional matching technique. The feature of the simulate system shows the capability of using three-dimensional matching system as an efficient way to identify the person through his or her skull by match it with database, this technique grantee fast processing with optimizing the false positive and negative as well .

  18. Homo erectus and Middle Pleistocene hominins: brain size, skull form, and species recognition.

    Science.gov (United States)

    Rightmire, G Philip

    2013-09-01

    Hominins that differ from Homo erectus, the Neanderthals, and recent humans are known from Middle Pleistocene localities across the Old World. The taxonomic status of these populations has been clouded by controversy. Perhaps the most critical problem has been an incomplete understanding of variation in skull form. Here, both H. erectus and later mid-Pleistocene hominins are the focus of an investigation aimed at clarifying the relationships among brain volume, basicranial dimensions, neurocranial shape, and certain facial characters. Brain size in H. erectus averages about 950 cm(3), while in a series of Middle Pleistocene crania from Africa and Europe, volume is about 1230 cm(3). If encephalization is the primary mechanism operating in the mid-Pleistocene, then diverse aspects of cranial form cannot all be treated as independent variables. Correlation is utilized to examine the associations among measurements for more than 30 H. erectus crania that are reasonably well preserved. A similar approach is used with the Middle Pleistocene sample. Patterns of covariation are compared in order to assess integration. Next, factor analysis is applied to the H. erectus specimens in an attempt to identify modules, tightly integrated traits that can evolve independently. Studies of the variation within H. erectus are followed by direct comparisons with the Middle Pleistocene population. Discriminant functions facilitate the description of intergroup differences. Traits that vary independently from brain volume include anterior frontal broadening, lateral expansion of the parietal vault, elevation of the lambda-inion chord, and rounding of the sagittal contour of the occipital. This finding helps to resolve the problem of species recognition. Neurocranial proportions as well as characters from the cranial base and face can be incorporated into a differential diagnosis for the mid-Pleistocene sample. Evidence presented here supports arguments for speciation in the Middle

  19. Comparison of Anterior Segment Measurements with Scheimpflug/Placido Photography-Based Topography System and IOLMaster Partial Coherence Interferometry in Patients with Cataracts.

    Science.gov (United States)

    Huang, Jinhai; Liao, Na; Savini, Giacomo; Bao, Fangjun; Yu, Ye; Lu, Weicong; Hu, Qingjie; Wang, Qinmei

    2014-01-01

    Purpose. To assess the consistency of anterior segment measurements obtained using a Sirius Scheimpflug/Placido photography-based topography system (CSO, Italy) and IOLMaster partial coherence interferometry (Carl Zeiss Meditec, Germany) in eyes with cataracts. Methods. A total of 90 eyes of 90 patients were included in this prospective study. The anterior chamber depth (ACD), keratometry (K), corneal astigmatism axis, and white to white (WTW) values were randomly measured three times with Sirius and IOLMaster. Concordance between them was assessed by calculating 95% limits of agreement (LoA). Results. The ACD and K taken with the Sirius were statistically significantly higher than that taken with the IOLMaster; however, the Sirius significantly underestimated the WTW values compared with the IOLMaster. Good agreement was found for Km and ACD measurements, with 95% LoA of -0.20 to 0.54 mm and -0.16 to 0.34 mm, respectively. Poor agreement was observed for astigmatism axis and WTW measurements, as the 95% LoA was -23.96 to 23.36° and -1.15 to 0.37 mm, respectively. Conclusion. With the exception of astigmatism axis and WTW, anterior segment measurements taken by Sirius and IOLMaster devices showed good agreement and may be used interchangeably in patients with cataracts. PMID:25400939

  20. Comparison of Anterior Segment Measurements with Scheimpflug/Placido Photography-Based Topography System and IOLMaster Partial Coherence Interferometry in Patients with Cataracts

    Directory of Open Access Journals (Sweden)

    Jinhai Huang

    2014-01-01

    Full Text Available Purpose. To assess the consistency of anterior segment measurements obtained using a Sirius Scheimpflug/Placido photography-based topography system (CSO, Italy and IOLMaster partial coherence interferometry (Carl Zeiss Meditec, Germany in eyes with cataracts. Methods. A total of 90 eyes of 90 patients were included in this prospective study. The anterior chamber depth (ACD, keratometry (K, corneal astigmatism axis, and white to white (WTW values were randomly measured three times with Sirius and IOLMaster. Concordance between them was assessed by calculating 95% limits of agreement (LoA. Results. The ACD and K taken with the Sirius were statistically significantly higher than that taken with the IOLMaster; however, the Sirius significantly underestimated the WTW values compared with the IOLMaster. Good agreement was found for Km and ACD measurements, with 95% LoA of −0.20 to 0.54 mm and −0.16 to 0.34 mm, respectively. Poor agreement was observed for astigmatism axis and WTW measurements, as the 95% LoA was −23.96 to 23.36° and −1.15 to 0.37 mm, respectively. Conclusion. With the exception of astigmatism axis and WTW, anterior segment measurements taken by Sirius and IOLMaster devices showed good agreement and may be used interchangeably in patients with cataracts.

  1. Minimum-norm cortical source estimation in layered head models is robust against skull conductivity error.

    Science.gov (United States)

    Stenroos, Matti; Hauk, Olaf

    2013-11-01

    The conductivity profile of the head has a major effect on EEG signals, but unfortunately the conductivity for the most important compartment, skull, is only poorly known. In dipole modeling studies, errors in modeled skull conductivity have been considered to have a detrimental effect on EEG source estimation. However, as dipole models are very restrictive, those results cannot be generalized to other source estimation methods. In this work, we studied the sensitivity of EEG and combined MEG+EEG source estimation to errors in skull conductivity using a distributed source model and minimum-norm (MN) estimation. We used a MEG/EEG modeling set-up that reflected state-of-the-art practices of experimental research. Cortical surfaces were segmented and realistically-shaped three-layer anatomical head models were constructed, and forward models were built with Galerkin boundary element method while varying the skull conductivity. Lead-field topographies and MN spatial filter vectors were compared across conductivities, and the localization and spatial spread of the MN estimators were assessed using intuitive resolution metrics. The results showed that the MN estimator is robust against errors in skull conductivity: the conductivity had a moderate effect on amplitudes of lead fields and spatial filter vectors, but the effect on corresponding morphologies was small. The localization performance of the EEG or combined MEG+EEG MN estimator was only minimally affected by the conductivity error, while the spread of the estimate varied slightly. Thus, the uncertainty with respect to skull conductivity should not prevent researchers from applying minimum norm estimation to EEG or combined MEG+EEG data. Comparing our results to those obtained earlier with dipole models shows that general judgment on the performance of an imaging modality should not be based on analysis with one source estimation method only.

  2. 手术治疗鼻窦-颅底区域良性纤维骨性病变%Surgical management of sinonasal and adjacent skull base benign fibro-osseous lesions

    Institute of Scientific and Technical Information of China (English)

    郭金宝; 张维天; 殷善开; 关建

    2011-01-01

    Objective: To explore the use of transnasal endoscopy and open surgical approaches for management of sinonasal and adjacent skull base benign fibro-osseous lesions, the surgical methods, precautions, clinical efficacies were also discribed. Method:Fifteen patients were reviewed, including osteoma in 6 cases, Ossifying fibroma in 2 cases and fibrous dysplasia in 7 cases. Analyzed the pathological features and CT images, and to select surgical approach according to the location and extent of lesions. Eleven patients were operated through transnasal endoscopic procedure,including 7 cases with ipsilateral nasal approach and 4 cases with extended binasal approach;4 cases with open surgical approach, including trans-eyebrow approach in 1 case and bicoronal approach in 3 cases.Result:All patients were followed up for 2 months to 4 years, gross resection of lesions in 10 cases but partial resection in 5 cases with fibrous dysplasia. The clinical symptoms and facial deformity in all cases were eliminated or significantly relieved postoperatively. Cerebrospinal fluid leakage occurred in 1 case, was successfully repaircd during the endoscopic operation. Preoperative diplopia in 3 cases, 2 cases disappeared after six months, one case was improved significantly. There were no postoperative orbital or intracranial complications. Conclusion: Surgery is an cffective means to resect lesions which had obviously clinical symptoms. The location and extent of lesions were the decisive factor to choose an open or endoscopic approach. Endoscopic sinus surgery can manage the midline skull base lesions which extend from the posterior wall of the frontal sinus to the clivus, well the open surgical approach is suitable for lesions locating the area beyond the medial orbital wall. No matter choosing which approach, osteoma, ossifying fibroma can be completely removed. For the fibrous dysplasia, as an extensive but selflimiting lesion, the surgery is performed only for relieving symptoms and

  3. IN VIVO KINEMATICS OF THE ANTERIOR CRUCIATE LIGAMENT DEFICIENT KNEE DURING WIDE-BASED SQUAT USING A 2D/3D REGISTRATION TECHNIQUE

    Directory of Open Access Journals (Sweden)

    Takeshi Miyaji

    2012-12-01

    Full Text Available Anterior cruciate ligament (ACL deficiency increases the risk of early osteoarthritis (OA. Studies of ACL deficient knee kinematics would be important to reveal the disease process and therefore to find mechanisms which would potentially slow OA progression. The purpose of this study was to determine if in vivo kinematics of the anterior cruciate ligament deficient (ACLD knee during a wide-based squat activity differ from kinematics of the contralateral intact knee. Thirty-three patients with a unilateral ACLD knee consented to participate in this institutional review board approved study with the contralateral intact knee serving as the control. In vivo knee kinematics during the wide-based squat were analyzed using a 2D/3D registration technique utilizing CT-based bone models and lateral fluoroscopy. Comparisons were performed using values between 0 and 100° flexion both in flexion and extension phases of the squat activity. Both the ACLD and intact knees demonstrated increasing tibial internal rotation with knee flexion, and no difference was observed in tibial rotation between the groups. The tibia in the ACLD knee was more anterior than that of the contralateral knees at 0 and 5° flexion in both phases (p < 0.05. Tibiofemoral medial contact points of the ACLD knees were more posterior than that of the contralateral knees at 5, 10 and 15° of knee flexion in the extension phase of the squat activity (p < 0.05. Tibiofemoral lateral contact points of the ACLD knees were more posterior than that of the contralateral knees at 0° flexion in the both phases (p < 0.05. The kinematics of the ACLD and contralateral intact knees were similar during the wide-based squat except at the low flexion angles. Therefore, we conclude the wide-based squat may be recommended for the ACLD knee by avoiding terminal extension

  4. A study on evaluation of skull base bone involvement of nasopharyngeal cancer with 99Tcm-MDP SPECT combined localizable CT%99Tcm-MDP SPECT结合定位CT评价鼻咽癌颅底骨侵犯

    Institute of Scientific and Technical Information of China (English)

    姚红霞; 刘生; 蒋宁一; 张弘; 陈少雄; 刘幸光; 卢献平; 梁九根; 张金山

    2009-01-01

    目的 用99Tcm-亚甲基二膦酸盐(MDP)SPECT结合定位CT.评价鼻咽癌(NPC)颅底骨侵犯(SBBI).方法 NPC患者44例,1周内行头颅Tcm-MDP SPECT、定位CT、全身骨显像(WBI)和MRI检查,对照组10例其他部位肿瘤患者行头颅99Tcm-MDP SPECT结合定位CT显像.于SPECT图像矢状面,颅底放射性浓聚程度最高(L)层面与高位颈椎体(C1-C3,S)处勾画相同大小的感兴趣区(ROI),L/S>1提示SBBI.对计数资料行X2检验或Fisher精确概率检验.结果 (1)对照组10例L/S=0.66±0.13.(2)根据MRI结果,SPELL结合定位CT、WBI和单独SPECT诊断SBBI的灵敏度、特异性、准确性分别为83.3%(20/24)、80.0%(16/20)、81.8%(36/44),70.8%(17/24)、70.0%(14/20)、70.4%(31/44)和77.3%(17/22)、72.7%(16/22)、75.0%(33/44),差异无统计学意义(X2=2.00,P=0.37);SPECT结合定位CT与MRI相关[X2=17.65,相依系数(CC)=0.535,P<0.05].(3)头痛组与无头痛组SBBI阳性率分别为92.9%(13/14)与36.7%(11/30),差异有统计学意义(X2=12 16,P<0.05),低分化鳞癌组与未分化癌组SBBI阳性率分别为50.O%(19/38)与83.3%(5/6),差异无统计学意义(X2=2.69,P=0.19).(4)SPECT结合定位CT图像除能提供准确的定位外,还能检测部分颅底骨破坏.结论 SPECT结合定位CT能有效地检测鼻咽癌SBBI.%Objective Whole body planar bone imaging(WBI)could not accurately evaluate skull base bone involvement(SBBI)due to complex structure of the nasopharynx.The purpose of this study was to preliminarily evaluate the role of SPECT combined localizable CT for diagnosing SBBI of nasopharyngeal cancer(NPC).Methods Forty-four patients with NPC underwent the skull 99Tcm-methylene diphosphonate (MDP)SPECT combined localizable CT,WBI and MRI within a week.Ten patients with non NPC were controls.The region of interest(ROI)of the suspected SBBI(L)was drawn and the same ROI was copied to the upper cervical vertebrae C1 to C3(S)on the 99Tcm-MDP sagittal SPECT imping.The uptake ratio of L and S(L/S)was calculated and

  5. Anatomical network analysis shows decoupling of modular lability and complexity in the evolution of the primate skull.

    Directory of Open Access Journals (Sweden)

    Borja Esteve-Altava

    Full Text Available Modularity and complexity go hand in hand in the evolution of the skull of primates. Because analyses of these two parameters often use different approaches, we do not know yet how modularity evolves within, or as a consequence of, an also-evolving complex organization. Here we use a novel network theory-based approach (Anatomical Network Analysis to assess how the organization of skull bones constrains the co-evolution of modularity and complexity among primates. We used the pattern of bone contacts modeled as networks to identify connectivity modules and quantify morphological complexity. We analyzed whether modularity and complexity evolved coordinately in the skull of primates. Specifically, we tested Herbert Simon's general theory of near-decomposability, which states that modularity promotes the evolution of complexity. We found that the skulls of extant primates divide into one conserved cranial module and up to three labile facial modules, whose composition varies among primates. Despite changes in modularity, statistical analyses reject a positive feedback between modularity and complexity. Our results suggest a decoupling of complexity and modularity that translates to varying levels of constraint on the morphological evolvability of the primate skull. This study has methodological and conceptual implications for grasping the constraints that underlie the developmental and functional integration of the skull of humans and other primates.

  6. Evolutionary morphology of the rabbit skull

    Science.gov (United States)

    Sherratt, Emma

    2016-01-01

    The skull of leporids (rabbits and hares) is highly transformed, typified by pronounced arching of the dorsal skull and ventral flexion of the facial region (i.e., facial tilt). Previous studies show that locomotor behavior influences aspects of cranial shape in leporids, and here we use an extensive 3D geometric morphometrics dataset to further explore what influences leporid cranial diversity. Facial tilt angle, a trait that strongly correlates with locomotor mode, significantly predicts the cranial shape variation captured by the primary axis of cranial shape space, and describes a small proportion (13.2%) of overall cranial shape variation in the clade. However, locomotor mode does not correlate with overall cranial shape variation in the clade, because there are two district morphologies of generalist species, and saltators and cursorial species have similar morphologies. Cranial shape changes due to phyletic size change (evolutionary allometry) also describes a small proportion (12.5%) of cranial shape variation in the clade, but this is largely driven by the smallest living leporid, the pygmy rabbit (Brachylagus idahoensis). By integrating phylogenetic history with our geometric morphometric data, we show that the leporid cranium exhibits weak phylogenetic signal and substantial homoplasy. Though these results make it difficult to reconstruct what the ‘ancestral’ leporid skull looked like, the fossil records suggest that dorsal arching and facial tilt could have occurred before the origin of the crown group. Lastly, our study highlights the diversity of cranial variation in crown leporids, and highlights a need for additional phylogenetic work that includes stem (fossil) leporids and includes morphological data that captures the transformed morphology of rabbits and hares.

  7. 脑出血后出血病灶的CT三维重建模型%Creation of hemorrhagre model of human skull and 3-dimensional reconstruction based on computed tomography images

    Institute of Scientific and Technical Information of China (English)

    佟德华; 郭守刚; 唐洲平; 湛彦强; 陈娣; 张苏明; 何锐波; 许理; 赵英俊

    2009-01-01

    Objective For the invention of computer-aided stereotaxic device,the model of human skull was designed,with that the 3-dimensional(3D)virtual model could be reconstructed by datum from computed tomography(CT)and the process of clinical minimally invasive neurosurgery of intracerebral hemorrhage(ICH)could be simulated.Method Melted paraffin was poured in a skull exemplar in which supposititious focus had been installed previously.After scanning of CT,the corresponding serials of DICOM datum was collected,3D reconstruction and preoperative planning was made on software platform.Finally,puncture to this model was simulated by compute-aided stereotaxic device.Resuits Pour-in-waxed hemorrhage model of human skull Was sueeessful.The marker,skull,paraffin and supposititious focus could be displayed apparently and distinctively in CT images and following 3D reconstruction.Conclusions The model is simple,cheap,reproducible,and also ideal to evaluate system performance of prototype of computer-aided stereotaxic device.%目的 为计算机辅助立体定向设备的研发设计的,可以依据CT扫描数据进行三维重建并模拟临床脑出血操作过程的颅骨模型.方法 以融解的石蜡灌铸内置有假想病灶的颅骨标本制为颅骨模型,采集CT扫描后的序列DICOM数据,通过自编软件平台进行3D重建、手术规划,由计算机辅助立体定向设备对该模型进行模拟微创穿刺.结果 完成蜡灌铸的脑出血颅骨模型,且该模型在CT扫描和之后的3D重建中可清晰显示和区别标记物、骨骼、石蜡、假想病灶.结论 蜡铸脑出血颅骨模型方法简单、可反复建模,能较理想地评估计算机辅助立体定向设备原型机的系统性能.

  8. Cave crawling in zebra finch skulls

    DEFF Research Database (Denmark)

    Larsen, Ole Næsbye; Salomon, Rasmus; Jensen, Kenneth Kragh;

    Cave crawling in zebra finch skulls: what is the functional interaural canal? Ole Næsbye Larsen, Rasmus Salomon, Kenneth Kragh Jensen, and Jakob Christensen-Dalsgaard Department of Biology, University of Southern Denmark, Campusvej 55, DK-5230 Odense M, Denmark The middle ears of birds are...... gains and delays in the IAC can produce very different directionalities of the ears but it is still uncertain how interaural transmission gain and delay can be shaped by evolution by anatomical adaptations. A closer inspection of the zebra finch cranium using micro-CT scanning reveals that not only is...

  9. CONGENITAL ANTERIOR TIBIOFEMURAL SUBLUXATION

    Directory of Open Access Journals (Sweden)

    A. Shahla

    2008-06-01

    Full Text Available Congenital anterior tibiofemoral subluxation is an extremely rare disorder. All reported cases accompanied by other abnormalities and syndromes. A 16-year-old high school girl referred to us with bilateral anterior tibiofemoral subluxation as the knees were extended and reduced at more than 30 degrees flexion. Deformities were due to tightness of the iliotibial band and biceps femuris muscles and corrected by surgical release. Associated disorders included bilateral anterior shoulders dislocation, short metacarpals and metatarsals, and right calcaneuvalgus deformity.

  10. Bilateral anterior shoulder dislocation

    OpenAIRE

    Meena, Sanjay; Saini, Pramod; Singh, Vivek; Kumar, Ramakant; Trikha, Vivek

    2013-01-01

    Shoulder dislocations are the most common major joint dislocations encountered in the emergency departments. Bilateral shoulder dislocations are rare and of these, bilateral posterior shoulder dislocations are more prevalent than bilateral anterior shoulder dislocations. Bilateral anterior shoulder dislocation is very rare. We present a case of 24-year-old male who sustained bilateral anterior shoulder dislocation following minor trauma, with associated greater tuberosity fracture on one side...

  11. Cases of Trephination in Ancient Greek Skulls

    Directory of Open Access Journals (Sweden)

    Vasiliki Ζafiri

    2012-01-01

    Full Text Available Background: Trephination, or trepanning, is considered to be one of the most ancient surgical operations with an especially extensive geographical incidence, both in the New World and in the Old. In Europe, more than 200 finds of trephination have been found, from Scandinavia to the Balkans. The technique of trephination or trepanning covers overall the last 10,000 years and exhibits great versatility and adjustability in the knowledge, technical means, therapeutic needs, prejudices and social standards of each period and of each population group. Hippocrates was the one to classify for the first time the kinds of cranial fractures and define the conditions and circumstances for carrying out a trepanning.Aim: The present research aims to investigate the Greek cranial trephinations on sculls from the collection of the Anthropological Museum of the Medical School of Athens that come from archaeological excavations.Method: Skulls were examined by macroscopic observation with reflective light. Furthermore, radiographic representation of the skulls was used.Results: The anthropological researches and the studies of anthropological skeleton remains that came out during archaeological excavations from different eras and areas have given information about the medical practices in the very important geographic area of Greece and in particular, we referred to cases of Greek trephinations.

  12. Intrauterine skull depression and intracranial hemorrhage in a premature infant

    Energy Technology Data Exchange (ETDEWEB)

    Batton, G.D.; DiCarmine, F.; Boal, D.K.

    1988-04-01

    The authors describe a case of a premature infant born with a parietal skull depression who suffered an intraventricular hemorrhage and an ipsilateral intracerebral injury. At 21 months of life the infant's gross motor milestones were delayed and he had moderate spastic hemiplegia. Although skull depressions at birth are usually benign, they may be associated with long-term neurologic sequelae.

  13. Intrauterine skull depression and intracranial hemorrhage in a premature infant

    International Nuclear Information System (INIS)

    The authors describe a case of a premature infant born with a parietal skull depression who suffered an intraventricular hemorrhage and an ipsilateral intracerebral injury. At 21 months of life the infant's gross motor milestones were delayed and he had moderate spastic hemiplegia. Although skull depressions at birth are usually benign, they may be associated with long-term neurologic sequelae. (orig.)

  14. Skull-stripping for Tumor-bearing Brain Images

    CERN Document Server

    Bauer, Stefan; Reyes, Mauricio

    2012-01-01

    Skull-stripping separates the skull region of the head from the soft brain tissues. In many cases of brain image analysis, this is an essential preprocessing step in order to improve the final result. This is true for both registration and segmentation tasks. In fact, skull-stripping of magnetic resonance images (MRI) is a well-studied problem with numerous publications in recent years. Many different algorithms have been proposed, a summary and comparison of which can be found in [Fennema-Notestine, 2006]. Despite the abundance of approaches, we discovered that the algorithms which had been suggested so far, perform poorly when dealing with tumor-bearing brain images. This is mostly due to additional difficulties in separating the brain from the skull in this case, especially when the lesion is located very close to the skull border. Additionally, images acquired according to standard clinical protocols, often exhibit anisotropic resolution and only partial coverage, which further complicates the task. There...

  15. Effect of Connector Design on Fracture Resistance in Zirconia-based Fixed Partial Dentures for Upper Anterior Region.

    Science.gov (United States)

    Ogino, Yasushi; Nomoto, Syuntaro; Sato, Toru

    2016-01-01

    The purpose of this study was to investigate the influence of the cross-sectional form and area of the connector on fracture resistance in three-unit zirconia fixed partial denture (FPD) frameworks for the upper anterior region. Sixty FPD framework specimens were fabricated using the CAD/CAM system. The cross-sectional form (Type I, II, or III) and area (9.0, 7.0, 5.0, or 3.0 mm(2)) of the connectors differed. The specimens were fixed to a jig capable of applying a load axially to the abutment teeth at an angle of 135 degrees. Each specimen was subjected to fracture load measurements using a universal testing machine and cross-sectional microscopic examination. Fracture load fell significantly with a decrease in cross-sectional area (p 5.0 mm(2). PMID:27320295

  16. Skull fracture and hemorrhage pattern among fatal and nonfatal head injury assault victims - a critical analysis

    Directory of Open Access Journals (Sweden)

    Chandrabhal Tripathi

    2010-07-01

    Full Text Available BACKGROUND: The global incidence of fatal head injuries as the result of assault is greater than the number of non-fatal cases. The important factors that determine the outcome in terms of survival of such head injury cases include the type of weapon used, type and site of skull fracture, intra cranial hemorrhage and the brain injury. The present study aims to highlight the role of skull fractures as an indirect indicator of force of impact and the intra cranial hemorrhage by a comparative study of assault victims with fatal and nonfatal head injuries. METHODS: 91 head injury cases resulting from assault were studied in the Department of Forensic Medicine, IMS, BHU Varanasi over a period of 2 years from which 18 patients survived and 73 cases had a lethal outcome. Details of the fatal cases were obtained from the police inquest and an autopsy while examination of the surviving patients was done after obtaining an informed consent. The data so obtained were analyzed and presented in the study. RESULTS: Assault with firearms often led to fatality whereas with assault involving blunt weapons the survival rate was higher. Multiple cranial bones were involved in 69.3% cases while comminuted fracture of the skull was common among the fatal cases. Fracture of the base of the skull was noted only in the fatal cases and a combination of subdural and subarachnoid haemorrhage was found in the majority of the fatal cases. CONCLUSIONS: The present study shows skull fractures to be an important indicator of severity of trauma in attacks to the head. Multiple bone fracture, comminuted fracture and base fractures may be considered as high risk factors in attempted homicide cases.

  17. Comparative analysis of the anterior and posterior length and deflection angle of the cranial base, in individuals with facial Pattern I, II and III

    Directory of Open Access Journals (Sweden)

    Guilherme Thiesen

    2013-02-01

    Full Text Available OBJECTIVE: This study evaluated the variations in the anterior cranial base (S-N, posterior cranial base (S-Ba and deflection of the cranial base (SNBa among three different facial patterns (Pattern I, II and III. METHOD: A sample of 60 lateral cephalometric radiographs of Brazilian Caucasian patients, both genders, between 8 and 17 years of age was selected. The sample was divided into 3 groups (Pattern I, II and III of 20 individuals each. The inclusion criteria for each group were the ANB angle, Wits appraisal and the facial profile angle (G'.Sn.Pg'. To compare the mean values obtained from (SNBa, S-N, S-Ba each group measures, the ANOVA test and Scheffé's Post-Hoc test were applied. RESULTS AND CONCLUSIONS: There was no statistically significant difference for the deflection angle of the cranial base among the different facial patterns (Patterns I, II and III. There was no significant difference for the measures of the anterior and posterior cranial base between the facial Patterns I and II. The mean values for S-Ba were lower in facial Pattern III with statistically significant difference. The mean values of S-N in the facial Pattern III were also reduced, but without showing statistically significant difference. This trend of lower values in the cranial base measurements would explain the maxillary deficiency and/or mandibular prognathism features that characterize the facial Pattern III.OBJETIVO: o presente estudo avaliou as variações da base craniana anterior (S-N, base craniana posterior (S-Ba, e ângulo de deflexão da base do crânio (SNBa entre três diferentes padrões faciais (Padrão I, II e III. MÉTODOS: selecionou-se uma amostra de 60 telerradiografias em norma lateral de pacientes brasileiros leucodermas, de ambos os sexos, com idades entre 8 anos e 17 anos. A amostra foi dividida em três grupos (Padrão I, II e III, sendo cada grupo constituído de 20 indivíduos. Os critérios de seleção dos indivíduos para cada grupo

  18. Accurate Measurement of Cochlea's Position and Orientation in Skull Base and Analysis of Their Aging Trend Based on Matlab Software%基于Matlab精确测量分析耳蜗在颅底中的位置及其年龄趋势

    Institute of Scientific and Technical Information of China (English)

    吕慧英; 杨琳; 张天宇; 戴培东

    2011-01-01

    In order to measure the cochlea ' s accurate position and the modiolus ' s orientation in skull base and to analyze their age, side and sex differences, CT serial images of 46 normal people(92 ears) were imported into Mimics software for image processing. Three-dimensional coordinate values of the cochlear cupula, the central point of the cochlear base and landmarks of key structures, which were used to define a standard three-dimensional coordinate system based on Frankfurt horizontal plane, were acquired. And then, the standard plane equations were approached by a self-developed calculation program, LabyCalculation, with the support of Matlab software. The spatial position of the cochlear cupula and cochlear base, and the spatial orientation of the modiolus in this new coordinate system were calculated. Finally, the data were analyzed statistically. The results show that cochlea ' s position and orientation in skull base have certain differences in different ages, sides and sexes. Our research can provide some help for ear development study and the cochlear implantation.%为测量耳蜗在颅底的精确位置与蜗轴方位,并分析其在不同年龄组、侧别和性别中的差异,研究将46例正常人(92侧耳)的CT序列图像数据导入Mimics软件,读取蜗顶、蜗底中心点以及为确定以法兰克福平面为基准的标准空间坐标系的关键结构标志点的三维坐标,并基于Matlab软件编制计算程序LabyCalculation,确定标准空间坐标系的相关方程,计算蜗顶、蜗底中心点以及蜗轴在标准坐标系下的空间位置和方位,最后对数据进行统计分析.结果表明,耳蜗的位置与方位在不同年龄组、侧别和性别中具有一定差异.研究可为耳蜗发育研究提供形态数据,并对相关人工耳蜗手术提供依据和帮助.

  19. Digital modelling of a human skull

    Directory of Open Access Journals (Sweden)

    O. Etxaniz

    2008-03-01

    Full Text Available Purpose: This paper describes the first step of a project that aims to improve the design and placement of dental prostheses through an in-depth analysis of jaw movement. This analysis requires prior obtaining quality digital models of all elements involved in the movement. The paper describes the process to obtain the digital models through Reverse Engineering techniques, and evaluates their quality.Design/methodology/approach: The process of digitalization of a human skull by means of a hand-held 3D laser scanner has been evaluated to see the suitability of this technique. A skull has been chosen as test element as it has several characteristics that make its digitisation by optical techniques difficult, such as a non-uniform surface and a complex geometry. The surfaces obtained by the scanner have been edited by point cloud edition software.Findings: Reverse Engineering optical hardware has several limitations to correctly digitize complex geometries, but these deficiencies can be solved using the Reverse Engineering software properly.Research limitations/implications: The same analysis should be performed by point clouds obtained through other Reverse Engineering technologies, such as structured light scanners. These technologies can achieve best values of accuracy and resolution, so that both results should be compared.Practical implications: This paper gives the chance to apply Reverse Engineering techniques to achieve high quality digital models of free form complex geometries. The constraints presented by optical digitization technologies can be solved through powerful point cloud edition software.Originality/value: This paper describes the process of digitalization of complex free form geometries and the subsequent point cloud edition.

  20. Repair of large frontal temporal parietal skull defect with digitally reconstructed titanium mesh: a report of 20 cases

    Directory of Open Access Journals (Sweden)

    Gang-ge CHENG

    2013-09-01

    Full Text Available Objective To explore the clinical effect and surgical technique of the repair of large defect involving frontal, temporal, and parietal regions using digitally reconstructed titanium mesh. Methods Twenty patients with large frontal, temporal, and parietal skull defect hospitalized in Air Force General Hospital from November 2006 to May 2012 were involved in this study. In these 20 patients, there were 13 males and 7 females, aged 18-58 years (mean 39 years, and the defect size measured from 7.0cm×9.0cm to 11.5cm×14.0cm (mean 8.5cm×12.0cm. Spiral CT head scan and digital three-dimensional reconstruction of skull were performed in all the patients. The shape and geometric size of skull defect was traced based on the symmetry principle, and then the data were transferred into digital precision lathe to reconstruct a titanium mesh slightly larger (1.0-1.5cm than the skull defect, and the finally the prosthesis was perfected after pruning the border. Cranioplasty was performed 6-12 months after craniotomy using the digitally reconstructed titanium mesh. Results The digitally reconstructed titanium mesh was used in 20 patients with large frontal, temporal, parietal skull defect. The surgical technique was relatively simple, and the surgical duration was shorter than before. The titanium mesh fit to the defect of skull accurately with satisfactory molding effect, good appearance and symmetrical in shape. No related complication was found in all the patients. Conclusion Repair of large frontal, temporal, parietal skull defect with digitally reconstructed titanium mesh is more advantageous than traditional manual reconstruction, and it can improve the life quality of patients.

  1. Anterior cruciate ligament (ACL) injury

    Science.gov (United States)

    Cruciate ligament injury - anterior; ACL injury; Knee injury - anterior cruciate ligament (ACL) ... knee. It prevents the knee from bending out. Anterior cruciate ligament (ACL) is in the middle of the knee. ...

  2. Correlation of petrous bone convergence angle and slope of its walls with dimensional skull characteristics of human craniotypes

    Directory of Open Access Journals (Sweden)

    Rossoshanskiy D.N.

    2012-12-01

    Full Text Available

    The aim. The purpose of this paper is to study the correlation between the angles of convergence and slope of the pyramids of the temporal bone and linear and angular parameters of the cranial depending on the basilar angle. Materials and Methods. Material study is based on 100 skulls of adult humans, divided into three craniotypes. The method of measurement were made craniotopometric these parameters with further calculation of average values of the calculated and the drafting of the correlation model. The results. Study of features of the correlation angle of convergence and the slope of the pyramids of the temporal bone and linear and angular parameters of the cranial showed varying in strength and direction of the relationship of each craniotypes. Conclusion. During the study, flexibasilar craniotypes installed close inverse relationship between: tilt the front surface of the pyramids and the long base of the skull; convergence angle of the pyramids and the length of posterior skull base, the long base of the skull to the posterior edge of the large aperture. In mediobasilar craniotypes study parameters showed mostly moderate and weak degree of multidirectional nature. For platibasilar craniotypes characterized by a close direct correlation between the convergence angle of the pyramids and the length of posterior skull base. Other dimensions of the pyramid of the temporal bone are subject to greater variability can be explained by complex, multi-directional factors shaping the internal structures of the skull base.

  3. 综合护理干预对颅底肿瘤切除术后患者吞咽障碍的作用%Comprehensive nursing intervention on effect of swallowing disorder in patients with after tumor resection of skull base

    Institute of Scientific and Technical Information of China (English)

    汪卫萍

    2015-01-01

    Objective:To study the comprehensive nursing intervention for patients with swallowing disorder after the tumor resection of the skull base.Methods:from March 2012 -March 2013 in our hospital 120 cases of swallowing disorder after the tumor resection of the skull base, had been randomly divided into observation group and control group.Observation group adopts comprehensive nursing inter-vention, the control group using conventional care method, compared two groups of patients discharged from hospital when swallowing function recovery.Results:the observation group total effective rate (100%) patients with swallowing functional recovery significantly higher than that of control group (75%) (P <0.05).Conclusion: comprehensive nursing intervention could effectively improve the swallowing disorder after the tumor resection of the skull base, might be worth promoting.%目的:探讨综合护理干预对颅底肿瘤切除术后患者吞咽障碍的作用。方法:选取了2012年3月~2013年3月于我院收治的120例颅底肿瘤切除术后吞咽障碍患者,将其随机分成观察组与对照组。观察组采用综合护理干预,对照组采用常规护理方法,对比分析2组患者出院时吞咽功能的恢复状况。结果:观察组患者吞咽功能恢复的总有效率(100%)要明显高于对照组(75%)(P<0.05)。结论:综合护理干预能够有效改善颅底肿瘤切除术后吞咽障碍,值得推广。

  4. Effects of the murine skull in optoacoustic brain microscopy.

    Science.gov (United States)

    Kneipp, Moritz; Turner, Jake; Estrada, Héctor; Rebling, Johannes; Shoham, Shy; Razansky, Daniel

    2016-01-01

    Despite the great promise behind the recent introduction of optoacoustic technology into the arsenal of small-animal neuroimaging methods, a variety of acoustic and light-related effects introduced by adult murine skull severely compromise the performance of optoacoustics in transcranial imaging. As a result, high-resolution noninvasive optoacoustic microscopy studies are still limited to a thin layer of pial microvasculature, which can be effectively resolved by tight focusing of the excitation light. We examined a range of distortions introduced by an adult murine skull in transcranial optoacoustic imaging under both acoustically- and optically-determined resolution scenarios. It is shown that strong low-pass filtering characteristics of the skull may significantly deteriorate the achievable spatial resolution in deep brain imaging where no light focusing is possible. While only brain vasculature with a diameter larger than 60 µm was effectively resolved via transcranial measurements with acoustic resolution, significant improvements are seen through cranial windows and thinned skull experiments.

  5. Costs and benefits of skull radiography for head injury

    International Nuclear Information System (INIS)

    Over a period of 10 weeks, nine accident-and-emergency units in England, Wales, and Scotland took part in an investigation into the use of skull radiography in the management of patients with head injury. The yield of potentially important radiological findings in 4829 patients with uncomplicated head injury was 2 basal, 1 frontal, and 64 vault fractures. In 4 of these patients intracranial haematomas developed, of which 3 would have been suspected clinically and the patients admitted for observation even if skull radiography had not been available. At best, skull radiography could have contributed to the detection of only 1 of the 4 intracranial haematomas. The incidence of unsuspected intracranial haematoma with skull fracture among patients with uncomplicated head injury currently radiographed in the United Kingdom is therefore 1 in 4800. The radiological cost of identifying this 1 patient in our series was Pound43,200. (author)

  6. The localization and morphology of pterion in adult West Anatolian skulls.

    Science.gov (United States)

    Aksu, Funda; Akyer, Sahika Pınar; Kale, Ayşin; Geylan, Serdar; Gayretli, Ozcan

    2014-07-01

    The pterion is an important skull landmark because it is located where the frontal, the great wing of sphenoid, parietal, and squamous parts of the temporal bone junction. The objectives of this study were to determine the localization and the shape of pterion on skulls and to find out the distances between the pterion and some certain anatomic landmarks on neighboring structures. The study was performed on the skulls of 128 (256 sides) adult West Anatolian people. All of the morphometric measurements of the distances between the pterion and the anatomic landmarks were performed using a Vernier caliper with an accuracy of 0.1 mm. The pterion was classified into 4 types: the sphenoparietal, frontotemporal, stellate, or epipteric types. The incidences of types of pterion in the skulls were also found as the sphenoparietal type (85.2%), the epipteric type (8.2%), the stellate type (5.5%), and the frontotemporal type (1.1%). The mean (SD) distances from the center of the pterion to the zygomatic arch were measured as 40.02 (4.06) mm and 39.88 (4.01) mm; to the frontozygomatic suture, 31.80 (4.51) mm and 31.44 (4.73) mm; to the zygomatic angle, 41.54 (4.95) mm and 41.35 (5.14) mm; to the mastoid process, 82.48 (5.45) mm and 81.81 (5.50) mm; and to the external acoustic meatus, 53.29 (4.55) mm and 56.22 (4.60) mm, on the right and left sides, respectively. The mean (SD) distances between the foremost point of pterion and the anterior edge of the lateral wall of the orbit were 31.02 (5.78) mm and 32.31 (5.79) mm on the right and left sides, respectively. The localization and the shape of pterion are of importance because it is an anatomic landmark and should be of use in surgical approaches and interventions via the pterion.

  7. Historical evidence of the 1936 Mojokerto skull discovery, East Java.

    Science.gov (United States)

    Huffman, O Frank; Shipman, Pat; Hertler, Christine; de Vos, John; Aziz, Fachroel

    2005-04-01

    To resolve ambiguities in the literature, we detail the discovery history of the Mojokerto child's skull (Perning 1), employing letters, maps, photographs, reports, and newspaper accounts not previously used for this purpose. Andoyo, an experienced vertebrate-fossil collector with the Geological Survey of the Netherlands Indies, found the skull on February 13, 1936, while collecting for Johan Duyfjes, who had mapped the field area geologically. On February 18-19 Andoyo sent the fossil and a 1:25,000-topographic map showing the discovery point to Survey headquarters. The locality lies between Perning and Sumbertengu villages, approximately 10km northeast of Mojokerto city, East Java. G.H. Ralph von Koenigswald, Survey paleontologist, identified the specimen as Pithecanthropus and then named it Homo modjokertensis (it is now accepted as Homo erectus). Unfortunately he confused the discovery record in a March 28 newspaper article by characterizing the skull as a "surface find" [Dutch: oppervlaktevondst] while also attributing it to ancient beds. von Koenigswald probably had insufficient basis for either assertion, having not yet talked to Andoyo or Duyfjes. Eugene Dubois challenged von Koenigswald on the "surface-find" issue, Andoyo was consulted, and Duyfjes went to the site. Duyfjes and von Koenigswald then published scientific papers stating that the skull was unearthed 1m deep from a hill-slope outcrop of conglomeratic sandstone in Duyfjes' Pucangan formation. A cross section by Andoyo, which may show the Mojokerto site, also indicates a skull at 1m depth in conglomeratic sandstone. Photographs taken in 1936-1938 show a shallow pit at a single field location that fits Duyfjes' site description and is identified as the Mojokerto-skull site in 1940-1943 publications. By WWII the scientific community accepted the skull as an early hominid. Although von Koenigswald's "surface-find" comment remains a source of doubt in the record, we consider in situ discovery for the

  8. The 'lamellated' skull in. beta. -thalassaemia

    Energy Technology Data Exchange (ETDEWEB)

    Orzincolo, C. (St. Anna Hospital, Ferrara (Italy). Dept. of Radiology); Castaldi, G. (St. Maria delle Croci Hospital, Ravenna (Italy). Dept. of Medicine); Scutellari, P.N. (Ferrara Univ. (Italy). Inst. of Radiology); Franceschini, F. (Ferrara Univ. (Italy). Inst. of Medical Semeiotica)

    1989-08-01

    The skull in homozygous {beta}-thalassaemia may present several abnormalities, such as osteopenia, widening of the diploic space, and a 'hair-on-end' appearance. In some cases it presents also a particular stratified appearance caused by a variable number of osseous lamellae, parallel with the inner table. This 'lamellated skull' was observed in 16 out of 150 patients affected by the disease (10.6%). (orig./GDG).

  9. The furnace for crystal growth by directional solidification in skull crucible

    OpenAIRE

    Таранюк, Владимир Иванович; Гектин, Александр Вульфович; Колесников, Александр Владимирович

    2014-01-01

    The furnace, based on the skull method for obtaining laboratory samples of halide crystals (40 mmin diameter and15 mmhigh) with the melting temperature of900 °C, is considered in the paper. This technological solution allows growing crystals without using expensive platinum crucibles and moving or rotating design elements. The process control system and the thermal unit design are designed for determining and controlling temperature and a thermal gradient for carrying out crystal growth and m...

  10. Stature and gender determination and their correlation using odontometry and skull anthropometry

    OpenAIRE

    Amit Gupta; Kiran Kumar; Devi Charan Shetty; Vijay Wadhwan; Anshi Jain; Kaveri Surya Khanna

    2014-01-01

    Background: When the body has been mutilated, it is common to have the extremities or head amputated from the trunk. In concern with forensic odontology, an estimate must have been made based on the correlation of osteometry along with odontometry in determining sex, race and stature. Objective: The objective of this study is to investigate and correlate height and gender from odontometry and anthropometric data of the skull. Materials and Methods: The study was conducted in the Department of...

  11. Leonardo da Vinci's "A skull sectioned": skull and dental formula revisited.

    Science.gov (United States)

    Gerrits, Peter O; Veening, Jan G

    2013-05-01

    What can be learned from historical anatomical drawings and how to incorporate these drawings into anatomical teaching? The drawing "A skull sectioned" (RL 19058v) by Leonardo da Vinci (1452-1519), hides more detailed information than reported earlier. A well-chosen section cut explores sectioned paranasal sinuses and ductus nasolacrimalis. A dissected lateral wall of the maxilla is also present. Furthermore, at the level of the foramen mentale, the drawing displays compact and spongious bony components, together with a cross-section through the foramen mentale and its connection with the canalis mandibulae. Leonardo was the first to describe a correct dental formula (6424) and made efforts to place this formula above the related dental elements. However, taking into account, the morphological features of the individual elements of the maxilla, it can be suggested that Leonardo sketched a "peculiar dental element" on the position of the right maxillary premolar in the dental sketch. The fact that the author did not make any comment on that special element is remarkable. Leonardo could have had sufficient knowledge of the precise morphology of maxillary and mandibular premolars, since the author depicted these elements in the dissected skull. The fact that the author also had access to premolars in situ corroborates our suggestion that "something went wrong" in this part of the drawing. The present study shows that historical anatomical drawings are very useful for interactive learning of detailed anatomy for students in medicine and dentistry.

  12. Congenital anterior urethral diverticulum.

    Science.gov (United States)

    Singh, Sanjeet Kumar; Ansari, Ms

    2014-09-01

    Congenital anterior urethral diverticulum (CAUD) may be found all along the anterior urethra and may present itself at any age, from infant to adult. Most children with this condition present with difficulty in initiating micturition, dribbling of urine, poor urinary stream, or urinary tract infection. A careful history will reveal that these children never had a good urinary stream since birth, and the telltale sign is a cystic swelling of the penile urethra. In this paper, we present two cases of CAUD that were managed by excision of the diverticulum with primary repair. PMID:26328174

  13. Chronology of the stratum containing the skull of the Dali Man

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    The field investigations of geomorphology and Quaternary sediment sequences show that the sediment stratigraphic profile containing the skull of the Homo sapiens Daliensis (Dali Man) at Tianshuigou trench, Jiefang Village (109°44′E, 34°52′N ), Dali County, Shaanxi Province, is composed of the loess-paleosol sequence, 17.3 m thick, in the upper part, and the alluvial silts, fine sands and sandy gravels interbedded, 15.4 m thick, in the lower part. There are the well developed layers L1, S1, L2 and S2 in the loess-paleosol sequence of the profile, which are comparable to those of the Luochuan loess section on the basis of magnetic succeptibility measurements and IRSL dating of the loess samples. An alluvial gravel layer, where the skull of the Dali Man was discovered, is in 13 m beneath the bottom of paleosol S2, implying that, the age of the Dali Man must be older than about 247 kaBP when the paleosol S2 began to be developed. The samples of mammal animal tooth and shell fossils from the gravel layer containing the skull of the Dali Man have been dated by uranium series and ESR methods respectively. Based on the multiple dating results and the stratigraphic chronology, the age of the Dali Man, therefore, would be estimated as older than 250 kaBP and younger than 350 kaBP, and reasonably estimated as 260-300 kaBP.

  14. Analysis of Stresses in Mandible and Skull under Angular Impact

    Directory of Open Access Journals (Sweden)

    Dr. Shobha E S1

    2015-12-01

    Full Text Available : Finite element analysis has gained a significant attention in the field of biomechanics. The versatility of finite element analysis is the major reason behind its implementation and adoption has made the study of biomechanics much easier and simpler. FEA, as a tool has helped in analyzing the various organs in human body in different loading conditions. Be it Orthopedic,Maxillofacial fractures,Orthodontics, Prosthodontics, hemodynamics, it is finding its applications in all areas of biomechanics. In this paper, one such study has been carried out to understand the behavior of skull and mandible under inclined impacts. Skull is one of the highly complicated structures made up of bones in the human body.A lot of research is being carried out throughout the world for studying the skull structure in multidisciplinary level. Research is also being carried out in treatments by effectively using FEA, developing new methodologies and materials for treatment in the field. Here, the model of the skull along with mandible is constructed using the CT scan data using which finite element model is created and impact analysis has been carried out to find out the stresses, strains and energy absorption of the skull material. Apart from the analysis, attempt has been made in this paper to suggest the optimum locations for placing implants to optimize treatment in trauma patients.

  15. Mechanical properties of the brain-skull interface.

    Science.gov (United States)

    Mazumder, Mohammad Mynuddin Gani; Miller, Karol; Bunt, Stuart; Mostayed, Ahmed; Joldes, Grand; Day, Robert; Hart, Robin; Wittek, Adam

    2013-01-01

    Knowledge of the mechanical properties of the brain-skull interface is important for surgery simulation and injury biomechanics. These properties are known only to a limited extent. In this study we conducted in situ indentation of the sheep brain, and proposed to derive the macroscopic mechanical properties of the brain-skull interface from the results of these experiments. To the best of our knowledge, this is the first ever analysis of this kind. When conducting in situ indentation of the brain, the reaction force on the indentor was measured. After the indentation, a cylindrical sample of the brain tissue was extracted and subjected to uniaxial compression test. A model of the brain indentation experiment was built in the Finite Element (FE) solver ABAQUS™. In the model, the mechanical properties of the brain tissue were assigned as obtained from the uniaxial compression test and the brain-skull interface was modeled as linear springs. The interface stiffness (defined as sum of stiffnesses of the springs divided by the interface area) was varied to obtain good agreement between the calculated and experimentally measured indentor force-displacement relationship. Such agreement was found to occur for the brain-skull interface stiffness of 11.45 Nmm⁻¹/mm². This allowed identification of the overall mechanical properties of the brain-skull interface. PMID:23951996

  16. MORPHOMETRIC EVALUATION OF FORAMEN MAGNUM IN DRY HUMAN SKULLS

    Directory of Open Access Journals (Sweden)

    Anil Kumar

    2015-06-01

    Full Text Available The foramen magnum is an important landmark in the posterior part of the cranial base, which is largely formed by the occipital bone. The dimensions of the foramen magnum are clinically important because of the vital structures passing through it. We studied thirty six dry human skulls of known sex and measured antero-posterior and transverse diameters with the help of Vernier caliper. Additionally surface area and Index of foramen magnum were also calculated. Oval shape is the main type of morphological variant found in this study. The transverse diameter of the foramen magnum was in a range of 25.75-34.25mm in males, whereas it was between 26-31.75mm in females. The anteroposterior diameter was in a range of 35 to 39.75mm in males while it was 29.5 to 34.75mm in females. The mean area of foramen magnum in males was 876.88±88.83mm whereas it was 776.87±68.51mm in females. In contrast to the area, the mean foramen magnum index was higher in females (89.01±6.84mm compared to males (81.75±5.99mm and this difference was also statistically significant (p<0.01. The prospective study will help surgeon for reference value for determining feasibility of transcondylar surgical approach, which are being done in an increasing trend in recent times for brain stem lesion.

  17. Meta-analysis of defunctioning stoma in low anterior resection with total mesorectal excision for rectal cancer: evidence based on thirteen studies

    OpenAIRE

    Gu, Wen-long; Wu, Sheng-wen

    2015-01-01

    Background Recent studies have shown that a protective stoma can reduce morbidity in low anterior resection for rectal cancer; however, the necessity of it is still controversially discussed. Methods We performed this meta-analysis to provide a comprehensive evaluation of the role of defunctioning stoma in low anterior resection for rectal cancer on the rates of anastomotic leakage and reoperation related to leakage with or without defunctioning stoma by calculating the pooled risk ratio. Res...

  18. Reconstrução tridimensional da face nos tumores avançados com invasão da fossa craniana anterior Tridimensional facial reconstruction following major resection of tumors involving the anterior cranial fossa

    Directory of Open Access Journals (Sweden)

    Mario Sergio Lomba Galvão

    2004-04-01

    Full Text Available OBJETIVO: Analisar as indicações cirúrgicas e o seguimento pós operatório, ressaltando as complicações e efetividade da abordagem multidisciplinar, para os tumores avançados da base do crânio. MÉTODO: Análise retrospectiva de 46 prontuários de pacientes submetidos à ressecção de tumores invadindo a fossa craniana anterior e reconstruídos com retalhos microcirúrgicos, operados entre março de 1990 e julho de 2002. Todos os pacientes foram operados pelo núcleo de cirurgia de base do crânio do INCA. RESULTADOS: As estruturas mais envolvidas na ressecção foram por ordem: a órbita (76,5%, seio maxilar (76,5%, seio esfenoidal (63,8%, paredes da cavidade nasal (59,5% e palato (42,5%. A dura-máter estava acometida em 32,6% dos casos. A reconstrução microcirúrgica utilizando os retalhos do músculo reto abdominal foi empregada em 93,5 % dos casos. A taxa de sucesso dos transplantes livres foi de 97,8%. As complicações ocorreram em 58,6% dos pacientes e as mais freqüentes foram: infecções locais (21,7%, fístulas liquóricas (15,2%, meningite (6,5% e hematoma (6,5%. CONCLUSÕES: A reconstrução com técnica microcirúrgica permite que se realizem ressecções alargadas destes tumores com limites seguros e índices de complicações aceitáveis, permitindo a estes pacientes uma melhoria da qualidade de vida e da sobrevida, com baixo índice de recidiva.BACKGROUND: The analysis of the surgical indications and the follow-up, stressing the surgical complications and efficiency of a team approach for the advanced tumors involving the anterior skull base are the purpose of the present study. METHODS: The authors present a retrospective evaluation of 46 patients who underwent resections of advanced tumors involving the anterior skull base, which were reconstructed with free flaps from May, 1990 to July, 2002. Those patients have been treated by the skull base surgical team of INCA. RESULTS: The commonest resected structures were

  19. [Two cases of tuberculosis of the skull cap (author's transl)].

    Science.gov (United States)

    Memin, Y; Zurbach, J; Mafart, Y; Lesobre, B; Piéron, R; Hercend, T

    The authors report two cases of tuberculosis of the skull cap. The first in a Black African with heterozygous sickle cell disease also presenting with: tuberculosis of the cervical lymph nodes, subcutaneous frontal tumefactions bacteriologically confirmed to be of tuberculous origin, multiple lacunae of the vault from the same origin; the second case is an Asian woman having a multifocal tuberculous osteitis involving the skull, spine, pelvis and probably the same affection in the spleen. These cases are a reminder that the principal features of tuberculosis of the skull vault are very often associated with other tuberculous lesions, and to the problems of diagnosis it entails; the existence of a subcutaneous tumefaction of the vault or of any accessible site one can aspirate and/or perform biopsy constitutes a diagnostic aid. PMID:6244640

  20. A novel silk-based artificial ligament and tricalcium phosphate/polyether ether ketone anchor for anterior cruciate ligament reconstruction - safety and efficacy in a porcine model.

    Science.gov (United States)

    Li, Xiang; He, Jiankang; Bian, Weiguo; Li, Zheng; Zhang, Wenyou; Li, Dichen; Snedeker, Jess G

    2014-08-01

    Loss of ligament graft tension in early postoperative stages following anterior cruciate ligament (ACL) reconstruction can come from a variety of factors, with slow graft integration to bone being widely viewed as a chief culprit. Toward an off-the-shelf ACL graft that can rapidly integrate to host tissue, we have developed a silk-based ACL graft combined with a tricalcium phosphate (TCP)/polyether ether ketone anchor. In the present study we tested the safety and efficacy of this concept in a porcine model, with postoperative assessments at 3months (n=10) and 6months (n=4). Biomechanical tests were performed after euthanization, with ultimate tensile strengths at 3months of ∼370N and at 6months of ∼566N - comparable to autograft and allograft performance in this animal model. Comprehensive histological observations revealed that TCP substantially enhanced silk graft to bone attachment. Interdigitation of soft and hard tissues was observed, with regenerated fibrocartilage characterizing a transitional zone from silk graft to bone that was similar to native ligament bone attachments. We conclude that both initial stability and robust long-term biological attachment were consistently achieved using the tested construct, supporting a large potential for silk-TCP combinations in the repair of the torn ACL.

  1. The relationship between skull asymmetry and CT findings

    International Nuclear Information System (INIS)

    In order to clarify the relationship between brain damage and skull asymmetry or supine head position preference, we classified CT findings of 330 cases with cerebral palsy or risk of motor disturbance into 6 groups according to skull shape. Those were severe (I, n = 37) and mild (II, n = 114) grades in the right occipital flatness, severe (III, n = 34) and mild (IV, n = 58) grades in the left occipital flatness, long skull with temporal flatness (V, n = 33) and symmetric round skull (control, n = 54). It was considered that the asymmetry of cortical atrophy in appearance was formed physicaly by skull asymmetry but that the asymmetric dilatation in appearance of lateral ventricle was related to the asymmetry of brain damage. The severity and the asymmetry of brain damage were tend to increase the grade of skull asymmetry. The incidence of cases with the right occipital flatness was 1.6 times more frequently than the left sided. The incidence of cases whose left (lateral) ventricle was larger than the right was 4.1 times more than the cases whose right ventricle was larger than the left. The cases with occipital flatness in the contralateral side of the larger lateral ventricle were found more than the cases with occipital flatness in the ipsilateral side of the larger ventricle, that is to say, the direction of supine head position preference during early infant was suspected to be the more severely disturbed side of body. These results suggest that the supine head position preference to the right in newborn babies and infants with scoliosis or cerebral palsy might be the result of transient or permanent asymmetric (left > right) brain dysfunction. (author)

  2. Occipital Emissary Foramina in South Indian Modern Human Skulls

    OpenAIRE

    Singhal, Suruchi; Ravindranath, Roopa

    2013-01-01

    An occipital emissary foramen has been traditionally described as a foramen present in the squamous part of the occipital bone at the occipital protuberance transmitting a vein that connects the confluence of sinuses with the occipital vein. The present study was done on 221 South Indian adult modern human skulls of unknown sex in the Department of Anatomy, St John’s Medical College, Bangalore, India. The foramen was observed in 21/221 (9.50%) skulls, 6/21 (28.57%) to the right of, 10/21 (47....

  3. [A skull of Mesopithecus with bite marks (author's transl)].

    Science.gov (United States)

    Zapfe, H

    1981-01-01

    A skull of Mesopithecus pentelicus (Roth and Wagner) from the Turolian (Upper Miocene) of Pikermi (Greece) shows hole-shaped bitemarks. Considering the behavior and the character of the dentition of the groups of carnivores represented in Pikermi, it is supposed that these bitemarks have been caused by a felid of the size of a leopard. In the fauna of Pikermi only Metailurus parvulus (Hensel) can be taken into consideration. By the defects on a skull of a juvenile Australopithecine, interpreted by Brain in 1970 as bitemarks of a leopard, the above explanation gets a very essential support. PMID:6792015

  4. Current approach in diagnosis and management of anterior uveitis

    OpenAIRE

    Agrawal Rupesh; Murthy Somasheila; Sangwan Virender; Biswas Jyotirmay

    2010-01-01

    Uveitis is composed of a diverse group of disease entities, which in total has been estimated to cause approximately 10% of blindness. Uveitis is broadly classified into anterior, intermediate, posterior and panuveitis based on the anatomical involvement of the eye. Anterior uveitis is, however, the commonest form of uveitis with varying incidences reported in worldwide literature. Anterior uveitis can be very benign to present with but often can lead to severe morbidity if not treated...

  5. Evolutionary patterns of shape and functional diversification in the skull and jaw musculature of triggerfishes (Teleostei: Balistidae).

    Science.gov (United States)

    McCord, Charlene L; Westneat, Mark W

    2016-06-01

    The robust skull and highly subdivided adductor mandibulae muscles of triggerfishes provide an excellent system within which to analyze the evolutionary processes underlying phenotypic diversification. We surveyed the anatomical diversity of balistid jaws using Procrustes-based geometric morphometric analyses and a phylomorphospace approach to quantifying morphological transformation through evolution. We hypothesized that metrics of interspecific cranial shape would reveal patterns of phylogenetic diversification that are congruent with functional and ecological transformation. Morphological landmarks outlining skull and adductor mandibulae muscle shape were collected from 27 triggerfish species. Procrustes-transformed skull shape configurations revealed significant phylogenetic and size-influenced structure. Phylomorphospace plots of cranial shape diversity reveal groupings of shape between different species of triggerfish that are mostly consistent with phylogenetic relatedness. Repeated instances of convergence upon similar cranial shape by genetically disparate taxa are likely due to the functional demands of shared specialized dietary habits. This study shows that the diversification of triggerfish skulls occurs via modifications of cranial silhouette and the positioning of subdivided jaw adductor muscles. Using the morphometric data collected here as input to a biomechanical model of triggerfish jaw function, we find that subdivided jaw adductors, in conjunction with a unique cranial skeleton, have direct biomechanical consequences that are not always congruent with phylomorphospace patterns in the triggerfish lineage. The integration of geometric morphometrics with biomechanical modeling in a phylogenetic context provides novel insight into the evolutionary patterns and ecological role of muscle subdivisions in triggerfishes. J. Morphol. 277:737-752, 2016. © 2016 Wiley Periodicals, Inc. PMID:26997352

  6. STUDY ON THE OCCURRENCE OF WORMIAN BONES AMONG THE MALE AND FEMALE SKULLS OF TAMIL NADU, INDIA

    Directory of Open Access Journals (Sweden)

    A. Mary Antony Praba

    2015-12-01

    Full Text Available Background: Wormian bones, also known as intra sutural bones are extra bone pieces that occur within a suture in the cranium. These are irregular isolated bones which appear in addition to the usual centers of ossification of the cranium and, although unusual, are not rare. The number of sutural bones varies considerably because different individuals and different population have different numbers of sutural bones. They occur mostly along the sutures and meeting point of the cranial sutures. They occur most frequently in the course of the lambdoid suture. They are also occasionally seen within the sagittal and coronal sutures. Materials and Methods: In this present study we analyzed the occurrence of sutural bones among 50 male and female skulls in Tamil Nadu region and we compared the results along with the studies of Indian skulls. Result and Conclusion: Based on the study we concluded that sutural bones are more among male skulls than in females among the skulls of Tamil Nadu and this is exactly the opposite of the results given in Indian population.

  7. Simulated activity but real trauma: a systematic review on Nintendo Wii injuries based on a case report of an acute anterior cruciate ligament rupture.

    Science.gov (United States)

    Müller, Sebastian A; Vavken, Patrick; Pagenstert, Geert

    2015-03-01

    Video gaming injuries are classically regarded as eccentric accidents and novelty diagnoses. A case of an anterior cruciate ligament (ACL) tear sustained during Wii boxing spurned us to review the literature for other Wii-related injuries and Wii-based posttraumatic rehabilitation. The English literature listed in PubMed was systematically reviewed by searching for "Wii (trauma or injury or fracture)." Full-text articles were included after duplicate, blinded review. The type and treatment of injury as well as the Wii-based rehabilitation programs found were analyzed. Additionally, a new case of an acute ACL tear-sustained playing, Wii boxing, is additionally presented. After exclusion of irrelevant articles, 13 articles describing Wii-related injuries were included reporting on 3 fractures, 6 nonosseous, 2 overuse injuries, and 2 rehabilitation programs using Wii for posttraumatic rehabilitation. Among the presented Wii-related injuries, only 12.5% were treated conservatively, whereas 87.5% underwent either surgical or interventional treatment. Because of the reported case, the literature search was limited to Wii-related injuries excluding other video games. Another limitation of this article lies in the fact that mainly case reports but no controlled trials exist on the topic. Assumingly, primarily the more severe injuries are reported in the literature with an unknown number of possibly minor injuries. Motion-controlled video games, such as Wii, are becoming increasingly popular as a recreational entertainment. Because of their wide acceptance and entertaining nature, they are also increasingly recognized as a tool in rehabilitation. However, although the activity is simulated, injuries are real. Our systematic review shows that Wii gaming can lead to severe injuries, sometimes with lasting limitations. PMID:25816033

  8. Nonmetric Skull Divergence in the Otter - Assessing Genetic Insulation of Populations

    OpenAIRE

    Stubbe, M; Ansorge, H.

    1995-01-01

    The craniometric variation and non-metric skull divergence between populations of the otter Lutra lutra (Linné, 1758) were studied using more than 430 skulls from different regions of Eastern Germany. No direct regional differences in skull measurements could be established for this area. The comparison of the morphological variation by non-metric skull characters adduces not or unimportant differentiations for most regions. Otter populations with greater geographic distances have partly high...

  9. [Somatotopic Representation of the Anterior Horn within Cervical Enlargement: Reappraisal of Known Doctrine Based on Clinicopathological Findings Seen in Hirayama Disease].

    Science.gov (United States)

    Hirayama, Keizo

    2016-05-01

    Clinical features (weakness and amyotrophy of intrinsic hand muscles and obliquely distributed amyotrophy of forearm muscles, figure 1), needle electromyographic findings (distribution of neurogenic activities, figure 2), and pathological findings (ischemic necroses of the anterior horns between C6 and T1, figure 3) of Hirayama disease suggest that understanding of somatotopic representation of the anterior horn innervating arm muscles in the cervical enlargement of spinal cord differs from the known doctrine. Anterior horn cells of the intrinsic hand muscles are located between C7 and T1, those of forearm muscles and triceps brachii muscle as elbow extensor are, contrary to the known doctrine, located in C5 and C6, and those of elbow flexors such as biceps brachii and brachioradialis are located in C4 and above (figure 5). Development of dexterity in human hand may reflect development of cervical enlargement in accord with larger areas representing the hand and fingers on cerebral motor cortex.

  10. Country of my skull/Skull of my country: Krog and Zagajewski, South Africa and Poland

    Directory of Open Access Journals (Sweden)

    P. van Schalkwyk

    2006-07-01

    Full Text Available In the ninth poem of the cycle “land van genade en verdriet” (“country of grace and sorrow” in the collection “Kleur kom nooit alleen nie” (“Colour never comes on its own”, Antjie Krog contends that the old is “stinking along” ever so cheerfully/ robustly in the new South African dispensation. This could also hold true for the new democratic Poland. Krog and the Polish poet Adam Zagajewksi could, in fact, be described as “intimate strangers”, specifically with regard to the mirrored imagery of “country of my skull”/“skull of my country” present in their work. The notion of “intimate strangers” may be seen as pointing toward the feminine dimension of subjectivity, which could be elaborated along the lines of Bracha Ettinger’s concept of “matrixial borderlinking”. Ettinger has made a significant contribution to the field of psychoanalysis, building on Freud and Lacan. She investigates the subject’s relation to the m/Other, and the intimate matrixial sharing of “phantasm”, “jouissance” and trauma among several entities. Critical of the conventional “phallic” paradigm, Ettinger turns to the womb in exploring the “borderlinking” of the I and the non-I within the matrix (the psychic creative “borderspace”. With these considerations as point of departure, and with specific reference to the closing poem in Krog’s “Country of my skull” and Zagajewski’s “Fire” (both exploring “weaning” experiences in recent personal and public history, I intend to show how the public/political is connected to the personal/psychological, and vice versa, and how committed literary works like those of Krog and Zagajewski can be clarified further from a psychoanalytical perspective. The image of the skull in the texts under scrutiny is investigated with recourse to the Lacanian notion of the “cavity”, as adopted and adapted by Ettinger. True to the mirror experience as described within

  11. Reliability of Craniofacial Superimposition Using Three-Dimension Skull Model.

    Science.gov (United States)

    Gaudio, Daniel; Olivieri, Lara; De Angelis, Danilo; Poppa, Pasquale; Galassi, Andrea; Cattaneo, Cristina

    2016-01-01

    Craniofacial superimposition is a technique potentially useful for the identification of unidentified human remains if a photo of the missing person is available. We have tested the reliability of the 2D-3D computer-aided nonautomatic superimposition techniques. Three-dimension laser scans of five skulls and ten photographs were overlaid with an imaging software. The resulting superimpositions were evaluated using three methods: craniofacial landmarks, morphological features, and a combination of the two. A 3D model of each skull without its mandible was tested for superimposition; we also evaluated whether separating skulls by sex would increase correct identifications. Results show that the landmark method employing the entire skull is the more reliable one (5/5 correct identifications, 40% false positives [FP]), regardless of sex. However, the persistence of a high percentage of FP in all the methods evaluated indicates that these methods are unreliable for positive identification although the landmark-only method could be useful for exclusion. PMID:26335587

  12. Intracranial hypertension secondary to a skull lesion without mass effect.

    Science.gov (United States)

    Serlin, Yonatan; Benifla, Mony; Kesler, Anat; Cohen, Avi; Shelef, Ilan

    2016-09-01

    We report and discuss five patients with intracranial hypertension due to a skull lesion reducing cerebral sinus patency with a compressive, non-thrombotic mechanism. We illustrate the importance of a high level of suspicion for this condition in patients presenting with headache, papilledema and increased intracranial pressure in the absence of focal signs or radiological evidence of mass effect. PMID:27283387

  13. Reduced skull sexual dimorphism in a local sheep breed

    OpenAIRE

    Parés Casanova, Pere-Miquel

    2014-01-01

    This study estimated the magnitude of sexual dimorphism in a relict sheep from Catalunya (NE Spain), called Fardasca, using geometric morphometric techniques. For these analyses, a total of 18 skull specimens (2 adult males and 16 females) were studied. Our results suggest that the breed is not cranially dimorphic, so sex determination using landmarks described here as criteria is likely to yield poor results.

  14. THE SKULL OF THE PERUVIAN BOOBY SULA VARIEGATA (AVES, SULIDAE

    Directory of Open Access Journals (Sweden)

    MARCELO STUCCHI

    Full Text Available This paper describes the morphology of the skull of the Peruvian booby Sula variegata (Tschudi, 1845, considering its ontogeny, and compared with other species of the family Sulidae and, similarly, with other families of the traditional order Pelecaniformes: Phalacrocoracidae, Anhingidae, Fregatidae, Phaetonthidae and Pelecanidae. In the comparisons could be found characteristics which the Peruvian booby shares with other members of Sulidae, and others that, taken together, distinguish it from other species of the genus Sula. Among the former are: (1 during ontogenetic development, they change the proportions between the rostrum and thebraincase, stretching the first and reducing the height of the second. (2 The skulls have a nasal opening in their early stages of development, which is completely closed with the growth of the bird. The respiratory function moves to a space that is below the pre-orbital fenestra and the jugal, which is protected by ranfoteca. (3 Adult individuals present a trabecular space in the inner part of the upper jaw and frontals that confers resistance to the skull. All these features allow the Sulidae to prevent the rupture or buckling of the skull under the force of the impact of the plunge. In the second case there are: (1 cranial roof slightly vaulted over the orbits; (2 Sagittal crest generally narrow, although wide in some individuals; (3 Short temporal region; (4 Straight proximal rostrum in front of the naso-frontal suture.

  15. Morphological Study of Wormian Bones in Dried Human Skulls

    Directory of Open Access Journals (Sweden)

    Divyesh Patel

    2015-09-01

    Full Text Available Background: Wormian bones may be defined as a those accidental bones found in the cranium having no regular relation to their normal ossification centre. They are assocated with cranial and central nervous system abnormalities. Knowledge of these bones is important for anthropo-logists, forensic experts, radiologists, orthopedic and neurosurgeons to avoid misleading for multiple fractures of the skull. Materials and Methods: Adult dry human skulls (n= 27 of unknown age and sex availablein the Department of Anatomy, Govt. Medical College, Surat were included in the study. Result: Overall incidence of wormian bone was 44.4%. They occurred more frequently at lambdoid suture (48.14%.Wormian bones were also presentat asterion (18.5%, along the coronal suture (0.03%, along the parito-temporal suture (0.07%, along the occipito-mastoid suture (0.03%,andat pterion (0.03 %. Wormain bones were found 48.1% on left half of skull and 37.03% on right half of skull. Conclusion: The Wormian bones were more frequent at the lambdoid suture. The clinical importances of these variant bones were emphasized with relevant review of literature. [Natl J Med Res 2015; 5(3.000: 222-225

  16. MORPHOLOGICAL STUDY OF WORMIAN BONES IN CADAVER SKULLS

    OpenAIRE

    Vasanthi; Adinarayana; Pujitha

    2015-01-01

    Wormian bones are accessory bones are not normally present in skull . They may or may not be associated with clinical abnormalities . In the present study a significant number of wormian bones were identified at the Department of Anatomy , Andhra Medical College , Visakhapatnam . Their incidence with other population were done in the presen t study

  17. Blunt force trauma to skull with various instruments.

    Science.gov (United States)

    Sulaiman, Nur Amirah; Osman, Khairul; Hamzah, Noor Hazfalinda; Amir, Sri Pawita Albakri

    2014-04-01

    Deaths due to blunt force trauma to the head as a result of assault are some of the most common cases encountered by the practicing forensic pathologist. Previous studies have shown inflicting injury to the head region is one of the most effective methods of murder. The important factors that determine severity of trauma include the type of weapon used, type and site of skull fracture, intracranial haemorrhage and severity of brain injury. The aim of this study was to determine the characteristics of blunt force trauma to the skull produced by different instruments. Nine adult monkeys (Macaca fascicularis) skulls were used as models. Commonly found blunt objects comprising of Warrington hammer, hockey stick and open face helmet were used in this study. A machine calibrated force generator was used to hold the blunt object in place and to hit the skulls at forces of 12.5N and 25N. Resultant traumatic effects and fractures (linear, depressed, basilar, comminuted, and distastic) were analyzed according to type of blunt object used; surface area of contact and absolute force (N/cm(2)) delivered. Results showed that all investigated instruments were capable of producing similar injuries. The severity of trauma was not related to the surface area of contact with the blunt objects. However, only high absolute forces produced comminuted fractures. These findings were observational, as the samples were too small for statistical conclusions. PMID:24763233

  18. Morphometric analysis of occipital bone in the domestic cat in comparison with selected skull size parameters and with special regard to skull morphotype.

    Science.gov (United States)

    Wasowicz, M; Kupczyńska, M; Wieladek, A; Barszcz, K

    2009-01-01

    The aim of this study was to elaborate criteria defining the morphotype and to perform a morphological and morphometric analysis of the squamous part of the occipital bone and of the foramen magnum in the European cat. The study material comprised 50 corpses of European cats of both sexes and of bodyweight from 1.35 to 7.7 kg, aged from 1 year to 17 years. The study material underwent detailed preparation and morphometries of the skull, squamous part of the occipital bone and the foramen magnum were performed. The skull index (IC) data obtained indicate that the European cat represents a mesaticephalic morphotype. In the morphometrical analysis of the foramen magnum the following were included: the foramen magnum index (IFM), the occipital index (IOF), and the index of the squamous part of the occipital bone (ISO). In the morphology of the squamous part of the occipital bone two categories were distinguished: the first was characterized by a form close to an isosceles triangle with its base directed to the bottom. In none of the specimens studied was a dorsal notch in the form of a "keyhole" observed, nor was there any other deformation in the foramen magnum, which takes the form of a slightly crosswise elongated regular oval. The results of this study indicate that in the European cat the foramen magnum is free from any pathology and its shape, in the individual development, is conservative. PMID:19645357

  19. Micrometeorite Impacts in Beringian Mammoth Tusks and a Bison Skull

    Energy Technology Data Exchange (ETDEWEB)

    Hagstrum, Jonathon T.; Firestone, Richard B; West, Allen; Stefanka, Zsolt; Revay, Zsolt

    2010-02-03

    We have discovered what appear to be micrometeorites imbedded in seven late Pleistocene Alaskan mammoth tusks and a Siberian bison skull. The micrometeorites apparently shattered on impact leaving 2 to 5 mm hemispherical debris patterns surrounded by carbonized rings. Multiple impacts are observed on only one side of the tusks and skull consistent with the micrometeorites having come from a single direction. The impact sites are strongly magnetic indicating significant iron content. We analyzed several imbedded micrometeorite fragments from both tusks and skull with laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS) and X-ray fluorescence (XRF). These analyses confirm the high iron content and indicate compositions highly enriched in nickel and depleted in titanium, unlike any natural terrestrial sources. In addition, electron microprobe (EMP) analyses of a Fe-Ni sulfide grain (tusk 2) show it contains between 3 and 20 weight percent Ni. Prompt gamma-ray activation analysis (PGAA) of a particle extracted from the bison skull indicates ~;;0.4 mg of iron, in agreement with a micrometeorite ~;;1 mm in diameter. In addition, scanning electron microscope (SEM) images and XRF analyses of the skull show possible entry channels containing Fe-rich material. The majority of tusks (5/7) have a calibrated weighted mean 14C age of 32.9 +- 1.8 ka BP, which coincides with the onset of significant declines<36 ka ago in Beringian bison, horse, brown bear, and mammoth populations, as well as in mammoth genetic diversity. It appears likely that the impacts and population declines are related events, although their precise nature remains to be determined.

  20. The anterior cingulate cortex

    Directory of Open Access Journals (Sweden)

    Pavlović D.M.

    2009-01-01

    Full Text Available The anterior cingulate cortex (ACC has a role in attention, analysis of sensory information, error recognition, problem solving, detection of novelty, behavior, emotions, social relations, cognitive control, and regulation of visceral functions. This area is active whenever the individual feels some emotions, solves a problem, or analyzes the pros and cons of an action (if it is a right decision. Analogous areas are also found in higher mammals, especially whales, and they contain spindle neurons that enable complex social interactions. Disturbance of ACC activity is found in dementias, schizophrenia, depression, the obsessive-compulsive syndrome, and other neuropsychiatric diseases.

  1. ANTERIOR OSTEOPHYTE IDENTIFICATION IN CERVICAL VERTEBRAE

    Directory of Open Access Journals (Sweden)

    A. T. Chougale

    2011-06-01

    Full Text Available Radiologist always examines X-ray to determine abnormal changes in cervical, lumbar & thoracic vertebrae. Osteophyte (bony growth may appear at the corners of vertebrae so that vertebral shape becomes abnormal. This paper presents the idea from Image processing techniques such as customised Hough transform which will be used for segmentation which should be independent of rotation, scale, noise & shape. This segmented image will be then used for computing size invariant, convex hull based features to differentiate normal cervical vertebrae from cervical vertebrae containing anterior osteophyte. This approach effectively finds anterior osteophytes in cervical vertebrae.

  2. Asymmetric activation of the anterior cerebral cortex in recipients of IRECA: Preliminary evidence for the energetic effects of an intention-based biofield treatment modality on human neurophysiology

    NARCIS (Netherlands)

    Pike, C.; Vernon, D.; Hald, L.A.

    2014-01-01

    Neurophysiologic studies of mindfulness link the health benefits of meditation to activation of the left-anterior cerebral cortex. The similarity and functional importance of intention and attentional stance in meditative and biofield therapeutic practices suggest that modulation of recipient anteri

  3. Anterior Cruciate Ligament OsteoArthritis Score (ACLOAS)

    DEFF Research Database (Denmark)

    Roemer, Frank W; Frobell, Richard; Lohmander, Stefan;

    2014-01-01

    OBJECTIVE: To develop a whole joint scoring system, the Anterior Cruciate Ligament OsteoArthritis Score (ACLOAS), for magnetic resonance imaging (MRI)-based assessment of acute anterior cruciate ligament (ACL) injury and follow-up of structural sequelae, and to assess its reliability. DESIGN...

  4. Combined operative technique with anterior surgical approach and video-assisted thoracoscopic surgical lobectomy for anterior superior sulcus tumours.

    Science.gov (United States)

    Yokoyama, Yuhei; Chen, Fengshi; Aoyama, Akihiro; Sato, Toshihiko; Date, Hiroshi

    2014-11-01

    Video-assisted thoracoscopic surgery (VATS) has been widely used, but surgical resections of superior sulcus tumours remain challenging because of their anatomical location. For such cases, less-invasive procedures, such as the anterior transcervical-thoracic and transmanubrial approaches, have been widely performed because of their excellent visualization of the subclavian vessels. Recently, a combined operative technique with an anterior surgical approach and VATS for anterior superior sulcus tumours has been introduced. Herein, we report three cases of anterior superior sulcus tumours successfully resected by surgical approaches combined with a VATS-based lobectomy. In all cases, operability was confirmed by VATS, and upper lobectomies with hilar and mediastinal lymph node dissections were performed. Subsequently, dissections of the anterior inlet of the tumours were performed using the transmanubrial approach in two patients and the anterior trans-cervical-thoracic approach in one patient. Both approaches provided excellent access to the anterior inlet of the tumour and exposure of the subclavian vessels, resulting in radical resection of the tumour with concomitant resection of the surrounding anatomical structures, including the chest wall and vessels. In conclusion, VATS lobectomy combined with the anterior surgical approach might be an excellent procedure for the resection of anterior superior sulcus tumours.

  5. Nonnecrotizing anterior scleritis mimicking orbital inflammatory disease

    Directory of Open Access Journals (Sweden)

    Lynch MC

    2013-08-01

    Full Text Available Michelle Chen Lynch,1 Andrew B Mick21Optometry Clinic, Ocala West Veterans Affairs Specialty Clinic, Ocala, FL, USA; 2Eye Clinic, San Francisco VA Medical Center, San Francisco, CA, USABackground: Anterior scleritis is an uncommon form of ocular inflammation, often associated with coexisting autoimmune disease. With early recognition and aggressive systemic therapy, prognosis for resolution is good. The diagnosis of underlying autoimmune disease involves a multidisciplinary approach.Case report: A 42-year-old African American female presented to the Eye Clinic at the San Francisco Veteran Affairs Medical Center, with a tremendously painful left eye, worse on eye movement, with marked injection of conjunctiva. There was mild swelling of the upper eyelid. Visual acuity was unaffected, but there was a mild red cap desaturation. The posterior segment was unremarkable. The initial differential diagnoses included anterior scleritis and orbital inflammatory disease. Oral steroid treatment was initiated with rapid resolution over a few days. Orbital imaging was unremarkable, and extensive laboratory work-up was positive only for antinuclear antibodies. The patient was diagnosed with idiopathic diffuse, nonnecrotizing anterior scleritis and has been followed for over 5 years without recurrence. The rheumatology clinic monitors the patient closely, as suspicion remains for potential arthralgias including human leukocyte antigen-B27-associated arthritis, lupus-associated arthritis, seronegative rheumatoid arthritis, recurrent juvenile idiopathic arthritis, and scleroderma, based on her constitutional symptoms and clinical presentation, along with a positive anti-nuclear antibody lab result.Conclusion: Untreated anterior scleritis can progress to formation of cataracts, glaucoma, uveitis, corneal melting, and posterior segment disease with significant risk of vision loss. Patients with anterior scleritis must be aggressively treated with systemic anti

  6. MR venography in cervical myelopathy before and after direct skull traction

    International Nuclear Information System (INIS)

    MR venography (MRV) was performed to evaluate the anterior cervical venous plexuses in five normal volunteers and eight patients with cervical myelopathy before and after direct skull traction. Visibility of the plexuses from C2 to C7 was evaluated and scored by five observers in those groups. The venography was performed with FISP sequences (fast imaging with steady state precession) and with the injection of Gd-derivatives. The MRV was obtained after maximum-intensity projection and 3D reconstruction. In the normal volunteers, the internal vertebral plexus (IVP), intervertebral vein (IV) and anastomotic vein (AV) were all well demonstrated. In the patients, those plexuses were less well demonstrated in comparison with the normal volunteer, particularly in C5 which is the most frequently affected area. The patient group had lower scores than the normal group. However, the score at C5 was not lower than those at non-affected sites. After treatment, MRV demonstrated those plexuses better in some cases of cervical myelopathy; although this was not evaluated statistically. (author)

  7. MR venography in cervical myelopathy before and after direct skull traction

    Energy Technology Data Exchange (ETDEWEB)

    Sekiguchi, Akira; Enomoto, Kyoko; Kato, Hiroshi [Saitama Medical School, Moroyama (Japan)

    1999-01-01

    MR venography (MRV) was performed to evaluate the anterior cervical venous plexuses in five normal volunteers and eight patients with cervical myelopathy before and after direct skull traction. Visibility of the plexuses from C2 to C7 was evaluated and scored by five observers in those groups. The venography was performed with FISP sequences (fast imaging with steady state precession) and with the injection of Gd-derivatives. The MRV was obtained after maximum-intensity projection and 3D reconstruction. In the normal volunteers, the internal vertebral plexus (IVP), intervertebral vein (IV) and anastomotic vein (AV) were all well demonstrated. In the patients, those plexuses were less well demonstrated in comparison with the normal volunteer, particularly in C5 which is the most frequently affected area. The patient group had lower scores than the normal group. However, the score at C5 was not lower than those at non-affected sites. After treatment, MRV demonstrated those plexuses better in some cases of cervical myelopathy; although this was not evaluated statistically. (author)

  8. Verifying three-dimensional skull model reconstruction using cranial index of symmetry.

    Directory of Open Access Journals (Sweden)

    Woon-Man Kung

    Full Text Available BACKGROUND: Difficulty exists in scalp adaptation for cranioplasty with customized computer-assisted design/manufacturing (CAD/CAM implant in situations of excessive wound tension and sub-cranioplasty dead space. To solve this clinical problem, the CAD/CAM technique should include algorithms to reconstruct a depressed contour to cover the skull defect. Satisfactory CAM-derived alloplastic implants are based on highly accurate three-dimensional (3-D CAD modeling. Thus, it is quite important to establish a symmetrically regular CAD/CAM reconstruction prior to depressing the contour. The purpose of this study is to verify the aesthetic outcomes of CAD models with regular contours using cranial index of symmetry (CIS. MATERIALS AND METHODS: From January 2011 to June 2012, decompressive craniectomy (DC was performed for 15 consecutive patients in our institute. 3-D CAD models of skull defects were reconstructed using commercial software. These models were checked in terms of symmetry by CIS scores. RESULTS: CIS scores of CAD reconstructions were 99.24±0.004% (range 98.47-99.84. CIS scores of these CAD models were statistically significantly greater than 95%, identical to 99.5%, but lower than 99.6% (p<0.001, p = 0.064, p = 0.021 respectively, Wilcoxon matched pairs signed rank test. These data evidenced the highly accurate symmetry of these CAD models with regular contours. CONCLUSIONS: CIS calculation is beneficial to assess aesthetic outcomes of CAD-reconstructed skulls in terms of cranial symmetry. This enables further accurate CAD models and CAM cranial implants with depressed contours, which are essential in patients with difficult scalp adaptation.

  9. Anterior hip pain.

    Science.gov (United States)

    O'Kane, J W

    1999-10-15

    Anterior hip pain is a common complaint with many possible causes. Apophyseal avulsion and slipped capital femoral epiphysis should not be overlooked in adolescents. Muscle and tendon strains are common in adults. Subsequent to accurate diagnosis, strains should improve with rest and directed conservative treatment. Osteoarthritis, which is diagnosed radiographically, generally occurs in middle-aged and older adults. Arthritis in younger adults should prompt consideration of an inflammatory cause. A possible femoral neck stress fracture should be evaluated urgently to prevent the potentially significant complications associated with displacement. Patients with osteitis pubis should be educated about the natural history of the condition and should undergo physical therapy to correct abnormal pelvic mechanics. "Sports hernias," nerve entrapments and labral pathologic conditions should be considered in athletic adults with characteristic presentations and chronic symptoms. Surgical intervention may allow resumption of pain-free athletic activity. PMID:10537384

  10. Trifocal distraction osteogenesis for reconstruction of skull defect

    Institute of Scientific and Technical Information of China (English)

    Ke Ke; Hai-Song Xu; Zhi-Hong Fan

    2013-01-01

    Objective:To apply trifocal distraction osteogenesis in canine model of skull segmental defects and to provide reference for clinical treatment. Methods:Six labrador dogs were selected in this study and divided into observation group and control group randomly. Each group contained 3 dogs. Skull segmental defects models were established by surgery, and dogs in bservation group received trifocal distraction osteogenesis treatment. Bone density was observed and compared between two groups during treatment. Results: There were no significant difference in bone density between two groups on th 1st day (P>0.05). The bone density of observation group on the 30th day, and 60th day were higher than that of control group (P<0.01). Conclusions: Trifocal distraction osteogenesis has significant clinical effect, and it would be widely used in clinical treatment.

  11. Reconstruction of skull defects in the middle ages and renaissance.

    Science.gov (United States)

    Missori, Paolo; Currà, Antonio; Paris, Harry S; Peschillo, Simone; Fattapposta, Francesco; Paolini, Sergio; Domenicucci, Maurizio

    2015-06-01

    In Egyptian, Greco-Roman, and Arabic medicine, the closure of a skull defect was not provided at the end of a therapeutic trepanation or in cases of bone removal. The literature from the Middle Ages and Renaissance disclosed some striking and forgotten practices. Gilbertus Anglicus (c. 1180 to c. 1250) cites the use of a piece of a cup made from wooden bowl (ciphum or mazer) or a gold sheet to cover the gap and protect the brain in these patients; this citation probably reflected a widely known folk practice. Pietro d'Argellata introduced the use of a fixed piece of dried gourd for brain protection to reconstruct a skull defect. In the late Renaissance, the negative folklore describing this outlandish practice likely led to the use of silver and lead sheets. Nevertheless, for centuries, large numbers of surgeons preferred to leave the dura mater uncovered after bone removal, and failed to apply any brain protection.

  12. A new skull of early Homo from Dmanisi, Georgia.

    Science.gov (United States)

    Vekua, Abesalom; Lordkipanidze, David; Rightmire, G Philip; Agusti, Jordi; Ferring, Reid; Maisuradze, Givi; Mouskhelishvili, Alexander; Nioradze, Medea; De Leon, Marcia Ponce; Tappen, Martha; Tvalchrelidze, Merab; Zollikofer, Christoph

    2002-07-01

    Another hominid skull has been recovered at Dmanisi (Republic of Georgia) from the same strata in which hominid remains have been reported previously. The Dmanisi site dated to approximately 1.75 million years ago has now produced craniofacial portions of several hominid individuals, along with many well-preserved animal fossils and quantities of stone artifacts. Although there are certain anatomical differences among the Dmanisi specimens, the hominids do not clearly represent more than one taxon. We assign the new skull provisionally to Homo erectus (=ergaster). The Dmanisi specimens are the most primitive and small-brained fossils to be grouped with this species or any taxon linked unequivocally with genus Homo and also the ones most similar to the presumed habilis-like stem. We suggest that the ancestors of the Dmanisi population dispersed from Africa before the emergence of humans identified broadly with the H. erectus grade. PMID:12098694

  13. Reconstruction of skull defects in the middle ages and renaissance.

    Science.gov (United States)

    Missori, Paolo; Currà, Antonio; Paris, Harry S; Peschillo, Simone; Fattapposta, Francesco; Paolini, Sergio; Domenicucci, Maurizio

    2015-06-01

    In Egyptian, Greco-Roman, and Arabic medicine, the closure of a skull defect was not provided at the end of a therapeutic trepanation or in cases of bone removal. The literature from the Middle Ages and Renaissance disclosed some striking and forgotten practices. Gilbertus Anglicus (c. 1180 to c. 1250) cites the use of a piece of a cup made from wooden bowl (ciphum or mazer) or a gold sheet to cover the gap and protect the brain in these patients; this citation probably reflected a widely known folk practice. Pietro d'Argellata introduced the use of a fixed piece of dried gourd for brain protection to reconstruct a skull defect. In the late Renaissance, the negative folklore describing this outlandish practice likely led to the use of silver and lead sheets. Nevertheless, for centuries, large numbers of surgeons preferred to leave the dura mater uncovered after bone removal, and failed to apply any brain protection. PMID:25403799

  14. MASTICATORY MUSCLES AND THE SKULL: A COMPARATIVE PERSPECTIVE

    OpenAIRE

    Herring, Susan W.

    2006-01-01

    Masticatory muscles are anatomically and functionally complex in all mammals, but relative sizes, orientation of action lines, and fascial subdivisions vary greatly among different species in association with their particular patterns of occlusion and jaw movement. The most common contraction pattern for moving the jaw laterally involves a force couple of protrusor muscles on one side and retrusors on the other. Such asymmetrical muscle usage sets up torques on the skull and combines with occ...

  15. Directional and fluctuating asymmetries in domestic sheep skulls

    OpenAIRE

    Parés Casanova, Pere-Miquel; Bravi, R.

    2014-01-01

    Morphological symmetry and asymmetry of three different sheep geographical populations (n=39), managed under semi-extensive conditions, were decomposed using geometric morphometric methods, on dorsal aspect of skulls. Fluctuating asymmetry (FA) was used as an indicator of environmental stress, and directional asymmetry (DA) as biomechanical constraints. The two-dimensional coordinates of 21 landmarks were digitized and analyzed using geometric morphometrics. Multivariate analyses show ed the ...

  16. Directional and fluctuating asymmetries in domestic pig skulls

    OpenAIRE

    Parés Casanova, Pere-Miquel; Esteve-Puig, C.

    2014-01-01

    Morphological symmetry and asymmetry of skulls of domestic pig (n=29) were studied using geometric morphometric (GM) methods on the ventral aspect. Fluctuating asymmetry (FA) was used as an indicator of environmental stress, and directional asymmetry as a biomechanical constraint. The two-dimensional coordinates of 27 landmarks were digitized and analysed using GM. Multivariate analyses showed the presence of subtle but significant FA in the entire sample, and distinctive differences were det...

  17. Morphometric Study on Foramen Magnum of Human Skulls

    OpenAIRE

    2013-01-01

    We utilized 100 human skulls to study the morphology and morphometric parameters of the foramen magnum in south Indian population. The anteroposterior diameter and transverse diameter of the foramen magnum were measured by using Vernier calliper to the nearest millimetre. All measurements were tabulated followed by student t” test and descriptive statistics were done in SPSS version to know the p” value for the significance. The mean anteroposterior diameter of foramen magnum in males was...

  18. Streamlined, Inexpensive 3D Printing of the Brain and Skull.

    Science.gov (United States)

    Naftulin, Jason S; Kimchi, Eyal Y; Cash, Sydney S

    2015-01-01

    Neuroimaging technologies such as Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) collect three-dimensional data (3D) that is typically viewed on two-dimensional (2D) screens. Actual 3D models, however, allow interaction with real objects such as implantable electrode grids, potentially improving patient specific neurosurgical planning and personalized clinical education. Desktop 3D printers can now produce relatively inexpensive, good quality prints. We describe our process for reliably generating life-sized 3D brain prints from MRIs and 3D skull prints from CTs. We have integrated a standardized, primarily open-source process for 3D printing brains and skulls. We describe how to convert clinical neuroimaging Digital Imaging and Communications in Medicine (DICOM) images to stereolithography (STL) files, a common 3D object file format that can be sent to 3D printing services. We additionally share how to convert these STL files to machine instruction gcode files, for reliable in-house printing on desktop, open-source 3D printers. We have successfully printed over 19 patient brain hemispheres from 7 patients on two different open-source desktop 3D printers. Each brain hemisphere costs approximately $3-4 in consumable plastic filament as described, and the total process takes 14-17 hours, almost all of which is unsupervised (preprocessing = 4-6 hr; printing = 9-11 hr, post-processing = Printing a matching portion of a skull costs $1-5 in consumable plastic filament and takes less than 14 hr, in total. We have developed a streamlined, cost-effective process for 3D printing brain and skull models. We surveyed healthcare providers and patients who confirmed that rapid-prototype patient specific 3D models may help interdisciplinary surgical planning and patient education. The methods we describe can be applied for other clinical, research, and educational purposes.

  19. Streamlined, Inexpensive 3D Printing of the Brain and Skull.

    Directory of Open Access Journals (Sweden)

    Jason S Naftulin

    Full Text Available Neuroimaging technologies such as Magnetic Resonance Imaging (MRI and Computed Tomography (CT collect three-dimensional data (3D that is typically viewed on two-dimensional (2D screens. Actual 3D models, however, allow interaction with real objects such as implantable electrode grids, potentially improving patient specific neurosurgical planning and personalized clinical education. Desktop 3D printers can now produce relatively inexpensive, good quality prints. We describe our process for reliably generating life-sized 3D brain prints from MRIs and 3D skull prints from CTs. We have integrated a standardized, primarily open-source process for 3D printing brains and skulls. We describe how to convert clinical neuroimaging Digital Imaging and Communications in Medicine (DICOM images to stereolithography (STL files, a common 3D object file format that can be sent to 3D printing services. We additionally share how to convert these STL files to machine instruction gcode files, for reliable in-house printing on desktop, open-source 3D printers. We have successfully printed over 19 patient brain hemispheres from 7 patients on two different open-source desktop 3D printers. Each brain hemisphere costs approximately $3-4 in consumable plastic filament as described, and the total process takes 14-17 hours, almost all of which is unsupervised (preprocessing = 4-6 hr; printing = 9-11 hr, post-processing = <30 min. Printing a matching portion of a skull costs $1-5 in consumable plastic filament and takes less than 14 hr, in total. We have developed a streamlined, cost-effective process for 3D printing brain and skull models. We surveyed healthcare providers and patients who confirmed that rapid-prototype patient specific 3D models may help interdisciplinary surgical planning and patient education. The methods we describe can be applied for other clinical, research, and educational purposes.

  20. Ground truth data generation for skull-face overlay.

    Science.gov (United States)

    Ibáñez, O; Cavalli, F; Campomanes-Álvarez, B R; Campomanes-Álvarez, C; Valsecchi, A; Huete, M I

    2015-05-01

    Objective and unbiased validation studies over a significant number of cases are required to get a more solid picture on craniofacial superimposition reliability. It will not be possible to compare the performance of existing and upcoming methods for craniofacial superimposition without a common forensic database available for the research community. Skull-face overlay is a key task within craniofacial superimposition that has a direct influence on the subsequent task devoted to evaluate the skull-face relationships. In this work, we present the procedure to create for the first time such a dataset. We have also created a database with 19 skull-face overlay cases for which we are trying to overcome legal issues that allow us to make it public. The quantitative analysis made in the segmentation and registration stages, together with the visual assessment of the 19 face-to-face overlays, allows us to conclude that the results can be considered as a gold standard. With such a ground truth dataset, a new horizon is opened for the development of new automatic methods whose performance could be now objectively measured and compared against previous and future proposals. Additionally, other uses are expected to be explored to better understand the visual evaluation process of craniofacial relationships in craniofacial identification. It could be very useful also as a starting point for further studies on the prediction of the resulting facial morphology after corrective or reconstructive interventionism in maxillofacial surgery.

  1. Preliminary report: The Little Skull Mountain earthquake, June 29, 1992

    International Nuclear Information System (INIS)

    The Little Skull Mountain earthquake occurred about 20 km from the potential high level nuclear repository at Yucca Mountain. The magnitude was 5.6, and the focal mechanism indicates normal faulting on a northeast trending structure. There is evidence that the earthquake was triggered by the magnitude MS = 7.5 earthquake in Landers, California, which occurred less than 24 hours earlier. Preliminary locations of the hypocenter and several aftershocks define an L shaped pattern near the southern boundary of the Nevada Test Site. One arm trends to the northeast beneath Little Skull Mountain, and a shorter, more diffuse zone trends to the southeast. The aftershocks are mostly located at depths between 7 km and 11 km, and may suggest a southeast dipping plane. There is no clear correlation with previously mapped surface faulting. The strongest recorded acceleration is about 0.21 g at Lathrop Wells, Nevada, 15 km from the epicenter. An extensive network of aftershock recorders was installed by the Seismological Laboratory, University of Nevada, Reno, by the US Geological Survey, Golden, Colorado, and by Lawrence Livermore Laboratory, Livermore, California. Aftershock experiments are ongoing as of November, 1992, and include experiments to improve location, depth, focal mechanism, and stress drop, study basin and ridge response near the epicenter and at Midway Valley, and study response of a tunnel at Little Skull Mountain. Analysis of this data, which includes thousands of aftershocks, has only begun

  2. Assessment of the role of sutures in a lizard skull: a computer modelling study.

    Science.gov (United States)

    Moazen, Mehran; Curtis, Neil; O'Higgins, Paul; Jones, Marc E H; Evans, Susan E; Fagan, Michael J

    2009-01-01

    Sutures form an integral part of the functioning skull, but their role has long been debated among vertebrate morphologists and palaeontologists. Furthermore, the relationship between typical skull sutures, and those involved in cranial kinesis, is poorly understood. In a series of computational modelling studies, complex loading conditions obtained through multibody dynamics analysis were imposed on a finite element model of the skull of Uromastyx hardwickii, an akinetic herbivorous lizard. A finite element analysis (FEA) of a skull with no sutures revealed higher patterns of strain in regions where cranial sutures are located in the skull. From these findings, FEAs were performed on skulls with sutures (individual and groups of sutures) to investigate their role and function more thoroughly. Our results showed that individual sutures relieved strain locally, but only at the expense of elevated strain in other regions of the skull. These findings provide an insight into the behaviour of sutures and show how they are adapted to work together to distribute strain around the skull. Premature fusion of one suture could therefore lead to increased abnormal loading on other regions of the skull causing irregular bone growth and deformities. This detailed investigation also revealed that the frontal-parietal suture of the Uromastyx skull played a substantial role in relieving strain compared with the other sutures. This raises questions about the original role of mesokinesis in squamate evolution.

  3. Mechanical characterization of bone anchors used with a bone-attached, parallel robot for skull surgery.

    Science.gov (United States)

    Kobler, Jan-Philipp; Prielozny, Lenka; Lexow, G Jakob; Rau, Thomas S; Majdani, Omid; Ortmaier, Tobias

    2015-05-01

    Bone-attached robots and microstereotactic frames, intended for deep brain stimulation and minimally invasive cochlear implantation, typically attach to a patient's skull via bone anchors. A rigid and reliable link between such devices and the skull is mandatory in order to fulfill the high accuracy demands of minimally invasive procedures while maintaining patient safety. In this paper, a method is presented to experimentally characterize the mechanical properties of the anchor-bone linkage. A custom-built universal testing machine is used to measure the pullout strength as well as the spring constants of bone anchors seated in four different bone substitutes as well as in human cranial bone. Furthermore, the angles at which forces act on the bone anchors are varied to simulate realistic conditions. Based on the experimental results, a substitute material that has mechanical properties similar to those of cranial bone is identified. The results further reveal that the pullout strength of the investigated anchor design is sufficient with respect to the proposed application. However, both the measured load capacity as well as the spring constants vary depending on the load angles. Based on these findings, an alternative bone anchor design is presented and experimentally validated. Furthermore, the results serve as a basis for stiffness simulation and optimization of bone-attached microstereotactic frames. PMID:25771430

  4. Psychological Aspects of Anterior Cruciate Ligament Injuries

    OpenAIRE

    Ardern, Clare; Kvist, Joanna; Webster, Kate E.

    2016-01-01

    Impairment-based evaluation has, until recently, been the mainstay of orthopaedic research in anterior cruciate ligament (ACL) reconstruction. However, participation-based outcomes, in particular returning to sport, have lately garnered increased research attention. This is important because returning to sport is typically a main concern of injured athletes. Recent metaanalyses have demonstrated that the return to sport rate after ACL reconstruction is disappointingly low, and that a range of...

  5. Method for measuring anterior chamber volume by image analysis

    Science.gov (United States)

    Zhai, Gaoshou; Zhang, Junhong; Wang, Ruichang; Wang, Bingsong; Wang, Ningli

    2007-12-01

    Anterior chamber volume (ACV) is very important for an oculist to make rational pathological diagnosis as to patients who have some optic diseases such as glaucoma and etc., yet it is always difficult to be measured accurately. In this paper, a method is devised to measure anterior chamber volumes based on JPEG-formatted image files that have been transformed from medical images using the anterior-chamber optical coherence tomographer (AC-OCT) and corresponding image-processing software. The corresponding algorithms for image analysis and ACV calculation are implemented in VC++ and a series of anterior chamber images of typical patients are analyzed, while anterior chamber volumes are calculated and are verified that they are in accord with clinical observation. It shows that the measurement method is effective and feasible and it has potential to improve accuracy of ACV calculation. Meanwhile, some measures should be taken to simplify the handcraft preprocess working as to images.

  6. Spontaneous extradural hemorrhage due to Langerhans cell histiocytosis of the skull in a child: A rare presentation

    Science.gov (United States)

    Bakhaidar, Mohamad G.; Alghamdi, Fahad A.; Baeesa, Saleh S.

    2016-01-01

    Eosinophilic granuloma (EG) represents a local form of Langerhans cell histiocytosis that occurs mostly in children. It usually presents with a gradually enlarging painless skull mass, and rarely presents a rapid clinical deterioration. This 7-year-old boy who was diagnosed with EG, based on a magnetic resonance imaging scan, after presenting with a painless right parietal swelling of 7-week duration. Three weeks prior his scheduled surgery, he presented to the emergency department with a 2-day history of sudden increased of the subcutaneous swelling associated with a headache, vomiting, and decreased the level of consciousness; there was no history of trauma. Brain computed tomography revealed a right parietal bone defect with large subgaleal and extradural hematoma. He underwent emergent surgical excision of the skull lesion and evacuation of the hematoma. Histopathological examination confirmed the diagnosis of EG. We aim to raise the awareness of physicians of this rare spontaneous hemorrhagic complication of EG and review the literature. PMID:27195034

  7. Human skulls with turquoise inlays: pre hispanic origin or replicas?; Craneos humanos con teselas de turquesa: origen prehispanico o replicas?

    Energy Technology Data Exchange (ETDEWEB)

    Silva V, Y. [FIME-UANL, Pedro A. del Alba s/n, Ciudad Universitaria, San Nicolas de los Garza, Nuevo Leon (Mexico); Castillo M, M.T.; Bautista M, J.P. [DRPMZA/INAH. Direccion de Registro Publico de Monumentos y Zonas Arqueologicas, Victoria 110, Copilco El Bajo, 04340 Mexico D.F. (Mexico); Arenas A, J. [IFUNAM, Circuito de la Investigacion Cientifica s/n, Ciudad Universitaria, 04510 Mexico D.F. (Mexico)]. e-mail: ysilva@fisica.unam.mx

    2006-07-01

    The lack of archaeological context determining if the manufacture of two human skulls adorned with turquoise inlays have pre-Columbian origin or not (replicas), led to perform other studies. Under these conditions, besides orthodox methodology commonly used to assign chronology and cultural aspects as form, style, decoration, iconography, etc., it was necessary to obtain more results based on the use of characterization techniques. The techniques employed were Scanning Electron Microscopy (SEM), X-Ray Energy Dispersive Spectroscopy (EDS), Transmission Electron Microscopy (TEM) and Fourier Transform Infrared Spectroscopy (FTIR), in order to determine the manufacture techniques and chemical composition of the materials used for the cementant. SEM analysis showed the presence of zones composed by Ca, O, C and Al. In some cases Mg, Cl, Fe and Pb were identified. High concentration of Cu was present in all samples, due to residues of turquoise inlays (CuAI{sub 6}(PO{sub 4}){sub 4}(OH){sub 8}(H{sub 2}O){sub 4}) with which the skulls were decorated. In the cementant was identified the Ca as base element of the cementant, as well as particles < 100 nm with irregular morphology and other amorphous zones. FTIR spectrums indicated the presence of organic substances that could be used as agglutinating in the cementant. The current work shows a progress identifying involved techniques in the manufacturing of two human skulls with turquoise inlays. (Author)

  8. Experimental Study of the Protrusion of the Dura Mater at Skull-base Defects%颅底骨缺损硬脑膜膨出的实验研究

    Institute of Scientific and Technical Information of China (English)

    宋冬雷; 丁祖荣; 周良辅; 李士其

    2001-01-01

    目的:建立颅底缺损硬脑膜膨出量评估公式,为临床颅底缺损重建提供科学实验依据。方法:通过力学蠕变挠度分析,得到预计硬脑膜膨出量的力学计算公式,设计相应的力学模拟实验和动物实验加以验证。结果:力学模拟实验及动物实验证明通过力学分析得到的公式是基本正确的。结论:我们建立的颅底骨缺损硬脑膜膨出量评估公式,可以用来预测硬脑膜及其替代物膨出量的动态变化。%Aim:To establish the biomechanical assessment formula that predicts protrusion ofthe dura mater at the cranial base bone defect, and provide scientific experimental basis for cranial base defect reconstruction. Methods: The biomeehanical formula is established by using the creep reflecton analysis and validated by the simulated test and animal expeximents. Results: The simulated test and animal experiments reveal that biomechanical formula is right. Conclusion: The biomechanical formula can be used to predict the dynamic change of protrusion of the dura mater as well as its substitutes at different sizes of cranial base bone defects.

  9. Intact skull chronic windows for mesoscopic wide-field imaging in awake mice

    Science.gov (United States)

    Silasi, Gergely; Xiao, Dongsheng; Vanni, Matthieu P.; Chen, Andrew C. N.; Murphy, Timothy H.

    2016-01-01

    Background Craniotomy-based window implants are commonly used for microscopic imaging, in head-fixed rodents, however their field of view is typically small and incompatible with mesoscopic functional mapping of cortex. New Method We describe a reproducible and simple procedure for chronic through-bone wide-field imaging in awake head-fixed mice providing stable optical access for chronic imaging over large areas of the cortex for months. Results The preparation is produced by applying clear-drying dental cement to the intact mouse skull, followed by a glass coverslip to create a partially transparent imaging surface. Surgery time takes about 30 minutes. A single set-screw provides a stable means of attachment for mesoscale assessment without obscuring the cortical field of view. Comparison with Existing Methods We demonstrate the utility of this method by showing seed-pixel functional connectivity maps generated from spontaneous cortical activity of GCAMP6 signals in both awake and anesthetized mice. Conclusions We propose that the intact skull preparation described here may be used for most longitudinal studies that do not require micron scale resolution and where cortical neural or vascular signals are recorded with intrinsic sensors. PMID:27102043

  10. [Early Stages of Skull Embryogenesis in the Grass Snake, Natrix natrix (Serpentes, Colubridae)].

    Science.gov (United States)

    Kovtun, M F; Sheverdyukova, H V

    2015-01-01

    Studies of previous authors on snake skull embryogenesis have been performed on embryos obtained from eggs after oviposition. The aim of this study was to investigate the initial stages of chondrocranium development in Grass-snake Natrixnatrix Linnaeus, 1758, embryos before oviposition. Natrix natrix embryos at early developmental stages (24-27 according to the table of normal development by D. Zehr (1962)) were obtained by means of caesarean section. At developmental stages 25-27, previously undescribed structures were found in the region of future skull formation. These structures exist during one or two stages and then disappear. Therefore, we call them "temporary structures." The assumption about the nature of these structures is based on their topography and comparison with the structures of developing or fully formed chondrocranium in other vertebrates. It is hypothesized that the temporary structures in Natrix natrix chondrocranium are vestiges ofprimary chondrocranium of ancestral vertebrate forms, and they indicate the existence of several variants in the formation of chondrocranium in the historical vertebrates.' development.

  11. Through Skull Fluorescence Imaging of the Brain in a New Near-Infrared Window

    CERN Document Server

    Hong, Guosong; Chang, Junlei; Antaris, Alexander L; Chen, Changxin; Zhang, Bo; Zhao, Su; Atochin, Dmitriy N; Huang, Paul L; Andreasson, Katrin I; Kuo, Calvin J; Dai, Hongjie

    2014-01-01

    To date, brain imaging has largely relied on X-ray computed tomography and magnetic resonance angiography with limited spatial resolution and long scanning times. Fluorescence-based brain imaging in the visible and traditional near-infrared regions (400-900 nm) is an alternative but currently requires craniotomy, cranial windows and skull thinning techniques, and the penetration depth is limited to 1-2 mm due to light scattering. Here, we report through-scalp and through-skull fluorescence imaging of mouse cerebral vasculature without craniotomy utilizing the intrinsic photoluminescence of single-walled carbon nanotubes in the 1.3-1.4 micrometre near-infrared window. Reduced photon scattering in this spectral region allows fluorescence imaging reaching a depth of >2 mm in mouse brain with sub-10 micrometre resolution. An imaging rate of ~5.3 frames/s allows for dynamic recording of blood perfusion in the cerebral vessels with sufficient temporal resolution, providing real-time assessment of blood flow anomaly...

  12. A rapid and reversible skull optical clearing method for monitoring cortical blood flow

    Science.gov (United States)

    Zhang, Chao; Zhao, Yanjie; Shi, Rui; Zhu, Dan

    2016-03-01

    In vivo cortex optical imaging is of great important for revealing both structural and functional architecture of brain with high temporal-spatial resolution. To reduce the limitation of turbid skull, researchers had to establish various skull windows or directly expose cortex through craniotomy. Here we developed a skull optical clearing method to make skull transparent. Laser speckle contrast imaging technique was used to monitor the cortical blood flow after topical treatment with the optical clearing agents. The results indicated that the image contrast increased gradually, and then maintained at a high level after 15 min for adult mice, which made the image quality and resolution of micro-vessels nearly approximate to those of exposed cortex. Both the cortical blood flow velocity almost kept constant after skull became transparent. Besides, the treatment of physiological saline on the skull could make skull return to the initial state again and the skull could become transparent again when SOCS retreated it. Thus, we could conclude that the skull optical clearing method was rapid, valid, reversible and safe, which provided us available approach for performing the cortical structural and functional imaging at high temporal-spatial resolution.

  13. Contributions to the functional morphology of caudate skulls: kinetic and akinetic forms.

    Science.gov (United States)

    Natchev, Nikolay; Handschuh, Stephan; Lukanov, Simeon; Tzankov, Nikolay; Naumov, Borislav; Werneburg, Ingmar

    2016-01-01

    A strongly ossified and rigid skull roof, which prevents parietal kinesis, has been reported for the adults of all amphibian clades. Our μ-CT investigations revealed that the Buresch's newt (Triturus ivanbureschi) possess a peculiar cranial construction. In addition to the typical amphibian pleurokinetic articulation between skull roof and palatoquadrate associated structures, we found flexible connections between nasals and frontals (prokinesis), vomer and parasphenoid (palatokinesis), and between frontals and parietals (mesokinesis). This is the first description of mesokinesis in urodelans. The construction of the skull in the Buresch's newts also indicates the presence of an articulation between parietals and the exocipitals, discussed as a possible kind of metakinesis. The specific combination of pleuro-, pro-, meso-, palato-, and metakinetic skull articulations indicate to a new kind of kinetic systems unknown for urodelans to this date. We discuss the possible neotenic origin of the skull kinesis and pose the hypothesis that the kinesis in T. ivanbureschi increases the efficiency of fast jaw closure. For that, we compared the construction of the skull in T. ivanbureschi to the akinetic skull of the Common fire salamander Salamandra salamandra. We hypothesize that the design of the skull in the purely terrestrial living salamander shows a similar degree of intracranial mobility. However, this mobility is permitted by elasticity of some bones and not by true articulation between them. We comment on the possible relation between the skull construction and the form of prey shaking mechanism that the species apply to immobilize their victims.

  14. Cerebral Venous Air Embolism due to a Hidden Skull Fracture Secondary to Head Trauma

    Directory of Open Access Journals (Sweden)

    Ai Hosaka

    2015-01-01

    Full Text Available Cerebral venous air embolism is sometimes caused by head trauma. One of the paths of air entry is considered a skull fracture. We report a case of cerebral venous air embolism following head trauma. The patient was a 55-year-old man who fell and hit his head. A head computed tomography (CT scan showed the air in the superior sagittal sinus; however, no skull fractures were detected. Follow-up CT revealed a fracture line in the right temporal bone. Cerebral venous air embolism following head trauma might have occult skull fractures even if CT could not show the skull fractures.

  15. Anterior Decompression and Anterior Instrumentation of Tuberculosis of Cervicothoracic Spine by Cervicomanubrial Approach

    Directory of Open Access Journals (Sweden)

    Anant Kumar Garg

    2012-04-01

    Full Text Available Background: Evaluation of result of anterior cervical approach with manubriotomy and anterior instrumentation in tuberculosis of cervicothoracic spine in terms of the neurological recovery, reconstruction of spine and prevention of deformity along with relief of pain. Materials and Methods: All five patients with cervicothoracic caries spine had surgery through anterior cervical approach with manubriotomy in our hospital and underwent excision of the involved vertebrae and intervertebral discs followed by anterior spinal reconstruction with titanium spacer cage filled with cancellous iliac crest bone graft and Orion plate with locking screw. Antitubercular drugs were administered for 12 months. The follow-up period ranged from 12 to 36 months. Results: Analysis of result was done on the basis of clinical and radiological criteria. Clinical assessment based on Frankel grade and modified JOA score showed significant improvement from preoperative findings. Radiological assessment showed osteointegration, no spinal instability and no progression of the deformity. The pain control, based on visual analog scale changed from a pre-operative average of 7.5 to 2 at the last follow-up thereby indicating significant improvement and all patients returned to preoperative functional status. One patient had transient hoarseness of voice. No other complication had been encountered in the immediate post operative and during the follow-up period. Conclusions: Our study showed that anterior cervical approach with manubriotomy and anterior insertion of titanium cage, filled with autogenous bone graft, secured with locking plate instrumentation has a successful role in the eradication of infection, neurological recovery, segmental spinal reconstruction and it also reduces surgical time, blood loss, and surgical complications and approach related comorbidity in follow up period. Level of Evidence- Level 4, Case series

  16. Multidisciplinary management of anterior diastemata

    DEFF Research Database (Denmark)

    Furuse, Adilson Yoshio; Herkrath, Fernando José; Franco, Eduardo Jacomino;

    2007-01-01

    the aesthetic results when orthodontic therapy itself is not feasible. This article presents integrated orthodonticrestorative solutions of anterior diastemata, associated with the conditioning of the gingival tissue with composite resin, and discusses the most relevant aspects related to their etiology...

  17. Anterior approach for knee arthrography

    International Nuclear Information System (INIS)

    Objective. To develop a new method of magnetic resonance arthrography (MRA) of the knee using an anterior approach analogous to the portals used for knee arthroscopy.Design. An anterior approach to the knee joint was devised mimicking anterior portals used for knee arthroscopy. Seven patients scheduled for routine knee MRA were placed in a decubitus position and under fluoroscopic guidance a needle was advanced from a position adjacent to the patellar tendon into the knee joint. After confirmation of the needle tip location, a dilute gadolinium solution was injected.Results and conclusion. All the arthrograms were technically successful. The anterior approach to knee MRA has greater technical ease than the traditional approach with little patient discomfort. (orig.)

  18. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... Taperloc Microplasty stem and E-poly antioxidant-infused technology during a hip replacement through the anterior supine ... renewed interest at this time due to several advantages that it brings. The approach that is performed ...

  19. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... it to have any real negative or deleterious effect by removing the anterior capsule. Now I would ... is what happens with one of the competitive designs. Like I told you, I just take a ...

  20. The use of surgical navigation system in brachytherapy of tumors in orbital apex and skull base%手术导航系统辅助下放射粒子植入治疗眶尖周、颅底肿瘤的探索

    Institute of Scientific and Technical Information of China (English)

    任仪鹏; 步荣发; 张蕾; 黄雪蕾

    2012-01-01

    PURPOSE:The aim of this study was to find a more precise and safe way to implant radioactive particles into the cranial base and orbital regions using the operation navigation system. METHODS: Eleven patients with invasive adenoid cystic carcinoma of the cranial base and orbital apex and a history of multiple surgeries were selected. A preoperative magnetic resonance scan was performed and the German BrainLAB surgical navigation system was used to aid the surgery. RESULTS:No intracranial injury or visual impairment occurred, and the response rate was 100%. CONCLUSION:This study indicates that the implantation of radioactive particles using the operation navigation system was an effective and safe method for treating tumors in the skull base and orbital apex, and should be considered for clinical use.%目的:将手术导航系统与放射性粒子内照射治疗相结合,探索更高精度植入125I放射粒子的方法,从而更加安全有效地控制已累及颅底及眶尖周的口腔颌面部恶性肿瘤.方法:肿瘤侵及颅底、眶尖周的腺样囊性癌患者11例,术前进行MRI扫描.术中运用BrainLAB手术导航系统定位并引导手术进行.结果:术中避免了颅脑及眶内组织损伤.完成了放射粒子组织内均匀分布,定位准确,无一例出现颅脑损伤及视力影响,治疗有效率(response rate,RR)达100%,疗效确切.结论:手术导航系统辅助下进行颅底眶尖周放射粒子植入是精确、安全的,有条件的情况下可考虑采用.

  1. Update on anterior ankle impingement

    OpenAIRE

    Vaseenon, Tanawat; Amendola, Annunziato

    2012-01-01

    Anterior ankle impingement results from an impingement of the ankle joint by a soft tissue or osteophyte formation at the anterior aspect of the distal tibia and talar neck. It often occurs secondary to direct trauma (impaction force) or repetitive ankle dorsiflexion (repetitive impaction and traction force). Chronic ankle pain, swelling, and limitation of ankle dorsiflexion are common complaints. Imaging is valuable for diagnosis of the bony impingement but not for the soft tissue impingemen...

  2. [Paleopathology of deafness: skulls of the Dupuytren Museum].

    Science.gov (United States)

    Benmoussa, Nadia; Muller, A -L; Kerner, J; Josset, P; Conan, P; Charlier, P

    2015-01-01

    In the 18th and 19th centuries, the Dupuytren Museum was indispensable for the knowledge of pathological anatomy for physicians and surgeons. Nowadays, it is more a museum than a learning unit, but it provides an opportunity to understand through numerous scientific studies the origin of diseases, injuries mechanism and the functional consequences of which could suffer some patients. This study illustrates the interest of the study on pieces in pathological anatomy's museums, this time across selected skulls which belonged to hearing loss people. bizarre.

  3. Telangiectatic osteosarcoma of the skull. A post-Paget case.

    Science.gov (United States)

    Donato, G; Lavano, A; Volpentesta, G; Chirchiglia, D; Veraldi, A; De Rose, F; Iannello, A N; Stroscio, C; Signorelli, C D

    1997-01-01

    We report a case of post-Paget telangiectatic osteosarcoma of the skull in a 75-year-old woman. Such a neoplasia is a rare variant of osteosarcoma, a tumor rare in the cranic bones. The patient was submitted for a careful analysis by the following procedures: technetium scintigram, X-rays, CT scan, and MRI. After the surgical procedure, pathological examination confirmed the diagnosis. Both radiological and pathological pattern of this tumor are discussed in relation to the differential diagnosis. Our report shows that benign lesions may represent a possible cause of diagnostic errors. They must be excluded by histological analysis.

  4. Anterior chamber depth during hemodialysis

    Directory of Open Access Journals (Sweden)

    Gracitelli CPB

    2013-08-01

    Full Text Available Carolina Pelegrini Barbosa Gracitelli,1 Francisco Rosa Stefanini,1 Fernando Penha,1 Miguel Ângelo Góes,2 Sérgio Antonio Draibe,2 Maria Eugênia Canziani,2 Augusto Paranhos Junior1 1Ophthalmology Department, 2Division of Nephrology, Federal University of São Paulo – UNIFESP, São Paulo, Brazil Background: Exacerbation of chronic glaucoma or acute glaucoma is occasionally observed in patients undergoing hemodialysis (HD because of anterior chamber depth changes during this therapy. Purpose: To evaluate anterior chamber depth and axial length in patients during HD sessions. Methods: A total of 67 eyes of 35 patients were prospectively enrolled. Axial length and anterior chamber depth were measured using ultrasonic biometry, and these measures were evaluated at three different times during HD sessions. Body weight and blood pressure pre- and post-HD were also measured. Results: There was no difference in the axial length between the three measurements (P = 0.241. We observed a significantly decreased anterior chamber depth (P = 0.002 during HD sessions. Conclusion: Our results support the idea that there is a change in anterior chamber depth in HD sessions. Keywords: anterior chamber, hemodialysis, axial length, acute angle-closure glaucoma

  5. Does skull morphology constrain bone ornamentation? A morphometric analysis in the Crocodylia.

    Science.gov (United States)

    Clarac, F; Souter, T; Cubo, J; de Buffrénil, V; Brochu, C; Cornette, R

    2016-08-01

    Previous quantitative assessments of the crocodylians' dermal bone ornamentation (this ornamentation consists of pits and ridges) has shown that bone sculpture results in a gain in area that differs between anatomical regions: it tends to be higher on the skull table than on the snout. Therefore, a comparative phylogenetic analysis within 17 adult crocodylian specimens representative of the morphological diversity of the 24 extant species has been performed, in order to test if the gain in area due to ornamentation depends on the skull morphology, i.e. shape and size. Quantitative assessment of skull size and shape through geometric morphometrics, and of skull ornamentation through surface analyses, produced a dataset that was analyzed using phylogenetic least-squares regression. The analyses reveal that none of the variables that quantify ornamentation, be they on the snout or the skull table, is correlated with the size of the specimens. Conversely, there is more disparity in the relationships between skull conformations (longirostrine vs. brevirostrine) and ornamentation. Indeed, both parameters GApit (i.e. pit depth and shape) and OArelat (i.e. relative area of the pit set) are negatively correlated with snout elongation, whereas none of the values quantifying ornamentation on the skull table is correlated with skull conformation. It can be concluded that bone sculpture on the snout is influenced by different developmental constrains than on the skull table and is sensible to differences in the local growth 'context' (allometric processes) prevailing in distinct skull parts. Whatever the functional role of bone ornamentation on the skull, if any, it seems to be restricted to some anatomical regions at least for the longirostrine forms that tend to lose ornamentation on the snout. PMID:27061077

  6. Osteoradionecrosis of the skull after radiation therapy for invasive carcinoma.

    Science.gov (United States)

    Nguyen, Michaela T; Billington, Alicia; Habal, Mutaz B

    2011-09-01

    Osteoradionecrosis (ORN) of the skull is a rare but fatal complication of radiation therapy for the treatment of head and neck malignancies. The pathogenesis of ORN follows the "3Hs Theory" proposed by Marx (J Oral Maxillofac Surg 1983;41:283-288) in which radiation induces tissue injury by causing vessel thrombosis (hypovascularity), which leads to hypoxia, and results in cell death of the skin and the underlying structure of the bony element (hypocellularity) including the deep visceral structures. This note details a patient with severe and extensive ORN of the parietooccipital region of the skull because of a large dose of radiation therapy for the treatment of an invasive basal cell carcinoma of the scalp. The patient's condition was further complicated by an extensive infection with methicillin-resistant Staphylococcus aureus, which leads to meningitis and cerebral edema as well as cerebritis. The patient was successfully treated with interdisciplinary medical and surgical aggressive therapy and radical procedures involving 4 separate trips to the operating room for an 18-month period. Success was achieved because of early clinical diagnosis of ORN, aggressive eradication of infected and necrotic tissues including the brain, and restoration of functioning and viable tissues through the use of local flaps to change an open wound to a closed wound. PMID:21959411

  7. High rate properties of porcine skull bone tissue

    Science.gov (United States)

    Herwig, Kyle Jeffry

    Several recent studies have shown the importance of understanding the nature of blast injuries. Traditionally, the lungs and other air filled organs were the focus of these injuries but it is being discovered that some level of brain trauma may result after encountering a blast. These injuries are referred to as traumatic brain injuries, or TBI. There has been many clinical studies and statistical analyses done concerning these injuries, but there is still no physical understanding of the problem. In order to develop a model of how this injury can occur, rate dependent material properties of the tissues the stress wave will travel through are needed. In this study, the compressive response of porcine skull bone through the thickness direction was experimentally determined over a wide range of rates, ranging from 0.001 sec -1 to approximately 3000 sec-1. The results reveal that for most mechanical properties there is a clear rate dependence of the material. However, only one subset of the skull section appeared to have a rate dependent initial modulus, with the rest showing no significant statistical dependence on loading rate. Other mechanical properties appeared to be affected by the loading rate, including the strain energy density.

  8. Synthesis of refractory-oxide materials by skull melting

    International Nuclear Information System (INIS)

    Skull melting is a cold-crucible technique for obtaining high-purity melts of refractory materials, particularly oxides. This technique has been used to synthesize high-purity minerals and to prepare single crystals of uraninite (UO2) and thorianite (ThO2) directly from the melt. A description of the crystal-growing technique is discussed. Los Alamos is also interested in developing the skull-melting technique to zone-refine spent UO2 nuclear reactor fuel pins. Since metallic fission products and actinides will behave as solute impurities in a UO2 solvent, the success of the zone-refining process will depend on the distribution of the impurities between molten and solid UO2. An effective distribution coefficient for Y2O3 segregated between molten and solid UO2 was experimentally determined by zone melting. An effective distribution coefficient of k = 0.75 +- 0.05 was obtained, in good agreement with an equilibrium value of k0 = 0.6, estimated from the Y2O3-UO2 phase diagram

  9. Hawaiian craniofacial morphometrics: average Mokapuan skull, artificial cranial deformation, and the "rocker" mandible.

    Science.gov (United States)

    Schendel, S A; Walker, G; Kamisugi, A

    1980-05-01

    Craniofacial morphology and cultural cranial deformation were analyzed by the computer morphometric system in 79 adult Hawaiian skulls from Mokapu, Oahu. The average Hawaiian male was large, but similar in shape to the female. Both were larger than the present Caucasian, showed a greater dental protrusion, and possessed a larger ANB angle, flatter cranial base, and larger facial heights. Correlations in Hawaiian craniofacial structure were found between an increasing mandibular plane angle and 1) shorter posterior facial height, 2) larger gonial angle, 3) larger cranial base angle, and 4) smaller SNA and SNB angles. Of the 79 skulls studied, 8.9% were found to have severe head molding or intentional cranial deformation. Significant statistical differences between the molded group and the nonmolded group are, in decreasing significance: 1) larger upper face height, 2) smaller glabella to occiput distance, and 3) increased lower face height with deformation. The morphometric differences were readily seen by graphic comparison between groups. It is postulated that external forces to the neurocranium result in redirection of the growth vectors in the neurocranial functional matrix, including the cranial base, and secondarily, to the orofacial functional matrix. There is a possibility that the cranial deformation is a retention of the normal birth molding changes. The Polynesian "rocker jaw" was found in 81% to 95% of this populace. This mandibular form occurs only with attainment of adult stature and craniofacial form. This data agrees with the hypothesis that mandibular form is modified by the physical forces present and their direction in the orofacial functional matrix.

  10. An historical skull collection and its use in forensic odontology and anthropology

    DEFF Research Database (Denmark)

    Sejrsen, B; Lynnerup, N; Hejmadi, M

    2005-01-01

    The Institute of Forensic Medicine, Copenhagen, houses a collection of historical skulls of unclear origin, marked with a general geographic or "racial descriptor". Would these historical skulls be of any value for the forensic odontologist and anthropologist concerned with teaching and casework?...

  11. HElmet therapy Assessment in infants with Deformed Skulls (HEADS): protocol for a randomised controlled trial

    NARCIS (Netherlands)

    Wijk, R.M. van; Boere-Boonekamp, M.M.; Groothuis-Oudshoorn, C.G. van; Vlimmeren, L.A. van; IJzerman, M.J.

    2012-01-01

    In The Netherlands helmet therapy is a commonly used treatment in infants with skull deformation (deformational plagiocephaly or deformational brachycephaly). However, evidence on the effectiveness of this treatment is lacking. The HEADS study (Helmet therapy Assessment in Deformed Skulls) aims to d

  12. No bilateral variation accompanies the skull size change in domestic pig

    OpenAIRE

    Parés Casanova, Pere-Miquel; Esteve-Puig, C.

    2015-01-01

    Morphological symmetry and asymmetry in a sample of 41 domestic pig skulls was decomposed into a component of symmetric and asymmetric variation using geometric morphometric methods. The leftright symmetric variation was similar to the asymmetric variation, and both mainly centred on the caudal part of skull.

  13. How We Got Here: Evolutionary Changes in Skull Shape in Humans & Their Ancestors

    Science.gov (United States)

    Price, Rebecca M.

    2012-01-01

    This activity uses inquiry to investigate how large changes in shape can evolve from small changes in the timing of development. Students measure skull shape in fetal, infant, juvenile, and adult chimpanzees and compare them to adult skulls of "Homo sapiens," "Homo erectus," and "Australopithecus afarensis." They conclude by re-interpreting their…

  14. Anterior segment parameters and eyelids in systemic sclerosis.

    Science.gov (United States)

    Sahin Atik, Sevinc; Koc, Feray; Akin Sari, Sirin; Sefi Yurdakul, Nazife; Ozmen, Mustafa; Akar, Servet

    2016-08-01

    To evaluate main numerical parameters of anterior segment and the effects of eyelid skin changes on these parameters in patients with systemic sclerosis (SSc). Thirty-four patients with SSc and 34 healthy individuals were enrolled. Besides full eye examination, anterior segment measurements including anterior chamber depth (ACD), anterior chamber volume, anterior chamber angle width, central corneal thickness, pupil size, corneal volume and keratometry were obtained using a Sirius Scheimpflug/Placido photography-based topography system. Eyelid thickness was evaluated using the scala of the modified Rodnan skin score and the patients were subgrouped with respect to these scores to evaluate the effect of eyelid thickening on the anterior segment parameters. Age and sex distributions of the groups were similar (p > 0.05). SSc patients had steeper and thinner corneas, smaller corneal volumes, narrower, shallower and smaller anterior segments but only the mean ACD value of right eyes was found significantly less than those of the controls (p = 0.047). The mean ACD values of SSc subgroup patients with moderate to severe eyelid thickening (50 %) had lower ACD measurements compared to those of control group. (p = 0.043 for the right eyes, p = 0.070 for the left eyes). However, SSc subgroup patients with none to mild eyelid thickening (50 %) had similar anterior segment parameters with control subjects (p > 0.05). Anterior chamber parameters of the SSc patients could show significant differences. These differences occur parallel to the eyelid changes but not secondary to it. PMID:26694912

  15. Basilar skull fracture in a Thoroughbred colt: Radiography or computed tomography?

    Directory of Open Access Journals (Sweden)

    Chee Kin Lim

    2013-02-01

    Full Text Available A two-year-old Thoroughbred colt was presented to the Equine Clinic, Onderstepoort Veterinary Academic Hospital for head trauma after rearing and falling backwards, hitting his head on the ground. Following medical therapy for acute onset neurological impairment secondary to a suspected basilar skull fracture, the horse was anaesthetised and computed tomography of the skull was performed. A diagnosis of a comminuted basilar skull fracture was made and skull radiographs were taken for comparison. The horse was subsequently euthanased owing to the poor prognosis; necropsy findings were compatible with imaging findings. The value and limitation of computed tomography versus radiography for the diagnosis of basilar skull fracture are discussed in this report.

  16. Experimental study of transmission of a pulsed focused beam through a skull phantom in nonlinear regime

    Energy Technology Data Exchange (ETDEWEB)

    Tsysar, S. A., E-mail: sergey@acs366.phys.msu.ru; Nikolaeva, A. V.; Khokhlova, V. A.; Yuldashev, P. V. [Physics Faculty, Moscow State University, Leninskie Gory, Moscow 119991 (Russian Federation); Svet, V. D. [Andreyev Acoustics Institute, 4, Shvernik Street, Moscow 117036 (Russian Federation); Sapozhnikov, O. A. [Physics Faculty, Moscow State University, Leninskie Gory, Moscow 119991 (Russian Federation); Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, 1013 NE 40th Street, Seattle, WA 98105 (United States)

    2015-10-28

    In the paper the use of receiving and radiating system, which allows to determine the parameters of bone by nonlinear pulse-echo technique and to image of brain structures through the skull bones, was proposed. Accuracy of the skull bone characterization is due to higher measured harmonic and is significantly better than in linear case. In the experimental part focused piezoelectric transducer with diameter 100 mm, focal distance 100 mm, the frequency of 1.092 MHz was used. It was shown that skull bone profiling can be performed with the use of 3rd harmonic since 1st harmonic can be used for visualization of the underlying objects. The use of wideband systems for both skull profiling and brain visualization is restricted by skull attenuation and resulting low effective sensitivity.

  17. Development of a practical ultrasonic approach for simultaneous measurement of the thickness and the sound speed in human skull bones: a laboratory phantom study

    International Nuclear Information System (INIS)

    The availability of a non-invasive express method for the in vivo measurement of both sound velocity and thickness of the human skull bone would be of great benefit to various transcranial ultrasonic imaging and treatment applications. This paper investigates two ultrasonic methods that measure both parameters and are based on the variable focus technique. All the experiments described in this paper were conducted on specially prepared custom skull bone phantoms, including flat and deformed samples, designed and developed in our laboratory. The first method uses a single immersion 2.25 MHz ultrasonic transducer consecutively focused on the front and back surfaces of the sample. The accuracy and precision of this method are demonstrated via single point measurements on flat samples with and without porosity. The measurement results from a specimen with the randomly curved back surface show the possibility of obtaining the inner profile of the skull bone. The second presented method is a practical modification of the variable focus technique for the linear phased array case. The method was tested on flat and curved skull bone phantoms with and without inner porosity showing higher measurement accuracy and simpler practical realization than its scanning counterpart. (paper)

  18. Hoffa's fat pad injuries and their relationship with anterior cruciate ligament tears: new observations based on MR imaging in patients and MR imaging and anatomic correlation in cadavers

    International Nuclear Information System (INIS)

    To determine the normal anatomic relationships of Hoffa's fat pad with the anterior cruciate ligament (ACL) and with the frequency of Hoffa's fat pad abnormalities in ACL-deficient knees. Retrospective clinical study on patients and observational anatomic study on cadavers. The study was approved by the Institutional Review Board. MR imaging studies of the knees of 100 patients (21-48 years old) with or without arthroscopically proven tears of the ACL, performed at a single institution, were reviewed by two readers for abnormalities of Hoffa's fat pad. Ten cadaveric knee specimens were studied with MR imaging and Faxitron radiographs, and by inspection of sections and histology. Alterations in Hoffa's fat pad on MR imaging were present in 64% (32/50) of patients with torn ACLs, and in 24% (12/50) of patients without a tear of the ACL (P < 0.05). Hoffa's fat pad inserted into the intercondylar notch in 50% (5/10) of cadaveric specimens, four in conjunction with the ligamentum mucosum and in one in an isolated fashion. Histological study demonstrated the composition of the ligamentum mucosum and Hoffa's fat pad and their course and insertion sites in the intercondylar notch. Abnormalities of Hoffa's fat pad, such as focal and diffuse edema, tears, scars and synovial proliferation, are more common in knees with torn ACLs than in knees with intact ACLs. (orig.)

  19. Bilateral elongated mandibular coronoid process in an Anatolian skull

    Science.gov (United States)

    Çorumlu, Ufuk; Demir, Mehmet Tevfik; Pirzirenli, Mennan Ece

    2016-01-01

    Elongation or hyperplasia of coronoid process of mandible is rare condition characterized by abnormal bone development which cause malocclusion and the limited mouth opening. In this study, in an Anatolian skull, a case of bilateral elongation of mandibular coronoid process was presented. Levandoski panographic analysis was performed on the panoramic radiographie to determine the hyperplasia of the coronoid process. The right condylar process was exactly hyperplastic. The measurements of Kr-Go/Cd-Go were 95.10 mm/79.03 mm on right side and 97.53 mm/87.80 mm on left side. The ratio of Kr-Go/Cd-Go on the right side was 1.20. Elongated coronoid process is one of the factors cause mandibular hypomobility, it as reported here might lead to limited mouth opening. The knowledge of this variation or abnormality can be useful for the radiologist and surgeons and prevent misdiagnosis. PMID:27722017

  20. Prevalence of adjacent segment disc degeneration in patients undergoing anterior cervical discectomy and fusion based on pre-operative MRI findings.

    Science.gov (United States)

    Lundine, Kristopher M; Davis, Gavin; Rogers, Myron; Staples, Margaret; Quan, Gerald

    2014-01-01

    Anterior cervical discectomy and fusion (ACDF) is a widely accepted surgical treatment for symptomatic cervical spondylosis. Some patients develop symptomatic adjacent segment degeneration, occasionally requiring further treatment. The cause and prevalence of adjacent segment degeneration and disease is unclear at present. Proponents for motion preserving surgery such as disc arthroplasty argue that this technique may decrease the "strain" on adjacent discs and thus decrease the incidence of symptomatic adjacent segment degeneration. The purpose of this study was to assess the pre-operative prevalence of adjacent segment degeneration in patients undergoing ACDF. A database review of three surgeons' practice was carried out to identify patients who had undergone a one- or two-level ACDF for degenerative disc disease. Patients were excluded if they were operated on for recent trauma, had an inflammatory arthropathy (for example, rheumatoid arthritis), or had previous spine surgery. The pre-operative MRI of each patient was reviewed and graded using a standardised methodology. One hundred and six patient MRI studies were reviewed. All patients showed some evidence of intervertebral disc degeneration adjacent to the planned operative segment(s). Increased severity of disc degeneration was associated with increased age and operative level, but was not associated with sagittal alignment. Disc degeneration was more common at levels adjacent to the surgical level than at non-adjacent segments, and was more severe at the superior adjacent level compared with the inferior adjacent level. These findings support the theory that adjacent segment degeneration following ACDF is due in part to the natural history of cervical spondylosis.

  1. Anterior cruciate ligament - updating article.

    Science.gov (United States)

    Luzo, Marcus Vinicius Malheiros; Franciozi, Carlos Eduardo da Silveira; Rezende, Fernando Cury; Gracitelli, Guilherme Conforto; Debieux, Pedro; Cohen, Moisés

    2016-01-01

    This updating article on the anterior cruciate ligament (ACL) has the aim of addressing some of the most interesting current topics in this field. Within this stratified approach, it contains the following sections: ACL remnant; anterolateral ligament and combined intra and extra-articular reconstruction; fixation devices; and ACL femoral tunnel creation techniques.

  2. Anterior cruciate ligament - updating article.

    Science.gov (United States)

    Luzo, Marcus Vinicius Malheiros; Franciozi, Carlos Eduardo da Silveira; Rezende, Fernando Cury; Gracitelli, Guilherme Conforto; Debieux, Pedro; Cohen, Moisés

    2016-01-01

    This updating article on the anterior cruciate ligament (ACL) has the aim of addressing some of the most interesting current topics in this field. Within this stratified approach, it contains the following sections: ACL remnant; anterolateral ligament and combined intra and extra-articular reconstruction; fixation devices; and ACL femoral tunnel creation techniques. PMID:27517015

  3. Anterior process calcaneal fractures: a systematic evaluation of associated conditions

    Energy Technology Data Exchange (ETDEWEB)

    Petrover, David [NYU Hospital for Joint Disease, Radiology Department, New York, NY (United States); Hopital Beaujon, Service de Radiologie, Paris (France); Schweitzer, Mark E. [NYU Hospital for Joint Disease, Radiology Department, New York, NY (United States); Laredo, J.D. [Hopital Lariboisiere, Service de Radiologie, Paris (France)

    2007-07-15

    The objective was to evaluate the association, by MRI, of anterior calcaneal process fractures with tarsal coalitions, ankle sprains, and bifurcate ligament abnormalities. A retrospective review of 1,479 foot and ankle MR images was performed, over a period of 5 years, for isolated anterior process fractures of the calcaneus. Fifteen 1.5-T MR examinations were systematically evaluated by two radiologists in consensus. Marrow edema patterns, presence of a calcaneonavicular coalition, as well as bifurcate and anterior talofibular ligaments, were evaluated. There were 15 fractures of the anterior calcaneal process with an incidence of 1%. The average patient age was 51 years (range 25-82). Twelve patients were women and 3 were men. The majority of the fractures (14 out of 15) presented as an edema pattern on T2-weighted images, either diffuse (9 out of 15), or vertical (5 out of 15). One case did not show marrow edema, but rather a hypointense line. Nine patients (60%) demonstrated calcaneonavicular coalition and anterior calcaneal process fracture. In 6 patients (50%) the anterior talofibular ligament (ATFL) was thickened. Three patients did not have axial images, and were classified as non-conclusive for the ATFL evaluation. The bifurcate ligament was thickened with hyperintense signal demonstrating a sprain in 9 out of 13 (69%). Only 2 patients (16.5%) had an anterior calcaneal process fracture without any associated abnormality. We believe that there is a probable association of anterior process fractures and calcaneonavicular coalitions. We also feel, based on our results and the prior literature that there is likely also an association with both ATFL injuries and bifurcate ligament injuries. (orig.)

  4. Anterior process calcaneal fractures: a systematic evaluation of associated conditions

    International Nuclear Information System (INIS)

    The objective was to evaluate the association, by MRI, of anterior calcaneal process fractures with tarsal coalitions, ankle sprains, and bifurcate ligament abnormalities. A retrospective review of 1,479 foot and ankle MR images was performed, over a period of 5 years, for isolated anterior process fractures of the calcaneus. Fifteen 1.5-T MR examinations were systematically evaluated by two radiologists in consensus. Marrow edema patterns, presence of a calcaneonavicular coalition, as well as bifurcate and anterior talofibular ligaments, were evaluated. There were 15 fractures of the anterior calcaneal process with an incidence of 1%. The average patient age was 51 years (range 25-82). Twelve patients were women and 3 were men. The majority of the fractures (14 out of 15) presented as an edema pattern on T2-weighted images, either diffuse (9 out of 15), or vertical (5 out of 15). One case did not show marrow edema, but rather a hypointense line. Nine patients (60%) demonstrated calcaneonavicular coalition and anterior calcaneal process fracture. In 6 patients (50%) the anterior talofibular ligament (ATFL) was thickened. Three patients did not have axial images, and were classified as non-conclusive for the ATFL evaluation. The bifurcate ligament was thickened with hyperintense signal demonstrating a sprain in 9 out of 13 (69%). Only 2 patients (16.5%) had an anterior calcaneal process fracture without any associated abnormality. We believe that there is a probable association of anterior process fractures and calcaneonavicular coalitions. We also feel, based on our results and the prior literature that there is likely also an association with both ATFL injuries and bifurcate ligament injuries. (orig.)

  5. Válvula de uretra anterior Anterior urethral valves

    Directory of Open Access Journals (Sweden)

    Silvio Tucci Jr.

    2003-02-01

    Full Text Available Objetivo: apresentar os aspectos clínicos, diagnósticos e terapêuticos de pacientes portadores de válvula da uretra anterior. Descrição: em dois neonatos, o diagnóstico presuntivo de patologia obstrutiva do trato urinário foi sugerido pela ultra-sonografia realizada no período pré-natal, confirmando-se o diagnóstico de válvula de uretra anterior pela avaliação pós-natal. Os pacientes foram submetidos a tratamento cirúrgico paliativo, com vesicostomia temporária e, posteriormente, definitivo, pela fulguração endoscópica das válvulas. Ambos evoluíram com função renal normal. Comentários: a válvula da uretra anterior é anomalia rara que deve ser considerada em meninos com quadro radiológico pré-natal sugestivo de obstrução infravesical, secundariamente à hipótese mais comum de válvula da uretra posterior. Ressaltamos a utilização da vesicostomia como derivação urinária temporária nestes casos, prevenindo potenciais complicações pela manipulação da uretra do recém-nascido.Objective: to discuss clinical signs, diagnostic tools and therapeutics of anterior urethral valves, an obstructive anomaly of the urinary system in males. Description: signs of urinary tract obstruction were identified on pre-natal ultrasound in two male fetuses and the diagnosis of anterior urethral valves was made through post-natal evaluation. As an initial treatment, vesicostomy was performed in both patients. Later, the valves were fulgurated using an endoscopic procedure. During the follow-up period both patients presented normal renal function. Comments: anterior urethral valves are a rare form of urethral anomaly that must be ruled out in boys with pre-natal ultrasound indicating infravesical obstruction. Vesicostomy used as an initial treatment rather than transurethral fulguration may prevent potential complications that can occur due to the small size of the neonatal urethra.

  6. Anticoagulation after anterior myocardial infarction and the risk of stroke.

    Directory of Open Access Journals (Sweden)

    Jacob A Udell

    Full Text Available BACKGROUND: Survivors of anterior MI are at increased risk for stroke with predilection to form ventricular thrombus. Commonly patients are discharged on dual antiplatelet therapy. Given the frequency of early coronary reperfusion and risk of bleeding, it remains uncertain whether anticoagulation offers additional utility. We examined the effectiveness of anticoagulation therapy for the prevention of stroke after anterior MI. METHODS AND FINDINGS: We performed a population-based cohort analysis of 10,383 patients who survived hospitalization for an acute MI in Ontario, Canada from April 1, 1999 to March 31, 2001. The primary outcome was four-year ischemic stroke rates compared between anterior and non-anterior MI patients. Risk factors for stroke were assessed by multivariate Cox proportional-hazards analysis. Warfarin use was determined at discharge and followed for 90 days among a subset of patients aged 66 and older (n = 1483. Among the 10,383 patients studied, 2,942 patients survived hospitalization for an anterior MI and 20% were discharged on anticoagulation therapy. Within 4 years, 169 patients (5.7% were admitted with an ischemic stroke, half of which occurred within 1-year post-MI. There was no significant difference in stroke rate between anterior and non-anterior MI patients. The use of warfarin up to 90 days was not associated with stroke protection after anterior MI (hazard ratio [HR], 0.68; 95% confidence interval [CI], 0.37-1.26. The use of angiotensin-converting-enzyme inhibitors (HR, 0.65; 95% CI, 0.44-0.95 and beta-blockers (HR, 0.60; 95% CI, 0.41-0.87 were associated with a significant decrease in stroke risk. There was no significant difference in bleeding-related hospitalizations in patients who used warfarin for up to 90 days post-MI. CONCLUSION: Many practitioners still consider a large anterior-wall MI as high risk for potential LV thrombus formation and stroke. Among a cohort of elderly patients who survived an anterior

  7. The Anterior Cingulate Cortex and Pain Processing

    Directory of Open Access Journals (Sweden)

    Perry Neil Fuchs

    2014-05-01

    Full Text Available The neural network that contributes to the suffering which accompanies persistent pain states involves a number of brain regions. Of primary interest is the contribution of the cingulate cortex in processing the affective component of pain. The purpose of this review is to summarize recent data obtained using novel behavioral paradigms in animals based on measuring escape and/or avoidance of a noxious stimulus. These paradigms have successfully been used to study the nature of the neuroanatomical and neurochemical contributions of the anterior cingulate cortex to higher order pain processing in rodents.

  8. Using QuickTime virtual reality objects in computer-assisted instruction of gross anatomy: Yorick--the VR Skull.

    Science.gov (United States)

    Nieder, G L; Scott, J N; Anderson, M D

    2000-01-01

    QuickTime virtual reality (QTVR) is a software technology that creates, on a normal computer screen, the illusion of holding and turning a three-dimensional object. QTVR is a practical photo-realistic virtual reality technology that is easily implemented on any current personal computer or via the Internet with no special hardware requirements. Because of its ability to present dynamic photo-quality images, we reasoned that QTVR can provide a more realistic presentation of anatomic structure than two-dimensional atlas pictures and facilitate study of specimens outside the dissection lab. We created QTVR objects, using portions of the skull, and incorporated them into an instructional program for first-year medical students. To obtain images, the bones of the skull were mounted on a rotating table, and a digital camera was positioned on a swinging arm so that the focal point remained coincident with the rotational center of the object as the camera was panned through a vertical arc. Digital images were captured at intervals of 10 degrees rotation of the object (horizontal pan). The camera was then swung through an arc with additional horizontal pan sequences taken at 10 degrees intervals of vertical pan. The images were edited to place the object on a solid black background, then assembled into a linear QuickTime movie. The linear movie was processed to yield a QTVR object movie that can be manipulated on vertical and horizontal axes using the mouse. QTVR movies were incorporated into an interactive environment that provided labeling, links to text-based information and self-testing capabilities. This program, Yorick-the VR Skull, has been used in our first-year medical and graduate gross anatomy courses for the past two years. Results of student evaluation of the program indicate that this QTVR-based program is an effective learning tool that is well received by students. PMID:10873221

  9. Compound soft regenerated skull material for repairing dog skull defects using bone morphogenetic protein as an inductor and nanohydroxyapatite as a scaffold

    Institute of Scientific and Technical Information of China (English)

    Zhidong Shi; Mingwang Liu; Zhongzong Qin; Qinmei Wang; Ying Guo; Haiyong He; Zhonghe Yu

    2008-01-01

    BACKGROUND: In previous studies of skull defects and regeneration, bone morphogenetic protein as an inductor and nanohydroxyapatite as a scaffold have been cocultured with osteoblasts.OBJECTIVE: To verify the characteristics of the new skull regenerated material after compound soft regenerated skull material implantatiom.DESIGN, TIME AND SETTING: The self-control and inter-group control animal experiment was perfurmed at the Sun Yat-sen University, China from February to July 2007.MATERIALS: Twenty-tour healthy adult dogs of both genders weighing 15-20 kg were used in this study. Nanohydroxyapatite as a scaffold was cocultured with osteoblasts. Using demineralized canine bone matrix as a carrier, recombinant human bone morphogenetic protein-2 was employed to prepare compound soft regenerated skull material. Self-designed compound soft regenerated skull material was implanted in models of skull defects.METHODS: Animals were randomly assigned into two groups, Group A (n = 16) and Group B (n = 8).Bilateral 2.5-cm-diameter full-thickness parietal skull defects were made in all animals. In Group A, the right side was reconstructed with calcium alginate gel, osteoblasts, and nanomcter bone meal composite;the left side was reconstructed with calcium alginate gel, osteoblasts, nanometer bone meal and recombinant human bone morphogenetic protein-2 composite. In Group B, the right side was kept as a simple skull detect, and the left side was reconstructed with calcium alginate gel, osteoblasts, nanometer bone meal and recombinant human bone morphogenetic protein-2 composite.MAIN OUTCOME MEASURES: Bone regeneration and histopathological changes at the site of the skull defect were observed with an optical microscope and a scanning electron microscope after surgery.The ability to form bone was measured by alizarin red S staining. In vitro cultured osteoblasts were observed for morphology.RESULTS: One month following surgery, newly formed bone trabeculae mostly covered the

  10. Hedgehog signaling is required for cranial neural crest morphogenesis and chondrogenesis at the midline in the zebrafish skull.

    Science.gov (United States)

    Wada, Naoyuki; Javidan, Yashar; Nelson, Sarah; Carney, Thomas J; Kelsh, Robert N; Schilling, Thomas F

    2005-09-01

    Neural crest cells that form the vertebrate head skeleton migrate and interact with surrounding tissues to shape the skull, and defects in these processes underlie many human craniofacial syndromes. Signals at the midline play a crucial role in the development of the anterior neurocranium, which forms the ventral braincase and palate, and here we explore the role of Hedgehog (Hh) signaling in this process. Using sox10:egfp transgenics to follow neural crest cell movements in the living embryo, and vital dye labeling to generate a fate map, we show that distinct populations of neural crest form the two main cartilage elements of the larval anterior neurocranium: the paired trabeculae and the midline ethmoid. By analyzing zebrafish mutants that disrupt sonic hedgehog (shh) expression, we demonstrate that shh is required to specify the movements of progenitors of these elements at the midline, and to induce them to form cartilage. Treatments with cyclopamine, to block Hh signaling at different stages, suggest that although requirements in morphogenesis occur during neural crest migration beneath the brain, requirements in chondrogenesis occur later, as cells form separate trabecular and ethmoid condensations. Cell transplantations indicate that these also reflect different sources of Shh, one from the ventral neural tube that controls trabecular morphogenesis and one from the oral ectoderm that promotes chondrogenesis. Our results suggest a novel role for Shh in the movements of neural crest cells at the midline, as well as in their differentiation into cartilage, and help to explain why both skeletal fusions and palatal clefting are associated with the loss of Hh signaling in holoprosencephalic humans.

  11. 38 CFR 3.379 - Anterior poliomyelitis.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Anterior poliomyelitis. 3... Specific Diseases § 3.379 Anterior poliomyelitis. If the first manifestations of acute anterior poliomyelitis present themselves in a veteran within 35 days of termination of active military service, it...

  12. Form and function of damselfish skulls: rapid and repeated evolution into a limited number of trophic niches

    Directory of Open Access Journals (Sweden)

    Cooper W James

    2009-01-01

    Full Text Available Abstract Background Damselfishes (Perciformes, Pomacentridae are a major component of coral reef communities, and the functional diversity of their trophic anatomy is an important constituent of the ecological morphology of these systems. Using shape analyses, biomechanical modelling, and phylogenetically based comparative methods, we examined the anatomy of damselfish feeding among all genera and trophic groups. Coordinate based shape analyses of anatomical landmarks were used to describe patterns of morphological diversity and determine positions of functional groups in a skull morphospace. These landmarks define the lever and linkage structures of the damselfish feeding system, and biomechanical analyses of this data were performed using the software program JawsModel4 in order to calculate the simple mechanical advantage (MA employed by different skull elements during feeding, and to compute kinematic transmission coefficients (KT that describe the efficiency with which angular motion is transferred through the complex linkages of damselfish skulls. Results Our results indicate that pomacentrid planktivores are significantly different from other damselfishes, that biting MA values and protrusion KT ratios are correlated with pomacentrid trophic groups more tightly than KT scores associated with maxillary rotation and gape angle, and that the MAs employed by their three biting muscles have evolved independently. Most of the biomechanical parameters examined have experienced low levels of phylogenetic constraint, which suggests that they have evolved quickly. Conclusion Joint morphological and biomechanical analyses of the same anatomical data provided two reciprocally illuminating arrays of information. Both analyses showed that the evolution of planktivory has involved important changes in pomacentrid functional morphology, and that the mechanics of upper jaw kinesis have been of great importance to the evolution of damselfish feeding. Our

  13. Facial heights: evolutionary relevance of postnatal ontogeny for facial orientation and skull morphology in humans and chimpanzees.

    Science.gov (United States)

    Bastir, Markus; Rosas, Antonio

    2004-11-01

    Facial heights, i.e. the vertical distances between the superior and inferior limits of facial compartments, contribute to the orientation of the viscerocranium in the primate skull. In humans, vertical facial variation is among the main sources of diversity and frequently associated with an integrated suite of other cranio-mandibular traits. Facial heights and kyphosis are also important factors in interspecific variation and models of hominoid evolution. The ontogenetic determination of adult facial orientation and its relation to phylogenetic variation are unclear, but crucial in all previously mentioned respects. We addressed these issues in a sample of 175 humans and chimpanzees with Procrustes based geometric morphometrics, testing hypotheses of interspecific similarity in postnatal ontogenetic trajectories, early versus later ontogenetic facial pattern determination, and a developmental model of morphological integration. We analyzed the contribution of postnatal morphogenesis to adult vertical facial variation by partitioning morphological variation into a portion of pure growth allometry and a non-allometric fraction. A statistically significant difference of growth-allometries revealed that in both species growth established the adult skull proportions by vertical facial expansion, but while in chimpanzees the complete viscerocranium showed reorientation, in humans only the lower face was modified. In both species the results support a hypothesis of early facial pattern determination. A coincident emergence of morphological traits favors a hypothesis of developmental integration of the face, excluding traits of the basi- and neurocranium. Interspecific differences in integration may have implications for evolutionary studies. The present findings indicate that growth establishes the adult skull proportions and integrates principal facial orientation patterns, already there in early postnatal ontogeny. PMID:15530353

  14. Epidermoid cyst in Anterior, Middle

    Directory of Open Access Journals (Sweden)

    Kankane Vivek Kumar

    2016-09-01

    Full Text Available Epidermoid cysts are benign slow growing more often extra-axial tumors that insinuate between brain structures, we present the clinical, imaging, and pathological findings in 35 years old female patients with atypical epidermoid cysts which was situated anterior, middle & posterior cranial fossa. NCCT head revealed hypodense lesion over right temporal and perisylvian region with extension in prepontine cistern with mass effect & midline shift and MRI findings revealed a non-enhancing heterogeneous signal intensity cystic lesion in right frontal & temporal region extending into prepontine cistern with restricted diffusion. Patient was detoriated in night of same day of admission, emergency Fronto-temporal craniotomy with anterior peterousectomy and subtotal resection was done. The histological examination confirms the epidermoid cyst. The timing of ectodermal tissue sequestration during fetal development may account for the occurrence of atypical epidermoid cysts.

  15. Assessment of the α-angle of femoral neck and morphological classification of the anterior femoral head-neck junction on CT-based images in normal Chinese adults

    International Nuclear Information System (INIS)

    Objective: To investigate the normal range of the femoral neck α-angle in normal Chinese adults and classify the morphology of the anterior femoral head-neck junction on CT-based images. Methods: Six hundred and fifty-two adult patients (Bilateral: 459 patients, unilateral: 193 patients) with the total of 1111 hips (552 left; 559 right, and 654 male, 457 female) without known diseases affecting the proximal femur or symptoms of femoroacetabular impingement (FAI) underwent 64- slice CT scanning for medical purpose with the hip included in the scan range. The volume CT data was used for further analysis in this study. Oblique sagittal plane images paralleling to the axis of the femoral neck were reconstructed with the volume CT data, the image through the middle of the femoral neck was chosen to measure α-angle with AutoCAD2006 software. The morphology of the anterior femoral head-neck junction was classified. Analysis of variance and t-test were performed with SPSS 15.0. Results: The mean value of a-angle of all 1111 hips was 38.2°±5.3°. The normal range of α-angle in Chinese adults was 28° to 49°. The mean value of left and right α-angles were 38.0°±5.3° and 38.4°±5.3°,respectively, and there was no statistically significant difference between both sides (t=-1.231, P>0.05 ). Males have greater α- angles than females 39.2°±5.8 vs 36.8°±4.1°, with t=-8.180, P0.05). In all 1111 proximal femora, 168 were classified as concave type, accounting for 15.1%, with a mean a-angle of 31.2°±2.0°, 726 were smooth type, accounting for 65.4%, with a mean α-angle of 37.4°±2.4°, and 217 were flat type, accounting for 19.5%, with a mean a-angle of 46.4°±3.8°. The differences of the α-angles of the three groups reached statistical significance (F=1636.107, P<0.01). Conclusions: The morphology of anterior femoral head-neck junction can be classified into three types: concave type (type Ⅰ), smooth type (type Ⅱ) and fiat type (type Ⅲ). This

  16. Anterior impingement syndrome in dancers

    OpenAIRE

    O’Kane, John William; Kadel, Nancy

    2007-01-01

    Anterior impingement is a common problem in dancers occurring primarily secondary to the repetitive forced ankle dorsiflexion inherent in ballet. Symptoms generally occur progressively and may respond to conservative treatment including addressing biomechanical faults that contribute to the problem. As impingement progresses, movements essential to ballet may become impossible and arthroscopic ankle surgery is often effective for both diagnosis and treatment, allowing athletes to return to da...

  17. Thanatophoric dysplasia type 1 with cloverleaf skull in a dichorionic twin.

    Science.gov (United States)

    Salinas-Torres, V M

    2015-01-01

    Here is reported for the first time, a case of thanatophoric dysplasia type 1 with cloverleaf skull in a (Mexican) dichorionic female twin. The patient's main clinical and radiographic findings included severe limb shortening, narrow thorax shape; short ribs, marked platyspondyly, curved short femurs, and a cloverleaf skull. The female twin sib had normal growth parameters and phenotypic appearance. According to the literature, cloverleaf skull in thanatophoric dysplasia type 1 is rare, even more so in dichorionic twins. Moreover, the present observation confirms that thanatophoric dysplasia type 1 patients may show phenotypic heterogeneity related to cloverleaf skull and other congenital anomalies. Therefore, a careful family history along with clinical, radiological, and molecular investigations is suggested, in order to achieve an accurate parental counseling for thanatophoric dysplasia. PMID:26043509

  18. HElmet therapy Assessment in infants with Deformed Skulls (HEADS): protocol for a randomised controlled trial

    NARCIS (Netherlands)

    Wijk, van R.M.; Boonekamp, M.M.; Groothuis-Oudshoorn, C.G.M.; Vlimmeren, van L.A.; IJzerman, M.J.

    2012-01-01

    Background In The Netherlands, helmet therapy is a commonly used treatment in infants with skull deformation (deformational plagiocephaly or deformational brachycephaly). However, evidence of the effectiveness of this treatment remains lacking. The HEADS study (HElmet therapy Assessment in Deformed

  19. HElmet therapy Assessment in infants with Deformed Skulls (HEADS): protocol for a randomised controlled trial

    NARCIS (Netherlands)

    Wijk, R.M. van; Boere-Boonekamp, M.M.; Groothuis-Oudshoorn, C.G.; Vlimmeren, L.A. van; MJ, I.J.

    2012-01-01

    BACKGROUND: In The Netherlands, helmet therapy is a commonly used treatment in infants with skull deformation (deformational plagiocephaly or deformational brachycephaly). However, evidence of the effectiveness of this treatment remains lacking. The HEADS study (HElmet therapy Assessment in Deformed

  20. [Methods of making the plaster copies of skulls for the medical and criminalistic identification of individuals].

    Science.gov (United States)

    Zviagin, V N; Berezovskiĭ, M E; Aunapu, S A

    2003-01-01

    A possibility was studied to use the plaster copies of skulls in the forensic medical identification of personality by applying the craniofacial method. No dependence was found between the plaster casts and the moulding types. Differences between the same craniometric sizes in the skull and in its cast are of an incidental nature. Such incidental deviation is related with an accuracy of determining the localization of craniometric points and with an instrumental precision of measuring devices. The necessity is substantiated that, while making a craniofacial examination, it is necessary to mark all anthropometric points in the skull cast, with the original being a control. The use of a plaster skull cast is possible in those cases, when the burial of the remains must be done in full. PMID:12866229

  1. Nonmetric Skull Divergence in the Otter - Assessing Genetic Insulation of Populations

    Directory of Open Access Journals (Sweden)

    M. Stubbe

    1995-04-01

    Full Text Available The craniometric variation and non-metric skull divergence between populations of the otter Lutra lutra (Linné, 1758 were studied using more than 430 skulls from different regions of Eastern Germany. No direct regional differences in skull measurements could be established for this area. The comparison of the morphological variation by non-metric skull characters adduces not or unimportant differentiations for most regions. Otter populations with greater geographic distances have partly higher measures of divergence. But only the population from the Baltic coast stand out against each other with a relative important epigenetic distance. Until now there does not exist a general reproductive and genetic insulation between the otter populations of Eastern Germany.

  2. Treatment experience of surgical repair for long-term skull defect

    Directory of Open Access Journals (Sweden)

    Shou-cheng FAN

    2015-12-01

    Full Text Available Retrospective analysis was performed on 30 patients of skull defect who underwent surgical repair. Intraoperative and postoperative curative effect was evaluated on those patients, and the results showed that the incidence rate of intraoperative dura mater defect (P = 0.001, early postoperative complications [new epilepsy (P = 0.035 and effusion (P = 0.021] and late postoperative complications [foreign body sensation (P = 0.035 and dizziness and headache (P = 0.050] in long-term skull defect group were all higher than those in control group. In conclusion, surgical repair of long-term skull defect incurring high risk and various complications will not be an ideal management. Therefore, early surgical treatment for skull defect is suggested. DOI: 10.3969/j.issn.1672-6731.2015.12.016

  3. Inca - interparietal bones in neurocranium of human skulls in central India

    OpenAIRE

    R R Marathe; A S Yogesh; S V Pandit; Joshi, M.; G N Trivedi

    2010-01-01

    Inca bones are accessory bones found in neurocranium of human skulls. Occurrence of Inca bones is rare as compared to other inter sutural bones such as wormian bones. These Inca ossicles are regarded as variants of the normal. The reporting of such occurrences is inadequate from Central India. Objectives: To find the incidence of Inca variants in Central India. Materials and Methods: In the present study, 380 dried adult human skulls were examined. All specimen samples were procured from v...

  4. Skull volume in Pekinese dogs. Tomodensitometry and sex-linked difference

    International Nuclear Information System (INIS)

    The skull volume of 30 Pekinese dogs (15 males and 15 females) was determined by computerized tomographic analysis on 5 mm thick serial sections. In males, the skull volume ranges from 64.10 to 65.49 cm2. In females, it ranges from 58.10 to 59.49 cm2. The method allows to distinguish sex with more than 99.99 p. 100 safety

  5. Geometric morphometric on dorsal aspect of skull does not differences between horned and polled domestic goats

    OpenAIRE

    Parés Casanova, Pere-Miquel

    2013-01-01

    Few previous studies have explored caprine skulls using geometric morphometric (GM) methods, which enable the quantitative analysis and visualisation of shape changes in skeletal elements and provide an important compliment to traditional lineal analyses. The aim of this research is to determine whether GM techniques can provide insights into how the shape of the goat skull differs between horned and polled animals, focusing on the differences between the dorsal aspects of the neurocranium. F...

  6. Unilateral compressive optic neuropathy due to skull hyperostosis secondary to nutritional vitamin A deficiency

    OpenAIRE

    Zayed, Mohammed G.; Hickman, Simon J.; Batty, Ruth; McCloskey, Eugene V.; Pepper, Irene M.

    2015-01-01

    We report a 17-year-old boy who presented with a chronic left unilateral optic neuropathy. Computerized tomography and magnetic resonance imaging demonstrated compression of the left optic nerve due to skull hyperostosis. He was found to be profoundly vitamin A deficient secondary to an unusual diet consisting predominantly of potato chips and crisps. Skull hyperostosis with cranial neuropathies and other neurological abnormalities has been described in growing animals fed vitamin A deficient...

  7. Paget's disease of the skull causing hyperprolactinemia and erectile dysfunction: a case report

    OpenAIRE

    Hepherd Rachel; Jennings Paul E

    2008-01-01

    Abstract Introduction Hyperprolactinemia is an uncommon cause of erectile dysfunction in men. Paget's disease of the skull is a relatively common disease. This case proposes a rare example of a causative link between the two and how treatment of the Paget's disease with bisphosphonates helped the patient regain erectile function. Case presentation A 67-year-old man with Paget's disease of the skull presented with prostatitis, erectile dysfunction, and hyperprolactinemia. Radio-isotope scannin...

  8. Optogenetic signaling-pathway regulation through scattering skull using wavefront shaping

    CERN Document Server

    Yoon, Jonghee; Lee, KyeoReh; Kim, Nury; Kim, Jin Man; Park, Jongchan; Choi, Chulhee; Heo, Won Do; Park, YongKeun

    2015-01-01

    We introduce a non-invasive approach for optogenetic regulation in biological cells through highly scattering skull tissue using wavefront shaping. The wavefront of the incident light was systematically controlled using a spatial light modulator in order to overcome multiple light-scattering in a mouse skull layer and to focus light on the target cells. We demonstrate that illumination with shaped waves enables spatiotemporal regulation of intracellular Ca2+ level at the individual-cell level.

  9. Association between linear skull fractures and intracranial hemorrhage in children with minor head trauma

    Energy Technology Data Exchange (ETDEWEB)

    Erlichman, David B.; Blumfield, Einat; Weiss, Amanda [Jacobi Medical Center, Department of Pediatric Radiology, Albert Einstein College of Medicine, Bronx, NY (United States); Rajpathak, Swapnil [Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY (United States)

    2010-08-15

    To determine whether skull fractures can be used to associate intracranial hemorrhage with minor head trauma (MHT). We conducted a retrospective study evaluating the association between linear skull fractures and intracranial hemorrhage among children with MHT. Furthermore, we evaluated the significance of small intracranial hemorrhages by assessing the need for neurosurgical interventions. The case group included 114 children with a diagnosis of a linear skull fracture and the control group included 125 children without the diagnosis. We conducted multivariable logistic regression analyses to estimate the odds ratio (OR) between linear skull fractures and intracranial bleeding. Among the cases, 29 of 114 (25%) children were diagnosed with an intracranial hemorrhage on CT, compared to only 14 of 125 (11%) among the controls. The multivariable OR for intracranial hemorrhages comparing cases and controls adjusted for age and gender was 2.17 (95% confidence interval [CI]: 1.01, 4.68). All the intracranial hemorrhages were small (3.8 {+-} 2.3 mm) and none of them required any neurosurgical intervention. The presence of a linear skull fracture is an independent risk factor for intracranial hemorrhage. However, all the intracranial hemorrhages associated with the skull fractures were small and did not require any neurosurgical interventions. (orig.)

  10. Developmental changes in the skull morphology of common minke whales Balaenoptera acutorostrata.

    Science.gov (United States)

    Nakamura, Gen; Kato, Hidehiro

    2014-10-01

    We investigated growth-related and sex-related morphological changes in the skulls of 144 North Pacific common minke whales Balaenoptera acutorostrata. Measurement was conducted at 39 points on the skull and mandible to extract individual allometric equations relating the length and zygomatic width of the skull. The results revealed no significant differences in skull morphology by sex except for width of occipital bone. The size relative to the skull of the anatomical parts involved in feeding, such as the rostrum and mandible, increased after birth. In contrast, the sensory organs and the anatomical regions involved in neurological function, such as the orbit, tympanic bullae, and foramen magnum, were fully developed at birth, and their relative size reduced over the course of development. This is the first study to investigate developmental changes in the skull morphology using more than 100 baleen whale specimens, and we believe the results of this study will contribute greatly to multiple areas of baleen whale research, including taxonomy and paleontology.

  11. Morphometric features of asterion in adult human skulls

    Directory of Open Access Journals (Sweden)

    Seema Deepak

    2015-06-01

    Results: Our study revealed that type II (absence of sutural bones was commoner than type I (presence of sutural bones asterion. The asterion was 4.82 +/- 0.58 cm from tip of the mastoid process on the right side and 4.70 +/- 0.70 cm on the left. It was greater in males than in females, p value being statistically significant (P = 0.00 and P = 0.02 for right and left sides respectively. The distance of asterion from supramastoid crest was 4.22 +/- 0.73 cm on the right and 4.23+/-0.58 cm on the left. The distance in males was more than in females. The P value 0.00 was statistically significant on the right side. Regarding the position of the asterion in relation to transverse sinus, it was on the transverse sinus in 62% cases, below it in 32% and above in 6%. Conclusions: The data obtained shows that the asterion is located either at the level or below the level of the transverse sinus in majority of the cases. This information is useful to neurosurgeons to reduce the risk during posterior cranial fossa surgeries. This work will also be useful to anthropologists, forensic science experts for determination of sex of the skull along with other parameters. [Int J Res Med Sci 2015; 3(6.000: 1325-1328

  12. MRI anatomy of anteriorly displaced anus: what obstructs defecation?

    Energy Technology Data Exchange (ETDEWEB)

    AbouZeid, Amr Abdelhamid [Ain-Shams University, Department of Pediatric Surgery, Cairo (Egypt); Mohammad, Shaimaa Abdelsattar; Khairy, Khaled Talaat [Ain-Shams University, Department of Radiodiagnosis, Cairo (Egypt)

    2014-07-15

    Anteriorly displaced anus is an anomaly that is debated with regard to its nomenclature, diagnosis and management. To describe MRI anatomy of the anal canal in children with anteriorly displaced anus and its impact on the process of defecation. We prospectively examined ten children (7 girls, 3 boys; age range 7 months to 8 years, mean 3 years) with anteriorly displaced anus between August 2009 and April 2012. Noncontrast MRI examinations were performed on a 1.5-T magnet. T1- and T2-weighted turbo spin-echo images were acquired in axial, sagittal and coronal planes of the pelvis. The anorectal angle and the relative hiatal distance were measured in mid-sagittal images, and compared with those of a control group using the Mann-Whitney test. In children with anteriorly displaced anus, no anatomical abnormality was depicted at the level of the proximal anal canal. However, the distal anal canal was displaced anteriorly, running out its external muscle cuff, which remained un-displaced at the usual site of the anus. This changes the orientation of the central axis of the anal canal by passing across instead of along the fibers of the longitudinal muscle coat. Children with anteriorly displaced anus had a more obtuse anorectal angle (mean 112.1 ), which was significantly greater than that of the control group (mean 86.2 ). MRI is a valuable tool in studying the anatomy of the anal canal in children with anteriorly displaced anus. The abnormal orientation of the longitudinal muscle across the anal canal can explain the obstructed defecation in these children. Based on this study, it might be of interest to use MRI in studying equivocal cases and children with unexplained constipation. (orig.)

  13. Variations in leopard cat (Prionailurus bengalensis) skull morphology and body size: sexual and geographic influences.

    Science.gov (United States)

    Sicuro, Fernando L; Oliveira, Luiz Flamarion B

    2015-01-01

    The leopard cat, Prionailurus bengalensis (Kerr, 1792), is one of the most widespread Asian cats, occurring in continental eastern and southeastern Asia. Since 1929, several studies have focused on the morphology, ecology, and taxonomy of leopard cats. Nevertheless, hitherto there has been no agreement on basic aspects of leopard cat biology, such as the presence or absence of sexual dimorphism, morphological skull and body differences between the eleven recognized subspecies, and the biogeography of the different morphotypes. Twenty measurements on 25 adult leopard cat skulls from different Asian localities were analyzed through univariate and multivariate statistical approaches. Skull and external body measurements from studies over the last 77 years were assembled and organized in two categories: full data and summary data. Most of this database comprises small samples, which have never been statistically tested and compared with each other. Full data sets were tested with univariate and multivariate statistical analyses; summary data sets (i.e., means, SDs, and ranges) were analyzed through suitable univariate approaches. The independent analyses of the data from these works confirmed our original results and improved the overview of sexual dimorphism and geographical morphological variation among subspecies. Continental leopard cats have larger skulls and body dimensions. Skulls of Indochinese morphotypes have broader and higher features than those of continental morphotypes, while individuals from the Sunda Islands have skulls with comparatively narrow and low profiles. Cranial sexual dimorphism is present in different degrees among subspecies. Most display subtle sex-related variations in a few skull features. However, in some cases, sexual dimorphism in skull morphology is absent, such as in P. b. sumatranus and P. b. borneoensis. External body measurement comparisons also indicate the low degree of sexual dimorphism. Apart from the gonads, the longer hind

  14. Features extraction in anterior and posterior cruciate ligaments analysis.

    Science.gov (United States)

    Zarychta, P

    2015-12-01

    The main aim of this research is finding the feature vectors of the anterior and posterior cruciate ligaments (ACL and PCL). These feature vectors have to clearly define the ligaments structure and make it easier to diagnose them. Extraction of feature vectors is obtained by analysis of both anterior and posterior cruciate ligaments. This procedure is performed after the extraction process of both ligaments. In the first stage in order to reduce the area of analysis a region of interest including cruciate ligaments (CL) is outlined in order to reduce the area of analysis. In this case, the fuzzy C-means algorithm with median modification helping to reduce blurred edges has been implemented. After finding the region of interest (ROI), the fuzzy connectedness procedure is performed. This procedure permits to extract the anterior and posterior cruciate ligament structures. In the last stage, on the basis of the extracted anterior and posterior cruciate ligament structures, 3-dimensional models of the anterior and posterior cruciate ligament are built and the feature vectors created. This methodology has been implemented in MATLAB and tested on clinical T1-weighted magnetic resonance imaging (MRI) slices of the knee joint. The 3D display is based on the Visualization Toolkit (VTK).

  15. Repairing skull defects in children with nano-hap/collagen composites:A clinical report of thirteen cases

    Institute of Scientific and Technical Information of China (English)

    Tuoyu Chen; Fuzhai Cui; Yuqi Zhang; Huancong Zuo; Yapeng Zhao; Chaoqiang Xue; Bin Luo; Qinglin Zhang; Jin Zhu; Xiumei Wang

    2016-01-01

    Objective: To evaluate the clinical results of repairing skull defects with biomimetic bone (nano-hap/collagen composites, NHACs) in children. Methods:Thirteen children with skull defects were treated with NHACs in our hospital. The NHACs molded with the help of a 3D printer were used in the operations. Results: All 13 operations were successful, and patients recovered without infection. Only one patient suffered from subcutaneous hydrops post-operation. The implanted NHACs remained fixed well after 1 year, and their CT HU values raised gradually. Skull shapes of children developed normally. Recovery of neurological and cognitive function was significant. Conclusions:NHAC, chosen to repair skull defects in children, can coexist with normal skull and reduce the negative effects on growth and development. NHAC could be a good choice for children with skull defects.

  16. Phylogenetic eigenvectors and nonstationarity in the evolution of theropod dinosaur skulls.

    Science.gov (United States)

    Diniz-Filho, J A F; Alves, D M C C; Villalobos, F; Sakamoto, M; Brusatte, S L; Bini, L M

    2015-07-01

    Despite the long-standing interest in nonstationarity of both phenotypic evolution and diversification rates, only recently have methods been developed to study this property. Here, we propose a methodological expansion of the phylogenetic signal-representation (PSR) curve based on phylogenetic eigenvectors to test for nonstationarity. The PSR curve is built by plotting the coefficients of determination R(2) from phylogenetic eigenvector regression (PVR) models increasing the number of phylogenetic eigenvectors against the accumulated eigenvalues. The PSR curve is linear under a stationary model of trait evolution (i.e. the Brownian motion model). Here we describe the distribution of shifts in the models R(2) and used a randomization procedure to compare observed and simulated shifts along the PSR curve, which allowed detecting nonstationarity in trait evolution. As an applied example, we show that the main evolutionary pattern of variation in the theropod dinosaur skull was nonstationary, with a significant shift in evolutionary rates in derived oviraptorosaurs, an aberrant group of mostly toothless, crested, birdlike theropods. This result is also supported by a recently proposed Bayesian-based method (AUTEUR). A significant deviation between Ceratosaurus and Limusaurus terminal branches was also detected. We purport that our new approach is a valuable tool for evolutionary biologists, owing to its simplicity, flexibility and comprehensiveness.

  17. Oldest known pantherine skull and evolution of the tiger.

    Directory of Open Access Journals (Sweden)

    Ji H Mazák

    Full Text Available The tiger is one of the most iconic extant animals, and its origin and evolution have been intensely debated. Fossils attributable to extant pantherine species-lineages are less than 2 MYA and the earliest tiger fossils are from the Calabrian, Lower Pleistocene. Molecular studies predict a much younger age for the divergence of modern tiger subspecies at <100 KYA, although their cranial morphology is readily distinguishable, indicating that early Pleistocene tigers would likely have differed markedly anatomically from extant tigers. Such inferences are hampered by the fact that well-known fossil tiger material is middle to late Pleistocene in age. Here we describe a new species of pantherine cat from Longdan, Gansu Province, China, Panthera zdanskyi sp. nov. With an estimated age of 2.55-2.16 MYA it represents the oldest complete skull of a pantherine cat hitherto found. Although smaller, it appears morphologically to be surprisingly similar to modern tigers considering its age. Morphological, morphometric, and cladistic analyses are congruent in confirming its very close affinity to the tiger, and it may be regarded as the most primitive species of the tiger lineage, demonstrating the first unequivocal presence of a modern pantherine species-lineage in the basal stage of the Pleistocene (Gelasian; traditionally considered to be Late Pliocene. This find supports a north-central Chinese origin of the tiger lineage, and demonstrates that various parts of the cranium, mandible, and dentition evolved at different rates. An increase in size and a reduction in the relative size of parts of the dentition appear to have been prominent features of tiger evolution, whereas the distinctive cranial morphology of modern tigers was established very early in their evolutionary history. The evolutionary trend of increasing size in the tiger lineage is likely coupled to the evolution of its primary prey species.

  18. Computer vision and soft computing for automatic skull-face overlay in craniofacial superimposition.

    Science.gov (United States)

    Campomanes-Álvarez, B Rosario; Ibáñez, O; Navarro, F; Alemán, I; Botella, M; Damas, S; Cordón, O

    2014-12-01

    Craniofacial superimposition can provide evidence to support that some human skeletal remains belong or not to a missing person. It involves the process of overlaying a skull with a number of ante mortem images of an individual and the analysis of their morphological correspondence. Within the craniofacial superimposition process, the skull-face overlay stage just focuses on achieving the best possible overlay of the skull and a single ante mortem image of the suspect. Although craniofacial superimposition has been in use for over a century, skull-face overlay is still applied by means of a trial-and-error approach without an automatic method. Practitioners finish the process once they consider that a good enough overlay has been attained. Hence, skull-face overlay is a very challenging, subjective, error prone, and time consuming part of the whole process. Though the numerical assessment of the method quality has not been achieved yet, computer vision and soft computing arise as powerful tools to automate it, dramatically reducing the time taken by the expert and obtaining an unbiased overlay result. In this manuscript, we justify and analyze the use of these techniques to properly model the skull-face overlay problem. We also present the automatic technical procedure we have developed using these computational methods and show the four overlays obtained in two craniofacial superimposition cases. This automatic procedure can be thus considered as a tool to aid forensic anthropologists to develop the skull-face overlay, automating and avoiding subjectivity of the most tedious task within craniofacial superimposition.

  19. The relationship between skull morphology, masticatory muscle force and cranial skeletal deformation during biting.

    Science.gov (United States)

    Toro-Ibacache, Viviana; Zapata Muñoz, Víctor; O'Higgins, Paul

    2016-01-01

    The human skull is gracile when compared to many Middle Pleistocene hominins. It has been argued that it is less able to generate and withstand high masticatory forces, and that the morphology of the lower portion of the modern human face correlates most strongly with dietary characteristics. This study uses geometric morphometrics and finite element analysis (FEA) to assess the relationship between skull morphology, muscle force and cranial deformations arising from biting, which is relevant in understanding how skull morphology relates to mastication. The three-dimensional skull anatomies of 20 individuals were reconstructed from medical computed tomograms. Maximal contractile muscle forces were estimated from muscular anatomical cross-sectional areas (CSAs). Fifty-nine landmarks were used to represent skull morphology. A partial least squares analysis was performed to assess the association between skull shape and muscle force, and FEA was used to compare the deformation (strains) generated during incisor and molar bites in two individuals representing extremes of morphological variation in the sample. The results showed that only the proportion of total muscle CSA accounted for by the temporalis appears associated with skull morphology, albeit weekly. However, individuals with a large temporalis tend to possess a relatively wider face, a narrower, more vertically oriented maxilla and a lower positioning of the coronoid process. The FEAs showed that, despite differences in morphology, biting results in similar modes of deformation for both crania, but with localised lower magnitudes of strains arising in the individual with the narrowest, most vertically oriented maxilla. Our results suggest that the morphology of the maxilla modulates the transmission of forces generated during mastication to the rest of the cranium by deforming less in individuals with the ability to generate proportionately larger temporalis muscle forces.

  20. Mechanisms of anterior cruciate ligament injury in basketball - Video analysis of 39 cases

    NARCIS (Netherlands)

    Krosshaug, Tron; Nakamae, Atsuo; Boden, Barry P.; Engebretsen, Lars; Smith, Gerald; Slauterbeck, James R.; Hewett, Timothy E.; Bahr, Roald

    2007-01-01

    Background: The mechanisms of anterior cruciate ligament injury in basketball are not well defined. Purpose: To describe the mechanisms of anterior cruciate ligament injury in basketball based on videos of injury situations. Study Design: Case series; Level of evidence, 4. Methods: Six international

  1. Anterior chest wall examination reviewed

    Directory of Open Access Journals (Sweden)

    F. Trotta

    2011-09-01

    Full Text Available Anterior chest wall involvement is not infrequently observed within inflammatory arthropaties, particularly if one considers seronegative spondiloarthritides and SAPHO syndrome. Physical examination is unreliable and conventional X-rays analysis is an unsatisfactory tool during diagnostic work-up of this region. Scintigraphic techniques yield informations both on the activity and on the anatomical extent of the disease while computerized tomography visualize the elementary lesions, such as erosions, which characterize the process. Moreover, when available, magnetic resonance imaging couple the ability to finely visualize such lesions with the possibility to show early alterations and to characterize the “activity” of the disease, presenting itself as a powerful tool both for diagnosis and follow-up. This review briefly shows the applications of imaging techniques for the evaluation of the anterior chest wall focusing on what has been done in the SAPHO syndrome which can be considered prototypical for this regional involvement since it is the osteo-articular target mainly affected by the disease.

  2. Bilaterally symmetric Fourier approximations of the skull outlines of temnospondyl amphibians and their bearing on shape comparison

    Indian Academy of Sciences (India)

    Dhurjati P Sengupta; Debapriya Sengupta; Parthasarathi Ghosh

    2005-06-01

    Present work illustrates a scheme of quantitative description of the shape of the skull outlines of temnospondyl amphibians using bilaterally symmetric closed Fourier curves. Some special points have been identified on the Fourier fits of the skull outlines, which are the local maxima, or minima of the distances from the centroid of the points at the skull outline. These points denotes break in curvature of the outline and their positions can be compared to differentiate the skull shapes. The ratios of arc-lengths of the posterior and lateral outline of 58 temnospondyl skulls have been plotted to generate a triaguarity series of the skulls. This series grades different families, some of their genera and species as well as some individuals according to their posterior and lateral skull length ratios. This model while comparing different taxa, takes into account the entire arc-length of the outline of the temnospondyl skulls, and does not depend on few geometric or biological points used by earlier workers for comparing skull shapes.

  3. Research on the measuring scope of skull base midline structure tumors in the mothod of single-nostril microscopy combined with neural endoscopy%经单鼻孔入路显微镜结合神经内窥镜对颅底中线结构肿瘤活体观察测量研究

    Institute of Scientific and Technical Information of China (English)

    陈胜利; 乔志刚; 张汉伟; 张子屏; 胡涛; 王春红; 郭建忠; 吉宏明

    2012-01-01

    bridge of nose.in the operation,measure the distance from nasal columella to aperture of sphenoidal sinus; observe the shape of aperture of sphenoidal sinus; measure the longest and the shortest distance between aperture of sphenoidal sinus; observe the shape of septum of sphenoidal sinus,three uplift and the relationship among them,as well as the color and texture of the tumor.Measure sphenoid sinus wall,screening room,sellar floor,extent of slope resection,operating space,as well as observation & study of selection and repairing of skull base reconstruction materials. Results The shape according to the discretion of the column is divided into butterfly saddle nose, normal nose, eagle nose and acromegaly hypertrophy nose.The nostrils shape is "kidney form","ball form","snow humanoid form"and" triangle form".The butterfly saddle biggest digging distance:between the cavernous sinus is( 18.9±2.51 ) mm,from saddle nodules to slope is(19.2 ±2.67) mm.After tumor resection,the transsphenoidal observation space is forward to former group of ethmoid sinus,back to the slope. Conclusion The measurement data might be benefit for selecting of speculum, evalution of placing depth on speculum and operation position and sellar floor opening range. It would also make it possible for a safer, minimally invasive and effective surgery by avoid damage to the internal carotid artery,cavernous sinus or cranial nerve.

  4. 中国耳鼻咽喉颅底外科杂志作者稿件学术不端常见问题分析%Analysis of common problems detected via academic misconduct literature check system in Chinese Journal of Otorhinolaryngology-Skull Base Surgery

    Institute of Scientific and Technical Information of China (English)

    李惠清; 钟礼沙; 俞诺

    2013-01-01

    Objective To understand the academic misconducts detected in manuscripts contributed to Chinese Journal of Otorhinolaryngology-Skull Base Surgery by on-line misconduct detection system of China National Knowledge Infrastructure (CNKI),and to put forward countermeasures to these problems according to the rules of the journal.Methods 454 manuscripts submitted were detected by above-mentioned system from Sept 2011 to Jan 2013.And all of them were free contributions,which were screened by the responsible editor in keeping with the magazine ' s form in Chinese.Results Of all 454 manuscripts detected,the replication rate was found to be greater than 30% in 99 (21.8%),among them the replication rate of 30% ~40%,40% ~50%,and higher than 50% were 9.3% in 42,4.2% in 19 and 8.37% in 38 respectively.The highest plagiarism rate was 89.8%.Number of The papers withno detectable replication was 81 (17.8%).The other main misconducts included falsified data,patchwork of articles,papers with low level repetition and disloyal citation of references.The manuscripts with replication rate higher than 35 % were all rejected.Conclusions Any academic misconduct should be exposed.The journals should full utilize the misconduct literature retrieval system.Editors should enhance their comprehensive quality to guarantee articles with high academic level,and should communicate with the related periodicals more closely in order to increase the penalties for acaclemic disconducts and to improve the academic consciousn