Virtual Endoscopy and 3-D Reconstruction/Prototyping in Head and Neck Surgeries
The use and application of the three-dimensional (3-D) reconstructions generated from suitable files digital imaging and communications in medicine (DICOM) of computed tomography (CT) or magnetic resonances (MR) have been expanding recently. Such reconstructions allow physicians to observe anatomic cavities and structures within our body with an incredible amount of details in addition to displaying the textures of variety of tissues. The applications of such reconstructions have varied from simple illustrations in exams up to the help in the diagnosis and preoperative planning in several medical specialties. As an example of such application we have virtual colonoscopy performed by GI colleagues and also CAD by cardiologists. In our specialty there have been some attempts to carry out virtual endoscopies and laryngoscopies. However, such application has been practically abandoned due to its complexity and need for computers with high power of graphic processing. However, with the evolution of proper computers and programs for reading and reconstruction of the DICOM files, currently some authors have recovered the use of such 3-D reconstructions for evaluation and preoperative planning specially related to head and neck surgeries and to recess and frontal sinus. Such 3-D reconstructions may offer potentially more usable information than those obtained with 2-D views in the axial, coronal, and sagittal plans. These images obtained in the three different planes, axial, coronal, and sagittal, are usable in the analysis of the recess and frontal sinus. However, these two-dimensional images are of more difficult comprehension for surgeons. We live in a three-dimensional world and despite a large part of the endoscopes still do not allow the performance of 3-D stereoscopic surgeries; the images obtained in the traditional endoscopic surgeries allow us the creation of 3-D relationships in our mind.
KeywordsVirtual endoscopy (3-D) reconstructions DICOM of computed tomography Prototyping Head and neck surgeries 3-D printing of airway pathology
3-D reconstruction of foreign body ingestion using different series and reconstruction methodology to accurately delineate the metallic FB (needle) and its relation to the different adjacent structures. (AVI 8220 kb)
3-D reconstruction of foreign body ingestion using different series and reconstruction methodology to accurately delineate the faint FB (fish bone) and its relation to the different adjacent structures (AVI 20627 kb)
3-D reconstruction of foreign body ingestion using different series and reconstruction methodology to accurately delineate the faint FB (fish bone) and its relation to the different adjacent structures (MOV 5347 kb)
Virtual endoscopy evaluation inside the trachea showing no extension of the FB into the tracheal lumen (MOV 8881 kb)
Preoperative naso-endoscopic evaluation revealed the presence of abnormal mucosal lined drumstick-shaped structure of odd presentation, yet with no signs of malignancy or hyper-vascularity (MP4 43,530 kb)
3-D reconstruction video shows displaced blade of the hyoid bone, in which the thyroid mass lesion was clearly visualized (MOV 8157 kb)
Naso-endoscopic assessment revealed a web formation at the level of the glottis extending from the anterior commissure to the junction between the anterior two-thirds and posterior one-third of the vocal cord (MP4 24,769 kb)
Virtual endoscopic evaluation was done which showed the web to be at a supraglottic region, while the glottic region was clear (MOV 2422 kb)
Virtual endoscopic evaluation was done which showed the web to be at a supraglottic region, while the glottic region was clear (MOV 24130 kb)
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