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1.
Direct Transoral Approach to C2 for Percutaneous Vertebroplasty 总被引:1,自引:0,他引:1
Jean-Baptiste Martin Philippe Gailloud Pierre-Yves Dietrich Marc E. Luciani Thierry Somon Pascal-André Sappino Daniel A. Rüfenach 《Cardiovascular and interventional radiology》2002,25(1)
Percutaneous vertebroplasty was performed via a transoral route in a 70-year-old woman with a C2 metastasis of thyroid origin involving anterior vertebral elements. Complete pain relief was obtained after an uncomplicated minimally invasive procedure. This preliminary experience demonstrates that a transoral approach under fluoroscopic control can provide safe access to the upper cervical spine at C2 level. 相似文献
2.
PURPOSE: To assess the value of a direct transoral approach to C2 for interventional procedures. MATERIALS AND METHODS: A transoral approach to C2 was used in 4 patients (9-64 year old) with lytic lesion of the C2 vertebra and/or base of the odontoid over a 10 year period. Three patients underwent biopsy and 1 patient underwent vertebroplasty using biplane fluoroscopy. All procedures were performed under general anesthesia using a 13G needle directly introduced in the C2 vertebra through the posterior pharyngeal wall. RESULTS: None of the patients reported ill-effects from the procedure. Needle placement was satisfactory in all patients, without technical difficulty. No technical complication was noted. Specifically, no infectious complication occurred. CONCLUSION: Our results indicate that a direct transoral approach to C2 is safe for biopsy or vertebroplasty. 相似文献
3.
The injection of polymethylmethacrylate (PMMA) is a minimally invasive, image-guided procedure used to treat vertebral fractures
due to osteoporosis, metastatic lesions, multiple myeloma, and benign but destabilizing bone tumors. The injection of PMMA
into the C2 vertebral body using the transoral technique has been reported in three separate patients for treatment of benign
tumors (a vertebral hemangioma and an aneurysmal bone cyst) and for multiple myeloma in the third patient. Although the injection
of PMMA into the vertebral body is most commonly performed to treat benign vertebral compression fractures, a transoral C2
approach has not been reported in the English literature as a treatment for a benign fracture of C2. We report the treatment
of a fracture and nonunion of the base of the dens and a subarticular fracture of the vertebral body of C2 using a bilateral
transoral approach. 相似文献
4.
Robert DOrtenzio Stefano Tolhurst Melissa Harvey Ravi Ghag Manraj KS Heran 《Journal of Radiology Case Reports》2021,15(3):1
Mass lesions presenting at the craniocervical junction often present a unique challenge due to the complex anatomic arrangement limiting access for tissue diagnosis. The transoral approach has predominantly been used for percutaneous vertebroplasty of high cervical vertebrae with limited literature describing image guided biopsy for bony lesions in this region in the pediatric patient. We describe a technique of computed tomography guided transoral biopsy of a poorly differentiated chordoma located at the C1–C2 level in a 5-year-old child, and review this diagnosis. 相似文献
5.
经口咽前路枢椎椎体次全切在陈旧性寰枢椎脱位中的应用 总被引:1,自引:0,他引:1
目的 探讨经口咽前路枢椎椎体次全切除椎管扩大范围减压术治疗陈旧性寰枢椎脱位伴以C2后方受压为主的脊髓压迫症的疗效。方法 对15例先天畸形或外伤(12例先天畸形,3例外伤)引起的陈旧性寰枢椎脱位伴高位脊髓压迫症患者,采用经口咽前路C2椎体次全切除术(11例仅行C2椎体次全切除,4例行C2椎体次全切除同时切除C1前结节和齿突)。结果 术后平均随访20个月,按Symon和Lavender临床评定标准和影像学评定标准评定疗效。临床总有效率15/15,显效率9/15,术后影像学显示椎管减压改善率平均为79.8%。本组无术中脊髓损伤、血管损伤及术后感染等并发症。结论 该术式减压充分,是治疗以C2后方受压为主的脊髓压迫症较好的术式。 相似文献
6.
7.
前后路一期减压内固定治疗陈旧性寰枢椎脱位 总被引:12,自引:2,他引:12
总结和介绍前后路一期减压、内固定手术治疗陈旧性寰枢椎脱位的临床效果。采用同次进行经口咽前路减压松解和后路减压枕颈内固定植骨融合治疗12例难复性寰枢椎脱位伴高位颈髓压迫症。平均随访20个月,参照Symon和Lavender标准评价临床疗效;测量并比较手术前后颈椎管造影或MRI扫描椎管矢径的变化。结果显示,临床总有效率为91.6%,显效率为50%;椎管减压改善率平均达73.6%。提示前后路一期减压内固定融合术是适应于陈旧性难复性和不可复性寰枢椎脱位伴颈髓压迫症的一种临床效果较好的治疗方法。 相似文献
8.
Taniura S Tatebayashi K Akatsuka K Takenobu A Kamitani H Yokota M Watanabe T 《AJNR. American journal of neuroradiology》2004,25(5):871-872
A 6-year-old girl was admitted for transoral penetrating injury by a half-split chopstick. Subsequent CT imaging examinations showed that the chopstick had passed between the basion and the dens and reached the subarachnoid space just at the medulla oblongata. A sagittal reconstructed CT scan was useful for the evaluation of the injury. Imaging findings and their clinical relevance are discussed. 相似文献
9.
H R D'Agostino R J Liebig M McGovern A Weinshelbaum S B Reich 《Investigative radiology》1989,24(11):899-902
Experimental aspiration of water soluble contrast agents was performed on rats via transoral endotracheal injection. Iopamidol, iohexol and diatrizoate were the contrast agents tested. One group of rats received normal saline as a control. Adjusted lung weights were measured at 2 and 24 hours post aspiration. Radiographs were taken at 2 and 24 hours post aspiration and scored for abnormal pulmonary air space density. Diatrizoate alone demonstrated an increase in adjusted lung weights. Diatrizoate, iopamidol and iohexol showed abnormal pulmonary air space disease on radiographs at 2 hours but not at 24 hours. Histopathologic examination of rat lungs following aspiration of all three contrasts showed pulmonary vascular congestion and perivascular edema. Iopamidol showed evidence of acute cellular inflammation. Iohexol provoked a pulmonary alveolar macrophage response. 相似文献
10.
Inaba Y Kamata M Arai Y Matsueda K Aramaki T Takaki H 《The British journal of radiology》2004,77(921):787-789
During attempted oesophageal stent placement in a patient with cervical oesophageal cancer in whom swallowing of even saliva was impossible, transoral access to the cervical oesophagus was unsuccessful. Under ultrasound and fluoroscopy guidance, percutaneous gastric puncture was performed, and using an angiographic catheter and guidewire, access to the oesophagus by a retrograde transgastric route was successfully achieved. The obstructed segment of the oesophagus was traversed. It was then possible to pull the guidewire through the mouth and place an oesophageal stent via an antegrade approach. 相似文献
11.
口内入路辅助颊部小切口穿颊微创治疗下颌骨角和升支骨折 总被引:1,自引:0,他引:1
目的观察口内和经颊小切口手术入路处理下颌骨角部和升支部骨折,并用小钛板坚固内固定的疗效。方法2000年1月—2006年7月期间21例连续的下颌骨角部和升支骨折患者,经口内切口联合颊部小切口复位内固定。随机选取同期的另26例同类型骨折患者,按照传统口外入路行手术切开复位内固定,对两组间的效果进行对比。结果用口内辅助经颊小切口入路患者中有1例内固定术后出现面瘫;口外入路行颌间固定手术患者中有6例出现面瘫,有2例需行术后颌间固定。没有术后感染需切开引流或取出固定物的病例。结论口内辅助颊部小切口入路行坚固内固定对不伴有严重错位或粉碎性骨折的下颌骨角部和升支部骨折有较好疗效。 相似文献
12.
M W van den Brekel L C Reitsma J J Quak L E Smeele J C van der Linden G B Snow J A Castelijns 《AJNR. American journal of neuroradiology》1999,20(9):1727-1731
BACKGROUND AND PURPOSE: The management of the clinically negative neck (NO) remains controversial because the incidence of occult metastases is high and the prognostic difference between elective treatment and a "wait and see" approach remains unclear. This study was undertaken to assess the role of sonographically guided aspiration cytology for the selection of the initial-management strategy for the neck and for the early detection of neck metastases during follow-up of patients with NO. METHODS: Seventy-seven clinically and cytologically confirmed NO patients, who underwent a transoral tumor excision and no neck treatment, were followed up for 1 to 4 years by both palpation and sonographically guided aspiration cytology. RESULTS: Fourteen patients (18%) had recurrent neck tumor; 10 (71%) of these necks were salvaged. Of the 14 neck failures, six were detected before being palpable and nine were detected within 7 months. Eleven of the 19 aspirated tumor-positive nodes had a minimal diameter smaller than 1 cm, and all four patients who eventually died had lymph node metastases larger than 14 mm. CONCLUSION: With sonographically guided aspiration cytology, the risk of missing occult metastases was 18%, which is less than expected after palpation only. Sonographically guided aspiration cytology is an effective technique for following up on the status of the neck after transoral tumor excision, and should be used at frequent intervals if no elective neck treatment is performed. 相似文献
13.
A T Walker J C Chaloupka C M Putman J J Abrahams D A Ross 《AJNR. American journal of neuroradiology》1996,17(2):377
A patient presented with transoral hemorrhage 3 months after CT-guided percutaneous biopsy of the masticator space, prompting concern about sentinel hemorrhage from impending carotid artery rupture related to prior radical head and neck surgery and radiation therapy. Angiographic evaluation showed the internal carotid artery to be normal but demonstrated a pseudoaneurysm of the buccal branch of the internal maxillary artery exactly corresponding to the site of prior fine-needle biopsy. 相似文献
14.
Objectives
Accurate measurement of the three-dimensional (3D) motion of the mandible in vivo is essential for relevant clinical applications. Existing techniques are either of limited accuracy or require the use of transoral devices that interfere with jaw movements. This study aimed to develop further an existing method for measuring 3D, in vivo mandibular kinematics using single-plane fluoroscopy; to determine the accuracy of the method; and to demonstrate its clinical applicability via measurements on a healthy subject during opening/closing and chewing movements.Methods
The proposed method was based on the registration of single-plane fluoroscopy images and 3D low-radiation cone beam CT data. It was validated using roentgen single-plane photogrammetric analysis at static positions and during opening/closing and chewing movements.Results
The method was found to have measurement errors of 0.1 ± 0.9 mm for all translations and 0.2° ± 0.6° for all rotations in static conditions, and of 1.0 ± 1.4 mm for all translations and 0.2° ± 0.7° for all rotations in dynamic conditions.Conclusions
The proposed method is considered an accurate method for quantifying the 3D mandibular motion in vivo. Without relying on transoral devices, the method has advantages over existing methods, especially in the assessment of patients with missing or unstable teeth, making it useful for the research and clinical assessment of the temporomandibular joint and chewing function. 相似文献15.
Murat Salihoglu Murat Eroglu Ali Osman Yildirim Adem Cakmak Umit Hardal Kemal Kara 《Clinical imaging》2013,37(3):465-467
PurposeTo evaluate the contribution of transoral ultrasonography (TUS) in the diagnosis and treatment of peritonsillar abscess.MethodsWe assessed the records of the patients who underwent TUS for suspected peritonsillar abscess.ResultsWe identified a total of 26 patients with a prediagnosis of peritonsillar abscess. Following TUS examination, while the diagnosis was confirmed for 23 of the 26 patients (88.46%), the remaining 3 (11.53%) were diagnosed as having peritonsillar cellulitis.ConclusionTUS allows the differentiation of peritonsillar abscess from cellulitis, hence to avoid an unnecessary invasive procedure in the case of a peritonsillar cellulitis. 相似文献
16.
The purpose of this study was to simplify a fluoroscopy guided gastrostomy technique using pull-type tubes which are traditionally
introduced with gastroscopic assistance. The stomach was transorally probed with a 5-Fr catheter and a guidewire. A second
access was performed percutaneously through the anterior abdominal and gastric wall using an 8-Fr sheath and an 8-Fr guiding
catheter. A duplicated guidewire was introduced through the guiding catheter in order to result in a great custom-made loop
within the stomach. The transoral guidewire was captured and tightened with this loop and the guiding catheter, and both were
subsequently pulled by the transoral guidewire until the tip of the guiding catheter exited the mouth. A thread was fed through
the guiding catheter for fixation of the pull-type gastrostomy tube. Finally, the fixed tube was pulled through the esophagus
into the stomach and through the abdominal wall until the anterior gastric wall fixed the retention plate of the tube. Thirty-seven
patients (28 male, 9 female; age, 65.1 ± 14.4 years) with miscellaneous indications for percutaneous gastrostomies were supplied
with pull-type gastrostomy catheters in a fluoroscopy technique without endoscopic assistance. Twenty-five of the 37 patients
(67.6%) had undergone unsuccessful preceding gastroscopically guided PEG attempts because of tumor stenosis (n = 12) or impossible transillumination of the abdominal wall (n = 13). All procedures were technically successful, without major complications. Particularly, all patients with frustrating
gastroscopic attempts were successfully provided with pull-type gastrostomy tubes. Five minor complications occurred: one
tube loss during the passage of the hypopoharynx because of a torn thread, one transient small leakage alongside the tube
(both successfully treated), and three cases of transient moderate local pain without leakage (symptomatic treatment). We
conclude that this fluoroscopy-guided pull-through gastrostomy technique is easy and safe to perform and may be suggested
as a standard procedure for radiological gastrostomies. It combines the ease of the radiological approach with the advantages
of the pull-type tube devices, particularly the benefits of the typical retention plates. 相似文献
17.
H Glanz 《Strahlentherapie und Onkologie》1989,165(6):420-424
Today an individualized proceeding is possible thanks to the progress in diagnostics. Different degrees of surgical procedures can be applied. The following methods are available: maxillectomy (partial transoral resection of the upper jaw, transfacial resection of the upper jaw, extended transfacial resection of the upper jaw) and lateral rhinotomy (lateral osteoplastic rhinotomy with resection of the ethmoid bone and evisceration of the inner nose, lateral osteoplastic rhinotomy with extended resection of the ethmoid bone, combined transfacial craniofrontal resection of the ethmoid bone). 相似文献
18.
Summary A 50-year old woman with a giant parapharyngeal meningioma extending from the intracranial cavity was admitted to our hospital. The parapharyngeal tumor was biopsied using the transoral approach and a histological section diagnosis suggested meningioma. Thereafter, further examination by magnetic resonance images (MRI) and contrast enhanced CT scans revealed a diffuse meningioma en plaque in the posterior fossa. Invasion extended from the clival dura to the right sigmoid sinus. The extracranial extension of a meningioma is very rare but a few cases have been reported. In almost all of the reported cases, a large intracranial meningioma was simultaneously or previously verified by CT scans.Our case was special in that the intracranial mass was not voluminous but showed en plaque extension, and also because the pathway of the extracranial extension through the jugular foramen was clearly visualized by CT and MRI. Obliteration and invasion of the right sigmoid sinus and the internal jugular vein by tumor were also demonstrated. 相似文献
19.
Quon H Finlay J Cengel K Zhu T O'Malley B Weinstein G 《Photodiagnosis and Photodynamic Therapy》2011,8(1):64-67
Photodynamic therapy (PDT) has been used for head and neck carcinomas with little experience in the oropharynx due to technical challenges in achieving adequate exposure. We present the case of a patient with a second right tonsil carcinoma following previous treatment with transoral robotic surgery (TORS) and postoperative chemoradiation for a left tonsil carcinoma. Repeat TORS for the right tonsil carcinoma reviewed multiple positive surgical margins. The power output from the robotic camera was modified to facilitate safe intraoperative three dimensional visualization of the tumor bed. The robotic arms facilitated clear exposure of the tonsil and tongue base with stable administration of the fluence. Real-time measurements confirmed stable photobleaching with augmentation of the prescribed light fluence secondary to light scatter in the oropharynx. We report a potential new role using TORS for exposure and accurate PDT in the oropharynx. 相似文献
20.
Leone A Costantini A Visocchi M Vestito A Colelli P Magarelli N Colosimo C Bonomo L 《La Radiologia medica》2012,117(4):636-653