Three-dimensional computed tomography reconstruction in treatment planning for large ameloblastoma

Assessment of quality of life in giant ameloblastoma adolescent patients who have had mandible defects reconstructed with a free fibula flap

Background

The reconstruction of mandibular defects after giant ameloblastoma resection is one of the most challenging problems facing reconstructive surgeons. Mandibular resection has been associated with a poor quality of life (QOL), particularly in adolescent patients reconstructed with a free fibula flap. This study aims to evaluate QOL outcomes in adolescent patients who have had mandibular resections of giant ameloblastoma and reconstruction with a free fibula flap and to collect information about their socio-cultural situation.

Methods

The present study assessed 45 adolescent patients who had undergone immediate mandible reconstruction with a free fibula flap for faint ameloblastoma using University of Washington Quality of Life (UW-QOL) and 14-item Oral Health Impact Profile (OHIP-14) questionnaires.

Results

Thirty-five of the 54 questionnaires were returned (64.81%). In the UW-QOL, of the twelve disease-specific domains, the best three scores from the patients related to pain, shoulder and appearance and the worst three scores related to chewing, anxiety and saliva. In the OHIP-14, the lowest-scoring domain was handicap, followed by physical pain and social disability.

Conclusions

Mandibular reconstruction with a free fibular flap significantly influenced the adolescent patients’ QOL. Adolescent patients pay more attention to postoperative facial appearance; this should be considered in surgical planning.

Three Dimensional Spiral CT Imaging of the Musculoskeletal System: Application and Advantages

BACKGROUND

Clinical applications of spiral computed tomography (CT) have increased extensively over the past decade and continue to widen rapidly. The introduction of three-dimensional(3-D) reconstruction in CT technology has revolutionized medical imaging. This advancement has been possible due to the combination of spiral computed tomography and various 3-D reconstruction protocols which have permitted rapid and comprehensive examination of all regions of the body. It has unequivocal advantages in the preoperative planning of craniofacial surgery, assessment of complex fractures of the skeletal system especially pelvis and in the surgical treatment of dysplastic hips in children.

METHODS

3-D spiral CT imaging of various parts of the musculoskeletal system was carried out in 60 cases using available protocols, at the CT scan center of a large tertiary care service hospital.

RESULTS

The study provided a new approach in the analysis of complex anatomic relationships of the musculoskeletal system. Therapeutic planning whether surgical or medical was to a great extent aided by the anatomic information available from these images.

CONCLUSION

3-D CT imaging is a rapid, non-invasive and accurate technique for diagnosis, pre-operative evaluation as well as post-operative assessment of a large number of musculoskeletal diseases. 3-D CT studies have come to stay and with continued improvement in CT technology it has now become an integral part of imaging studies of the musculoskeletal system.

Diagnostic imaging with newly developed ortho cubic super-high resolution computed tomography (Ortho-CT)

OBJECTIVE

Ortho cubic super-high resolution computed tomography (Ortho-CT), which we have developed, is characterized by the small size of the unit and the ability to produce 3-dimensional images of high resolution with low-radiation doses. The purpose of this study was to investigate the clinical usefulness of Ortho-CT for the diagnosis of diseases in the oral and maxillofacial region.

STUDY DESIGN

Ortho-CT has been used for the imaging diagnosis of a radicular cyst of the upper first molar, mesiodense, tooth fractures in the upper anterior region, a fracture of the condylar process, or presurgical evaluation for a dental implant. The usefulness of 3-dimensional images obtained by Ortho-CT was investigated in this study.

RESULTS

Ortho-CT produced images of high resolution, enabling identification of the extent of the lesions and the fracture line, the condition of the impacted tooth, and the relationship with the maxillary sinus, mandibular canal, and adjacent teeth.

CONCLUSION

Because Ortho-CT can take high-resolution 3-dimensional images at any tomographic layer with only 1 exposure, it is useful for the diagnosis of diseases in the oral and maxillofacial region.