Search results for: skull base surgery
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3100

Search results for: skull base surgery

2860 Pre-Operative Tool for Facial-Post-Surgical Estimation and Detection

Authors: Ayat E. Ali, Christeen R. Aziz, Merna A. Helmy, Mohammed M. Malek, Sherif H. El-Gohary

Abstract:

Goal: Purpose of the project was to make a plastic surgery prediction by using pre-operative images for the plastic surgeries’ patients and to show this prediction on a screen to compare between the current case and the appearance after the surgery. Methods: To this aim, we implemented a software which used data from the internet for facial skin diseases, skin burns, pre-and post-images for plastic surgeries then the post- surgical prediction is done by using K-nearest neighbor (KNN). So we designed and fabricated a smart mirror divided into two parts a screen and a reflective mirror so patient's pre- and post-appearance will be showed at the same time. Results: We worked on some skin diseases like vitiligo, skin burns and wrinkles. We classified the three degrees of burns using KNN classifier with accuracy 60%. We also succeeded in segmenting the area of vitiligo. Our future work will include working on more skin diseases, classify them and give a prediction for the look after the surgery. Also we will go deeper into facial deformities and plastic surgeries like nose reshaping and face slim down. Conclusion: Our project will give a prediction relates strongly to the real look after surgery and decrease different diagnoses among doctors. Significance: The mirror may have broad societal appeal as it will make the distance between patient's satisfaction and the medical standards smaller.

Keywords: k-nearest neighbor (knn), face detection, vitiligo, bone deformity

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2859 A Comparison between Shear Bond Strength of VMK Master Porcelain with Three Base-Metal Alloys (Ni-Cr-T3, Verabond, Super Cast) and One Noble Alloy (X-33) in Metal-Ceramic Restorations

Authors: Ammar Neshati, Elham Hamidi Shishavan

Abstract:

Statement of Problem: The increase in the use of metal-ceramic restorations and a high prevalence of porcelain chipping entails introducing an alloy which is more compatible with porcelain and which causes a stronger bond between the two. This study is to compare shear bond strength of three base-metal alloys and one noble alloy with the common VMK Master Porcelain. Materials and Method: Three different groups of base-metal alloys (Ni-cr-T3, Super Cast, Verabond) and one group of noble alloy (x-33) were selected. The number of alloys in each group was 15. All the groups went through the casting process and change from wax pattern into metal disks. Then, VMK Master Porcelain was fired on each group. All the specimens were put in the UTM and a shear force was loaded until a fracture occurred. The fracture force was then recorded by the machine. The data was subjected to SPSS Version 16 and One-Way ANOVA was run to compare shear strength between the groups. Furthermore, the groups were compared two by two through running Tukey test. Results: The findings of this study revealed that shear bond strength of Ni-Cr-T3 alloy was higher than the three other alloys (94 Mpa or 330 N). Super Cast alloy had the second greatest shear bond strength (80. 87 Mpa or 283.87 N). Both Verabond (69.66 Mpa or 245 N) and x-33 alloys (66.53 Mpa or 234 N) took the third place. Conclusion: Ni-Cr-T3 with VMK Master Porcelain has the greatest shear bond strength. Therefore, the use of this low-cost alloy is recommended in metal-ceramic restorations.

Keywords: shear bond, base-metal alloy, noble alloy, porcelain

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2858 Evaluation of Zr/NH₄ClO₄ and Zr/KClO₄ Compositions for Development of Igniter for Ammonium Perchlorate and Hydroxyl-Terminated Polybutadiene Based Base Bleed System

Authors: Amir Mukhtar, Habib Nasir

Abstract:

To achieve an enhanced range of large calibre artillery a base bleed unit equipped with ammonium perchlorate and hydroxyl-terminated polybutadiene (AP/HTPB) based composite propellant grain is installed at the bottom of a projectile which produces jet of hot gasses and reduces base drag during flight of the projectile. Upon leaving the muzzle at very high muzzle velocity, due to sudden pressure drop, the propellant grain gets quenched. Therefore, base-bleed unit is equipped with an igniter to ensure ignition as well as reignition of the propellant grain. Pyrotechnic compositions based on Zr/NH₄ClO₄ and Zr/KClO₄ mixtures have been studied for the effect of fuel/oxidizer ratio and oxidizer type on ballistic properties. Calorific values of mixtures were investigated by bomb calorimeter, the average burning rate was measured by fuse wire technique at ambient conditions, and high-pressure closed vessel was used to record pressure-time profile, maximum pressure achieved (Pmax), time to achieve Pmax and differential pressure (dP/dt). It was observed that the 30, 40, 50 and 60 wt.% of Zr has a very significant effect on ballistic properties of mixtures. Compositions with NH₄ClO₄ produced higher values of Pmax, dP/dt and Calorific value as compared to Zr/KClO₄ based mixtures. Composition containing KClO₄ comparatively produced higher burning rate and maximum burning rate was recorded at 8.30 mm/s with 60 wt.% Zr in Zr/KClO₄ pyrotechnic mixture. Zr/KClO₄ with 50 wt. % of Zr was tests fired in igniter assembly by electric initiation method. Igniter assembly was test fired several times and average burning time of 3.5 sec with igniter mass burning rate of 6.85 g/sec was recorded. Igniter was finally fired on static and dynamic level with base bleed unit which gave successful ignition to the base bleed grain and extended range was achieved with 155 mm artillery projectile.

Keywords: base bleed, closed vessel, igniter, zirconium

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2857 Geochemical and Petrological Survey in Northern Ethiopia Basement Rocks for Investigation of Gold and Base Metal Mineral Potential in Finarwa, Southeast Tigray, Ethiopia

Authors: Siraj Beyan Mohamed, Woldia University

Abstract:

The study is accompanied in northern Ethiopian basement rocks, Finarwa area, and its surrounding areas, south eastern Tigray. From the field observations, the geology of the area haven been described and mapped based on mineral composition, texture, structure, and colour of both fresh and weather rocks. Inductively coupled plasma mass spectrometry (ICP-MS) and atomic absorption spectrometry (AAS) have conducted to analysis gold and base metal mineralization. The ore mineral under microscope are commonly base metal sulphides pyrrhotite, Chalcopyrite, pentilanditeoccurring in variable proportions. Galena, chalcopyrite, pyrite, and gold mineral are hosted in quartz vein. Pyrite occurs both in quartz vein and enclosing rocks as a primary mineral. The base metal sulfides occur as disseminated, vein filling, and replacement. Geochemical analyses result determination of the threshold of geochemical anomalies is directly related to the identification of mineralization information. From samples, stream sediment samples and the soil samples indicated that the most promising mineralization occur in the prospect area are gold(Au), copper (Cu), and zinc (Zn). This is also supported by the abundance of chalcopyrite and sphalerite in some highly altered samples. The stream sediment geochemical survey data shows relatively higher values for zinc compared to Pb and Cu. The moderate concentration of the base metals in some of the samples indicates availability base metal mineralization in the study area requiring further investigation. The rock and soil geochemistry shows the significant concentration of gold with maximum value of 0.33ppm and 0.97 ppm in the south western part of the study area. In Finarwa, artisanal gold mining has become an increasingly widespread economic activity of the local people undertaken by socially differentiated groups with a wide range of education levels and economic backgrounds incorporating a wide variety of ‘labour intensive activities without mechanisation.

Keywords: gold, base metal, anomaly, threshold

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2856 Comparative DNA Binding of Iron and Manganese Complexes by Spectroscopic and ITC Techniques and Antibacterial Activity

Authors: Maryam Nejat Dehkordi, Per Lincoln, Hassan Momtaz

Abstract:

Interaction of Schiff base complexes of iron and manganese (iron [N, N’ Bis (5-(triphenyl phosphonium methyl) salicylidene) -1, 2 ethanediamine) chloride, [Fe Salen]Cl, manganese [N, N’ Bis (5-(triphenyl phosphonium methyl) salicylidene) -1, 2 ethanediamine) acetate) with DNA were investigated by spectroscopic and isothermal titration calorimetry techniques (ITC). The absorbance spectra of complexes have shown hyper and hypochromism in the presence of DNA that is indication of interaction of complexes with DNA. The linear dichroism (LD) measurements confirmed the bending of DNA in the presence of complexes. Furthermore, isothermal titration calorimetry experiments approved that complexes bound to DNA on the base of both electrostatic and hydrophobic interactions. Furthermore, ITC profile exhibits the existence of two binding phases for the complex. Antibacterial activity of ligand and complexes were tested in vitro to evaluate their activity against the gram positive and negative bacteria.

Keywords: Schiff base complexes, ct-DNA, linear dichroism (LD), isothermal titration calorimetry (ITC), antibacterial activity

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2855 Biosorption of Ni (II) Using Alkaline-Treated Rice Husk

Authors: Khanom Simarani

Abstract:

Rice husk has been widely reported as a good sorbent for heavy metals. Pre treatment of rice husk minimizes cellulose crystallinity and increases the surface area thus ensuring better adsorption capacity. Commercial base and natural base-treated rice husk were used to investigate the potential of Ni(II) adsorption from synthetic solutions and waste water in batch systems. Effects of process variables such as pH, contact time, adsorbent dose, initial Ni (II) concentration were studied. Optimum Ni (II) adsorption was observed at pH 6 within 60 min of contact time. Experimental data showed increased amount of adsorbed Ni(II) with increasing adsorbent dose and decreased percent of adsorption with increasing initial Ni(II) concentration. Kinetic isotherms (Langmuir, Freundlich) were also applied. Biosorption mechanism of rice husk was analyzed using SEM/EDS, FT-IR, and XRD. The results revealed that natural base produced from agroindustrial waste could be used as efficient as commercial bases during pre treatment rice husk in removing Ni(II) from waste waters within 15 min.

Keywords: Nickel removal, adsorbent, heavy metal, biomass

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2854 Investigation of Heating Behaviour of E-Textile Structures

Authors: Hande Sezgin, Senem Kursun Bahadır, Yakup Erhan Boke, Fatma Kalaoğlu

Abstract:

Electronic textiles (e-textiles) are fabrics that contain electronics and interconnections with them. In this study, two types of base yarns (cotton and acrylic) and three conductive steel yarns with different linear resistance values (14Ω/m, 30Ω/m, 70Ω/m) were used to investigate the effect of base yarn type and linear resistance of conductive yarns on thermal behavior of e-textile structures. Thermal behavior of samples were examined by thermal camera.

Keywords: conductive yarn, e-textiles, smart textiles, thermal analysis

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2853 Implementing a Hospitalist Co-Management Service in Orthopaedic Surgery

Authors: Diane Ghanem, Whitney Kagabo, Rebecca Engels, Uma Srikumaran, Babar Shafiq

Abstract:

Hospitalist co-management of orthopaedic surgery patients is a growing trend across the country. It was created as a collaborative effort to provide overarching care to patients with the goal of improving their postoperative care and decreasing in-hospital medical complications. The aim of this project is to provide a guide for implementing and optimizing a hospitalist co-management service in orthopaedic surgery. Key leaders from the hospitalist team, orthopaedic team and quality, safety and service team were identified. Multiple meetings were convened to discuss the comanagement service and determine the necessary building blocks behind an efficient and well-designed co-management framework. After meticulous deliberation, a consensus was reached on the final service agreement and a written guide was drafted. Fundamental features of the service include the identification of service stakeholders and leaders, frequent consensus meetings, a well-defined framework, with goals, program metrics and unified commands, and a regular satisfaction assessment to update and improve the program. Identified pearls for co-managing orthopaedic surgery patients are standardization, timing, adequate patient selection, and two-way feedback between hospitalists and orthopaedic surgeons to optimize the protocols. Developing a service agreement is a constant work in progress, with meetings, discussions, revisions, and multiple piloting attempts before implementation. It is a partnership created to provide hospitals with a streamlined admission process where at-risk patients are identified early, and patient care is optimized regardless of the number or nature of medical comorbidities. A wellestablished hospitalist co-management service can increase patient care quality and safety, as well as health care value.

Keywords: co-management, hospitalist co-management, implementation, orthopaedic surgery, quality improvement

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2852 Adherence of Trauma and Orthopaedics Surgery Operative Notes to the RCS Good Surgical Practice Guidelines in Ashford and St. Peter's Hospital

Authors: Maryam Risla Shahul Hameed, Tharsiga Yogarajah, Fritzy Mathew, Tayyaba Syed, Shalin Shaunak

Abstract:

Aim: Auditing the adherence of Trauma and Orthopaedics Operative notes to the RCS Good Surgical Practice Guidelines. Method: Clinical audit conducted on 150 operative notes over a period of 2 months April- May 2023, including emergency and elective surgeries performed in Ashford and St. Peter’s Hospital. The RCS Good Practice Surgical Guidelines for an ideal operative note were used to compare.Results: Date of the procedure and signature of the surgeon were mentioned in all the notes by default in the electronic template being used. Title of the operation performed and whether elective or emergency were mentioned by 92% and 45%, respectively. Name of theatre anaesthetist and operating surgeons were mentioned by 73% and 93% respectively. Time of surgery mentioned by 26%. Operative findings and operative diagnosis mentioned by 83% and 53% respectively. Incision and complications of surgery mentioned in 80% and 53%, respectively. Details of tissue added/ altered/ removed mentioned by 46%. Information on prosthesis or implant used is mentioned by 54%. Details of closure and anticipated blood loss mentioned in 91% and 45% respectively. Antibiotic prophylaxis was mentioned by 63%, out of which only 23% mentioned the name and duration of the antibiotic. VTE prophylaxis was mentioned by 84%, out of which only 23% and 29% mentioned the name and duration of the prophylaxis, respectively. Conclusion: There is more for improvement in the operative notes for better continuity of care between the operating surgeons and other doctors in the wards taking care of the patients post operatively. We recommend to follow a standardized guidelines by all the nationwide and a standard template to be followed by all.

Keywords: surgery, notes, RCS, guidelines

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2851 Impact of 99mTc-MDP Bone SPECT/CT Imaging in Failed Back Surgery Syndrome

Authors: Ching-Yuan Chen, Lung-Kwang Pan

Abstract:

Objective: Back pain is a major health problem costing billions of health budgets annually in Taiwan. Thousands of back pain surgeries are performed annually with up to 40% of patients complaining of back pain at time of post-surgery causing failed back surgery syndrome (FBSS), although diagnosis in these patients may be complex. The aim of study is to assess the feasibility of using bone SPECT-CT imaging to localize the active lesions causing persistent, recurrent or new backache after spine surgery. Materials and Methods: Bone SPECT-CT imaging was performed after the intravenous injection of 20 mCi of 99mTc-MDP for all the patients with diagnosis of FBSS. Patients were evaluated using status of subjectively pain relief, functional improvement and degree of satisfaction by reviewing the medical records and questionnaires in a 2 more years’ follow-up. Results: We enrolled a total of 16 patients were surveyed in our hospital from Jan. 2015 to Dec. 2016. Four people on SPEC/CT imaging ensured significant lesions were undergone a revised surgery (surgical treatment group). The mean visual analogue scale (VAS) decreased 5.3 points and mean Oswestry disability index (ODI) improved 38 points in the surgical group. The remaining 12 on SPECT/CT imaging were diagnosed as no significant lesions then received drug treatment (medical treatment group). The mean VAS only decreased 2 .1 point and mean ODI improved 12.6 points in the medical treatment group. In the posttherapeutic evaluation, the pain of the surgical treatment group showed a satisfactory improvement. In the medical treatment group, 10 of the 12 were also satisfied with the symptom relief while the other 2 did not improve significantly. Conclusions: Findings on SPECT-CT imaging appears to be easily explained the patients' pain. We recommended that SPECT/CT imaging was a feasible and useful clinical tool to improve diagnostic confidence or specificity when evaluating patients with FBSS.

Keywords: failed back surgery syndrome, oswestry disability index, SPECT-CT imaging, 99mTc-MDP, visual analogue scale

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2850 The Pile Group Efficiency for Different Embedment Lengths in Dry Sand

Authors: Mohamed M. Shahin

Abstract:

This study investigated the design of the pile foundation to support heavy structures-especially bridges for highways-in the Sahara, which contains many dunes of medium dense sand in different levels, where the foundation is supposed to be piles. The base resistance of smooth model pile groups in sand under static loading is investigated experimentally in a pile soil test apparatus. Improvement were made to the sand around the piles in order to increase the shaft resistance of the single pile and the pile groups, and also base resistance especially for the central pile in pile groups. The study outlines the behaviour of a single-pile, 4-, 5-, and 9- pile groups arranged in a doubly symmetric [square] layout with different embedment lengths and pile spacing in loose dry sand [normal] and dense dry sand [compacted] around the piles. This study evaluate the variation of the magnitude and the proportion of end bearing capacity of individual piles in different pile groups. Also to investigate the magnitude of the efficiency coefficient in the case of different pile groups.

Keywords: pile group, base resistance, efficiency coefficient, pile spacing, pile-soil interaction

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2849 Emergency Surgery in the Elderly, What Particularities

Authors: Mekroud Amel

Abstract:

Introduction The rate of use by the elderly of emergency departments, operating rooms and intensive care units has increased worldwide. Emergency surgery is a context where evaluation is often insufficient, with incomplete information gathering. The aim of this work is to shed light on the frequent use of emergency surgeries by the elderly and their characteristics, as well as on the lack of geriatric assessment scores in the emergency room. Material : Prospective, observational and descriptive, monocentric study. Patients aged 65 and over, admitted for emergency surgery in the operating room, were counted. Emergency operating room including visceral surgery, urology, traumatology and neurosurgery. Parameters studied: Patient characteristics, degree of autonomy, type of surgical pathology, operative management times, preoperative evaluation, postoperative outcome Results : 192 patients were identified over 12 months, from 09.01.2017 to 08.31.2018 Age from 65 to 101 years, 79.81 years +/- 8.38. With predominance of the age group between [65-75 years] 41.1% Female predominance, Sexratio = 0.81 Elderly subjects with total motor autonomy are in the majority at 57.8% Subjects without pathological ATCD represent 12.5% of cases Those who are on only one type of medication or without any treatment are at 36.9% Discussion : The emergency operative care of the elderly patient for a surgical or traumatological pathology is characterized by many specificities linked first to the emergency context, where the evaluation is often insufficient, besides the fact that the elderly patient has particularities requiring reception in centers with experience in the care of this category of patient, or, failing that, a center which uses the minimum of geriatric evaluation scores which are simplified for the emergency departments. In our hospital, we have not yet made this evaluation routine in the emergency room and this delay in the introduction of these scores can be directly attributed to the covid 19 pandemic. Besides the standard preoperative assessment, only 43.2% of patients were assessed in the preoperative period by an anesthesiologist. Traumatological emergencies come first 68.2% followed by visceral emergencies 19.2% (including proctological, urological emergencies), neurosurgical emergencies 7.8% and finally peripheral emergency surgery all acts combined 4.7%. Hospital stay at 9.6 +/- 16.8 days, average operability time of 4.5 +/- 3 days. Death rate at 7.29% Conclusion This work has demonstrated the major impact of emergency surgery, which remains curable for the most part, on the elderly patient despite total motor and cognitive autonomy preoperatively. The improvement of the preoperative evaluation, the reduction of the operating time and enhanced recovery after surgery, with personalized protocols, are the only guarantee for the resumption of preoperative autonomy in these patients.

Keywords: emergency surgery, elderly patients, preoperative geriatric scores, curable emergency surgical pathologies

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2848 Microbiological Analysis on Anatomical Specimens of Cats for Use in Veterinary Surgery

Authors: Raphael C. Zero, Marita V. Cardozo, Thiago A. S. S. Rocha, Mariana T. Kihara, Fernando A. Ávila, Fabrício S. Oliveira

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There are several fixative and preservative solutions for use on cadavers, many of them using formaldehyde as the fixative or anatomical part preservative. In some countries, such as Brazil, this toxic agent has been increasingly restricted. The objective of this study was to microbiologically identify and quantify the key agents in tanks containing 96GL ethanol or sodium chloride solutions, used respectively as fixatives and preservatives of cat cadavers. Eight adult cat corpses, three females and five males, with an average weight of 4.3 kg, were used. After injection via the external common carotid artery (120 ml/kg, 95% 96GL ethyl alcohol and 5% pure glycerin), the cadavers were fixed in a plastic tank with 96GL ethanol for 60 days. After fixing, they were stored in a 30% sodium chloride aqueous solution for 120 days in a similar tank. Samples were collected at the start of the experiment - before the animals were placed in the ethanol tanks, and monthly thereafter. The bacterial count was performed by Pour Plate Method in BHI agar (Brain Heart Infusion) and the plates were incubated aerobically and anaerobically for 24h at 37ºC. MacConkey agar, SPS agar (Sulfite Polymyxin Sulfadizine) and MYP Agar Base were used to isolate the microorganisms. There was no microbial growth in the samples prior to alcohol fixation. After 30 days of fixation in the alcohol solution, total aerobic and anaerobic (<1.0 x 10 CFU/ml) were found and Pseudomonas sp., Staphylococcus sp., Clostridium sp. were the identified agents. After 60 days in the alcohol fixation solution, total aerobes (<1.0 x 10 CFU/ml) and total anaerobes (<2.2 x 10 CFU/mL) were found, and the identified agents were the same. After 30 days of storage in the aqueous solution of 30% sodium chloride, total aerobic (<5.2 x 10 CFU/ml) and total anaerobes (<3.7 x 10 CFU/mL) were found and the agents identified were Staphylococcus sp., Clostridium sp., and fungi. After 60 days of sodium chloride storage, total aerobic (<3.0 x 10 CFU / ml) and total anaerobes (<7.0 x 10 CFU/mL) were found and the identified agents remained the same: Staphylococcus sp., Clostridium sp., and fungi. The microbiological count was low and visual inspection did not reveal signs of contamination in the tanks. There was no strong odor or purification, which proved the technique to be microbiologically effective in fixing and preserving the cat cadavers for the four-month period in which they are provided to undergraduate students of University of Veterinary Medicine for surgery practice. All experimental procedures were approved by the Municipal Legal Department (protocol 02.2014.000027-1). The project was funded by FAPESP (protocol 2015-08259-9).

Keywords: anatomy, fixation, microbiology, small animal, surgery

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2847 Dimensional Investigation of Food Addiction in Individuals Who Have Undergone Bariatric Surgery

Authors: Ligia Florio, João Mauricio Castaldelli-Maia

Abstract:

Background: Food addiction (FA) emerged in the 1990s as a possible contributor to the increasing prevalence of obesity and overweight, in conjunction with changing food environments and mental health conditions. However, FA is not yet listed as one of the disorders in the DSM-5 and/or the ICD-11. Although there are controversies and debates in the literature about the classification and construct of FA, the most common approach to access it is the use of a research tool - the Yale Food Addiction Scale (YFAS) - which approximates the concept of FA to the concept diagnosis of dependence on psychoactive substances. There is a need to explore the dimensional phenotypes accessed by YFAS in different population groups for a better understanding and scientific support of FA diagnoses. Methods: The primary objective of this project was to investigate the construct validity of the FA concept by mYFAS 2.0 in individuals who underwent bariatric surgery (n = 100) at the Hospital Estadual Mário Covas since 2011. Statistical analyzes were conducted using the STATA software. In this sense, structural or factor validity was the type of construct validity investigated using exploratory factor analysis (EFA) and item response theory (IRT) techniques. Results: EFA showed that the one-dimensional model was the most parsimonious. The IRT showed that all criteria contributed to the latent structure, presenting discrimination values greater than 0.5, with most presenting values greater than 2. Conclusion: This study reinforces a FA dimension in patients who underwent bariatric surgery. Within this dimension, we identified the most severe and discriminating criteria for the diagnosis of FA.

Keywords: obesity, food addiction, bariatric surgery, regain

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2846 Biocompatibility Tests for Chronic Application of Sieve-Type Neural Electrodes in Rats

Authors: Jeong-Hyun Hong, Wonsuk Choi, Hyungdal Park, Jinseok Kim, Junesun Kim

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Identifying the chronic functions of an implanted neural electrode is an important factor in acquiring neural signals through the electrode or restoring the nerve functions after peripheral nerve injury. The purpose of this study was to investigate the biocompatibility of the chronic implanted neural electrode into the sciatic nerve. To do this, a sieve-type neural electrode was implanted at proximal and distal ends of a transected sciatic nerve as an experimental group (Sieve group, n=6), and the end-to-end epineural repair was operated with the cut sciatic nerve as a control group (reconstruction group, n=6). All surgeries were performed on the sciatic nerve of the right leg in Sprague Dawley rats. Behavioral tests were performed before and 1, 4, 7, 10, 14, and weekly days until 5 months following surgery. Changes in sensory function were assessed by measuring paw withdrawal responses to mechanical and cold stimuli. Motor function was assessed by motion analysis using a Qualisys program, which showed a range of motion (ROM) related to the joints. Neurofilament-heavy chain and fibronectin expression were detected 5 months after surgery. In both groups, the paw withdrawal response to mechanical stimuli was slightly decreased from 3 weeks after surgery and then significantly decreased at 6 weeks after surgery. The paw withdrawal response to cold stimuli was increased from 4 days following surgery in both groups and began to decrease from 6 weeks after surgery. The ROM of the ankle joint was showed a similar pattern in both groups. There was significantly increased from 1 day after surgery and then decreased from 4 days after surgery. Neurofilament-heavy chain expression was observed throughout the entire sciatic nerve tissues in both groups. Especially, the sieve group was showed several neurofilaments that passed through the channels of the sieve-type neural electrode. In the reconstruction group, however, a suture line was seen through neurofilament-heavy chain expression up to 5 months following surgery. In the reconstruction group, fibronectin was detected throughout the sciatic nerve. However, in the sieve group, the fibronectin was observed only in the surrounding nervous tissues of an implanted neural electrode. The present results demonstrated that the implanted sieve-type neural electrode induced a focal inflammatory response. However, the chronic implanted sieve-type neural electrodes did not cause any further inflammatory response following peripheral nerve injury, suggesting the possibility of the chronic application of the sieve-type neural electrodes. This work was supported by the Basic Science Research Program funded by the Ministry of Science (2016R1D1A1B03933986), and by the convergence technology development program for bionic arm (2017M3C1B2085303).

Keywords: biocompatibility, motor functions, neural electrodes, peripheral nerve injury, sensory functions

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2845 Application of PV/Wind-Based Green Energy to Power Cellular Base Station

Authors: Francis Okodede, Edafe Lucky Okotie

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Conventional energy sources based on oil, coal, and natural gas has posed a trait to environment and to human health. Green energy stands as an alternative because it has proved to be eco-friendly. The prospective of renewable energy sources are quite vast as they can, in principle, meet many times the world’s energy demand. Renewable energy sources, such as wind and solar, can provide sustainable energy services based on the use of routinely available indigenous resources. New renewable energy sources (solar energy, wind energy, and modern bio-energy) are currently contributing immensely to global energy demand. A number of studies have shown the potential and contribution of renewable energy to global energy supplies, indicating that in the second half of the 21st century, it is going to be a major source and driver in the telecommunication sector. Green energy contribution might reach as much as 50 percent of global energy demands if the right policies are in place. This work suggests viable non-conventional means of energy supply to power a cellular base station.

Keywords: base station, energy storage, green energy, rotor efficiency, solar energy, wind energy

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2844 Comparison between Infusion Pumps: Fentanyl/Ketamine and Fentanyl/Paracetamol in Pain Control Following Tight and Leg Surgeries

Authors: Maryam Panahi

Abstract:

Background: Adjuvants such as ketamine, promethazine, and paracetamol could bring up patient's satisfaction and control the harmful effects of opioids besides lessening their needed doses, as seen by the fentanyl/paracetamol and fentanyl/ketamine combination before. The current study is headed to compare paracetamol and ketamine, in addition to fentanyl, applied by infusion pumps in order to pain relief following major surgery. Materials and Methods: Through a double-blinded, randomized clinical trial, patients between18 and 65 with elective surgery for tight or leg fractures with ASA Class 1 and 2 referred to a university hospital in Arak, a town in the central region of Iran, were recruited and used infusion pump for their postoperative pain control. The participants were divided into cases and controls regarding using ketamine/fentanyl (KF) or paracetamol/fentanyl (PF) infusion pumps. Results: The mean pain score was a total of 3.87, with the highest value in KF (5.06) and the lowest in PF (4.50) immediately after finishing the surgery and getting conscious when started using an infusion pump. There was no statistical difference between the groups in this regard. Concerning the side effects of the applied medications, blood pressure and heart rate had no differences comparing the groups. Conclusion: This study showed that paracetamol used in infusion pumps could be brilliant in pain control after major surgeries like those done in lower extremities and joint replacement while lessening opioid use. Although paracetamol was more effective than ketamine in the current trial, more qualified studies at bigger sizes and in other fields of surgery besides orthopedic ones would be useful to support the effects if applicable

Keywords: infusion pump, Ketamine, Paracetamol, pain

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2843 Cosmetic Value of Collatamp in Breast Conserving Surgery

Authors: Chee Young Kim, Tae Hyun Kim, Anbok Lee, Hyun-Ah Kim, Woosung Lim, Ku Sang Kim, Jinsun Lee, Yoo Seok Kim, Beom Seok Ko

Abstract:

Background: CollatampTM is Gentamicin-containing collagen sponge well known for its hemostatic effect, commonly utilized in surgeries. We inserted CollatempTM wrapped by SurgicelTM (oxidized cellulose polymer) to fill up the defect after breast conserving surgery. The purpose of this study is to verify the furthermore cosmetic value of CollatampTM in breast conserving surgery conducted in breast cancer patients. Methods: 17 patients were enrolled in this study, underwent breast conserving surgery with CollatampTM wrapped by SurgicelTM insertion, in Inje University Busan Paik Hospital from October 2015 to September 2016. Patient satisfaction, cosmetic outcome, results at 6 months from operation was analyzed to verify the effectiveness and usefulness of CollatampTM for cosmetics. Patient satisfaction was investigated through interviews on a scale of good, fair, poor, and the cosmetic outcome was investigated through physical examination by a surgeon who did not participate in the operations. Results: Among 17 patients, nine of them gave ‘good’ for patient satisfaction, eight gave ‘fair’ and none of them ‘poor’. Also, cosmetic outcome came out with 11 ‘good’s, six ‘fair’s, no ‘poor’. In ‘good’ patient satisfaction group, the mean value of resection to breast volume ratio was 16%, compared to 24% of ‘fair’ group. The mean value of actual resection volume was 100.6cm3, 102.7cm3 each. In ‘good’ cosmetic outcome group, the mean value of resection to breast volume ratio was 18%, compared to 23% of ‘fair’ group. The mean value of actual resection volume was 99.2cm3, 105.9cm3 respectively. According to these results, patient satisfaction and cosmetic outcome after surgeries were more reliable on the resection to breast volume ratio, rather than the actual resection volume. There were eight cases of postoperative complications, consisting of a lymphedema, a seroma, and six patients had mild pain. Conclusions: Cosmetic effect of CollatampTM in breast conserving surgery was more reliable on the resection to breast volume ratio, rather than the actual resection volume. In this short term survey, patients were tend to be satisfied with the cosmetics, all giving either good or fair scores. However, long term outcomes should be further assessed.

Keywords: breast cancer, breast conserving surgery, collatamp, cosmetics

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2842 A New Reliability based Channel Allocation Model in Mobile Networks

Authors: Anujendra, Parag Kumar Guha Thakurta

Abstract:

The data transmission between mobile hosts and base stations (BSs) in Mobile networks are often vulnerable to failure. Thus, efficient link connectivity, in terms of the services of both base stations and communication channels of the network, is required in wireless mobile networks to achieve highly reliable data transmission. In addition, it is observed that the number of blocked hosts is increased due to insufficient number of channels during heavy load in the network. Under such scenario, the channels are allocated accordingly to offer a reliable communication at any given time. Therefore, a reliability-based channel allocation model with acceptable system performance is proposed as a MOO problem in this paper. Two conflicting parameters known as Resource Reuse factor (RRF) and the number of blocked calls are optimized under reliability constraint in this problem. The solution to such MOO problem is obtained through NSGA-II (Non-dominated Sorting Genetic Algorithm). The effectiveness of the proposed model in this work is shown with a set of experimental results.

Keywords: base station, channel, GA, pareto-optimal, reliability

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2841 Gas Tungsten Arc Welded Joints of Cast Al-Mg-Sc Alloy

Authors: K. Subbaiah, C. V. Jeyakumar, S. R. Koteswara Rao

Abstract:

Cast Aluminum-Magnesium-Scandium alloy was Gas Tungsten Arc (GTA) welded, and the microstructure and mechanical properties of the joint and its component parts were examined and analyzed. The global joint fractured in the base metal, and thus possessed slightly greater tensile strength than the base metal. These results clearly show that Gas Tungsten Arc welding is an optimum / suitable welding process for cast Aluminum-Magnesium-Scandium alloys.

Keywords: cast Al-Mg-Sc alloy, GTAW, microstructure, mechanical properties

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2840 Review of the Safety of Discharge on the First Postoperative Day Following Carotid Surgery: A Retrospective Analysis

Authors: John Yahng, Hansraj Riteesh Bookun

Abstract:

Objective: This was a retrospective cross-sectional study evaluating the safety of discharge on the first postoperative day following carotid surgery - principally carotid endarterectomy. Methods: Between January 2010 to October 2017, 252 patients with mean age of 72 years, underwent carotid surgery by seven surgeons. Their medical records were consulted and their operative as well as complication timelines were databased. Descriptive statistics were used to analyse pooled responses and our indicator variables. The statistical package used was STATA 13. Results: There were 183 males (73%) and the comorbid burden was as follows: ischaemic heart disease (54%), diabetes (38%), hypertension (92%), stage 4 kidney impairment (5%) and current or ex-smoking (77%). The main indications were transient ischaemic attacks (42%), stroke (31%), asymptomatic carotid disease (16%) and amaurosis fugax (8%). 247 carotid endarterectomies (109 with patch arterioplasty, 88 with eversion and transection technique, 50 with endarterectomy only) were performed. 2 carotid bypasses, 1 embolectomy, 1 thrombectomy with patch arterioplasty and 1 excision of a carotid body tumour were also performed. 92% of the cases were performed under general anaesthesia. A shunt was used in 29% of cases. The mean length of stay was 5.1 ± 3.7days with the range of 2 to 22 days. No patient was discharged on day 1. The mean time from admission to surgery was 1.4 ± 2.8 days, ranging from 0 to 19 days. The mean time from surgery to discharge was 2.7 ± 2.0 days with the of range 0 to 14 days. 36 complications were encountered over this period, with 12 failed repairs (5 major strokes, 2 minor strokes, 3 transient ischaemic attacks, 1 cerebral bleed, 1 occluded graft), 11 bleeding episodes requiring a return to the operating theatre, 5 adverse cardiac events, 3 cranial nerve injuries, 2 respiratory complications, 2 wound complications and 1 acute kidney injury. There were no deaths. 17 complications occurred on postoperative day 0, 11 on postoperative day 1, 6 on postoperative day 2 and 2 on postoperative day 3. 78% of all complications happened before the second postoperative day. Out of the complications which occurred on the second or third postoperative day, 4 (1.6%) were bleeding episodes, 1 (0.4%) failed repair , 1 respiratory complication (0.4%) and 1 wound complication (0.4%). Conclusion: Although it has been common practice to discharge patients on the second postoperative day following carotid endarterectomy, we find here that discharge on the first operative day is safe. The overall complication rate is low and most complications are captured before the second postoperative day. We suggest that patients having an uneventful first 24 hours post surgery be discharged on the first day. This should reduce hospital length of stay and the health economic burden.

Keywords: carotid, complication, discharge, surgery

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2839 Anatomy of the Human Mitral Valve Leaflets: Implications for Transcatheter and Surgical Mitral Valve Repair Techniques

Authors: Agata Krawczyk-Ozog, Mateusz K. Holda, Mateusz Koziej, Danuta Sorysz, Zbigniew Siudak, Wieslawa Klimek-Piotrowska, Dariusz Dudek

Abstract:

Introduction: Rapid development of the surgical and less-invasive percutaneous mitral valve repair procedures greatly increase the interest of the mitral valve anatomy. The aim of this study was to characterize morphological variability of the mitral valve leaflets and to provide the size of their particular parts. Materials and Methods: In the study, we included 200 autopsied human hearts from Caucasian individuals (25% females) with mean age 47.5 (±17.9) without any valvular diseases. The morphology of the mitral valve was evaluated. The intercommissural and aorto-mural diameters of the mitral annulus were measured. All leaflets and their scallops were identified. The base and the height of the posteromedial commissure (PM-C), anterolateral commissure (AL-C), anterior leaflet (AL) and posterior leaflet (PL) with their scallops were measured. Results: The intercommissural diameter was 28.0±4.8 mm, the aorto-mural diameter 19.7±4.8 mm, circumference of the mitral annulus 89.9±12.6 mm and the area of the mitral valve 485.4±171.4 mm2. Classical mitral valves (AL+AL-C+PL(P1,P2,P3)+PM-C) were found in 141 (70.5%) specimens. In classical type, the mean AL base and height were 30.8±4.9 mm and 20.6±4.2 mm, while mean PL base and height 45.1±8.2 mm 12.9±2.8 mm respectively. The mean ratio of the AL base to PL base was 0.7±0.2. Variations in PL were found in 55 (27.5%) and in AL in 5 (2.5%) hearts. The most common variations were: valve with one accessory scallop (AcS) between P3 and PM-C (7%); AcS between P1 and AL-C (4%); connections of P2 and P3 scallops (4%); connections of P1 and P2 scallops (3%); AcS in AL (2.5%). All AcS were smaller than the main PL scallops. The mean intertrigonal distance was 21.9±3.8 mm. Conclusions: In all cases, the mitral valve is built by two main leaflets with possible variants in secondary to leaflets scallops (29.5%). The variations are largely associated with PL and are mostly related to the presence of AcS. Anatomically the AL is not divided into scallops, and it occupies 34.5% of the mitral annulus circumference. Understanding the anatomy of the mitral valve leaflets helps to planning and performing mitral valve repair procedures.

Keywords: accessory scallop, commissure, connected scallops, human heart, mitral leaflets, mitral valve

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2838 Transient Heat Transfer of a Spiral Fin

Authors: Sen-Yung Lee, Li-Kuo Chou, Chao-Kuang Chen

Abstract:

In this study, the problem of temperature transient response of a spiral fin, with its end insulated, is analyzed with base end subjected to a variation of fluid temperature. The hybrid method of Laplace transforms/Adomian decomposed method-Padé, is applied to the temperature transient response of the fin, the result of the temperature distribution and the heat flux at the base of the spiral fin are obtained, show a good agreement in the physical phenomenon.

Keywords: Laplace transforms, Adomian decomposed method- Padé, transient response, heat transfer

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2837 Nonlinear Dynamic Analysis of Base-Isolated Structures Using a Partitioned Solution Approach and an Exponential Model

Authors: Nicolò Vaiana, Filip C. Filippou, Giorgio Serino

Abstract:

The solution of the nonlinear dynamic equilibrium equations of base-isolated structures adopting a conventional monolithic solution approach, i.e. an implicit single-step time integration method employed with an iteration procedure, and the use of existing nonlinear analytical models, such as differential equation models, to simulate the dynamic behavior of seismic isolators can require a significant computational effort. In order to reduce numerical computations, a partitioned solution method and a one dimensional nonlinear analytical model are presented in this paper. A partitioned solution approach can be easily applied to base-isolated structures in which the base isolation system is much more flexible than the superstructure. Thus, in this work, the explicit conditionally stable central difference method is used to evaluate the base isolation system nonlinear response and the implicit unconditionally stable Newmark’s constant average acceleration method is adopted to predict the superstructure linear response with the benefit in avoiding iterations in each time step of a nonlinear dynamic analysis. The proposed mathematical model is able to simulate the dynamic behavior of seismic isolators without requiring the solution of a nonlinear differential equation, as in the case of widely used differential equation model. The proposed mixed explicit-implicit time integration method and nonlinear exponential model are adopted to analyze a three dimensional seismically isolated structure with a lead rubber bearing system subjected to earthquake excitation. The numerical results show the good accuracy and the significant computational efficiency of the proposed solution approach and analytical model compared to the conventional solution method and mathematical model adopted in this work. Furthermore, the low stiffness value of the base isolation system with lead rubber bearings allows to have a critical time step considerably larger than the imposed ground acceleration time step, thus avoiding stability problems in the proposed mixed method.

Keywords: base-isolated structures, earthquake engineering, mixed time integration, nonlinear exponential model

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2836 Predictors of Clinical Failure After Endoscopic Lumbar Spine Surgery During the Initial Learning Curve

Authors: Daniel Scherman, Daniel Madani, Shanu Gambhir, Marcus Ling Zhixing, Yingda Li

Abstract:

Objective: This study aims to identify clinical factors that may predict failed endoscopic lumbar spine surgery to guide surgeons with patient selection during the initial learning curve. Methods: This is an Australasian prospective analysis of the first 105 patients to undergo lumbar endoscopic spine decompression by 3 surgeons. Modified MacNab outcomes, Oswestry Disability Index (ODI) and Visual Analogue Score (VAS) scores were utilized to evaluate clinical outcomes at 6 months postoperatively. Descriptive statistics and Anova t-tests were performed to measure statistically significant (p<0.05) associations between variables using GraphPad Prism v10. Results: Patients undergoing endoscopic lumbar surgery via an interlaminar or transforaminal approach have overall good/excellent modified MacNab outcomes and a significant reduction in post-operative VAS and ODI scores. Regardless of the anatomical location of disc herniations, good/excellent modified MacNab outcomes and significant reductions in VAS and ODI were reported post-operatively; however, not in patients with calcified disc herniations. Patients with central and foraminal stenosis overall reported poor/fair modified MacNab outcomes. However, there were significant reductions in VAS and ODI scores post-operatively. Patients with subarticular stenosis or an associated spondylolisthesis reported good/excellent modified MacNab outcomes and significant reductions in VAS and ODI scores post-operatively. Patients with disc herniation and concurrent degenerative stenosis had generally poor/fair modified MacNab outcomes. Conclusion: The outcomes of endoscopic spine surgery are encouraging, with a low complication and reoperation rate. However, patients with calcified disc herniations, central canal stenosis or a disc herniation with concurrent degenerative stenosis present challenges during the initial learning curve and may benefit from traditional open or other minimally invasive techniques.

Keywords: complications, lumbar disc herniation, lumbar endoscopic spine surgery, predictors of failed endoscopic spine surgery

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2835 Investigation into the Possibility of Using Recycled Polyethelene to Replace Natural Rubber in the Production of Different Products

Authors: Otokiti Mojeed Jimoh

Abstract:

This work investigates the possibility of using recycled polyethylene LDPE as a base polymer in production of different products (shoe sole, foot mat, and many more) using carbon black as a filler to improve its mechanical properties, like hardness, tensile stress properties and elongation at break properties, from the result so far gotten there is a possibility that there is an increase in the mechanical properties of the sample compare to natural rubber sample.

Keywords: recycled polyethylene, base polymer, hardness, stress properties

Procedia PDF Downloads 394
2834 Risk Factors for Postoperative Fever in Patients Undergoing Lumbar Fusion

Authors: Bang Haeyong

Abstract:

Purpose: The objectives of this study were to determine the prevalence, incidence, and risk factors for postoperative fever after lumbar fusion. Methods: This study was a retrospective chart review of 291 patients who underwent lumbar fusion between March 2015 and February 2016 at the Asan Medical Center. Information was extracted from electronic medical records. Postoperative fever was measured at Tmax > 37.7 ℃ and Tmax > 38.3 ℃. The presence of postoperative fever, blood culture, urinary excretion, and/or chest x-ray were evaluated. Patients were evaluated for infection after lumbar fusion. Results: We found 222 patients (76.3%) had a postoperative temperature of 37.7 ℃, and 162 patients (55.7%) had a postoperative temperature of 38.3 ℃ or higher. The percentage of febrile patients trended down following the mean 1.8days (from the first postoperative day to seventh postoperative day). Infection rate was 9 patients (3.1%), respiratory virus (1.7%), urinary tract infection (0.3%), phlebitis (0.3%), and surgical site infection (1.4%). There was no correlation between Tmax > 37.7℃ or Tmax > 38.3℃, and timing of fever, positive blood or urine cultures, pneumonia, or surgical site infection. Risk factors for increased postoperative fever following surgery were confirmed to be delay of defecation (OR=1.37, p=.046), and shorten of remove drainage (OR=0.66, p=.037). Conclusions: The incidence of fever was 76.3% after lumbar fusion and the drainage time was faster in the case of fever. It was thought that the bleeding was absorbed at the operation site and fever occurred. The prevalence of febrile septicemia was higher in patients with long bowel movements before surgery than after surgery. Clinical symptoms should be considered because postoperative fever cannot be determined by fever alone because fever and infection are not significant.

Keywords: lumbar surgery, fever, postoperative, risk factor

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2833 Iron Supplementation for Patients Undergoing Cardiac Surgery: A Systematic Review and Meta-Analysis of Randomized-Controlled Trials

Authors: Matthew Cameron, Stephen Yang, Latifa Al Kharusi, Adam Gosselin, Anissa Chirico, Pouya Gholipour Baradari

Abstract:

Background: Iron supplementation has been evaluated in several randomized controlled trials (RCTs) for the potential to increase baseline hemoglobin and decrease the incidence of red blood cell (RBC) transfusion during cardiac surgery. This study's main objective was to evaluate the evidence for iron administration in cardiac surgery patients for its effect on the incidence of perioperative RBC transfusion. Methods: This systematic review protocol was registered with PROSPERO (CRD42020161927) on Dec. 19th, 2019, and was prepared as per the PRISMA guidelines. MEDLINE, EMBASE, CENTRAL, Web of Science databases, and Google Scholar were searched for RCTs evaluating perioperative iron administration in adult patients undergoing cardiac surgery. Each abstract was independently reviewed by two reviewers using predefined eligibility criteria. The primary outcome was perioperative RBC transfusion, with secondary outcomes of the number of RBC units transfused, change in ferritin level, reticulocyte count, hemoglobin, and adverse events, after iron administration. The risk of bias was assessed with the Cochrane Collaboration Risk of Bias Tool, and the primary and secondary outcomes were analyzed with a random-effects model. Results: Out of 1556 citations reviewed, five studies (n = 554 patients) met the inclusion criteria. The use of iron demonstrated no difference in transfusion incidence (RR 0.86; 95% CI 0.65 to 1.13). There was a low heterogeneity between studies (I²=0%). The trial sequential analysis suggested an optimal information size of 1132 participants, which the accrued information size did not reach. Conclusion: The current literature does not support the routine use of iron supplementation before cardiac surgery; however, insufficient data is available to draw a definite conclusion. A critical knowledge gap has been identified, and more robust RCTs are required on this topic.

Keywords: cardiac surgery, iron, iron supplementation, perioperative medicine, meta-analysis, systematic review, randomized controlled trial

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2832 Rank-Based Chain-Mode Ensemble for Binary Classification

Authors: Chongya Song, Kang Yen, Alexander Pons, Jin Liu

Abstract:

In the field of machine learning, the ensemble has been employed as a common methodology to improve the performance upon multiple base classifiers. However, the true predictions are often canceled out by the false ones during consensus due to a phenomenon called “curse of correlation” which is represented as the strong interferences among the predictions produced by the base classifiers. In addition, the existing practices are still not able to effectively mitigate the problem of imbalanced classification. Based on the analysis on our experiment results, we conclude that the two problems are caused by some inherent deficiencies in the approach of consensus. Therefore, we create an enhanced ensemble algorithm which adopts a designed rank-based chain-mode consensus to overcome the two problems. In order to evaluate the proposed ensemble algorithm, we employ a well-known benchmark data set NSL-KDD (the improved version of dataset KDDCup99 produced by University of New Brunswick) to make comparisons between the proposed and 8 common ensemble algorithms. Particularly, each compared ensemble classifier uses the same 22 base classifiers, so that the differences in terms of the improvements toward the accuracy and reliability upon the base classifiers can be truly revealed. As a result, the proposed rank-based chain-mode consensus is proved to be a more effective ensemble solution than the traditional consensus approach, which outperforms the 8 ensemble algorithms by 20% on almost all compared metrices which include accuracy, precision, recall, F1-score and area under receiver operating characteristic curve.

Keywords: consensus, curse of correlation, imbalance classification, rank-based chain-mode ensemble

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2831 Preoperative 3D Planning and Reconstruction of Mandibular Defects for Patients with Oral Cavity Tumors

Authors: Janis Zarins, Kristaps Blums, Oskars Radzins, Renars Deksnis, Atis Svare, Santa Salaka

Abstract:

Wide tumor resection remains the first choice method for tumors of the oral cavity. Nevertheless, remained tissue defect impacts patients functional and aesthetical outcome, which could be improved using microvascular tissue transfers. Mandibular reconstruction is challenging due to the complexity of composite tissue defects and occlusal relationships for normal eating, chewing, and pain free jaw motions. Individual 3-D virtual planning would provide better symmetry and functional outcome. The main goal of preoperative planning is to develop a customized surgical approach with patient specific cutting guides of the mandible, osteotomy guides of the fibula, pre-bended osteosynthesis plates to perform more precise reconstruction, to decrease the surgery time and reach the best outcome. Our study is based on the analysis of 32 patients operated on between 2019 to 2021. All patients underwent mandible reconstruction with vascularized fibula flaps. Patients characteristics, surgery profile, survival, functional outcome, and quality of life was evaluated. Preoperative planning provided a significant decrease of surgery time and the best arrangement of bone closely similar as before the surgery. In cases of bone asymmetry, deformity and malposition, a new mandible was created using 3D planning to restore the appearance of lower jaw anatomy and functionality.

Keywords: mandibular, 3D planning, cutting guides, fibula flap, reconstruction

Procedia PDF Downloads 111