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Biomedical subjects

A R Gunkel

Publications and source records attributed to A R Gunkel.

42 records · Page 3Linked to original sources
PubMed1997

3D image-guided surgery on the example of the 5,300-year-old Innsbruck Iceman.

Interventional Video Tomography (IVT) is regularly used for computer-assisted 3D navigation in ear-, nose, throat, and head & neck surgery in our clinic. We present the technology and its application to collect biopsies of a 5,300 year old, completely conserved male cadaver, the Iceman. IVT links intraoperative live video with medical imaging data sets, realizing real-time surgical guidance in the live video and/or in the medical images. The IVT data contain the video images and the spatial sensor information; this has a large potential for documentation, training, teaching, and telepresence. IVT allowed us to sample the Iceman's mucosa by the minimally invasive endoscopic approach of the maxillary sinus, the nasal cavity, and the larynx, minimizing tissue damage. Visual inspection of the sinuses and the mucosa revealed the typical mucosa of a fresh cadaver, albeit originating from the stone-age.

Animals↗
PubMed1996

[Transoral CO2 laser resection of extensive nasal and oropharyngeal teratoma].

BACKGROUND: Teratomas are quite rare congenital tumours, especially originating from the skull base in the region of the nasopharynx (1:40,000). PATIENTS: We report on a premature 36-week old girl with an extensive nasopharyngeal and oral teratoma. METHOD: With CO2 laser and micro-endoscopic techniques the tumour was successfully resected directly via the transoral route without needing external incisions. RESULTS AND CONCLUSIONS: These techniques, and particularly the use of CO2 laser, allow gentle resection of nasopharyngeal teratomas with only moderate bleeding. General pathological aspects, clinical symptoms and update management or teratomas in the head and neck area are discussed, based on this case. CO2 laser in conjunction with microscope and videoendoscope seems to offer an advantage compared to resection with conventional instruments alone.

Adult↗
PubMed1995

Complete sphenoethmoidectomy and computer-assisted surgery.

Many surgical procedures in the field of ENT take place in close proximity to vital structures like the orbit, the skull base, the internal carotid artery etc. In our clinic we have decided to study two different computer-assisted navigation systems to reduce the risk of trauma to these structures during endonasal endoscopic procedures. Such systems should be able to correlate the position of the surgical instrument, ideally in the submillimeter range, to CT- or MR-images. The ARTMA Virtual Patient finds the position of the instrument by permanently measuring magnetic fields. The ISG-system uses a mechanical arm to localize the probe in the patient. Using Computer-Assisted-Surgery (CAS) does not significantly extend the time needed for surgery. We found that it prevents the surgeon from inadvertently injuring structures. Other groups have shown (1) that CAS-systems minimize the risk of complications of surgical procedures in the frontobasis arising from mishaps in the usage of the endoscope or the surgical tool. If properly used, CAS-systems can be a very helpful tool in the hand of an experienced surgeon but will never replace his expertise and knowledge.

Ethmoid Sinus↗
PubMedDate not supplied

Angioneurotic edema as a reaction to angiotensin-converting enzyme inhibitors.

While the incidence of ACEI-induced angioedema is low, ACEI use will continue to increase its frequency. Emergency physicians and otolaryngologists should play a key role in identifying patients with angioedema associated with ACEIs. Every patient with acute angioedema, especially in the region of the mouth, the tongue, and the upper airways, must be asked for medication with ACEIs. The physician must be aware of the fact that a moderate swelling can rapidly develop to a massive swelling, which requires an intubation or even a coniotomy. Thus, in any of these cases, the patient should be observed at least for 24 hours in the clinic or until the edema subsided almost completely.

Adolescent↗