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Article ; Online: The distal fibular perforating axial flap for lateral malleolus coverage: an anatomical description and surgical technique.

Clavert, Philippe / Puliero, Benjamin / Eichler, David / Ollivier, Irène / Bonnomet, François

2023 Volume 45, Issue 10, Page(s) 1191–1196

Abstract: Purpose: Skin closure disorders in ankle surgery are a recurrent problem not only in traumatology but also in elective surgery. The aim of the study was to describe the anatomical basis of the fasciocutaneous vascularization of the lateral malleolus ... ...

Abstract	Purpose: Skin closure disorders in ankle surgery are a recurrent problem not only in traumatology but also in elective surgery. The aim of the study was to describe the anatomical basis of the fasciocutaneous vascularization of the lateral malleolus region to develop a posterior cover flap for the region. Methods: We dissected ten fresh frozen specimens after arterial injection of an Indian ink preparation and individualized the perforating arteries. Their positions and diameters were collated. Then, the surgical technique was clinically applied for two different cases by transferring the fasciocutaneous flap posterior to the lateral malleolus to cover a loss of skin substance. Results: There were in average 5 fibular perforators over the last 100 mm of the fibula. The average diameter of the first two perforating arteries was 0.6 ± 0.12 mm and 0.9 ± 0.25 mm, respectively, and the consistency of the latter makes it possible to produce a skin flap with anterior translation. This is an axial flap. Two patients were operated on using this technique. There was no necrosis of the posterior fibular flap and healing was achieved by the third post-operative week. Conclusion: This study showed the presence of fibular perforating arteries with a high reproducibility of their dissection. This anatomical description served as the basis for the description of a new distal fibular perforating flap.
MeSH term(s)	Humans ; Fibula/blood supply ; Reproducibility of Results ; Surgical Flaps/blood supply ; Plastic Surgery Procedures ; Lower Extremity
Language	English
Publishing date	2023-08-08
Publishing country	Germany
Document type	Journal Article
ZDB-ID	632839-8
ISSN	1279-8517 ; 0930-312X ; 0930-1038
ISSN (online)	1279-8517
ISSN	0930-312X ; 0930-1038
DOI	10.1007/s00276-023-03204-w
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Article ; Online: Generation of synthetic training data for SEEG electrodes segmentation.

Pantovic, Anja / Ren, Xiaoxi / Wemmert, Cédric / Ollivier, Irène / Essert, Caroline

International journal of computer assisted radiology and surgery

2022 Volume 17, Issue 5, Page(s) 937–943

Abstract: Purpose: Stereoelectroencephalography (SEEG) is a minimally invasive surgical procedure, used to locate epileptogenic zones. An accurate identification of the metallic contacts recording the SEEG signal is crucial to ensure effectiveness of the upcoming ...

Abstract	Purpose: Stereoelectroencephalography (SEEG) is a minimally invasive surgical procedure, used to locate epileptogenic zones. An accurate identification of the metallic contacts recording the SEEG signal is crucial to ensure effectiveness of the upcoming treatment. However, due to the presence of metal, post-operative CT scans contain strong streak artefacts that interfere with deep learning segmentation algorithms and require a lot of training data to distinguish from actual contacts. We propose a method to generate synthetic data and use them to train a neural network to precisely locate SEEG electrode contacts. Methods: Random electrodes were generated following manufacturer's specifications and dimensions and placed in acceptable regions inside metal-free CT images. Metal artefacts were simulated in the generated data set using radon transform, beam hardening, and filtered back projection. A UNet neural network was trained for the contacts segmentation task using various training set-ups combining real data, basic augmented data, and synthetic data. The results were compared. Results: We reported a higher accuracy when including synthetic data during the network training, while training only on real and basic augmented data more often led to misclassified artefacts or missed contacts. The network segments post-operative CT slices in less than 2 s using 4 GeForce RTX2080 Ti GPUs and in under a minute using a standard PC with GeForce GTX1060. Conclusion: Using synthetic data to train the network significantly improves contact detection and segmentation accuracy.
MeSH term(s)	Algorithms ; Artifacts ; Electrodes ; Electrodes, Implanted ; Electroencephalography/methods ; Humans ; Stereotaxic Techniques ; Tomography, X-Ray Computed
Language	English
Publishing date	2022-03-11
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2365628-1
ISSN	1861-6429 ; 1861-6410
ISSN (online)	1861-6429
ISSN	1861-6410
DOI	10.1007/s11548-022-02585-4
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Article ; Online: Musculocutaneous flap of the medial head of the triceps brachii: pedicled flap to cover the posterior cubital region.

Bruyere, Alexandra / Ollivier, Irène / Antoni, Maxime / Bodin, Frédéric / Clavert, Philippe

Surgical and radiologic anatomy : SRA

2022 Volume 44, Issue 3, Page(s) 479–484

Abstract: Introduction: The medial head of the triceps brachii flap is already described as a local muscular or as a free flap. It allows coverage of defects of the posterior cubital region. The aim of this study was to describe the vascular anatomy of the ... ...

Abstract	Introduction: The medial head of the triceps brachii flap is already described as a local muscular or as a free flap. It allows coverage of defects of the posterior cubital region. The aim of this study was to describe the vascular anatomy of the musculocutaneous medial triceps brachii pedicled flap. Methods: Eleven fresh-frozen upper limbs (6 come from women and 5 from men) were proximally injected with Indian ink agar solution. The medial head of the triceps brachii muscle was dissected and the superior ulnar collateral artery (SUCA) was isolated with its collaterals. The collateral arteries were dissected to determine whether there were septocutaneous or musculocutaneous arteries for vascularization of the skin in front of the medial head. Lengths of those collaterals arteries were measured. Results: The average number of collaterals arteries from the SUCA supplying the medial head of the triceps brachii is 4.5 (from 3 to 6 arteries). Among these collaterals' arteries, there are one average 1.5 (0.6-4.5) septocutaneous arteries and 3 (1-4.8) musculocutaneous arteries. Discussion and conclusion: A musculocutaneous flap with the medial head of the triceps brachii muscle can be described with the muscle. The SUCA gives perforator arteries musculocutaneous and septocutaneous for the vascularization of the triceps brachii medial head. The use of local pedicled flap with similar tissue maximizes healing with a minimal morbidity of the donor site. This study demonstrated the feasibility of the medial head triceps brachii musculocutaneous flap to cover defect of the posterior aspect of the elbow.
MeSH term(s)	Arm ; Elbow/surgery ; Female ; Humans ; Male ; Muscle, Skeletal/anatomy & histology ; Myocutaneous Flap ; Perforator Flap ; Ulnar Artery
Language	English
Publishing date	2022-02-10
Publishing country	Germany
Document type	Journal Article
ZDB-ID	632839-8
ISSN	1279-8517 ; 0930-312X ; 0930-1038
ISSN (online)	1279-8517
ISSN	0930-312X ; 0930-1038
DOI	10.1007/s00276-022-02900-3
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Article ; Online: An anatomical study of the fetal superior capsule of the glenohumeral joint.

Clavert, Philippe / Bruyere, Alexandra / Ollivier, Irène / Nourrissat, Geoffroy / Lädermann, Alexandre

Orthopaedics & traumatology, surgery & research : OTSR

2021 Volume 107, Issue 8S, Page(s) 103073

Abstract: Introduction: The superior part of the glenohumeral joint capsule has an intimate relationship with the tendons of the rotator cuff and the tendon of the long head of the biceps. One of the strategies currently proposed in the event of a massive cuff ... ...

Abstract	Introduction: The superior part of the glenohumeral joint capsule has an intimate relationship with the tendons of the rotator cuff and the tendon of the long head of the biceps. One of the strategies currently proposed in the event of a massive cuff rupture is to reconstruct this superior capsule. The main objective of this anatomical study was to describe the superior joint capsule of the embryonic glenohumeral joint and its relationship to the tendons of the rotator cuff. Hypothesis: The hypothesis was that this structure was an anatomical entity, morphologically identifiable from the embryogenesis of the joint (more pronounced tissue boundaries in the fetus). Material and methods: In total, 101 continuous fetal anatomical sections (4 fetuses of 336mm), in the frontal plane, made it possible to identify and measure: diameters of the humeral head and glenoid, dimensions of the joint capsule insertion zone at the level of the greater tubercle, as well as the different thicknesses of this insertion zone. The ratios above the head of the biceps and against the superior labrum were also measured. Results: At the level of its distal insertion on the greater tuberosity, the thickness of the superior joint capsule varies on average between 0.8mm laterally and 1.2mm next to the tendons of the supraspinatus and infraspinatus; the thickness is 0.9mm next to the middle part of the supraspinatus tendon (the "rotator cable" zone). For its insertion at the level of the glenoid labrum, the superior capsule measures 0.6mm thick on average. The capsule around the tendon of the long head of the biceps is 1.5mm thick on average. Discussion: Here, we confirm the existence of this superior joint capsule, which can potentially be reconstructed. It is inserted on the greater tubercle covering 30 to 60% of its surface with variations in thickness. The joint capsule is fused to the supraspinatus tendon at the rotator cuff insertion area, preventing independent reinsertion of the tendon. Level of evidence: IV; anatomical study.
MeSH term(s)	Cadaver ; Fetus ; Humans ; Humeral Head ; Joint Capsule/surgery ; Rotator Cuff/diagnostic imaging ; Rotator Cuff/surgery ; Rotator Cuff Injuries ; Shoulder Joint/surgery
Language	English
Publishing date	2021-09-22
Publishing country	France
Document type	Journal Article
ISSN	1877-0568
ISSN (online)	1877-0568
DOI	10.1016/j.otsr.2021.103073
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Article ; Online: Intermetatarsal ligament section assisted with sonography for the percutaneous surgery of Morton's disease: Cadaveric study.

Saur, Maurise / Bejarano-Pineda, Lorena / Ollivier, Irène / Koch, Guillaume / Clavert, Philippe

Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons

2022 Volume 28, Issue 7, Page(s) 1106–1109

Abstract: Background: Surgical treatment of Morton's neuroma remains controversial. Several surgical techniques have been described including percutaneous transection of the deep metatarsal transverse ligament (DMTL).: Purpose: To evaluate the efficacy and ... ...

Abstract	Background: Surgical treatment of Morton's neuroma remains controversial. Several surgical techniques have been described including percutaneous transection of the deep metatarsal transverse ligament (DMTL). Purpose: To evaluate the efficacy and safety of percutaneous release of the DMTL under ultrasound guidance for the treatment of Morton's syndrome. Materials and methodology: Percutaneous release of the DMTL was performed with ultrasound guidance in 48 intermetatarsal spaces of 16 cadaveric specimens. Specimens were then dissected to assess the completion of the release and the presence of any injuries of the neurovascular and tendinous adjacent structures. Results: The DMTL was visualized with ultrasound in all cases. Complete release of the ligament was achieved in 87.5% (42/48) cases. One case of interdigital nerve injury was found. Conclusion: Percutaneous release of DMTL with ultrasound guidance for the treatment of Morton's disease has an acceptable rate of complications but care must be taken to ensure the complete release of the ligament.
MeSH term(s)	Cadaver ; Foot ; Foot Diseases/surgery ; Humans ; Ligaments, Articular/diagnostic imaging ; Ligaments, Articular/surgery ; Morton Neuroma/surgery ; Neuroma/surgery
Language	English
Publishing date	2022-03-17
Publishing country	France
Document type	Journal Article
ZDB-ID	1424533-4
ISSN	1460-9584 ; 1268-7731
ISSN (online)	1460-9584
ISSN	1268-7731
DOI	10.1016/j.fas.2022.03.007
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Article ; Online: Three Different FDG Patterns in Periventricular Nodular Heterotopia Correlated to Video Stereoelectroencephalography.

Bund, Caroline / Hirsch, Maria Paola Valenti / Ollivier, Irène / Hirsch, Edouard / Namer, Izzie Jacques

Clinical nuclear medicine

2021 Volume 46, Issue 7, Page(s) 586–588

Abstract: Abstract: A 40-year-old woman with a drug-resistant focal epilepsy underwent cerebral FDG PET in phase 1 presurgical epilepsy study. MRI essentially showed multiple periventricular nodular heterotopias. The stereoelectroencephalography coupled to MRI ... ...

Abstract	Abstract: A 40-year-old woman with a drug-resistant focal epilepsy underwent cerebral FDG PET in phase 1 presurgical epilepsy study. MRI essentially showed multiple periventricular nodular heterotopias. The stereoelectroencephalography coupled to MRI and FDG PET helped to define the anatomofunctional correlation of the epileptogenic zone network. This procedure brought to light 3 distinct patterns of FDG consumption, corresponding to different anatomoelectroclinical features. This pattern was already found in a previous FDG PET reflecting a "stable" permanent intralesional intercritical stereoelectroencephalography activity, an electrical "signature" of the lesion. Finally, functional imaging improved thermocoagulation in this patient and emphasized the use of FDG in drug-resistant epilepsy.
MeSH term(s)	Adult ; Drug Resistant Epilepsy/complications ; Electroencephalography ; Female ; Fluorodeoxyglucose F18 ; Humans ; Magnetic Resonance Imaging ; Periventricular Nodular Heterotopia/complications ; Periventricular Nodular Heterotopia/diagnostic imaging ; Positron-Emission Tomography
Chemical Substances	Fluorodeoxyglucose F18 (0Z5B2CJX4D)
Language	English
Publishing date	2021-03-03
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	197628-x
ISSN	1536-0229 ; 0363-9762
ISSN (online)	1536-0229
ISSN	0363-9762
DOI	10.1097/RLU.0000000000003573
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Article: Comparison of interactive and automatic segmentation of stereoelectroencephalography electrodes on computed tomography post-operative images: preliminary results.

Benadi, Sahar / Ollivier, Irene / Essert, Caroline

Healthcare technology letters

2018 Volume 5, Issue 5, Page(s) 215–220

Abstract: Stereoelectroencephalography is a surgical procedure used in the treatment of pharmacoresistant epilepsy. Multiple electrodes are inserted in the patient's brain in order to record the electrical activity and detect the epileptogenic zone at the source ... ...

Abstract	Stereoelectroencephalography is a surgical procedure used in the treatment of pharmacoresistant epilepsy. Multiple electrodes are inserted in the patient's brain in order to record the electrical activity and detect the epileptogenic zone at the source of the seizures. An accurate localisation of their contacts on post-operative images is a crucial step to interpret the recorded signals and achieve a successful resection afterwards. In this Letter, the authors propose interactive and automatic methods to help the surgeon with the segmentation of the electrodes and their contacts. Then, they present a preliminary comparison of the methods in terms of accuracy and processing time through experimental measurements performed by two users, and discuss these first results. The final purpose of this work is to assist the neurosurgeons and neurologists in the contacts localisation procedure, make it faster, more precise and less tedious.
Language	English
Publishing date	2018-09-17
Publishing country	England
Document type	Journal Article
ZDB-ID	2782924-8
ISSN	2053-3713
ISSN	2053-3713
DOI	10.1049/htl.2018.5070
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Article: Delayed Intracerebral Hematoma after Ventriculoperitoneal Shunt in the Context of Ruptured Brain Arteriovenous Malformation: A Literature Review.

Dannhoff, Guillaume / Chibbaro, Salvatore / Mallereau, Charles-Henry / Ganau, Mario / Agbo-Ponzo, Martial / Santin, Marie des Neiges / Ollivier, Irène / Pop, Raoul / Proust, François / Todeschi, Julien

Brain sciences

2023 Volume 13, Issue 8

Abstract: Hemorrhagic complications arising from ventricular drainage procedures are typically asymptomatic and of low volume. A particular subset of these complications, known as delayed intracranial hemorrhage (DICH), is however recognized for its particularly ... ...

Abstract	Hemorrhagic complications arising from ventricular drainage procedures are typically asymptomatic and of low volume. A particular subset of these complications, known as delayed intracranial hemorrhage (DICH), is however recognized for its particularly poor prognosis. We primarily aimed to identify epidemiological characteristics associated with DICH, to shed light on its occurrence and potential risk factors. To do so, we performed a retrospective analysis of a series of ten patients who presented with DICH in the context of a ruptured brain arteriovenous malformation (bAVM) and a systematic literature review of all DICH cases reported in the literature. Our ten patients showed delayed neurological deterioration after a ventriculoperitoneal shunt (VPS) procedure, with a computed tomography (CT) scan revealing a DICH surrounding the ventricular catheter, distinct and away from the nidus of their previously ruptured bAVM. Four patients (40%) rapidly declined and passed away, three (30%) required surgical management and the remaining three (30%) demonstrated gradual clinical improvement with conservative management. In the literature, most patients presenting with DICH had hydrocephalus associated with neurovascular disorders (47% of cases), such as bAVM rupture in our present series. These constatations point out the significance of the underlying pathologies potentially being predisposed to these unusual complications.
Language	English
Publishing date	2023-08-03
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2651993-8
ISSN	2076-3425
ISSN	2076-3425
DOI	10.3390/brainsci13081159
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Article ; Online: Approaching Intradural Lesions of the Anterior Foramen Magnum and Craniocervical Junction: Anatomical Comparison of the Open Posterolateral and Anterior Extended Endonasal Endoscopic Approaches.

Dannhoff, Guillaume / Gallinaro, Paolo / Todeschi, Julien / Ganau, Mario / Spatola, Giorgio / Ollivier, Irène / Cebula, Hélène / Mallereau, Charles-Henry / Baloglu, Seyyid / Pop, Raoul / Proust, Francois / Chibbaro, Salvatore

World neurosurgery

2023 Volume 178, Page(s) e410–e420

Abstract: Background: Lesions of the foramen magnum (FM) and craniocervical junction area are traditionally managed surgically through anterior, anterolateral, and posterolateral skull-base approaches. This anatomical study aimed to compare the usefulness of a ... ...

Abstract	Background: Lesions of the foramen magnum (FM) and craniocervical junction area are traditionally managed surgically through anterior, anterolateral, and posterolateral skull-base approaches. This anatomical study aimed to compare the usefulness of a modified extended endoscopic approach, the so-called far-medial endonasal approach (FMEA), versus the traditional posterolateral far-lateral approach (FLA). Methods: Ten fixed silicon-injected heads specimens were used in the Skull Base ENT-Neurosurgery Laboratory of the University Hospital of Strasbourg, France. A total of 20 FLAs and 10 FMEAs were realized. A high-resolution computed tomography scan was performed for quantitative analysis of the different approaches. The analysis aimed to estimate the extent of surgical exposure and freedom of movement (maneuverability) through the operating channel using a polygonal surface model to obtain a morphometric estimation of the area of interest (surface and volume) on postdissection computed tomography scans using Slicer 3D software. Results: FMEA allows for a more direct route to the anterior FM, with wider brainstem exposure compared with the FLA and an excellent visualization of all anterior midline structures. The limitations of the FMEA include the deep and narrow surgical corridor and difficulty in reaching lesions located laterally over the jugular foramen and hypoglossal canal. Conclusions: The FMEA and FLA are both effective surgical routes to reach FM and craniocervical junction lesions. Modern skull base surgeons should have a good command of both because they appear complementary. This anatomical study provides the tools for comprehensive preoperative evaluations and selection of the most appropriate surgical approach.
Language	English
Publishing date	2023-07-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2023.07.080
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Article ; Online: Anatomical variations of the cavernous Internal Carotid Artery: Validation of an MRI-based classification.

Dannhoff, Guillaume / Bozzi, Maria Teresa / Scibilia, Antonino / Severac, François / Ollivier, Irène / Mallereau, Charles-Henry / Todeschi, Julien / Chibbaro, Salvatore / Proust, François / Gaillard, Stephan / Cebula, Hélène

Clinical neurology and neurosurgery

2023 Volume 227, Page(s) 107647

Abstract: Objective: Variations of the cavernous Internal Carotid Artery (ICA) angulation (C4-bend) have been classified into 4 anatomical subtypes with particular surgical relevance, as a very angulated ICA comes in closest contact with the pituitary gland ... ...

Abstract	Objective: Variations of the cavernous Internal Carotid Artery (ICA) angulation (C4-bend) have been classified into 4 anatomical subtypes with particular surgical relevance, as a very angulated ICA comes in closest contact with the pituitary gland leading to higher risk of iatrogenic vascular injury. This study aimed to validate this classification using current routine imaging techniques. Methods: The different cavernous ICA bending angles were measured on 109 MRI TOF sequences, within a retrospective database of patients with no sellar lesions. Each ICA was classified into one of 4 anatomical subtypes as already defined in a previous study [1]. Interrater agreement was assessed by a Kappa Correlation Coefficient. Results: Kappa Correlation Coefficient was of 0.90 [0.82-0.95], validating the strong level of agreement between all observers when using the present classification. Conclusion: Classification of the cavernous ICA in 4 subtypes appears statistically valid on routinely used pre-operative MRI, providing an efficient tool to estimate the vascular iatrogenic risk prior to endoscopic endonasal transsphenoidal surgery.
MeSH term(s)	Humans ; Carotid Artery, Internal/surgery ; Retrospective Studies ; Endoscopy/methods ; Magnetic Resonance Imaging ; Iatrogenic Disease ; Pituitary Neoplasms/diagnostic imaging ; Pituitary Neoplasms/surgery ; Pituitary Neoplasms/pathology
Language	English
Publishing date	2023-02-27
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	193107-6
ISSN	1872-6968 ; 0303-8467
ISSN (online)	1872-6968
ISSN	0303-8467
DOI	10.1016/j.clineuro.2023.107647
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