case_images: PMC4073452_01
case_images: On clinical examination reduced mouth opening, increasing restriction in the jaw's latero- and protrusion movement, a right deviation while opening and diffuse pain in the right lower jaw had been noticed since 2 months following inferior alveolar nerve block anesthesia
case_images: AMS-4-110-g001.jpg
case_images: PMC4073452_01_AMS-4-110-g001.jpg
case_images: F1
case_images: He had noticed reduced mouth opening, increasing restriction in the jaw's latero- and protrusion movement, a right deviation during mouth-opening and diffuse pain in the right lower jaw since 2 months [Figure 1].
case_images: Magnetic resonance imaging-scan; a 2 cm x 1.7 cm x 2.4 cm sharp defined hypointense suspect mass of 7 mm diameter was detected lateral to the right lateral pterygoid muscle and medial to the right temporal muscle
case_images: AMS-4-110-g002.jpg
case_images: PMC4073452_01_AMS-4-110-g002.jpg
case_images: F2
case_images: An already existing fat saturated 2T-weighted magnetic resonance imaging (MRI) performed at a local hospital showed a 2 cm x 1.7 cm x 2.4 cm sharp defined hypointense mass of 7 mm diameter and an intense contrast enhancement lateral to the right lateral pterygoid muscle and medial to the right temporal muscle [Figure 2].
case_images: Reconstruction of high resolution computed tomographydata sets (digital imaging and communications in medicine files) on the navigation workstation (StealthStation TREON plus, Louisville, USA). Reconstruction was depicted in a three-plane view (coronal, axial and sagittal) by the navigation system's software (StealthMergeTM, Medtronic and Louisville, USA). The lesion was visualized as a clear anatomical target for virtual operation access planning
case_images: AMS-4-110-g003.jpg
case_images: PMC4073452_01_AMS-4-110-g003.jpg
case_images: F3
case_images: The performed CT-data sets (standard DICOM files) were preoperatively transferred to the navigation workstation (StealthStation TREON plus, Louisville, USA) and were reconstructed in a three-plane view (coronal, axial and sagittal) by the navigation system's software (StealthMerge , Medtronic, Louisville, USA). Thus the lesion was visualized as a clear anatomical target on the system's navigation monitor in a multiplanar (axial, coronal and sagittal) image formation [Figures 3 and 4].
case_images: Preoperative surgical operation access planning in a three plane view on the navigation workstation
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case_images: F4
case_images: The performed CT-data sets (standard DICOM files) were preoperatively transferred to the navigation workstation (StealthStation TREON plus, Louisville, USA) and were reconstructed in a three-plane view (coronal, axial and sagittal) by the navigation system's software (StealthMerge , Medtronic, Louisville, USA). Thus the lesion was visualized as a clear anatomical target on the system's navigation monitor in a multiplanar (axial, coronal and sagittal) image formation [Figures 3 and 4].
case_images: Dynamic reference frame fixed with screws on the patient's skull in contact with the navigation workstation ("line of sight")
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case_images: PMC4073452_01_AMS-4-110-g005.jpg
case_images: F5
case_images: After intubation a dynamic reference frame was fixed with screws on the patient's skull [Figure 5] in visual contact with the three infrared cameras of the navigation workstation ("line of sight").
case_images: Navigation workstation. The navigation probe was calibrated for intraoperative computed tomography-tracking and direct visualization on the workstation's monitor by touching the operation field
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case_images: PMC4073452_01_AMS-4-110-g006.jpg
case_images: F6
case_images: Furthermore the navigation probe was calibrated for intraoperative CT-tracking and direct visualization on the workstation's monitor by touching the operation field [Figures 6 and 7].
case_images: Navigation probe (front) and reference frame fixed on the patient's skull (back)
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case_images: PMC4073452_01_AMS-4-110-g007.jpg
case_images: F7
case_images: Furthermore the navigation probe was calibrated for intraoperative CT-tracking and direct visualization on the workstation's monitor by touching the operation field [Figures 6 and 7].
case_images: Intraoperative navigation; simultaneous, multiplanar (coronal, axial and sagittal) view of the marked lesion
case_images: AMS-4-110-g008.jpg
case_images: PMC4073452_01_AMS-4-110-g008.jpg
case_images: F8
case_images: Under direct visual control using the navigation probe [Figure 8] the described lesion and the surrounding capsulated structure could be excised completely as one specimen [Figure 9].
case_images: The lesion and the surrounding capsulated structure could be excised completely as one specimen under direct visual control using the navigation system
case_images: AMS-4-110-g009.jpg
case_images: PMC4073452_01_AMS-4-110-g009.jpg
case_images: F9
case_images: Under direct visual control using the navigation probe [Figure 8] the described lesion and the surrounding capsulated structure could be excised completely as one specimen [Figure 9].