Publications by authors named "I Klapan"

31 Publications

Virtual reality in rhinology-a new dimension of clinical experience.

Ear Nose Throat J 2016 Jul;95(7):E23-8

Corresponding author: Pero Raos, PhD, Mechanical Engineering Faculty in Slavonski Brod, Trg I. B. Mazuranic 2, HR-35000, Slavonski Brod, Croatia. Email: From the Department of Otorhinolaryngology, University of Osijek School of Medicine, Osijek, Croatia, and Klapan Medical Group Polyclinic, Zagreb, Croatia (Dr. Klapan); the Department of Production Technologies, University of Osijek Mechanical Engineering Faculty in Slavonski Brod, Croatia (Dr. Raos and Dr. Galeta); and the Radiology Division, Sunce Polyclinic, Zagreb (Dr. Kubat). The cases described in this article occurred at Klapan Medical Group Polyclinic.

There is often a need to more precisely identify the extent of pathology and the fine elements of intracranial anatomic features during the diagnostic process and during many operations in the nose, sinus, orbit, and skull base region. In two case reports, we describe the methods used in the diagnostic workup and surgical therapy in the nose and paranasal sinus region. Besides baseline x-ray, multislice computed tomography, and magnetic resonance imaging, operative field imaging was performed via a rapid prototyping model, virtual endoscopy, and 3-D imaging. Different head tissues were visualized in different colors, showing their anatomic interrelations and the extent of pathologic tissue within the operative field. This approach has not yet been used as a standard preoperative or intraoperative procedure in otorhinolaryngology. In this way, we tried to understand the new, visualized "world of anatomic relations within the patient's head" by creating an impression of perception (virtual perception) of the given position of all elements in a particular anatomic region of the head, which does not exist in the real world (virtual world). This approach was aimed at upgrading the diagnostic workup and surgical therapy by ensuring a faster, safer and, above all, simpler operative procedure. In conclusion, any ENT specialist can provide virtual reality support in implementing surgical procedures, with additional control of risks and within the limits of normal tissue, without additional trauma to the surrounding tissue in the anatomic region. At the same time, the virtual reality support provides an impression of the virtual world as the specialist navigates through it and manipulates virtual objects.
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July 2016

Additive Manufacturing of Medical Models--Applications in Rhinology.

Coll Antropol 2015 Sep;39(3):667-73

In the paper we are introducing guidelines and suggestions for use of 3D image processing SW in head pathology diagnostic and procedures for obtaining physical medical model by additive manufacturing/rapid prototyping techniques, bearing in mind the improvement of surgery performance, its maximum security and faster postoperative recovery of patients. This approach has been verified in two case reports. In the treatment we used intelligent classifier-schemes for abnormal patterns using computer-based system for 3D-virtual and endoscopic assistance in rhinology, with appropriate visualization of anatomy and pathology within the nose, paranasal sinuses, and scull base area.
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September 2015

Virtual endoscopy and 3D volume rendering in the management of frontal sinus fractures.

Coll Antropol 2009 Dec;33 Suppl 2:43-51

Department of Radiology, Special Hospital "Krapinske Toplice", Krapinske Toplice, Croatia.

Frontal sinus fractures (FSF) are commonly caused by traffic accidents, assaults, industrial accidents and gunshot wounds. Classical roentgenography has high proportion of false negative findings in cases of FSF and is not particularly useful in examining the severity of damage to the frontal sinus posterior table and the nasofrontal duct region. High resolution computed tomography was inavoidable during the management of such patients but it may produce large quantity of 2D images. Postprocessing of datasets acquired by high resolution computer tomography from patients with severe head trauma may offer a valuable additional help in diagnostics and surgery planning. We performed virtual endoscopy (VE) and 3D volume rendering (3DVR) on high resolution CT data acquired from a 54-year-old man with with both anterior and posterior frontal sinus wall fracture in order to demonstrate advantages and disadvantages of these methods. Data acquisition was done by Siemens Somatom Emotion scanner and postprocessing was performed with Syngo 2006G software. VE and 3DVR were performed in a man who suffered blunt trauma to his forehead and nose in an traffic accident. Left frontal sinus anterior wall fracture without dislocation and fracture of tabula interna with dislocation were found. 3D position and orientation of fracture lines were shown in by 3D rendering software. We concluded that VE and 3DVR can clearly display the anatomic structure of the paranasal sinuses and nasopharyngeal cavity, revealing damage to the sinus wall caused by a fracture and its relationship to surrounding anatomical structures.
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December 2009

Our experience with virtual endoscopy of paranasal sinuses.

Coll Antropol 2008 Sep;32(3):887-92

Special Hospital for Medical Rehabilitation "Krapinske Toplice", Krapinske Toplice, Croatia.

The main goal of our work was to evaluate advantages and disadvantages of virtual endoscopy (VE) techniques in routinely diagnostic and preoperative management of patients with various sinus diseases or head traumas in our practice. Fly-through algorithm was performed using an Xeon based workstation on data sets created from axial CT images acquired from 320 patients with various paranasal sinus disorders. Images were created using Siemens Somatom Emotion 16 continiously rotating helical CT scanner and archived in DICOM format. In comparison with real endoscopy, the VE has several advantages. It is completely non-invasive. It is possible to repeat the same procedure several times, therefore it may be a valuable tool for training. Interactive control of all virtual camera parameters, including the field-of-view is possible. Endoscopic viewing as opposed to real endoscopy is not restricted to the spaces defined by inner surfaces. The viewer may penetrate the walls and see the extent of lesions within and beyond the wall as well as the adjacent anatomic structures. Virtual endoscopy also has a potential to stage tumors by determining the location and the extent of transmural extension.
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September 2008

Application of advanced virtual reality and 3D computer assisted technologies in tele-3D-computer assisted surgery in rhinology.

Coll Antropol 2008 Mar;32(1):217-9

University Department of ENT, Head and Neck Surgery, University Hospital Center Zagreb, Zagreb, Croatia.

The real-time requirement means that the simulation should be able to follow the actions of the user that may be moving in the virtual environment. The computer system should also store in its memory a three-dimensional (3D) model of the virtual environment. In that case a real-time virtual reality system will update the 3D graphic visualization as the user moves, so that up-to-date visualization is always shown on the computer screen. Upon completion of the tele-operation, the surgeon compares the preoperative and postoperative images and models of the operative field, and studies video records of the procedure itself Using intraoperative records, animated images of the real tele-procedure performed can be designed. Virtual surgery offers the possibility of preoperative planning in rhinology. The intraoperative use of computer in real time requires development of appropriate hardware and software to connect medical instrumentarium with the computer and to operate the computer by thus connected instrumentarium and sophisticated multimedia interfaces.
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March 2008
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