There is a paid version of Horos called ‘OsiriX MD’, which is produced by Pixmeo, however it is expensive so not ideal for basic teaching purposes, although has great functionality.
This programme is only available on Apple computers, hence why so many radiologists own MacBooks.
Osirix lite length tool not working software#
This is a free open source version of the software used by the Royal College of Radiologists for the viva part of the Final FRCR 2B exam, so obviously it makes sense to use it for teaching as well. Customised reconstruction of CT images will give a better idea about level and extent of airway narrowing/deviation, helping the anaesthesiologist to formulate the best and safest plan for securing the airway.A popular software for radiologists working in the UK is currently a programme called ‘ Horos‘. Using DICOM viewer we can make contrast changes and delineate the airway precisely.
Osirix lite length tool not working movie#
Three dimensional reconstruction of the airway as well as a simulated virtual bronchoscopic movie using CT images have been described in the management of difficult airway. An awake fiberoptic intubation, though a first choice in adults, was not possible in our patient. However, in our child, the lesion was solid in consistency, hence, pre-operative aspiration to improve the airway was not an option. Cystic lesions have the advantage of the reduction in size after aspiration. We opted for videolaryngoscopy as the first plan of intubation since the magnified view would have benefited not only the anaesthesiologist performing laryngoscopy but also the assistant to provide optimum external laryngeal manipulation. Supraglottic airway devices could not have been used for ventilation or as an intubation conduit since the median axis of larynx did not align with that of the oral cavity. The CT images showed deviated larynx from the midline. The OsiriX Lite™ (demo version, Pixmeo, Geneva, Switzerland) imaging software allows Virtual endoscopy, a novel tool which can also be used to generate high-quality airway images to generate a ‘fly-through’ airway reconstruction. These DICOM Viewers can be freely downloaded. However, with the help of DICOM Viewer and the softcopy provided one can procure customised images. CT plates have too many images and create more confusion in anaesthesiologists' mind. Whenever any patient undergoes CT scan, the diagnostic laboratory provides a hard copy (CT plates) and a soft copy (digital versatile disc). He was extubated and shifted to the recovery room for observation. Patient maintained stable haemodynamics throughout surgery. Muscle relaxant injection atracurium 0.5 mg/kg was given after confirming ETT placement. Nasal oxygen was provided continuously during our attempt to secure the airway. We used a paediatric optical laryngoscope, Airtraq ® (Prodol Ltd., Vizcaya, Spain) and intubated the trachea with a 4.0 mm internal diameter endotracheal tube (ETT). Sevoflurane was administered using Jackson Rees' circuit and mask to achieve a minimum alveolar concentration of 1.5. We pre-medicated the child with injection midazolam 0.05 mg/kg intravenous to achieve easy parental separation a crying child would have resulted in increased airway secretions and worsened the already narrowed airway calibre.
Otorhinolaryngologists were kept on standby for rigid bronchoscopy. Front of neck access in this patient would have been technically difficult due to the huge mass covering an entire anterior aspect of the neck. The Difficult airway cart was kept ready. Along with the printed CT images, we also received a soft copy of the CT scan given on a digital versatile disc that could be viewed on the digital imaging and communications in medicine (DICOM) Viewer. There was displacement of the floor of mouth and larynx to the right with resultant narrowing of the airway. CT images showed a 9.3 cm × 8.0 cm × 8.6 cm lesion suspected to be lipomatosis. On examination, it was found to be a solid mass.
He did not have any symptoms suggestive of airway obstruction. Clinical picture of the patient, (a) computed tomography image of deviated larynx (at the level of epiglottis) from mid vertebral axis, (b) measurements of airway lumen (at the level of first tracheal ring) using OsiriX Lite™ (c)Ī small swelling was noticed by the parents at the neck of the child at 3 months of age which gradually grew to the present size.
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