Publications by authors named "Max J H Witjes"

In cases of large mandibular continuity defects resulting from malignancy resection, the current standard of care involves using patient-specific/custom titanium reconstruction plates along with autogenous grafts (fibula, scapula, or iliac crest segments). However, when grafts are not feasible or desired, only the reconstruction plate is used to bridge the gap. Unfortunately, metal osteosynthesis and reconstruction plates, including titanium, exhibit adverse effects such as stress-shielding and limitations in accurate postoperative irradiation (especially with proton-beam therapy).

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Objectives: This study aimed to explore differences in demographics, tumour characteristics and outcomes in oral squamous cell carcinoma (OSCC) patients with a history of non-smoking, non-drinking (NSND) versus smoking and/or drinking (SD).

Materials And Methods: Newly diagnosed OSCC patients undergoing curative surgical treatment were prospectively included in OncoLifeS, a data biobank. Cox regression analysis was performed yielding hazard ratios (HRs) and 95% confidence intervals (95%CIs).

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Objectives: The shape is commonly used to describe the objects. State-of-the-art algorithms in medical imaging are predominantly diverging from computer vision, where voxel grids, meshes, point clouds, and implicit surface models are used. This is seen from the growing popularity of ShapeNet (51,300 models) and Princeton ModelNet (127,915 models).

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Background: Treatment for oral or oropharyngeal squamous cell carcinoma (O&OSCC) often leads to problems with speech articulation. Articulatory-kinematic data may be especially informative in designing new therapeutic approaches for individuals treated for these tumours.

Aims: To provide a systematic review of the literature assessing the articulatory-kinematic consequences of oral and oropharyngeal cancer treatment.

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Article Synopsis
  • Shortwave-infrared (SWIR) imaging is suggested to improve contrast in fluorescence-guided surgery compared to near-infrared (NIR) imaging, but it has only been tested in animal studies so far.
  • The study aims to evaluate the benefits of SWIR imaging in clinical samples treated with the NIR dye cetuximab-IRDye800CW, focusing on tumor-targeted applications in penile and head and neck cancers.
  • Results indicate that while SWIR performs similarly to NIR in penile cancer samples, NIR outperforms SWIR in most criteria for head and neck cancer due to high background autofluorescence, suggesting that SWIR may enhance contrast in some situations but not universally across all clinical
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Transoral Robotic Surgery (TORS) is utilized for treating various malignancies, such as early-stage oropharyngeal cancer and lymph node metastasis of an unknown primary tumor (CUP), and also benign conditions, like obstructive sleep apnea (OSA) and chronic lingual tonsillitis. However, the success and failure of TORS have not been analyzed to date. In this retrospective observational multicenter cohort study, we evaluated patients treated with TORS using the da Vinci surgical system.

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Objective: To investigate the feasibility of fluorescence molecular imaging (FMI), using cetuximab-800CW, as an intraoperative tool to determine surgical margins in penile squamous cell carcinoma (PSCC).

Patients And Methods: A total of 11 patients with PSCC received 75 mg cetuximab followed by 15 mg cetuximab-800CW 2 days before surgery. FMI of the whole excision specimen and tissue slices was performed.

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Purpose: To investigate glycoprotein nonmetastatic melanoma protein B (GPNMB) and vascular endothelial growth factor (VEGF) as potential fluorescent imaging markers by comparing their protein expression to epidermal growth factor receptor (EGFR).

Materials And Methods: Thirty-eight paired samples of untreated head and neck squamous cell carcinoma (HNSCC) primary tumours (PT) and corresponding synchronous lymph node metastases (LNM) were selected. After immunohistochemical staining, expression was assessed and compared by the percentage of positive tumour cells.

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Objectives: Intraoperative fluorescence imaging (FI) of head and neck squamous cell carcinoma (HNSCC) is performed to identify tumour-positive surgical margins, currently using epidermal growth factor receptor (EGFR) as imaging target. EGFR, not exclusively present in HNSCC, may result in non-specific tracer accumulation in normal tissues. We aimed to identify new potential HNSCC FI targets.

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Purpose: The purpose of this study was to quantify sentence-level articulatory kinematics in individuals treated for oral squamous cell carcinoma (ITOC) compared to control speakers while also assessing the effect of treatment site (jaw vs. tongue). Furthermore, this study aimed to assess the relation between articulatory-kinematic measures and self-reported speech problems.

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Aims: Proper preoperative planning benefits fracture reduction, fixation, and stability in tibial plateau fracture surgery. We developed and clinically implemented a novel workflow for 3D surgical planning including patient-specific drilling guides in tibial plateau fracture surgery.

Methods: A prospective feasibility study was performed in which consecutive tibial plateau fracture patients were treated with 3D surgical planning, including patient-specific drilling guides applied to standard off-the-shelf plates.

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Significance: Surgical excision is the main treatment for solid tumors in oral squamous cell carcinomas, where wide local excision (achieving a healthy tissue margin of around the excised tumor) is the goal as it results in reduced local recurrence rates and improved overall survival.

Aim: No clinical methods are available to assess the complete surgical margin intraoperatively while the patient is still on the operating table; and while recent intraoperative back-bench fluorescence-guided surgery approaches have shown promise for detecting "positive" inadequate margins (), they have had limited success in the detection of "close" inadequate margins (1 to 5 mm). Here, a dual aperture fluorescence ratio (dAFR) approach was evaluated as a means of improving detection of close margins.

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Objectives: We assessed the radiation dosages (D) on implant regions to identify the threshold for implant loss in patients with an intraoral malignancy treated with dental implants to support a mandibular denture during ablative surgery before volumetric-modulated arc therapy (VMAT).

Materials And Methods: Data was collected prospectively from 28 patients treated surgically for an intraoral malignancy, followed by postoperative radiotherapy (VMAT) and analyzed retrospectively. Patients received 2 implants in the native mandible during ablative surgery.

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Background: The two-staged prefabricated vascularized fibula free flap is used in maxillofacial reconstruction. We describe the possible cause and management of two cases of fibula fracture after implant placement.

Methods: The patients were treated with two-stage reconstruction with a prefabricated vascularized fibula free flap.

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Article Synopsis
  • This study developed a new 3D method to measure tibial plateau fracture displacement, addressing the low reliability of traditional measurement techniques.
  • A multicenter analysis involving 362 patients post-tibial plateau fracture surgery assessed the relationship between fracture displacement and functional outcomes using the KOOS questionnaire.
  • Results indicated that greater initial and residual fracture displacement was linked to significantly worse patient-reported outcomes, suggesting the importance of accurate measurement in treatment and recovery.
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Inadequate surgical margins occur frequently in oral squamous cell carcinoma surgery. Fluorescence molecular imaging (FMI) has been explored for intraoperative margin assessment, but data are limited to phase-I studies. In this single-arm phase-II study (NCT03134846), our primary endpoints were to determine the sensitivity, specificity and positive predictive value of cetuximab-800CW for tumor-positive margins detection.

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Purpose: A substantial proportion of conventional tibial plateau plates have a poor fit, which may result in suboptimal fracture reduction due to applied -uncontrolled- compression on the bone. This study aimed to assess whether patient-specific osteosyntheses could facilitate proper fracture reduction in medial tibial plateau fractures.

Methods: In three Thiel embalmed human cadavers, a total of six tibial plateau fractures (three Schatzker 4, and three Schatzker 6) were created and CT scans were made.

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Background: Radiographic measurements of initial displacement of tibial plateau fractures and of postoperative reduction are used to determine treatment strategy and prognosis. We assessed the association between radiographic measurements and the risk of conversion to total knee arthroplasty (TKA) at the time of follow-up.

Methods: A total of 862 patients surgically treated for tibial plateau fractures between 2003 and 2018 were eligible for this multicenter cross-sectional study.

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Purpose: Currently used classification systems and measurement methods are insufficient to assess fracture displacement. In this study, a novel 3D measure for fracture displacement is introduced and associated with risk on conversion to total knee arthroplasty (TKA).

Methods: A multicenter cross-sectional study was performed including 997 patients treated for a tibial plateau fracture between 2003 and 2018.

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Background: In all giant-cell-rich lesions (GCRL) occurring in bone, a common underlying excessive RANKL expression is held responsible for the osteolytic activity. Apart from giant cell tumour of bone (GCTB), systematic outcome analysis of RANKL inhibition in other GCRL is unavailable. The aim of this study is to assess the efficacy and safety of a 1-year denosumab protocol in giant cell lesions of the jaw (GCLJ).

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This study aims to develop a three-dimensional (3D) measurement for acetabular fracture displacement, determine the inter- and intra-observer variability, and correlate the measurement with clinical outcome. Three-dimensional models were created for 100 patients surgically treated for acetabular fractures. The ‘3D gap area’, the 3D surface between all the fracture fragments, was developed.

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For patients who suffer from severe dysfunction of the temporomandibular joint (TMJ), a total joint replacement (TJR) in the form of a prosthesis may be indicated. The position of the centre of rotation in TJRs is crucial for good postoperative oral function; however, it is not determined patient-specifically (PS) in any current TMJ-TJR. The aim of this current study was to develop a 4D-workflow to ascertain the PS mean axis of rotation, or fixed hinge, that mimics the patient's specific physiological mouth opening.

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Article Synopsis
  • The study looked at two different imaging techniques, Narrow Band Imaging (NBI) and Fluorescence Molecular Imaging (FMI), to see which one works better for finding tumor edges during surgery for mouth cancer.
  • Researchers found FMI was more accurate at pinpointing the tumor borders compared to NBI.
  • NBI was still useful for early-stage tumors that hadn't been treated before, making it a good choice in some cases because of cost and practicality.
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Over the past decade, the demand for three-dimensional (3D) patient-specific (PS) modelling and simulations has increased considerably; they are now widely available and generally accepted as part of patient care. However, the patient specificity of current PS designs is often limited to this patient-matched fit and lacks individual mechanical aspects, or parameters, that conform to the specific patient's needs in terms of biomechanical acceptance. Most biomechanical models of the mandible, e.

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