Search Results (7,701)

Background: Heller myotomy (HM) is the standard surgical treatment for achalasia. Complete muscular division while preserving mucosal integrity is essential for optimal outcomes. Indocyanine green fluorescence (ICG) imaging has recently emerged as a potential intraoperative adjunct during minimally invasive HM, although evidence remains limited and heterogeneous. Methods: A scoping review was conducted according to PRISMA-ScR recommendations. PubMed, Scopus, and Web of Science were systematically searched to identify clinical studies reporting intraoperative ICG use during laparoscopic or robotic HM. Data regarding surgical approach, fluorescence technique, intraoperative applications, and outcomes were extracted and descriptively synthesized. Results: Four clinical studies published between 2022 and 2024 were included, involving 58 patients overall, of whom 41 underwent minimally invasive HM with intraoperative ICG fluorescence assessment. Two main fluorescence strategies were identified. Intravenous ICG administration was exclusively evaluated during robotic Heller myotomy, whereas all laparoscopic studies employed intraluminal ICG instillation through a nasogastric tube. Fluorescence imaging was used to assess myotomy completeness, identify residual muscle fibers, and detect mucosal perforation. Intraluminal ICG enabled direct visualization of the mucosal tube and facilitated leak detection, whereas intravenous administration enhanced tissue contrast and identification of residual muscular bundles. No ICG-related adverse events were reported. However, the available evidence was limited to small observational series with heterogeneous protocols and inconsistent outcome reporting. Conclusions: ICG fluorescence appears technically feasible during minimally invasive HM and may support intraoperative assessment of myotomy completeness and mucosal integrity. Although early clinical experience is encouraging, the available evidence remains insufficient to support routine implementation of ICG-guided assessment during Heller myotomy, highlighting the need for standardized prospective comparative studies. Full article

Objectives: This study aimed to describe implant survival rates and associated risk factors in patients treated with two sinus augmentation techniques—Lateral Window (LW) and Transcrestal (TC)—at a single center. Methods: A retrospective cohort analysis was performed using medical records of patients who underwent maxillary sinus augmentation and subsequent dental implant placement between 2015 and 2019 at the Rambam Healthcare Center. Data on demographic variables, surgical approach, graft materials, implant characteristics, and clinical outcomes were collected from electronic medical records. Results: A total of 135 patients met the inclusion criteria, contributing 144 TC procedures (with 144 implants) and 46 LW procedures (90 implants) to the final analysis. The overall implant failure rate was 7.7%, with a significantly higher failure rate for TC (11.11%) compared to LW (2.22%). Procedure type was a significant predictor of implant survival (OR 1.62); however, as residual bone height (RBH) data were unavailable, confounding by indication cannot be excluded and this finding should be interpreted with caution. Implant length demonstrated a significant influence on outcomes (OR 1.28 per mm increase); shorter implants (8 mm) exhibited lower survival rates (81.3%) compared to 10 mm implants (92.3%). Smoking status was identified as a negative predictor of implant survival (OR 0.23). Schneiderian membrane ruptures occurred in nine cases, seven of which were LW procedures. Smoking was the only factor affecting graft survival (OR 0.29). Conclusions: In this retrospective cohort, implant survival rates were higher in the LW group than in the TC group; however, given that individual residual bone height data were unavailable and case assignment, although governed by standardized departmental criteria, was not randomized, the possibility of confounding by indication cannot be excluded. Smoking and shorter implants were significant risk factors for implant failure. Smoking was also associated with graft failure. Full article

Injuries to the posterolateral corner (PLC) of the knee represent a complex clinical entity that is frequently underdiagnosed and undertreated, often leading to persistent instability and failure of concomitant ligament reconstructions. Although open surgical approaches to the PLC have been extensively described, the role of arthroscopy in the diagnosis and management of these injuries remains less clearly defined despite increasingly encouraging clinical and biomechanical results. The aim of this narrative review was to analyze the role of knee arthroscopy in the diagnosis, evaluation, and treatment of PLC injuries. A comprehensive literature review was performed focusing on studies investigating arthroscopic findings, diagnostic signs, and arthroscopic or arthroscopy-assisted techniques for PLC management. Relevant clinical, anatomical, biomechanical, and surgical studies were analyzed to provide an integrated arthroscopy-oriented perspective. Arthroscopy enables direct visualization of key posterolateral structures and identification of characteristic diagnostic findings, such as the lateral drive-through sign, potentially improving detection of subtle or combined PLC injuries. In addition, arthroscopic assessment facilitates evaluation of associated intra-articular lesions and may contribute to more accurate characterization of injury patterns. Emerging arthroscopic and arthroscopy-assisted reconstruction techniques may offer advantages in selected cases by supporting tailored surgical strategies, accurate graft positioning, and reduced surgical morbidity. Knee arthroscopy is assuming an increasingly important role in the comprehensive management of PLC injuries, extending beyond the treatment of associated intra-articular pathology alone. Integration of arthroscopy into the diagnostic and therapeutic algorithm of PLC injuries may improve surgical decision-making and patient-specific management. Nevertheless, further high-quality clinical studies are required to establish standardized arthroscopic criteria and validate the long-term clinical advantages of arthroscopy-guided approaches. Full article

Background/Objectives: Chronic heart failure (CHF) is a leading cause of global morbidity and mortality, particularly among older adults, significantly impacting their quality of life and imposing a substantial economic burden. While pharmacological and surgical treatments remain essential, non-pharmacological interventions led by nurses are gaining prominence due to their comprehensive approach and biopsychosocial impact. The objective of this study was to synthesise and integrate such interventions for community-dwelling older adults with CHF. Methods: An integrative review was conducted in accordance with the Joanna Briggs Institute protocols and the PRISMA statement, utilising a systematic search across databases including PubMed and Cochrane. Qualitative, quantitative, and mixed-methods studies evaluating non-pharmacological interventions in the home setting were included, whilst those targeting non-specific populations were excluded. Following a rigorous screening process, 12 studies were selected, and their methodological quality was appraised based on study design. Results: The 12 included studies involved a total of 2466 participants and addressed interventions across the domains of education, physical activity, telehealth, and nutrition, with programme durations ranging from 4 weeks to 16 months. Notable improvements were observed in physical capacity, cognitive function, quality of life, and self-care capabilities, alongside potential reductions in hospitalisations reported in some studies. However, considerable methodological variability was identified across the literature. Conclusions: This review synthesises non-pharmacological nursing interventions for older adults with CHF, demonstrating varied benefits across multiple biopsychosocial domains. The findings emphasise the critical need for further research to evaluate the economic viability of these programmes and to adapt interventions to enhance the delivery of community-based care. Full article

Cytoreductive surgery remains one of the key treatment modalities in advanced ovarian cancer. Complete cytoreduction is the main surgical goal. PARP inhibitors are currently established mainly as maintenance therapy after response to platinum-based chemotherapy, particularly in patients with BRCA-mutated or homologous recombination-deficient tumors. Their use before cytoreductive surgery remains investigational. This review evaluates preoperative PARP inhibition from a surgical perspective. This narrative review summarizes current evidence, ongoing clinical trials, and perioperative considerations related to preoperative or neoadjuvant PARP inhibitor strategies in advanced ovarian cancer. Particular attention was given to the review of current clinical trials’ strategies, resectability, complete cytoreduction, patient selection, perioperative safety, treatment timing, and surgery-specific endpoints. Current studies explore several preoperative approaches, including short window-of-opportunity treatment before primary debulking surgery, PARP inhibitor monotherapy as potential conversion therapy in homologous recombination-deficient disease, PARP inhibitor-based strategies before interval debulking surgery, combination regimens with immunotherapy or antiangiogenic therapy, and preoperative PARP inhibitor use before secondary cytoreduction in recurrent disease. These studies suggest that preoperative PARP inhibition may provide biological and surgical insights, but available evidence remains preliminary. Key concerns include hematologic toxicity, surgical postponement, perioperative complications, wound healing, postoperative recovery, and the risk of delaying standard chemotherapy or surgery. Preoperative PARP inhibitor therapy is theoretically promising but an unproven strategy in ovarian cancer. Its future value will depend on prospective trials showing that it can safely improve resectability and complete cytoreduction without compromising treatment timing. Future studies should include surgery-specific endpoints in addition to conventional oncologic outcomes. Full article

Posterior pituitary and hypothalamic neuronal tumors are uncommon sellar and suprasellar neoplasms that can mimic pituitary neuroendocrine tumors clinically and radiologically. The 5th edition World Health Organization classifications (Endocrine and Neuroendocrine Tumors) reinforce a lineage-based framework that separates anterior pituitary tumors from posterior pituitary and hypothalamic neuronal lineages, which is particularly important in hormone-negative lesions and limited tissue samples. This narrative review provides a practical, pathology-centered approach to classification by integrating key anatomic and radiologic clues with histomorphology and targeted immunohistochemistry. We highlight the value and limitations of thyroid transcription factor 1, outline a stepwise workflow incorporating anterior pituitary transcription factors and neuronal differentiation markers, and discuss when vasopressin immunostaining is informative. We also summarize selected molecular insights and clinical management considerations relevant to surgical planning and follow-up. Full article

Cardiac arrhythmias complicate 20–50% of surgical procedures and contribute substantially to perioperative morbidity, mortality, and healthcare costs, with postoperative atrial fibrillation (POAF) being the most frequent form. Their genesis reflects the convergence of surgical stress, anaesthetic agents, autonomic imbalance, systemic inflammation, and electrolyte disturbances, explaining the limited efficacy of single-mechanism interventions. This narrative review synthesises contemporary evidence on pathophysiology, risk stratification, prevention, acute management, and emerging technologies, emphasising individualised, patient-tailored approaches. MEDLINE, Embase, and Cochrane CENTRAL were searched (January 2010–January 2026), prioritising randomised trials, meta-analyses, and guidelines. Contemporary risk stratification integrates clinical scores, biomarkers, and electrocardiographic parameters; machine-learning models show moderate discrimination (pooled AUC 0.84) and may enable more personalised prediction pending external validation. Evidence-based prophylaxis—beta-blockade, magnesium, selective amiodarone, and emerging anti-inflammatory strategies such as colchicine—reduces POAF in high-risk populations, while acute management is guided by haemodynamic status and individual risk. Anticoagulation follows CHA₂DS₂-VASc stratification, although optimal timing and duration remain undefined. Wearable monitoring, AI-based detection, and atrial-selective agents show clinical promise. Systematic, personalised integration of risk assessment, prophylaxis, monitoring, and management offers the clearest path to reducing arrhythmia-associated morbidity. Full article

Background: Chronic low back pain (CLBP) is the leading cause of years lived with disability globally, affecting over 600 million individuals. Intervertebral disc degeneration (IVDD) is a principal structural contributor, yet conventional treatments, including pharmacotherapy, physical therapy, and surgical intervention, do not reverse the underlying degenerative pathology. Regenerative medicine has introduced a spectrum of biological therapies for IVDD, including cell-based mesenchymal stromal cell (MSC) therapy, platelet-derived products such as platelet-rich plasma (PRP) and platelet lysate, extracellular vesicle-based approaches using MSC-derived extracellular vesicles (EVs), and secretome-based therapies using MSC-derived secretomes. However, these approaches have largely been studied in isolation, without a unified framework to compare their respective advantages and limitations in CLBP secondary to IVDD. Accordingly, this narrative review aims to provide an integrated and comparative evaluation of these regenerative strategies within a single translational and clinical context. Methods: For this narrative review, PubMed, Scopus, and Web of Science were searched from January 2000 to January 2026 using terms combining regenerative modalities with intervertebral disc degeneration, and chronic low back pain. Randomized controlled trials (RCTs), prospective cohort studies, systematic reviews, and preclinical studies with translational relevance were included. Results: Intradiscal MSC therapy has demonstrated safety across multiple phase I–III trials, but two recent landmark RCTs (RESPINE and the Mesoblast phase III trial) failed to meet primary efficacy endpoints, highlighting the gap between preclinical promise and clinical outcomes. PRP has the largest clinical evidence base, with level II evidence supporting short- to medium-term pain relief for discogenic pain, although standardization remains a critical barrier. Platelet lysate, MSC-derived EVs, and MSC-derived secretomes show compelling preclinical data, including extracellular matrix restoration, anti-inflammatory modulation, and attenuation of nucleus pulposus cell apoptosis, but remain at early translational stages for spinal applications, with no completed RCTs. The hostile disc microenvironment (avascular, hypoxic, acidic, and nutrient-poor) poses unique challenges for all regenerative modalities, differing fundamentally from other musculoskeletal applications. Conclusions: The studies included in this narrative review suggest that no single regenerative modality has yet shown consistent and unequivocal efficacy for CLBP secondary to IVDD across clinical trials. Cell-free approaches offer manufacturing, scalability, and safety advantages over cell-based therapies, but lack clinical validation. Future progress requires standardized preparation protocols, disc-specific delivery systems, patient phenotyping strategies, and rigorously designed comparative clinical trials. This narrative review provides a framework for researchers and clinicians to evaluate these therapies in context rather than isolation. Full article

Background and Objectives: Hysterectomy is one of the most frequently performed gynecological surgical procedures worldwide. It is well established that the laparoscopic approach offers better outcomes for patients compared to abdominal hysterectomy. However, the technique for vaginal cuff closure during laparoscopic hysterectomy (TLH) remains insufficiently standardized in the international literature. Based on our results, we aim to demonstrate that closure of the vaginal cuff using a figure-of-eight suture is a sufficient, reproducible, time-efficient and safe method during total laparoscopic hysterectomy. Materials and Methods: Our retrospective observational study analyzed 173 patients who underwent a TLH from January 2016 to December 2021 at the University of Debrecen, Department of Obstetrics and Gynecology. Standardized surgical steps were applied in all cases (ligation of the uterine arteries at their origin, fenestration of the broad ligament above the ureter), and the vaginal cuff was closed laparoscopically with an absorbable suture, incorporating vesicovaginal fascia, vaginal mucosa and uterosacral ligaments. Patient demographics, operative data, and perioperative outcomes were extracted and analyzed. Results: TLH was successfully performed in 173 cases, and no conversion to open surgery was necessary. The mean age of the patients was 51.4 (23–86) years, the median body mass index (BMI) was 26.9 (16.9–45) kg/m², and the operative time was 92 (35–240) minutes. The mean uterine weight was 151 (16–440) g. The mean hemoglobin drop was 15.8 (0–44) g/L after the surgery. Regarding complications, ureteral injuries occurred in two cases (1.2%). One patient (0.6%) required relaparotomy due to rectosigmoid perforation. Postoperative complications included vaginal cuff dehiscence in two cases (1.2%), with one patient (0.6%) requiring resuturing, fever in six cases (3.5%), vaginal discharge in four cases (2.3%), and vaginal bleeding in one case (0.6%). Pulmonary embolism occurred in one patient (0.6%). Three patients (1.7%) required blood transfusion based on postoperative blood counts. Conclusions: Our results demonstrate an acceptable operative time and a low rate of postoperative complications, suggesting that closing of the vaginal cuff with a figure-of-eight suture is a sufficient and safe technique. This method can be reliably reproduced and incorporated into the standardized steps of total laparoscopic hysterectomy. Full article

Background/Objectives: Sinonasal osteomas are benign, slow-growing tumors that are typically asymptomatic and incidentally detected. However, in rare cases, they may present with atypical and potentially serious complications involving other sinonasal, orbital, or intracranial structures. This review aims to synthesize these unusual manifestations and to highlight the underlying mechanisms, diagnostic challenges, and management implications. Methods: A narrative review of the literature was conducted, focusing on reported cases of sinonasal osteomas with rare or complicated presentations. Studies were analyzed with emphasis on clinical features, imaging findings, pathophysiological mechanisms, and treatment strategies. Results: Unusual presentations of sinonasal osteomas are primarily driven by sinus obstruction, progressive expansion, and skull-base erosion. These processes may result in complications such as pneumocephalus, intracranial mucoceles, cerebrospinal fluid leaks, orbital compression, and secondary infections. Clinical manifestations are often nonspecific, including headache, seizures, visual disturbances, or focal neurological deficits, which may delay diagnosis. High-resolution computed tomography is essential for identifying the osseous lesion and associated bone changes, while magnetic resonance imaging is critical for assessing soft-tissue involvement and intracranial extension. Management is individualized, with surgical resection indicated in most symptomatic or complicated cases, using endoscopic, open, or combined approaches. Conclusions: Although rare, atypical manifestations of sinonasal osteomas can result in significant morbidity. A mechanism-based understanding, supported by appropriate imaging, is essential for accurate diagnosis and timely management. Increased clinical awareness is crucial to improving outcomes in these uncommon but clinically significant cases. Full article

The diagnostic evaluation of interstitial lung diseases (ILDs) remains challenging when clinical assessment and imaging findings are inconclusive. Although surgical lung biopsy has traditionally represented the diagnostic gold standard, its invasiveness and perioperative risks limit its applicability, particularly in patients with advanced disease or impaired respiratory reserve. This review aims to examine the evolving roles of transbronchial lung cryobiopsy (TBLC) and awake video-assisted thoracoscopic surgery (Awake VATS) within contemporary diagnostic pathways for ILD. A narrative review of the current literature was performed, focusing on studies evaluating the diagnostic performance, safety profiles, clinical indications, and complementary integration of TBLC and Awake VATS in patients with suspected ILD. Evidence from multidisciplinary ILD referral centers and recent guideline recommendations was critically analyzed. TBLC has progressively emerged as an appropriate first-line histological procedure in many ILD centers, providing a pooled diagnostic yield of approximately 80% with an acceptable safety profile. Awake VATS has refined the surgical approach by preserving spontaneous ventilation while maintaining high diagnostic accuracy. Current evidence suggests that these techniques should be considered complementary rather than competitive. A TBLC-first strategy, followed by selective surgical escalation when endoscopic sampling is non-diagnostic or insufficient, appears to achieve diagnostic accuracy comparable to upfront surgical biopsy while reducing complications, length of hospital stay, and overall patient burden. The choice between Awake VATS and conventional surgical biopsy should be individualized according to patient characteristics, institutional expertise, and available resources. TBLC and Awake VATS represent complementary tools within a multidisciplinary, personalized, and risk-adapted diagnostic framework for ILD. Their integrated use enables optimization of diagnostic accuracy while minimizing procedural invasiveness and improving patient safety, supporting a stratified approach to histological assessment in contemporary clinical practice. Full article

Background/Objectives: Uterine fibroids are one of the most prevalent forms of benign tumors in women and may substantially impair quality of life due to heavy menstrual bleeding, pelvic pain, and pressure-related symptoms. Transvaginal radiofrequency ablation (TV-RFA) has emerged as a promising minimally invasive, uterus-sparing treatment approach. However, there exists a paucity of data regarding the early vascular response evaluated through quantitative Doppler parameters. This study aimed to assess the short-term clinical outcomes and ultrasound effectiveness of TV-RFA in treating symptomatic uterine fibroids, with particular emphasis on early vascular and morphological response. Methods: This retrospective study included 38 women who presented with symptomatic uterine fibroids and underwent TV-RFA between July 2024 and December 2025. Inclusion criteria were as follows: (1) presence of up to three intramural fibroids (FIGO types 3–6) and (2) maximum diameter of fibroids: ≤6 cm. Patients were assessed at baseline and at 1- and 3-month follow-up visits. Ultrasound evaluation included the measurement of fibroid dimensions and volume as well as quantitative Doppler parameters (Pixels Power, Ratio, and CM² Power Index). Clinical outcomes were assessed based on the intensity and duration of menstrual bleeding. Statistical analysis was performed using nonparametric tests with significance set at p < 0.05. Results: Significant reductions in fibroid dimensions and volume were observed at both follow-up time points, with the greatest effect at 3 months (p < 0.001). Doppler analysis demonstrated a marked decrease in vascularization parameters, particularly CM² Power Index and Pixels Power (p < 0.001), suggesting an early vascular response to treatment. Clinically, the proportion of patients experiencing heavy menstrual bleeding considerably reduced, accompanied by a significant shortening of bleeding duration (p < 0.001). No major complications requiring surgical intervention were reported. Conclusions: TV-RFA was associated with significant short-term reductions in fibroid vascularization, fibroid volume, and bleeding-related symptoms in this cohort of women with symptomatic uterine fibroids. Quantitative Doppler parameters may serve as valuable early markers of treatment response; however, further studies with larger cohorts and a longer follow-up duration are warranted. Full article

Craniomaxillofacial trauma (CMFt) poses a significant burden, yet in many countries the evidence base is fragmented across single-center hospital series without specialized registry. Using Chile as a case study, we demonstrate a dual-synthesis approach to construct a national CMFt profile. Six databases were searched through February 2026 (PROSPERO: CRD420261290860). Two reviewers independently screened studies. Risk of bias was assessed with the JBI critical appraisal tool. Fracture-site proportions were pooled via random-effects meta-analysis and synthesized using GRADE. DEIS trauma discharges (2001–2024) were analyzed with negative binomial interrupted time-series. Nineteen studies were included. CMFt represented 2.6–6.1% of emergency consultations. CMFt admissions were 54.2/1000 trauma discharges; this rate dropped during 2020–2021 and rebounded post-2022. Pooled fracture-site distributions were highest for mandibular (45.3%) and zygomatic (24.2%) fractures. CMFt disproportionately affected males across both hospital series and national discharge data. According to DEIS, low-energy accidental injuries were the predominant etiology, followed by transport-related high-energy injuries and interpersonal violence, contrasting with hospital series where interpersonal violence predominated among adult surgical cohorts. Fracture admissions had longer length of stay (LOS) than soft-tissue CMFt (+0.94 days), with mean LOS ranging from 2.08 (nasal) to 8.35 days (multiple skull/facial fractures). These findings support prioritizing surgical preparedness and training in common fracture patterns, while strengthening trauma surveillance, referral pathways, and service planning in health systems without dedicated CMFt registries. Full article

Background and Objectives: Endoscope-assisted posterior fossa decompression with duraplasty (PFDD) is a minimally invasive alternative treatment for Chiari I malformation; however, its comparative effectiveness remains unclear. Therefore, this study aimed to compare the outcomes of conventional open decompression with those of endoscope-assisted minimally invasive decompression combined with duraplasty to assess the balance between limited surgical exposure and associated technical challenges. Materials and Methods: This retrospective single-center study compared 22 patients who underwent endoscope-assisted PFDD with a historical cohort of 16 patients treated with conventional open PFDD. Patients with C1–2 instability, prior craniovertebral surgery, or concomitant pathology requiring an alternative surgical strategy were excluded. The clinical outcomes, radiological findings, surgical variables, and complications were analyzed. Results: Clinical improvement, overall recovery, and 3-month Chicago Chiari Outcome Scale (CCOS) scores were comparable between the groups. The endoscopic group had higher CCOS scores at discharge. Syrinx resolution rates were similar, whereas postoperative cisterna magna expansion was more limited in the endoscopic cohort. The endoscopic approach was associated with a significantly shorter incision length and earlier mobilization. The rates of complications, including pseudomeningocele, cerebrospinal fluid fistula, and wound infection, did not differ significantly between the groups. Conclusions: Endoscope-assisted PFDD may be a less invasive alternative with comparable short-term clinical and radiological outcomes. Despite the technical challenges related to a limited working corridor, it can be considered a feasible option for selected patients. Full article

Background: Maxillary tuberosity fracture is an uncommon but clinically significant complication of maxillary molar extraction. It may compromise immediate surgical outcomes, reduce posterior maxillary bone volume, and complicate subsequent prosthetic or implant rehabilitation. Despite its clinical relevance, the available literature remains limited and heterogeneous, and no universally accepted recommendations for diagnosis or management have been established. Methods: This structured narrative review was undertaken to synthesize clinically relevant evidence on anatomical risk factors, biomechanical mechanisms, diagnostic considerations, and management strategies associated with maxillary tuberosity fractures, with particular emphasis on biomechanical interpretation and intraoperative surgical decision-making. A targeted search of PubMed/MEDLINE and Scopus identified English-language publications relevant to the topic. After assessment for clinical relevance, 37 publications covering the period from 1967 to March 2026 were included in the final narrative synthesis. Results: The reviewed literature indicates that maxillary tuberosity fractures result from the interaction of anatomical and biomechanical factors, including maxillary sinus pneumatization, reduced posterior maxillary bone support, complex root morphology, and excessive or inappropriate force application during extraction. Early recognition of increased intraoperative resistance and timely modification of the surgical approach emerged as key factors in reducing structural complications. The available evidence also demonstrates substantial heterogeneity in reported management strategies and the absence of standardized clinical recommendations. Based on the narrative synthesis, a clinically oriented classification and decision-making framework are presented to support intraoperative assessment and surgical reasoning. Conclusions: Although the available evidence is derived predominantly from case reports, case series, retrospective studies, narrative reviews, anatomical studies, and selected surgical textbooks, the structured synthesis of this evidence provides a practical foundation for clinical decision-making. Improved recognition of biomechanical risk factors and structured intraoperative assessment may contribute to safer surgical management, preservation of posterior maxillary bone support, and maintenance of future prosthetic and implant rehabilitation options. Full article