Image‐Guided Functional Endoscopic Sinus Surgery
2000; Wiley; Volume: 123; Issue: 3 Linguagem: Inglês
10.1067/mhn.2000.107453
ISSN1097-6817
AutoresGarth T. Olson, Martin J. Citardi,
Tópico(s)Pituitary Gland Disorders and Treatments
ResumoINTRODUCTION Computer‐aided surgery (CAS) technology in functional endoscopic sinus surgery (FESS) has engendered considerable discussion. OBJECTIVE The goals of this study were to describe CAS preoperative planning (software‐based CT image analysis) and to develop intraoperative CAS strategies for endoscopic sinus surgery. STUDY DESIGN Between October 1, 1997, and December 31, 1998, the StealthStation (Sofamor Danek, Memphis, TN) was used in 61 FESS cases, and a retrospective review of the findings was performed. The indication for surgery in all instances was chronic rhinosinusitis refractory to medical management. The StealthStation was used to review all CT scans before surgery. Anatomic fiducial registration supplemented by contour mapping was used. RESULTS Localization accuracy was estimated to be within 2 mm or better. The StealthStation was used for both CT image review and intraoperative localization. CAS was useful in the frontal recess, sphenoethmoid region, posterior ethmoid system, and skull base area. CAS was deemed helpful in situations where the surgical anatomy was altered by previous surgery and extensive inflammatory disease (polyposis, fungal sinusitis, and pansinusitis). CONCLUSION The paradigm of image‐guided FESS surgery, which integrates CAS into FESS, will serve to increase surgical effectiveness and decrease surgical morbidity. (Otolaryngol Head Neck Surg 2000; 123:188‐94.)
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