Navigation in Endoscopic Sinus Surgery: The First Indian Experience (original) (raw)
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Image-Guidance for Endoscopic Sinus Surgery
The Laryngoscope, 2008
Objectives/Hypothesis: Image-guided surgery (IGS) is a critical tool. However, its clinical validity remains controversial. A review of indications and a consensus based on literature are presented.
Intraoperative surgical navigation for endoscopic sinus surgery: rationale and indications
Current opinion in otolaryngology & head and neck surgery, 2007
The present review discusses the rationale and indications for image-guided surgery through a critical discussion of registration concepts as well as clinical reports. The surgical navigation accuracy achieved by commercially available image-guided surgery systems is best reported as target registration error. Clinically achievable target registration error is probably in the 1.5-2.0 mm range. Dry lab studies of registration serve to highlight the principles of registration, the process through which image-guided surgery systems calculate the one-to-one mapping relationship between the preoperative imaging data and the intraoperative surgical volume. Reports on image-guided surgery have highlighted its usefulness in primary and revision endoscopic sinus surgery, osteoplastic frontal sinusotomy, transsphenoidal hypophysectomy, endoscopic cerebrospinal fluid leak repair and endoscopic pterygomaxillary fossa biopsy. Both three-dimensional computed tomography angiography and computed to...
Intraoperative Image Guidance during Endoscopic Sinus Surgery
American Journal of Rhinology, 1996
Endoscopic sinus surgery (ESS) is one of the most commonly performed procedures in otorhinolaryngology and is associated with a definite risk for both intraoperative and postoperative complications. Intraoperative image guidance is expected to have a major effect on procedures such as ESS by allowing the clinician to more efficiently remove pathology and by improving surgeon confidence and knowledge of anatomy, particularly in revision procedures or in patients with altered anatomy. As a consequence, complications during these pro-' cedures will decrease and patient safety will increase. Several guidance modalities are available including computed tomography (CT), magnetic resonance imaging (MRI), and fluoros-From the
Comparison of Endoscopic Sinus Surgery with and without Image Guidance
American Journal of Rhinology, 2002
Background Image guidance based on preacquired computed tomography scans of the patient is a technique used to assist the physician during endoscopic sinus surgery (ESS). This study seeks to compare ESS with and without image guidance, analyzing a number of parameters that can impact on efficacy. Methods Retrospective chart review took place at a tertiary care referral center. The study group consisted of 97 consecutive patients confirmed to have undergone ESS using an electromagnetic intraoperative image guidance system (IGS). The control group consisted of 61 consecutive patients who underwent ESS, before the IGS was available at the study hospital. The main outcomes measured were analysis of patient profile, including coexisting conditions such as asthma and polyposis, assessment of which specific sinuses underwent surgical treatment; major and minor complications; estimated blood loss (EBL); operative time; and the need for repeat surgery. Results The IGS group had 74% of patien...
A systematic review of common landmarks in navigated endoscopic sinus surgery (NESS)
Computer Assisted Surgery, 2021
Background: Navigation brought about a tremendous improvement in functional endoscopic sinus surgery (FESS). When upgraded accordingly, FESS becomes navigated endoscopic sinus surgery (NESS). Indications for intraoperative use of navigation can be broadened to almost any FESS case. NESS in advanced sinus surgery is currently still not used routinely and requires systematic practice guidelines. Purpose: The purpose of this paper is to report on commonly identified landmarks while performing advanced NESS according to evidence-based medicine (EBM) principles. Material and methods: This review paper has been assembled following PRISMA guidelines. A PubMed and Scopus (EMBASE) search on anatomical landmarks in functional endoscopic and navigated sinus surgery resulted in 47 results. Of these, only 14 (29.8%) contained original data, constituting the synthesis of best-quality available evidence. Results: Anatomical landmarks are considered to be the most important points of orientation for optimal use of navigation systems during FESS surgery. The most commonly identified significant landmarks are as follows: (1) Maxillary sinus ostium; (2) Orbital wall; (3) Frontal recess; (4) Skull base; (5) Ground lamella; (6) Fovea posterior; (7) Sphenoid sinus ostium. Conclusions: Establishing common landmarks are essential in performing NESS. This is true for advanced and novice surgeons alike and offers a possibility to use navigation systems systematically, taking advantage of all the benefits of endoscopic navigated surgery.
European Annals of Otorhinolaryngology, Head and Neck Diseases, 2010
Image-guided surgery (IGS) is extremely useful for anatomic location in at-risk sinus surgery: extensive inflammatory disease, sinus cavity revision, and frontal sinus, posterior ethmoid, sphenoid or nasosinal tumor surgery. There are two systems on the market, based on electromagnetic and infrared detection, respectively; optimal functioning depends on calibration. IGS is only a location aid, complementary to and not a substitute for endoscopy. It enables the experienced endonasal surgeon to check the endoscopic location at any time, and provides appreciable ''psychological'' comfort in what are difficult and sometimes stressful operations, the limits of which are being forever pushed back.
Image Guidance in Endoscopic Sinus Surgery: Where Are We Heading?
Current Otorhinolaryngology Reports, 2017
Purpose The purpose of this review is to identify new developments in image guided surgery (IGS) for endoscopic sinus surgery (ESS), with a focus on how these innovations will serve to aid the endoscopic sinus surgeon. Findings Several developments in both the software and hardware of IGS systems have been introduced or are under development. These include augmented reality and three-dimensional (3D) virtual endoscopy for integrating navigational and endoscopic images. Intraoperative registration can further improve the accuracy within a given operative field. Wireless instrumentation and consolidated IGS workstations can improve operating room logistics. IGS integrated robotic surgery can enhance surgical precision and automate critical portions of the procedure. Emerging evidence suggests that IGS is useful for the avoidance of complications in ESS and improving surgeon workload. Summary Numerous developments in IGS for ESS will serve to aid the endoscopic sinus surgeon in avoiding complications and improving patient outcomes.
Image-Guided Sinus Surgery: Current Concepts and Technology
Otolaryngologic Clinics of North America, 2005
Since its introduction in the 1980s, image-guided surgery (IGS) technology has gained considerable acceptance for its applications in functional endoscopic sinus surgery (FESS). Appropriate use of IGS during surgical procedures requires that the rhinologic surgeon understand the fundamental principles that guide the technique. Such knowledge will also serve to elucidate potential IGS limitations and minimize secondary complications. Domain of computer-aided surgery In 1996, the International Society for Computer-Aided Surgery (ISCAS, www.iscas.net) was established as a multidisciplinary forum for the development of semiconductor-based technologies for surgical applications. Since its founding, ISCAS has promoted a broad definition of computeraided surgery (CAS): ''The scope of Computer-Aided Surgery encompasses all fields within surgery, as well as biomedical imaging and instrumentation, and digital technology employed as an adjunct to imaging in diagnosis, therapeutics, and surgery'' [1]. The domain of CAS includes surgical navigation, computer-aided image review, stereotactic surgery, robotic surgery, telemedicine, electronic medical records, and many other specific applications of semiconductor-based technologies [2]. IGS falls within this broad definition of CAS. IGS is another term for intraoperative surgical navigation, which provides three-dimensional (3D) localization data about specific points in the operating field volume relative Disclosure: Dr. Citardi was a consult for CBYON (Mountain View, CA) from 1999 to 2003. He has been a consultant for GE Healthcare Navigation and Visualization (Waukesha, WI) since 2003.
Image‐guided functional endoscopic sinus surgery
Otolaryngology–Head and Neck Surgery, 1999
Stereotactic guidance for intracranial surgery dates back to the early 1900s. Frameless stereotactic surgical navigation systems have recently been developed for functional endoscopic sinus surgery. Image-guided functional endoscopic sinus surgery provides a "real time," 3-dimensional link between the preoperative CT information and the intraoperative surgical anatomy. Transmitters are incorporated into both a patient headset and the surgical instrument(s). The transmitters allow a computer digitizer to precisely locate the patient and instrument in space. Intraoperatively, the surgeon can place the surgical instrument on intranasal structures and view the precise location on coronal, axial, and sagittal CT images in real time. Many authors feel this technique allows for a more complete surgical resection, while reducing the risk of complications. In this article an overview of image-guided technology is presented, the current literature on image-guided functional endoscopic sinus surgery is reviewed, and the advantages and disadvantages of each technique are compared. Curr Opin