Computer‐aided endoscopic sinus surgery

Anon, Jack B.

doi:10.1097/00005537-199807000-00001

Cited by 133 publications

(83 citation statements)

References 40 publications

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“…We did not find a correlation between the registration errors and our recorded errors, which supports the need for accuracy evaluations. Although other authors have quantified the system accuracy by various methods [1][2][3][4][5][6][7][8][9][10][11][12][13][14], none has described so rigorous an intraoperative analysis as that performed here. As fluoroscopy is the standard localizing tool used during transsphenoidal surgery, computer-assisted navigational systems should be judged against it.…”

Section: Discussionmentioning

confidence: 99%

“…The accuracy of the Elekta Viewscope (which uses an optical tracker and infrared light-emitting diodes) in pituitary surgery was determined by comparing the locations of a radio-opaque probe displayed simultaneously by the fluoroscope and by the Viewscope. Others have described the accuracy of frameless stereotactic systems in craniotomy [1][2][3][4][5][6][7][8][9][10][11], but this method is the first quantitative intraoperative accuracy analysis between these two devices in transsphenoidal surgery.…”

Section: Introductionmentioning

confidence: 99%

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Frameless Stereotactic Navigation in Transsphenoidal Surgery: Comparison with Fluoroscopy

McCutcheon

Kitagawa

Demasi

et al. 2004

Stereotact Funct Neurosurg

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Surgical navigation systems (frameless stereotaxy) have been used in addition to or instead of fluoroscopy during transsphenoidal surgery. This study compares the intraoperative localization by an optical tracking system (Elekta Viewscope) with fluoroscopy. Viewscope and fluoroscope sagittal images were compared by the establishment of a Cartesian coordinate system based on anatomical landmarks and by the spatial localization of surgically relevant points for 20 patients. The Viewscope was found to have a total deviation of 3.0 ± 0.6 mm (mean ± SD) compared to fluoroscopy (p < 0.01). Much of the error resulted from the registration process, which according to the Viewscope software had an expected error of 3.1 ± 0.8 mm for this series of patients, and from the probe-to-system correlation (error of 1.0 ± 0.3 mm). Although frameless stereotactic systems give the surgeon useful trajectory data with three-dimensional visualizations, they remain somewhat inaccurate. The multiplanar abilities of the Viewscope provide an additional but not mandatory advantage to the simplicity and accuracy of fluoroscopy during this type of surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Frameless Stereotactic Navigation in Transsphenoidal Surgery: Comparison with Fluoroscopy

McCutcheon

Kitagawa

Demasi

et al. 2004

Stereotact Funct Neurosurg

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“…Also the use of computer-aided surgery (CAS) technology, which allows a direct comparison of the intraoperative anatomy with preoperative imaging information furthers the operative accuracy. After a registration and calibration process, the surgeon may point to a specific structure with the CAS instrument and then view the location of the instrument tip on the CT image [37,38]. The use of CAS systems may allow for more precise dissections and greater rates of sinus patency outcomes and fewer complications [39].…”

Section: Surgical Managementmentioning

confidence: 99%

Nasal Polyposis: Current Trends

Rajguru¹

2011

Indian J Otolaryngol Head Neck Surg

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Nasal polyps (NP) are one of the most common inflammatory mass lesions of the nose, affecting up to 4% of the population. They present with nasal obstruction, anosmia, rhinorrhoea, post nasal drip, and less commonly facial pain. Their etiology remains unclear, but they are known to have associations with allergy, asthma, infection, fungus, cystic fibrosis, and aspirin sensitivity. However, the underlying mechanisms interlinking these pathologic conditions to NP formation remain unclear. Also strong genetic factors are implicated in the pathogenesis of NP, but genetic and molecular alterations required for its development and progression are still unclear. Management of NP involves a combination of medical therapy and surgery. There is good evidence for the use of corticosteroids (systemic and topical) both as primary treatment and as postoperative prophylaxis against recurrence, but the prolonged course of the disease and adverse effects of systemic steroids limits their use. Hence several new drugs are under trial. Surgical treatment has been refined significantly over the past 20 years with the advent of endoscopic sinus surgery and, in general, is reserved for cases refractory to medical treatment. Recurrence of the polyposis is common with severe disease recurring in up to 10% of patients. Over the last two decades, increasing insights in the pathophysiology of nasal polyposis opens perspective for new pharmacological treatment options, with eosinophilic inflammation, IgE, fungi and Staphylococcus aureus as potential targets. A better understanding of the pathophysiology underlying the persistent inflammatory state in NP is necessary to ultimately develop novel pharmacotherapeutic approaches. In this paper we present the newer treatment options available for better control and possibly cure of the disease.

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“…Auch das Erlernen von neuen Operationen oder Zugangswegen kann durch die Möglichkeiten der präoperativen Planung und intraoperativen Korrelation mit den radiologischen Schnittbildern wertvoll sein. Unübersichtliche Zugangswege, Biopsieentnahme oder die Fremdkörpersuche [25,26] [27].…”

Section: Diskussionunclassified

Dreidimensionale Navigation mit dem EasyGuide<sup>®</sup>-System im Kopf-Hals-Bereich

Heermann¹,

Husstedt

Schwab³

et al. 2000

Otorhinolaryngol Nova

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Fragestellung: Die Verbreitung der minimal invasiven Operationstechniken hat zu neuen chirurgischen Herausforderungen geführt. Insbesondere bei veränderter Anatomie und fehlenden anatomischen Landmarken kann die Orientierung auch für den erfahrenen Chirurgen schwierig sein. Hier haben die intraoperativen Navigationssysteme in den letzten Jahren neue Möglichkeiten eröffnet. Methode/Patienten: Das Navigationssystem EasyGuide^® Neuro (Philips Medizinische Systeme, Best, Niederlande) basiert auf einem dreidimensionalen optoelektronischen Messsystem. Infrarotemittierende Dioden an verschiedenen Pointerinstrumenten sowie der Patientenkopfhalterung werden durch ein Kamerasystem erfasst. Mittels weiterer mathematischer Transformation wird die Position der Instrumente in Bezug zum Patienten berechnet und mit den präoperativ gewonnenen radiologischen Datensätzen korreliert. Durch Studien an verschiedenen Phantomen wurden zunächst die technische Genauigkeit und die Grenzen der optischen Detektion evaluiert. Dann erfolgte bei 38 Patienten der operative Eingriff im Bereich der vorderen und seitlichen Schädelbasis mit Unterstützung des Navigationssystems. Hierbei wurden klinische Genauigkeit, Praktikabilität, Vorteile und Probleme des Systems untersucht. Ergebnisse: Am Phantom bot das System eine Abweichung von unter 1 mm. Im klinischen Einsatz konnte nur mit Kopffixierung und knochenverankerten Referenzmarkern eine Genauigkeit von etwa 1,5 mm erreicht werden. Bei Hautklebereferenzmarkern und flexibler Kopflagerung waren aufgrund der unzuverlässigen Kopfnachführung Abweichungen von bis zu 28 mm möglich. Die präoperative Vorbereitungszeit betrug 20–30 min, je nach Aufwand der Operationsplanung. Schlussfolgerungen: Das intraoperative Orientierungssystem stellt insbesondere bei untypischen anatomischen Verhältnissen eine deutliche Orientierungshilfe dar. HNO-spezifische Veränderungen sind jedoch notwendig, um den routinemässigen Einsatz im Bereich der Nasennebenhöhlenchirurgie zu gewährleisten.

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Computer‐aided endoscopic sinus surgery

Abstract: Computer-aided endoscopic sinus surgery appears to be the wave of the future. Nevertheless, the modern endoscopic sinus surgeon must have thorough training in the basic anatomy of the paranasal sinuses as well as the various surgical techniques.

Cited by 133 publications

References 40 publications

Frameless Stereotactic Navigation in Transsphenoidal Surgery: Comparison with Fluoroscopy

Frameless Stereotactic Navigation in Transsphenoidal Surgery: Comparison with Fluoroscopy

Nasal Polyposis: Current Trends

Dreidimensionale Navigation mit dem EasyGuide<sup>®</sup>-System im Kopf-Hals-Bereich

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