Image‐Guidance for Endoscopic Sinus Surgery

Abstract

IGS is reliable, and a scientific validation of outcomes would entail unethical strategies. An expanding spectrum of indications is anticipated, although IGS does not replace proper training.

Image guidance systems for minimally invasive sinus and skull base surgery in children

“…However, due to the low complication rate in endoscopic sinus surgery, a prohibitively large patient series would be required to demonstrate any direct benefit to patients [11][12][13]. Currently in children as well as in adults, prospective randomized controlled trials designed to evaluate the complications of IGS are neither feasible nor ethical [1,14].…”

“…Image-guided surgery (IGS) has the potential to offer substantial benefit for procedures in this area, specifically in the treatment of complications of acute sinusitis and for evaluation and treatment of tumors, traumatic and congenital abnormalities. In the adult literature, IGS has been shown to decrease the incidence of major complications and allow a more complete and effective surgery [1]. The American Academy of Otolaryngology Head and Neck Surgery formulated a consensus of expert opinion on indications for image-guided surgery [2] that includes revision surgery, distorted anatomy, skull base defects, and sinonasal neoplasms.…”

Novel compact laptop‐based image‐guidance system: Preliminary study

“…This information cannot substitute a thorough knowledge of the surgical anatomy, but it can be particularly valuable in cases with poor anatomic landmarks caused by extensive disease or previous surgery. 1,2,[4][5][6][7] However, the use of this new technology is associated with increased costs, mainly due to equipment and surgical time. 2,9 To try to solve this matter, new devices are being developed using technological advances, reducing the size and cost of equipment.…”

“…However, there are still some pitfalls with this technique that can result in serious complications, including intracranial penetration, massive bleeding, loss of vision, and even death. [1][2][3][4] Image-guidance systems are a technology developed to help surgeons to identify critical anatomic landmarks intraoperatively. Initially developed for neurosurgical procedures, these systems use computerized tracking devices to monitor the position of the endoscopes or instruments relative to the patient's anatomic landmarks.…”

Evaluation of a System for High-Accuracy 3D Image-Based Registration of Endoscopic Video to C-Arm Cone-Beam CT for Image-Guided Skull Base Surgery

“…Such lesions are particularly challenging to access endonasally due to the proximity of critical neurovasculature, including the carotid arteries and cranial nerves [2]. Due to the complexity of these surgeries, navigation systems are often used to assist the surgeon [3], and studies have shown that navigation helps reduce the morbidity of the endonasal approach [4], [5]. Active research continues to improve the accuracy of the navigation systems [6]–[8] and reports that current less invasive registration methods, e.g., surface tracing, are not sufficient for all skull base procedures.…”