Indications for computer-assisted surgery in otorhinolaryngology

CT Radiation Dose for Computer-Assisted Endoscopic Sinus Surgery: Dose Survey and Determination of Dose-Reduction Limits

“…mage-guided navigation systems are increasingly used for minimally invasive techniques like functional endoscopic surgery of the paranasal sinuses (FESS) 1,2 and other ear, nose, and throat (ENT) surgical procedures [3][4][5] or in neurosurgery. 6 In FESS, only a limited view of the anatomy is warranted, and the use of these systems aims at avoiding injury to important anatomic structures around the orbit and the anterior skull base, especially the internal carotid artery, the optic nerve, and the floor of the anterior skull base.…”

“…6 In FESS, only a limited view of the anatomy is warranted, and the use of these systems aims at avoiding injury to important anatomic structures around the orbit and the anterior skull base, especially the internal carotid artery, the optic nerve, and the floor of the anterior skull base. 5 Although these systems improve orientation in narrow anatomic compartments, they lead to an increased intervention time 3 and the need for preoperative imaging. Although endoscopic sinus surgery with intraoperative MR imaging guidance is feasible, 7 the use of CT-based datasets for navigation is still standard, involving radiation exposure to the patient.…”

Navigation with the StealthStation™ in Skull Base Surgery: An Otolaryngological Perspective

“…12,14 The technology also could be applied to access routes with associated restricted visibility, biopsies, and surgical exploration for foreign bodies. [30][31][32][33] The use of high-tech equipment implies additional expense, and navigation cannot be justified in these times of limited health resources if it also necessitates additional staffing. It should be possible for the system to be operated by the surgeon or scrub nurse.…”

Navigational Risks Associated With Sinus Surgery and the Clinical Effects of Implementing a Navigational System for Sinus Surgery

“…The authors concluded that both navigational systems provided accurate localization data during sinus surgery and concurred with other authors that these technologies are not a substitute for anatomic knowledge, surgical training, or operative judgment. 111,116,119 Currently, the electromagnetic and the optical systems are the most widely used in otolaryngology because of their acceptable accuracy to within 2 mm or less, the freedom of head movement, and the ability to track a variety of instruments. 105 Opinion regarding the optimal use of navigational systems varies from using the technology in all endoscopic sinus cases 111 to selective use in revision surgery, abnormal anatomy, skull base surgery, or use for educational purposes.…”

“… 105 Opinion regarding the optimal use of navigational systems varies from using the technology in all endoscopic sinus cases 111 to selective use in revision surgery, abnormal anatomy, skull base surgery, or use for educational purposes. 118,119 …”