J Oeken1, J Törpel. 1. Kopf- und Halschirurgie, Klinik für HNO-Heilkunde, Flemmingstrasse 2, 09116 Chemnitz. jens.oeken@skc.de
Abstract
BACKGROUND: Over the last few years, navigation systems have been used in endoscopic sinus surgery (ESS). We were interested determining whether this has repercussions on surgical procedures. MATERIAL AND METHODS: From December 2003 to April 2006, we prospectively evaluated all navigated ESS procedures (Vector vision, Brain lab) by means of a questionnaire. Numerous data were determined including diagnosis, navigation benefit, difficulty of the operation, radiological score and complications. RESULTS: Navigated ESS was carried out on 106 patients (54 male symbol; 52 female symbol, average age 55 years) with the following diagnoses: 59 chronic sinusitis with nasal polyposis (13 primary surgery, 46 revision surgery), 14 mucocele, 8 benign tumour, 10 malignant sinonasal tumour, and 15 other diseases. There was only a slight correlation between the difficulty of the operation and the use of navigation (r=0.51, P=0.00) and no significant correlation between the radiological score with chronic sinusitis and the use of navigation (r=0.22, P=1.23). On the other hand, we found a significant difference between the benefit of navigation using primary and revision functional ESS in cases of chronic sinusitis with nasal polyps (P=0.005). The degree of benefit of navigation for the different diagnoses was in descending order: recurrent polyposis, mucocele, osteoma, malignant tumors, polyposis (primary surgery) and inverted papilloma. Without navigation, 15 operations (14%) would not have been possible as an endonasal procedure, and 12 operations (11%) would not have been carried out thoroughly enough. In spite of navigation in three operations (3%) the endonasal approach had to be changed to a transfacial approach. Twelve slight and three serious complications (1 dura defect + pneumoencephalos, dura defect, meningitis without CSF leak) occurred. CONCLUSIONS: Navigation exerts a substantial influence on the execution of the ESS by clearly extending its possibilities.
BACKGROUND: Over the last few years, navigation systems have been used in endoscopic sinus surgery (ESS). We were interested determining whether this has repercussions on surgical procedures. MATERIAL AND METHODS: From December 2003 to April 2006, we prospectively evaluated all navigated ESS procedures (Vector vision, Brain lab) by means of a questionnaire. Numerous data were determined including diagnosis, navigation benefit, difficulty of the operation, radiological score and complications. RESULTS: Navigated ESS was carried out on 106 patients (54 male symbol; 52 female symbol, average age 55 years) with the following diagnoses: 59 chronic sinusitis with nasal polyposis (13 primary surgery, 46 revision surgery), 14 mucocele, 8 benign tumour, 10 malignant sinonasal tumour, and 15 other diseases. There was only a slight correlation between the difficulty of the operation and the use of navigation (r=0.51, P=0.00) and no significant correlation between the radiological score with chronic sinusitis and the use of navigation (r=0.22, P=1.23). On the other hand, we found a significant difference between the benefit of navigation using primary and revision functional ESS in cases of chronic sinusitis with nasal polyps (P=0.005). The degree of benefit of navigation for the different diagnoses was in descending order: recurrent polyposis, mucocele, osteoma, malignant tumors, polyposis (primary surgery) and inverted papilloma. Without navigation, 15 operations (14%) would not have been possible as an endonasal procedure, and 12 operations (11%) would not have been carried out thoroughly enough. In spite of navigation in three operations (3%) the endonasal approach had to be changed to a transfacial approach. Twelve slight and three serious complications (1 dura defect + pneumoencephalos, dura defect, meningitis without CSF leak) occurred. CONCLUSIONS: Navigation exerts a substantial influence on the execution of the ESS by clearly extending its possibilities.
Authors: R Eliashar; J-Y Sichel; M Gross; E Hocwald; I Dano; A Biron; A Ben-Yaacov; A Goldfarb; J Elidan Journal: Postgrad Med J Date: 2003-12 Impact factor: 2.401