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[Endoscopic endonasal surgery with image-guidance].

N Otori1, S Haruna, M Yoshiyuki

  • 1Department of Otorhinolaryngology, Jikei University Hospital, Tokyo.

Nihon Jibiinkoka Gakkai Kaiho
|March 1, 2000
PubMed
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Image-guided endoscopic endonasal surgery using the Insta Trak system offers benefits for various conditions. While it aids navigation and prevents complications, surgeons must account for setup time and potential inaccuracies in image-guided surgery.

Area of Science:

  • Otolaryngology
  • Neurosurgery
  • Medical Technology

Background:

  • Endoscopic endonasal surgery is increasingly utilized for complex sinonasal and skull base pathologies.
  • Image guidance systems aim to enhance surgical precision and safety in these delicate procedures.

Purpose of the Study:

  • To evaluate the advantages and disadvantages of image-guided endoscopic endonasal surgery using the Insta Trak electromagnetic navigation system.
  • To assess the system's utility in various pathologies including chronic sinusitis, cysts, tumors, and pituitary adenomas.

Main Methods:

  • Thirty-three patients underwent endonasal surgery with the Insta Trak system between September 1998 and May 1999.
  • The Insta Trak system utilizes electromagnetic sensors to track instrument position on preoperative CT scans.

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Main Results:

  • The system successfully displayed lesion location and direction, aiding in the identification of critical structures like the orbit and optic canal.
  • It proved particularly useful in cases with distorted anatomy or uncontrollable bleeding, preventing intraoperative complications.
  • Disadvantages included additional setup time (15-20 minutes) and reliance on preoperative imaging, which doesn't account for intraoperative changes or potential navigation errors.

Conclusions:

  • Image-guided surgery with Insta Trak integrates computer technology with surgical expertise for improved endoscopic endonasal procedures.
  • The system is a valuable surgical adjunct, enhancing safety and adequacy, but requires careful consideration of its limitations.