Imaging of the sinuses for functional sinus surgery using navigational guidance

Area of Science:

• Otolaryngology
• Medical Imaging
• Surgical Innovation

Background:

• Chronic and recurrent sinusitis significantly impacts quality of life, necessitating effective surgical interventions.
• Functional endoscopic sinus surgery (FESS) represents a major advancement in managing sinonasal diseases, now used in over 50% of sinus surgeries.
• Understanding sinonasal pathophysiology and mucociliary function is key to surgical improvements.

Purpose of the Study:

• To review the evolution and current state of functional endoscopic sinus surgery (FESS).
• To highlight the role of advanced imaging and navigation in FESS.
• To discuss the importance of radiation dose reduction in sinonasal imaging.

Main Methods:

• Review of current literature on functional endoscopic sinus surgery (FESS) and sinonasal imaging.
• Discussion of preoperative planning using computed tomography (CT) and navigation systems.
• Exploration of intraoperative tool localization with navigation datasets.

Main Results:

• FESS, pioneered by endoscopic surgery, is the dominant surgical approach for sinusitis.
• Preoperative CT imaging is crucial for evaluating inflammatory causes, complications, and anatomical variations.
• Navigational datasets enhance surgical strategy and intraoperative tool localization.

Conclusions:

• Modern FESS techniques, aided by navigation and advanced imaging, improve surgical outcomes for sinusitis.
• Minimizing radiation exposure is critical due to the young average age of patients and potential for recurrent disease.
• Emerging technologies like cone-beam tomography offer promise for improved dose reduction and spatial resolution in sinonasal imaging.