Stereotactic anatomical localization in complex sinus surgery: A systematic review and meta-analysis
Thomas D Vreugdenburg1, Robyn S Lambert1, Yasoba N Atukorale1
1Australian Safety and Efficacy Register of New Interventional Procedures-Surgical, Royal Australasian College of Surgeons, Adelaide, South Australia, Australia.
The Laryngoscope
|October 28, 2015
Summary
Stereotactic anatomical localization (SAL) may reduce total, major, and orbital complications in complex endoscopic sinus surgery (ESS). While not statistically significant for all outcomes, SAL shows a decreased likelihood of adverse events in challenging ESS cases.
Area of Science:
- Otolaryngology
- Neurosurgery
- Medical Imaging
Background:
- Stereotactic anatomical localization (SAL) is a navigation technique used in endoscopic sinus surgery (ESS).
- Its utility is debated, potentially offering greater benefits in complex cases compared to routine procedures.
Purpose of the Study:
- To evaluate the safety and efficacy of SAL in complex indications for ESS.
- To determine if SAL improves outcomes in challenging sinus surgeries.
Main Methods:
- Systematic review and meta-analysis of English studies comparing ESS with and without SAL.
- Databases searched: PubMed, EMBASE, CDR, Cochrane Library (up to April 2014).
- Inclusion criteria: Complex ESS cases (revision, inverted papilloma, extensive disease, tumor biopsy); outcomes included complications and efficacy.
Main Results:
- Nine studies met inclusion criteria.
- Meta-analysis showed SAL reduced total (OR=0.58), major (OR=0.36), and orbital (OR=0.38) complications.
- No significant benefit of SAL for revision surgery, major hemorrhage, or minor complications.
Conclusions:
- Primary studies often lacked statistical power due to rare outcomes.
- Meta-analyses suggest SAL use decreases total, major, and orbital complications in complex ESS.
- SAL may enhance safety in intricate endoscopic sinus procedures.
