Real-time 3-D model-based navigation system for endoscopic paranasal sinus surgery

This paper presents a three-dimensional (3-D)-model-based navigation system for endoscopic sinus surgery treating paranasal sinusitis. Endoscopic surgery is becoming more common because of its low invasiveness. Its problem with disorientation, however, is one of the toughest barriers for the novice and may lead even an expert to commit serious surgical errors, e.g., causing cerebrospinal fluid (CSF) leakage or blinding the patient. To prevent such complications and optimize training, our system aids in navigation by showing a single perspective view of the patient and the endoscope models. This virtual endoscope has a viewing cone with a simulated light to indicate the viewing direction and visual field in real-time. The system's three clipping planes automatically follow the endoscope and help keep the surgeon aware of the endoscope's actual position. An experiment comparing the system to conventional navigation using a triplanar display showed that the perspective view was referenced very frequently, giving a positive impressions, while the triplanar display was almost completely ignored, apparently because it was too difficult to interpret immediately.