Computer-assisted navigation system in pediatric intranasal surgery.
OBJECTIVE
To introduce a computer-assisted navigation system and to evaluate its application in pediatric sinusonasal surgery.


METHODS
A commercially available wireless passive marker system that allows the calibration and tracking of virtually any instrument was adapted to children and used during pediatric endoscopic sinusonasal surgery.


RESULTS
The headset localizer that was initially used in computed tomographic scanning was not well accepted by children. Correlation of the preoperative computed tomographic scan to the actual patient was made possible by a laser device. Setup time was able to be decreased from an initial 20 minutes to 3 minutes. The average recording accuracy was 1.1 mm. The advantages of the system became apparent as experience increased in cases involving sinus polyposis, choanal atresia, nasopharyngeal fibroma removal, tumor biopsy, and minimally invasive maxillary, frontal, and sphenoidal surgery.


CONCLUSIONS
The computer-assisted navigation system was used first as a control system and then, as experience increased, as a true surgical guide. Indications for its use also increased. Pediatric intranasal surgery was performed using 2 complementary guides: an endoscopic view and a computed tomographic view of the instrument's position.
Department of Otorhinolaryngology, Hôpital E. Herriot, Place d'Arsonval, 69437 Lyon, France.
Florence
F
Postec
Denis
D
Bossard
François
F
Disant
Patrick
P
Froehlich
D000293:Adolescent; D001706:Biopsy / Q000379:methods; D002648:Child; D002675:Child, Preschool; D002754:Choanal Atresia / Q000601:surgery; D003550:Cystic Fibrosis / Q000150:complications; D004724:Endoscopy / Q000379:methods*; D005147:Facial Bones / Q000601:surgery; D005260:Female; D005350:Fibroma / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009298:Nasal Polyps / Q000150:complications / Q000601:surgery; D009303:Nasopharyngeal Neoplasms / Q000601:surgery; D012516:Osteosarcoma / Q000601:surgery; D010256:Paranasal Sinuses / Q000601:surgery*; D012086:Reoperation; D012888:Skull Neoplasms / Q000601:surgery; D025321:Surgery, Computer-Assisted / Q000379:methods*