Impact of image guidance on complications during osteoplastic frontal sinus surgery.
OBJECTIVE
To evaluate the impact of image-guidance technology on intraoperative complications during frontal sinus obliteration surgery.


METHODS
Retrospective case control. Twenty-four patients underwent frontal sinus obliteration with image-guidance technology (n = 15) or conventional instrumentation (n = 9) between 1992 and 2003. The image-guidance system was used to delineate the frontal sinus perimeter and direct cuts through the frontal bone.


RESULTS
Intraoperative complications occurred in none of the patients in the image-guidance group and in 3 patients in the control group (P = 0.042). Adverse events included dural tear with CSF leak in 2 patients and exposure of orbital fat in 1 patient. The incidence of postoperative complications was similar between groups (P = 0.326). No patients required revision surgery. Mean follow-up was 5.2 years.


CONCLUSIONS
The use of surgical navigation during frontal sinus obliteration appears to improve intraoperative safety.


CONCLUSIONS
This is the first report to document a reduction in the rate of intraoperative complications when image guidance is utilized for frontal sinus surgery.
Sindwani
Raj
R
Department of Otolaryngology, Massachusetts, Eye and Ear Infirmary, Boston, Massachusetts, USA.
Metson
Ralph
R
D016022:Case-Control Studies; D005260:Female; D005626:Frontal Sinus / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional; D015994:Incidence; D007430:Intraoperative Care; D007431:Intraoperative Complications / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D010254:Paranasal Sinus Diseases / Q000601:surgery*; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted