title: Clinical experience with angulated, hand-activated, wireless instruments in an optical tracking system for endoscopic sinus surgery.
abstract: OBJECTIVE
  Image-guided surgery of the paranasal sinuses has become a valuable tool in endoscopic sinus surgery. Optical image-guided systems using infrared tracking technology are widely used. We present our experience with new angulated, hand-activated, wireless instruments in an optical tracking system for endoscopic sinus surgery.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Community university teaching hospital.
  
  
  METHODS
  Sixty-five consecutive patients underwent computer-assisted endoscopic sinus surgery using a Stryker Navigation System (Stryker Canada LP, Burlington, ON). Patients underwent preoperative fine-cut axial computed tomography. At the time of surgery, anatomic fiducials were registered and the measured fiducial registration error (FRE), which is an indicator of the accuracy of the optical system, was recorded. Angulated battery-powered active instrumentation was used during the surgery.
  
  
  METHODS
  FRE, the number of anatomic fiducials used, complication rates pre- and postuse of computer-assisted sinus surgery.
  
  
  RESULTS
  The mean FRE was 2.02 +/- 0.48 mm. The mean number of anatomic fiducials used for registration was 5.98. There were no major orbital or intracranial complications. Use of angulated instruments rarely caused a line of sight problem.
  
  
  CONCLUSIONS
  The new optical system has a measured FRE comparable to that of other image guidance systems. Our clinical experience shows that the instrumentation decreases the "line of sight" problem and is easy to navigate and manipulate without a wire attachment to the main computer.
authors.affiliation: Toronto East General Hospital, Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Fuoco
authors.forename: Albino
authors.initials: A
authors.lastname: Chiodo
authors.forename: Oakley
authors.initials: O
authors.lastname: Smith
authors.forename: William
authors.initials: W
authors.lastname: El Masri
authors.forename: Ramy
authors.initials: R
authors.lastname: Guirgis
mesh_terms: D004724:Endoscopy / Q000379:methods*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation*; D007259:Infrared Rays; D008297:Male; D010256:Paranasal Sinuses / Q000601:surgery*; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*; D013525:Surgical Instruments; D014057:Tomography, X-Ray Computed