Clinical experience with angulated, hand-activated, wireless instruments in an optical tracking system for endoscopic sinus surgery.
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.
Fuoco
Gabriel
G
Toronto East General Hospital, Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON.
Chiodo
Albino
A
Smith
Oakley
O
El Masri
William
W
Guirgis
Ramy
R
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