[Does CT-navigation improve the outcome of functional endonasal sinus surgery?].
BACKGROUND
Computer-assisted surgery (CAS) has found widespread use in functional endonasal sinus surgery (FESS) over the past few years. The present study investigates if CAS leads to a better outcome in FESS.


METHODS
All patients who underwent endonasal sphenoethmoidectomy were enrolled in a prospective, non-randomized study. The procedures were done without CAS (group A) in 2003 and in 2004 with CAS (group B), using a Stryker navigation unit. 62 patients (113 sphenoidectomies) were included in group A and 61 patients (109 sphenoidectomies) in group B. The underlying disease was recurrent chronic sinusitis or polyposis nasi in all patients except for inverted papilloma in one patient of group A and in two patients of group B. The follow-up period was 6 months. Preoperatively and at 6 months postoperatively, a CT-scan was obtained and symptom scores were assessed using a questionnaire.


RESULTS
No significant difference was found between group A and B with respect to symptom scores, and CT-scans preoperatively and at 6 months postoperatively. The operation strategy did not change by the introduction of CAS. The frontal sinus was entered in group A and B in 59% and 64%, respectively. All parameters significantly improved postoperatively, compared to the preoperative values. As far as complications are concerned, two anterior orbital injuries and one retrobulbar haematoma occurred in group A and one postoperative lacrimal stenosis in group B.


CONCLUSIONS
CAS does not lead to a better clinical outcome in FESS. Our data suggest that the rate of complications may be reduced using CAS. However, studies with a much larger number of patients would be necessary for a definite answer to this issue.
Thomaser
E G
EG
Klinik für Hals-, Nasen- und Ohrenheilkunde, Hals- und Gesichtschirurgie Kantonsspital Liestal, Schweiz. esther.thomaser@ksli.ch
Tschopp
K
K
D000328:Adult; D000368:Aged; D005005:Ethmoid Sinus / Q000601:surgery*; D015521:Ethmoid Sinusitis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005626:Frontal Sinus / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D018308:Papilloma, Inverted / Q000601:surgery*; D010255:Paranasal Sinus Neoplasms / Q000601:surgery*; D011127:Polyps / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D013101:Sphenoid Sinus / Q000601:surgery*; D015524:Sphenoid Sinusitis / Q000601:surgery*; D025321:Surgery, Computer-Assisted; D014057:Tomography, X-Ray Computed