title: Feasibility of near real-time image-guided sinus surgery using intraoperative fluoroscopic computed axial tomography.
abstract: OBJECTIVE
  One of the main limitations of image-guided surgery is that navigation relies on the use of a CT scan obtained before surgery and is unable to be updated during the procedure. A software addition has been developed to allow reconstruction of CT-like images from a series of fluoroscopic scans and integrate these into an image-guided system (GE Healthcare Surgical Navigation, Lawrence, MA). We report our initial experience with a series of patients undergoing intraoperative fluoroscopic navigation in sinus surgery.
  
  
  METHODS
  After institutional review board clearance, we prospectively studied 14 consecutive patients undergoing image-guided sinus surgery with the use of intraoperative fluoroscopy.
  
  
  RESULTS
  All patients had preoperative and postoperative fluoroscopic images reconstructed into CT-like images. By the conclusion of the study, images were adequate in quality and accurate navigation was achieved.
  
  
  CONCLUSIONS
  Real-time image-guided sinus surgery using fluoroscopy is feasible. Future studies will need to focus on defining the procedures that could benefit, such as tumor resection, to enhance patient safety during these operations.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Albert Einstein College of Medicine, Bronx, NY 10467, USA. sethmbrown@msn.com
authors.forename: Seth M
authors.initials: SM
authors.lastname: Brown
authors.forename: Babak
authors.initials: B
authors.lastname: Sadoughi
authors.forename: Hernando
authors.initials: H
authors.lastname: Cuellar
authors.forename: Ron
authors.initials: R
authors.lastname: von Jako
authors.forename: Marvin P
authors.initials: MP
authors.lastname: Fried
mesh_terms: D003199:Computer Systems; D005240:Feasibility Studies; D005471:Fluoroscopy; D006801:Humans; D007432:Intraoperative Period; D009078:Mucocele / Q000000981:diagnostic imaging / Q000601:surgery; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D010254:Paranasal Sinus Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D011446:Prospective Studies; D025321:Surgery, Computer-Assisted; D014057:Tomography, X-Ray Computed / Q000379:methods*