Use of intraoperative CT scanning in endoscopic sinus surgery: a preliminary report.
BACKGROUND
Image-guided functional endoscopic sinus surgery (IG-FESS) using preoperatively acquired CT images for navigation has been proven to facilitate complicated endoscopic sinus procedures and decrease the need for revision procedures. However, this system does not render the intraoperative anatomic changes that occur throughout the procedure. The purpose of this study is to show the technical feasibility and the potential impact of intraoperative CT scanning in conjunction with real-time update of computer-assisted navigation during ESS.


METHODS
Intraoperative CT scanning was performed in selected patients undergoing FESS. A scan was taken before the conclusion of surgery performed by skilled endoscopic sinus surgeons. The scans were evaluated for residual disease or cellular partitions. Where indicated, intraoperative scan was then loaded into the image guidance system and intraoperative scans were then used for additional IGS. The scan findings were documented.


RESULTS
Intraoperatively acquired CT scans were obtained successfully in <40 seconds and able to be loaded into the image guidance system within minutes. All surgeries were preformed without complication. New information obtained from the intraoperative CT scan led to alteration in the surgical plan in 30% of patients.


CONCLUSIONS
Intraoperative CT scanning can be preformed with currently available technology and has the potential to improve the extent of surgery in patients with complicated anatomy and extensive disease.
Jackman
Alexis H
AH
Department of Otorhinolaryngology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York 10467, USA. ajackman@montefiore.org
Palmer
James N
JN
Chiu
Alexander G
AG
Kennedy
David W
DW
D000328:Adult; D000368:Aged; D003392:Cranial Sinuses / Q000601:surgery*; D004724:Endoscopy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D025321:Surgery, Computer-Assisted; D014057:Tomography, X-Ray Computed