Outcome of functional endonasal sinus surgery with and without CT-navigation.
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 case-control study. The procedures were done without CAS (group A) in 2003 and with CAS (group B) in 2004, using a Stryker navigation unit. Sixty-two 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 from group A and in two patients from group B. The follow-up period was 12 months. Symptom scores were assessed preoperatively and at 12 months postoperatively, using a questionnaire. A CT-scan was obtained in all patients preoperatively and at 6 months postoperatively.


RESULTS
No significant difference was found between group A and B, neither with respect to symptom scores at 12 months postoperatively, nor in postoperative CT-scans. The operation strategy did not change by the introduction of CAS. The frontal sinuses were entered in group A and B in 59% and 64% of the patients, respectively. All parameters improved significantly 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 in order to definitely answer the question of whether CAS reduce complications in FESS.
Tschopp
Kurt P
KP
Department of Otolaryngology, Head and Neck Surgery, Cantonal Hospital of Liestal, Liestal, Switzerland. kurt.tschopp@ksli.ch
Thomaser
Esther G
EG
D000328:Adult; D000368:Aged; D004724:Endoscopy; D005005:Ethmoid Sinus; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010254:Paranasal Sinus Diseases / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D011446:Prospective Studies; D011788:Quality of Life; D013101:Sphenoid Sinus; D025321:Surgery, Computer-Assisted; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome