Clinical application of virtual endoscopy as a support system for endoscopic sinus surgery.
CONCLUSIONS
Computer processing of conventional CT images can provide virtual endoscopic images (VEIs). Surgeons observing these images feel as if they are observing the lesion using an endoscope. Simulation based on animated VEIs before endoscopic sinus surgery (ESS) is useful for the improvement of surgical safety and surgeons' education. Although the production of VEIs requires certain surgical experience, after the production of VEIs, surgeons can repeat simulation of a surgical procedure and have confidence in the actual operation.


OBJECTIVE
We investigated the clinical application of CT-reconstructed VEIs as a support system for ESS.


METHODS
A GE Light Speed Ultra 16 as a 16-slice CT scanner and Advantage Workstation 4.2 were used. Software called Navigator in this workstation allows the production of CT-reconstructed VEIs. We applied simulation based on VEIs to endoscopic operations for mucocele or sinusitis.


RESULTS
In nine cases of mucoceles and sinusitis, simulation based on animated VEIs was applied. According to the simulation, surgeries were performed, and the mucoceles and obstructed sinuses could be opened readily and safely. This system was more effective when there were landmarks such as polyps or irregular mucosal surfaces allowing macroscopic confirmation ahead of the viewpoint.
Fujikura
Terumichi
T
Department of Otorhinolaryngology, Nippon Medical School, Musashikosugi Hospital, 1-396 Kosugi-cho, Nakahara-ku, Kawasaki-shi, Kanagawa, Japan. teru-fujik@nms.ac.jp
Tanaka
Nobuaki
N
Sugiura
Eisaku
E
Ide
Natsumi
N
Miyajima
Keisuke
K
D000368:Aged; D003198:Computer Simulation; D004724:Endoscopy / Q000379:methods*; D005005:Ethmoid Sinus / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D005626:Frontal Sinus / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008443:Maxillary Sinus / Q000000981:diagnostic imaging / Q000601:surgery; D008875:Middle Aged; D009078:Mucocele / Q000000981:diagnostic imaging / Q000601:surgery*; D010254:Paranasal Sinus Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D011856:Radiographic Image Enhancement / Q000379:methods; D012984:Software; D013101:Sphenoid Sinus / Q000000981:diagnostic imaging / Q000601:surgery; D025321:Surgery, Computer-Assisted; D014057:Tomography, X-Ray Computed; D014584:User-Computer Interface