title: [Virtual endoscopy of the nose and paranasal sinuses in real-time. Surgical planning system "Sinus endoscopy" (SPS-SE)].
abstract: OBJECTIVE
  The aim of this study was the development and clinical evaluation of a new method for virtual endoscopy of the nose and paranasal sinuses.
  
  
  METHODS
  The surgical planning system "sinus endoscopy" (SPS-SE) was completely newly developed. The surfaces of the CT images are represented with direct volume rendering (raycasting) which allows a sufficiently high image repetition frequency with the movement of the virtual endoscopy and material effects for a natural appearance were added. Detail accuracy of the virtual illustrations was examined with the help of a picture-statistic comparison between optical and the virtual endoscopy. The evaluation of the system by the patients and physicians was made with a validated questionnaire.
  
  
  RESULTS
  The deviations from defined landmarks of virtual in comparison to optical endoscopy are between 1.4 mm and 11.1 mm. Manoeuvering the virtual endoscope was found to be better than with the optical endoscope but the important parameters for visualization were similar. The accuracy of volume rendering, the high variability of scaling of the anatomical borders and orientation were judged to be negative factors. Altogether there was a balanced opinion from the ENT surgeons but without exception patients judged the system positively.
  
  
  CONCLUSIONS
  This investigation proved the efficiency of SPS-SE for three-dimensional real time reconstruction of high-resolution CT data of the nose and paranasal sinuses. However, some modifications are necessary before introduction into routine use.
authors.affiliation: Klinik und Poliklinik für HNO-Heilkunde/Plastische Operationen, Innovation Center Computer Assisted Surgery, Universität Leipzig, Liebigstrasse 10-14, 04103, Leipzig. Gero.Strauss@medizin.uni-leipzig.de
authors.forename: G
authors.initials: G
authors.lastname: Strauss
authors.forename: E
authors.initials: E
authors.lastname: Limpert
authors.forename: M
authors.initials: M
authors.lastname: Fischer
authors.forename: M
authors.initials: M
authors.lastname: Hofer
authors.forename: C
authors.initials: C
authors.lastname: Kubisch
authors.forename: A
authors.initials: A
authors.lastname: Krüger
authors.forename: A
authors.initials: A
authors.lastname: Dietz
authors.forename: J
authors.initials: J
authors.lastname: Meixensberger
authors.forename: C
authors.initials: C
authors.lastname: Trantakis
authors.forename: M
authors.initials: M
authors.lastname: Strauss
authors.forename: B
authors.initials: B
authors.lastname: Preim
mesh_terms: D000328:Adult; D000368:Aged; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008875:Middle Aged; D009666:Nose / Q000473:pathology / Q000601:surgery*; D009668:Nose Diseases / Q000473:pathology / Q000601:surgery*; D010256:Paranasal Sinuses / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome; D014584:User-Computer Interface; D055815:Young Adult