title: Role of intraoperative CT-updates during image-guided endoscopic sinus surgery for sinonasal fibro-osseous lesions.
abstract: Fibrous dysplasia, ossifying fibroma and osteomas are collectively known as fibro-osseous lesions. Occurrence in the sinonasal region is rare, and its management can be technically challenging. We report a case of an 8-year-old female with cemento-ossifying fibroma of the ethmoid sinus who underwent a two-staged, endoscopically assisted, transfacial resection of the lesion and a 31-year-old male with fibrous dysplasia of the ethmoid sinus who underwent endoscopic removal of the tumor. Both cases utilized intraoperative computed tomography (CT)-updated image-guided systems (IGS) to improve surgical precision. In the second patient, further resection was undertaken after CT-update in the same surgery. The postoperative courses were uneventful, and at 1-year follow-up no tumor recurrence was observed in either patient. Our experience suggested that the use of intraoperative CT-updated IGS in endoscopic or endoscopically assisted surgeries for sinonasal fibro-osseous lesions will lead to more optimal tumor control, which can translate into greater patient safety.
authors.affiliation: Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Wai Keat
authors.initials: WK
authors.lastname: Wong
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Matsuwaki
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Omura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Moriyama
mesh_terms: D000328:Adult; D002648:Child; D004724:Endoscopy; D005005:Ethmoid Sinus / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D018214:Fibroma, Ossifying / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007432:Intraoperative Period; D008279:Magnetic Resonance Imaging; D008297:Male; D009668:Nose Diseases / Q000175:diagnosis / Q000601:surgery*; D010254:Paranasal Sinus Diseases / Q000175:diagnosis / Q000601:surgery*; D025321:Surgery, Computer-Assisted; D014057:Tomography, X-Ray Computed