title: Imaging of the sinuses for functional sinus surgery using navigational guidance.
abstract: Advances in the understanding of mucociliary activity and pathophysiology of the nasal cavity and paranasal sinuses have revolutionized the surgical management of chronic and recurrent sinusitis. The development of functional endoscopic sinus surgery (FESS) can also be seen as the pioneer task in endoscopic surgery. Today, in more than 50% of all sinus surgeries FESS is being used. Inflammatory causes are the most common indication for surgery, which can be evaluated best preoperatively using (multi-detector) computed tomography. Even today there are further relevant developments of FESS that result in alleviation of the surgeon due to different degrees of automation. Using a preoperatively acquired navigational dataset helps choosing the optimal surgical strategy. Intraoperatively the navigational dataset is at present mainly used for localization of surgical tools. These newer operation methods demand for high-quality radiological imaging and evaluation, consisting of delineation of the local (inflammatory) process, detection of disease related complications and description of anatomical variations that may be important to the surgeon. Since patients with chronic recurrent sinusitis are relatively young on average and recurrent disease or further CT examinations are not uncommon, there should always be a focus on reduction of radiation exposure as much as possible. Technical advances like cone-beam tomography seem promising to further improve dose reduction as well as spatial resolution.
authors.affiliation: Universitätsklinikum Leipzig AöR, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Leipzig, Germany. Martin.Reiss-Zimmermann@medizin.uni-leipzig.de
authors.forename: M
authors.initials: M
authors.lastname: Reiss-Zimmermann
authors.forename: T
authors.initials: T
authors.lastname: Schulz
authors.forename: T
authors.initials: T
authors.lastname: Kahn
authors.forename: M
authors.initials: M
authors.lastname: Hofer
mesh_terms: D057189:Checklist; D002908:Chronic Disease; D054893:Cone-Beam Computed Tomography / Q000295:instrumentation; D004724:Endoscopy / Q000295:instrumentation*; D004867:Equipment Design; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation*; D009079:Mucociliary Clearance / Q000502:physiology*; D061330:Multidetector Computed Tomography / Q000295:instrumentation*; D009298:Nasal Polyps / Q000503:physiopathology* / Q000601:surgery*; D010255:Paranasal Sinus Neoplasms / Q000503:physiopathology* / Q000601:surgery*; D010256:Paranasal Sinuses / Q000503:physiopathology / Q000601:surgery; D011829:Radiation Dosage; D012852:Sinusitis / Q000503:physiopathology* / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*; D013523:Surgical Equipment