Tele-3-Dimensional Computer-Assisted Functional Endoscopic Sinus Surgery: New Dimension in the Surgery of the Nose and Paranasal Sinuses

2002 ◽  
Vol 127 (6) ◽  
pp. 549-557 ◽  
Author(s):  
Ivica Klapan ◽  
Ljubimko Šimičić ◽  
Ranko Rišavi ◽  
Nada Bešenski ◽  
Karlo Pasarić ◽  
...  

One of the main objectives of our 3-dimensional (3D) computer-assisted functional endoscopic sinus surgery was to design a computer-assisted 3D approach to the presurgical planning, intraoperative guidance, and postoperative analysis of the anatomic regions of the nose and paranasal sinuses. Such an extremely powerful approach should allow better insight into the operating field, thereby significantly increasing the safety of the procedure. The last step to implementing the technology in the operating room was to connect the computer workstations and video equipment to remote locations by using a high-speed, wide-bandwidth computer network. During patient preparation, the surgeon in the operating room consulted remote experienced and skillful surgeons by viewing CT images and 3D models on computer workstations. The surgeon and consultants used software for CT image previews and 3D model manipulations on top of collaboration tools to define the pathosis, produce an optimal path to the pathosis, and decide how to perform the real surgical procedure. With tele-flythrough or tele-virtual endoscopy rendered through the use of 3D models, both surgeons can preview all the characteristics of the region (ie, anatomy, pathosis) and so predict and determine the next steps of the operation. This ensures greater safety thanks to the operation guidance and reduces the possibility of intraoperative error. The duration of the teleconsultation is thus shortened, which may prove the greatest benefit of tele-3D computer-assisted surgery. If this method were used, clinical institutions would spend less money for telesurgical consultation.

2006 ◽  
Vol 120 (12) ◽  
pp. 1026-1032 ◽  
Author(s):  
K Stelter ◽  
M Andratschke ◽  
A Leunig ◽  
H Hagedorn

Introduction: This paper presents our experience with a navigation system for functional endoscopic sinus surgery. In this study, we took particular note of the surgical indications and risks and the measurement precision and preparation time required, and we present one brief case report as an example.Materials and methods: Between 2000 and 2004, we performed functional endoscopic sinus surgery on 368 patients at the Ludwig Maximilians University, Munich, Germany. We used the Vector Vision Compact® system (BrainLAB) with laser registration. The indications for surgery ranged from severe nasal polyps and chronic sinusitis to malignant tumours of the paranasal sinuses and skull base.Results: The time needed for data preparation was less than five minutes. The time required for preparation and patient registration depended on the method used and the experience of the user. In the later cases, it took 11 minutes on average, using Z-Touch® registration. The clinical plausibility test produced an average deviation of 1.3 mm. The complications of system use comprised one intra-operative re-registration (18 per cent) and one complete failure (5 per cent). Despite the assistance of an accurate working computer, the anterior ethmoidal artery was incised in one case. However, in all 368 cases, we experienced no cerebrospinal fluid leaks, optic nerve lesions, retrobulbar haematomas or intracerebral bleeding. There were no deaths.Discussion: From our experience with computer-guided surgical procedures, we conclude that computer-guided navigational systems are so accurate that the risk of misleading the surgeon is minimal. In the future, their use in certain specialized procedures will be not only sensible but mandatory. We recommend their use not only in difficult surgical situations but also in routine procedures and for surgical training.


1993 ◽  
Vol 7 (1) ◽  
pp. 31-35 ◽  
Author(s):  
William E. Davis ◽  
Giulio J. Barbero ◽  
William R. LaMear ◽  
Jerry W. Templer ◽  
Peter Konig

Six patients between the ages of 6 and 22 years old with cystic fibrosis were found to have mucoceles of the paranasal sinuses. Four were male and two were female. They experienced nasal obstruction, purulent rhinorrhea, and anosmia, but none had fever or pain. Nasal endoscopy and coronal computerized tomography scans revealed the lateral nasal wall to be displaced medially against the septum. Functional endoscopic sinus surgery revealed large cystic spaces filled with thick yellow-green mucus. Postoperatively most patients are able to smell and breathe through their noses. The mucocele probably begins as an obstructed anterior ethmoid cell, which then enlarges and obstructs the osteomeatal complex, which further impairs drainage of the other sinuses into this area.


2018 ◽  
Vol 7 (2) ◽  
pp. 43-47
Author(s):  
Paulina Kołodziejczyk ◽  
Tomasz Gotlib

Functional endoscopic sinus surgery (FESS) is most commonly used in chronic rhinosinusitis treatment. This method is also applicable to other diseases, including the treatment of symptomatic ectopic teeth. Ectopic teeth are a quite rare phenomenon. They may appear within the facial region, as well as in other parts of the body. The article describes two cases of ectopic teeth appearing within the nose area and paranasal sinuses, there endoscopic surgery has been used in the extraction, which resulted in the remission of symptoms.


1997 ◽  
Vol 107 (1) ◽  
pp. 112-117 ◽  
Author(s):  
Jean-Michel Klossek ◽  
Elie Serrano ◽  
Louis Péloquin ◽  
Josiane Percodani ◽  
Jean-Pierre Fontanel ◽  
...  

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Yang Yang ◽  
Yuling Li ◽  
Haibin Zhang ◽  
Yong Xu ◽  
Binquan Wang

Abstract Background Functional endoscopic sinus surgery (FESS) is required to minimize bleeding to maintain a clear operative field during surgery, so it is important to preoperative anti-anxiety and stable hemodynamics. Initial evidence suggests cognitive behavioral therapy (CBT) is effective to minimize surgery-related stress and to speed up recovery. The study aimed to evaluate the efficacy of a newly developed computer-assisted CBT (cCBT) program on surgery-related psychobiological responses in patients undergoing FESS. Methods Participants were allocated to a CCBT group (cCBT; n = 50) or a UC group (usual care; n = 50) by random number table. The State Anxiety Inventory (SAI), Patients Health Questionnaire-9 (PHQ-9), Athens Insomnia Scale (AIS), systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were assessed before intervention (T1), at 1 h before operation (T2), at postoperative 48 h (T3), and 96 h (T4: after intervention completed) respectively. The stress hormone was assayed at T1 and T2. The duration of surgery, anesthesia, and post-anesthesia care unit (PACU) were recorded. A satisfaction survey about nursing services was completed by participants before discharge. Results Compared to the UC group, the SAI scores at T2 and the AIS scores at T3 were lower in the CCBT group (p < 0.01 and p = 0.002). The positive rate of participants who were moderate and severe anxiety (SAI score > 37) at T2 were lower (72% vs. 88%, p = 0.04); the cortisol levels, SBP, DBP, and HR at T2 in the CCBT group were lower (p = 0.019 and all p < 0.01); the duration of anesthesia and PACU was shorter (p = 0.001 and p < 0.01); the CCBT group showed higher satisfaction scores. Conclusion The newly developed cCBT program was an effective non-pharmacological adjunctive treatment for improving the surgery-related psychosomatic responses and perioperative outcomes. Trial registration The study was registered with the Chinese Clinical Trial Registry (ChiCTR1900025994) on 17 September 2019.


2021 ◽  
Vol 10 (38) ◽  
pp. 3351-3355
Author(s):  
Ganesh Manohar Vihapure ◽  
Akshay Sorade ◽  
Kaenat Ahmed ◽  
Lakshmi Sravya Yarlagadda ◽  
Khaleel Basha Munnaru

BACKGROUND The paranasal sinuses (PNS) have various anatomical difference. Computed tomography (CT) is an excellent means of providing anatomical information of this region, disease extent, assisting endoscopic evaluation and guiding treatment. Functional endoscopic sinus surgery (FESS) has become an increasingly popular treatment for chronic sinus diseases. CT of the paranasal sinuses has become a roadmap for FESS. The present study focuses on the assessment of the efficacy, safety and benefits of functional endoscopic sinus surgery in cases of maxillary pathologies and also study the anatomical variations in maxillary sinus in computed tomography and its usefulness in planning and management of chronic sinonasal diseases. METHODS It was a prospective study and a total of 80 patients were included in this study from July 2019 to June 2020 in the Otolaryngology Department, KIMS, Karad. Standard surgical steps were applied in each case according to the extent of disease. All patients underwent standard post-operative care. All findings were recorded and studied. RESULTS Total number of patients were 80. Of which, 31 (38.75 %) patients were operated for ethmoidal polyp, 24 (30 %) for chronic rhinosinusitis, 10 (12.5 %) for antrochoanal polyp, 9 (11.25 %) for rhinosporidiosis and 6 (7.5 %) for inverted papilloma. Postoperative complications were periorbital echymoses (13 %), synechiae (2.5 %), epiphora (2.5 %), infection (2.5 %), hemorrhage (4 %). Complete relief of symptoms were noted in 81.67 % cases. CONCLUSIONS Successful outcome and patient satisfaction post treatment can be obtained by careful evaluation and patient selection by history, examination and most importantly, proper imaging of the sinuses. KEY WORDS Maxillary Sinus, Sinusitis, Nasal Polyp, Paranasal Sinus Disease, Computed Tomography (CT)


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