scholarly journals Image-Guided Endoscopic Sinus Surgery with 3D Volumetric Visualization of the Nasal Cavity and Paranasal Sinuses: A Clinical Comparative Study

2021 ◽  
Vol 11 (8) ◽  
pp. 3675
Author(s):  
Sang-Jeong Lee ◽  
Ji-Yong Yoo ◽  
Sung-Keun Yoo ◽  
Ryun Ha ◽  
Dong-Hyuk Lee ◽  
...  

(1) Background: The purpose of this study was to develop an image-guided endoscopic sinus surgery (IGESS) system, named Medigator®, based on the leave-one-out registration strategy and three-dimensional (3D) volumetric visualization of the nasal cavity and paranasal sinuses. (2) Methods: A phantom was designed and fabricated using a 3D printer. We then performed a phantom-based accuracy evaluation to validate the performance of the developed registration method. We included 11 patients who underwent IGESS for clinical study to compare the performance of the developed IGESS system with that of a commercialized system. (3) Results: The fiducial registration error (FRE) was 0.14 mm, and the target registration error (TRE) was 0.82 ± 0.50 mm by the phantom-based evaluation. As a result of the clinical comparative study, the average registration times were 36.04 ± 4.7 and 89.35 ± 26.1 s for the developed and commercialized systems, respectively (p < 0.05). The image loading time of the developed system was also shorter than that of the commercialized system (p < 0.05). The average accuracy score of the developed system was not significantly different from that of the commercialized system (p > 0.05). (4) Conclusions: The developed system provided an accurate point-to-point registration method based on the leave-one-out strategy. According to the results of the clinical comparative study, we demonstrated that the developed system showed reliable potential for clinical application.

Author(s):  
Seung-Kyu Chung

Endoscopic sinus surgery is a treatment method for chronic rhinosinusitis not controlled with medical treatment. It had started with functional endoscopic sinus surgery and the concept of reboot approach was introduced recently. For safe surgical treatment, understanding the anatomy especially personal variations between well-known structures is important. The practical points of surgical concept during endoscopic sinus surgery was suggested.


2010 ◽  
Vol 125 (1) ◽  
pp. 30-37 ◽  
Author(s):  
G-X Xiong ◽  
J-M Zhan ◽  
K-J Zuo ◽  
L-W Rong ◽  
J-F Li ◽  
...  

AbstractBackground:Chronic rhinosinusitis is commonly treated by functional endoscopic sinus surgery involving excision of the uncinate process and opening of the osteomeatal complex.Methods:Computational fluid dynamics were used to compare nasal airflow after two different surgical interventions which involved opening the paranasal sinuses, excising the ethmoid sinus, and excising or preserving the uncinate process, in a cadaveric head model. Cross-sectional computed tomography images were obtained before and after the interventions. Imaging data were used to prepare computer simulations, which were used to assess the airflow characteristics of the nasal cavities and paranasal sinuses during inspiration and expiration, before and after intervention.Results:Significantly larger nasal cavity airflow velocity changes were apparent following the uncinate process excising procedure. Nasal cavity airflow distribution remained relatively unchanged following the uncinate process preserving procedure. There was a significantly greater increase in airflow volume following the uncinate process excising procedure, compared with the uncinate process preserving procedure.Conclusion:Preservation of the uncinate process may significantly reduce the alteration of nasal cavity airflow dynamics occurring after functional endoscopic sinus surgery for chronic rhinosinusitis.


2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Satoru Kodama ◽  
Toshiaki Kawano ◽  
Masashi Suzuki

Inverted papilloma (IP) is a benign tumor of the nasal cavity and paranasal sinuses that is unilateral in most cases. Bilateral IP, involving both sides of the nasal cavity and sinuses, is extremely rare. This paper describes a large IP that filled in both sides of the nasal cavity and sinuses, mimicking association with malignancy. The tumor was successfully treated by bilateral endoscopic medial maxillectomy (EMM). The patient is without evidence of the disease 24 months after surgery. If preoperative diagnosis does not confirm the association with malignancy in IP, endoscopic sinus surgery (ESS) should be selected, and ESS, including EMM, is a good first choice of the treatment for IP.


2009 ◽  
Vol 2009 ◽  
pp. 1-4 ◽  
Author(s):  
Kenji Takasaki ◽  
Takeshi Watanabe ◽  
Tomayoshi Hayashi ◽  
Naoe Kinoshita ◽  
Hidetaka Kumagami ◽  
...  

Solitary fibrous tumor (SFT) is an uncommon neoplasm that usually arises from the pleura. To our knowledge, only 30 cases of SFTs in the nasal cavity and paranasal sinuses have been reported in the literature. We describe an SFT that arose from the right sphenoid sinus and extended to the nasal cavity and epipharynx. The tumor was completely removed by endoscopic sinus surgery without complication. The patient is taking an uneventful course without any evidence of recurrence of the disease 8 months after surgery now.


2001 ◽  
Vol 15 (4) ◽  
pp. 219-224 ◽  
Author(s):  
Ford D. Albritton ◽  
Todd T. Kingdom ◽  
John M. DelGaudio

Image-guided systems are becoming more widely used in endoscopic sinus and skull base surgery. All systems require initial registration to correlate the CT scan images to the patient's anatomy. Multiple registration techniques can be used. The ideal technique is one that is easy, reproducible, and provides the most accurate registration in the least amount of time. This study used an optical-based image-guided system (LandmarX) to test a unique mask registration technique and compared it to a previously used anatomic registration technique. Twenty-one patients were scanned with the mask and underwent surgery. Registration was performed using both the registration mask and the anatomic landmarks. Mean registration error and time were recorded. Results are reported for 20 patients. Mean registration error for the mask technique was 0.96 mm and took a mean of 41 seconds. Anatomic registration error using five or six points resulted in a mean initial error of 2.08 mm and took 31.2 seconds. Mean final anatomic registration error was 1.53 mm, requiring reregistration of a mean of 4.6 points, and took 106 seconds. Statistically significant differences were obtained between the two techniques with regard to registration error and time to final registration. We found that the registration mask technique is a more reliable technique in ease, accuracy, and time of registration. This technique should be especially beneficial to the less experienced image-guided surgeon.


2021 ◽  
pp. 014556132110320
Author(s):  
Han Chen ◽  
Bing Zhou ◽  
Qian Huang ◽  
Cheng Li ◽  
Yubin Wu ◽  
...  

Objective: To observe the efficacy and safety of postoperative long-term low-dose oral administration of clarithromycin in patients with refractory chronic rhinosinusitis (RCRS), to explore the characteristics of postoperative microbiota in the nasal cavity in patients with RCRS, and to compare the differences and changes in microbiota in the nasal cavity before and after medication. Methods: This was a prospective, self-controlled study. Eighteen patients with RCRS who had persistent symptoms after endoscopic sinus surgery and standard therapy with normal immunoglobulin E and eosinophil level were included. Low dose (250 mg, once daily) clarithromycin was orally administrated for 12 weeks. Symptom severity and endoscopic findings were evaluated before, after 4 weeks, and 12 weeks of treatment, and nasal cavity microbiota was analyzed simultaneously. Results: A total of 18 patients with RCRS were enrolled and 17 patients completed the study. Four weeks after oral administration of clarithromycin, significant improvement was observed in subjective symptoms including nasal congestion, rhinorrhea, postnasal drip, and general discomfort, as well as endoscopic findings including general surgical cavity condition, rhinedema, and rhinorrhea ( P < .05). After continuous treatment to the 12th week, symptoms showed significant improvement compared with baseline, and endoscopic score showed significant improvement compared with both baseline and 4 weeks after treatment. Analysis of middle nasal meatus flora revealed a significant decrease of Streptococcus pneumoniae after 12 weeks of clarithromycin treatment ( P < .05), while the richness, composition, and diversity were similar before and after treatment. Patients enrolled experienced no adverse drug reaction or allergic reaction, nor clinical significant liver function impairment observed. Conclusion: Postoperative low-dose long-term oral administration of clarithromycin in patients with RCRS can improve the clinical symptoms and facilitate the mucosal epithelialization, with good tolerance and safety. The efficacy of clarithromycin in patients with RCRS may be related to its regulatory effect on nasal cavity microbiota.


1993 ◽  
Vol 102 (9) ◽  
pp. 705-711 ◽  
Author(s):  
Gerald Wolf ◽  
Wolfgang Anderhuber ◽  
Frederick Kuhn

The pediatric nasal cavity and paranasal sinuses, when compared to those in adults, differ not only in size but also in proportion. Knowledge of the unique anatomy and pneumatization of children's sinuses is an important prerequisite to understanding the pathogenesis of sinusitis and its complications. It is also important in evaluation of radiographs and in planning surgical interventions. In order to study the development of the paranasal sinuses in children and relate clinical anatomy to sinus surgery, the sinuses in 102 pediatric skulls and cadaver heads were measured. The results were classified by stage of development into 4 different age groups: newborn and 1 to 4, 4 to 8, and 8 to 12 years. The characteristics of each group and their clinical importance for paranasal sinus surgery are described.


2019 ◽  
Vol 29 (3) ◽  
pp. 311-320
Author(s):  
G. L. Shumkova ◽  
E. L. Amelina ◽  
V. M. Svistushkin ◽  
E. V. Sin’kov ◽  
S. A. Krasovskiy ◽  
...  

The aim of this study was to evaluate prevalence of chronic rhinosinusitis (CRS) and nasal polyps in adult patients with cystic fibrosis (CF) in Russian Federation. Additionally, we investigated the clinical course of CRS and developed the optimal therapeutic strategy.Methods. Three hundred and forty eight CF patients were involved in the study. Physical examination, computed tomography (CT) of paranasal sinuses and audiometry, if needed, were used. CRS and bilateral nasal polyps were diagnosed in 28 patients. Nasal endoscopy, SNOT-20 questionnaire, rhinomanometry, micro - biological examination of sputum and mucus from paranasal sinuses (obtained during puncture or surgery), spirometry, and measurement of serum markers of inflammation were used. Endoscopic sinus surgery was used in 14 patients (the group 1) and others were treated non-surgically (the group 2). Both group were treated during 6 months using intranasal mometasone, mucolytics and antibiotics via PARI SINUSTM nebulizer.Results. An improvement in symptoms, CT signs, rhinomanometry parameters and endoscopic signs was seen in both groups after treatment and was more prominent in the surgical treatment group compared to the non-surgical treatment group. Bacterial load reduction in nasal sinuses, decrease in the rate of pulmonary disease exacerbations, and an improvement in oxygen blood saturation were found in the surgical treatment group only. Treatment of CRS did not affect lung function, sputum microbiology and serum inflammatory markers.Conclusion. Endoscopic sinus surgery followed by intranasal mucolytics and antibacterials is an effective and well-tolerated treatment in adult CF patients with CRS. 


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