ABSTRACT
OBJECTIVE@#To discuss the role of image navigation in resection of the ossifying fibroma of paranasal sinuses and anterior skull base with nasal endoscope.@*METHOD@#Fourteen cases with ossifying fibroma involving paranasal sinuses and anterior skull base were underwent intranasal endoscopic surgery under the guidance of image navigation. Sequential nasal sinuses CT scans were obtained before and after operation. CT scans demonstrated that the nasal septum, orbital wall and anterior skull base were involved in every case. The anterior boundary of the frontal recess cells was involved in 10 cases. The lesions were adjacent to the orbital apex and optic canal in 5 cases. The sella turcica and clivus were invaded in 3 cases and the pterygopalatine fossa was invaded in 2 cases.@*RESULT@#The tumors were thoroughly removed in all cases. The average operative time was 280 minutes and the average registration time of navigation was 9 minutes. Postoperation CT scans demonstrated that the tumors were totally resected.@*CONCLUSION@#The image-guided endoscopic surgery of the ossifying fibroma of paranasal sinuses and anterior skull base provided accurate tumor resection, increased surgical effectiveness, decreased overall surgical complications.
Subject(s)
Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , Endoscopy , Methods , Fibroma, Ossifying , General Surgery , Paranasal Sinus Neoplasms , General Surgery , Paranasal Sinuses , Skull Base , Surgery, Computer-AssistedABSTRACT
OBJECTIVE To recognize the frontal recess cells and analyze their distributional characteristics during image navigation assisted endoscopic sinus surgery. METHODS 20 cases(39 sides)of chronic sinusitis with nasal polyps were observed in this study. The fontal recess cells and frontal sinus were opened under the endoscope and the distributional characteristics were observed and recorded, and then confirmed by the image navigation system. RESULTS Centred on frontal sinus ostium, frontal recess cells were divided into three areas: the agger nasi cell(ANC)and frontal cells(FC)are located in front of frontal sinus ostium(FS); frontal septum cells(IFSSC)and terminal cells(RT)are located at the same plane of FS; supra-ethmoidal bulla recess(SBR), frontal bulla cell(FBC)and super-obital cells(SOEC)are in the posterior area. The coincidence of identification for ANC, FCI and II, SBR, FBC and IFSSC under endoscope and image navigation is 100%, the coincidence of identification for FS is 89.7%, SOEC 80%, RT 71.4% and FC III and IV 60%. CONCLUSION The distribution of the frontal recess cells around the frontal ostium showed a fixed pattern.It would well benefit the orientation of frontal ostium and the opening of frontal sinus. Furthermore, it is significant for the orientation and opening of the frontal recess cells.