Application of computer assisted navigation system in endoscopic sinus and skull base surgery / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the applicative value of computer assisted navigation system in endoscopic sinus and skull base surgery.@*METHOD@#Forty-nine endoscopic surgery procedures were performed with the help of computer assisted navigation system, among which there were 25 cases of recurrent sinusitis and nasal polyps, 9 cases of nasal and sinus tumour, 7 cases of cerebrospinal fluid rhinorrhea, 2 cases of meningoencephalocele, 4 cases of congenital choanal atresia, 1 case of pituitary tumor and 1 case of foreign body in middle cranial fossa.@*RESULT@#The preoperative time was 5-13 minutes for preparation, 7 minutes in average. The target error was less than or equal to 1.5 mm. All the 49 cases had successful surgery without complications.@*CONCLUSION@#Computer assisted navigation system can help the surgeon to determine the sinus, skull base and adjacent anatomic landmarks correctly, improve surgical accuracy and safety, and reduce intraoperative and postoperative complications.

A comparison between anatomical landmark registration and surface registration for computer-assisted endoscopic sinus surgery / 临床耳鼻咽喉头颈外科杂志

Objective:To evaluate the clinical advantage and disadvantage of anatomical landmark registration(ALR) and surface registration(SR) in computer-assisted endoscopic sinus surgery(CAESS).Method:Twenty-six patients were selected for the CAESS, the preparatory times and mean target registration errors (TRE) were recorded in order to compare the difference between them two, their convenience and their value were also analyzed.Result:CAESSs were successfully used in 26 cases without complications. The average preparation time of SR was(8.5±1.9)minutes, that of ALR was(6.5±1.7)minutes. In the SR group, the TRE of naso-labial angle was(1.43±0.26)mm, that of front end of middle turbinate was(1.92±0.47)mm, that of front end of inferior turbinate was (1.82±0.49)mm, and that of back end of inferior turbinate was (2.03±0.42)mm. Them in ALR group were (1.58±0.35)mm,(2.05±0.37)mm,(1.92±0.31)mm and (2.48±0.64)mm ,respectively.24 cases (92.2%) were not affected or were slightly affected by the navigation system. The value of navigation was affirmative in 22 cases (84.6%), and its value was mainly related to TRE.Conclusion:The accuracy of surface registration was superior to that of anatomical landmark registration, but the anatomical landmark registration was more convenient and need less preparation time. The value of navigation system is its accuracy, convenience and no disturbance to surgery. The navigation system is more valuable in the complex cases than that in the general case.

A comparison between anatomical landmark registration and surface registration for computer-assisted endoscopic sinus surgery / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the clinical advantage and disadvantage of anatomical landmark registration (ALR) and surface registration (SR) in computer-assisted endoscopic sinus surgery (CAESS).@*METHOD@#Twenty-six patients were selected for the CAESS, the preparatory times and mean target registration errors (TRE) were recorded in order to compare the difference between them two, their convenience and their value were also analyzed.@*RESULT@#CAESSs were successfully used in 26 cases without complications. The average preparation time of SR was (8.5 +/- 1.9) minutes, that of ALR was (6.5 +/- 1.7) minutes. In the SR group, the TRE of naso-labial angle was (1. 43 +/- 0.26) mm, that of front end of middle turbinate was (1.92 +/- 0.47) mm, that of front end of inferior turbinate was (1.82 +/- 0.49) mm, and that of back end of inferior turbinate was (2.03 +/- 0.42) mm. Them in ALR group were (1.58 +/- 0.35) mm, (2.05 +/- 0.37) mm, (1.92 +/- 0.31) mm and (2.48 +/- 0.64) mm, respectively. 24 cases (92. 2%) were not affected or were slightly affected by the navigation system. The value of navigation was affirmative in 22 cases (84. 6%), and its value was mainly related to TRE.@*CONCLUSION@#The accuracy of surface registration was superior to that of anatomical landmark registration, but the anatomical landmark registration was more convenient and need less preparation time. The value of navigation system is its accuracy, convenience and no disturbance to surgery. The navigation system is more valuable in the complex cases than that in the general case.

Functional evaluation and management of lower cranial nerve injuring after jugular foramen tumor surgery / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the injuring and rehabilitation of lower cranial nerve after surgery of jugular foramen tumors.@*METHOD@#The lower cranial nerve functions were analyzed retrospectively in 32 cases with jugular foramen tumors in the past six years, including 12 jugular glomus, 10 schwannomas, three meningiomas, one cholesteatoma, two giant cell tumors, one fibromatosis, one chondromyxosarcoma, one adenoid cystic carcinoma and one embryonal rhabdomyosarcoma. All patients received surgical procedures. Total tumor removal was achieved in 30 cases, subtotal and partial resection were performed on one case respectively.@*RESULT@#One case was died of intracranial bleeding after surgery, the other 31 were followed-up with a period from one to six years. Normal lower nerve functions were observed in five cases and new nerve deficits were observed in eight cases. Eighteen cases with poor nerve functions before surgery experienced additional nerve injuring manifestations. Eight cases received tracheotomy in perisurgical period, in which three were transient and five went home with tubes. Twenty cases were compensated well after a short period, and six cases failed to compensate. With a long-term follow-up for these six patients, three cases had well functional rehabilitation, two were partially compensated, and one was decompensated.@*CONCLUSION@#Lower cranial nerve dysfunction was the most common complication after jugular foramen tumor surgery. Preoperative nerve function evaluations, protection of nerve during surgery and early postoperative functional rehabilitation training were the key to better prognosis.