Availability of Computer Aided Endoscopic Sinus Surgery / 대한이비인후과학회지

ABSTRACT

BACKGROUND AND OBJECTIVE: Endoscopic sinus surgery (ESS) is the choice of paranasal sinus surgery, hut its major complication (blindness, CNS trauma) can occur because of the dysharmony between preoperative CT images and perioperative endoscopic findings. Recently, Computer Aided Endoscopic Sinus Surgery (CAESS) reduced complications dramatically and the preoperative images of the surgical field of bony structures match exactly with the perioperative findings. We wanted to find ways to visualize the surgical anatomy and to operate exactly in the key area (frontal recess, natural osteum, sphenoid sinus) with CAESS. MATERIALS AND METHODS: Forty patients (30 patients without history of sinus surgery and 10 returning patients who had history of sinus surgery) with nasal polyp were included for the study. Preoperative coronal CT and axial CT were checked. The first operation was classical ESS, the second operation was CAESS, and we compared the accuracy between them. RESULTS: Of 60 patients with nasal polyp, 45 (75%) were identified with frontal recess, 52 (87%) were identified with natural osteum, and 52 (87fo) were identified with sphenoid sinus. Of the patients returning for surgery (N=20), 9 (45%), 14 (70%), 11 (55%) were identified with Frontal recess, natural osteum, sphenoid sinus, respectively. When CAFSS was used, all key areas were identified. CONCLUSION: Frontal recess is the most difficult site to identify during ESS, and CAESS is very useful in cases which show distorted normal anatomy during frontal recess and sphenoid sinus operation.