Assessing the Value of a Pre-operative CT Sinus Anatomy Review Tool.

Abstract

Performing endoscopic sinus surgery requires an intricate understanding of the anatomy of the paranasal sinuses, orbits and skull base. Avoidance of adverse events requires careful review of pre-operative computed tomography (CT) images to recognize potential areas of safety concern. Using a preoperative checklist may aid surgeons in identifying these features. The objective of this study is to determine the educational value of a pre-operative CT sinus review tool and todetermine if itsuse improves identification of important anatomical features.Otolaryngologists from varying practice levels reviewed 2 preoperative sinus CTs, with and without the tool. A 6-item Likert scale questionnaire assessed the operator experience with the tool. The number of high-risk features identified, determination of overall safety risk and difficulty, and time needed for review were compared between the two groups.A total of 18 participants reviewed 36 CT scans. The use of the CT review tool improved identification of important anatomical feature from 47% to 74% on average. All participants agreed that the tool was useful in capturing important anatomical variations in an organized manner and enabled overall assessment of surgical risk and difficulty. The checklist required significantly more time to complete.A preoperative CT sinus tool is perceived to be a useful tool by surgeons who perform endoscopicsinus surgery. The tool requires more time, but increases the number and consistency of high-risk features identified.