Computer-assisted navigation system in intranasal surgery

Abstract

Due to anatomical variability and limited visibility of endoscopic image, endoscopic operations of nose and paranasal sinuses are ones of the most difficult surgical procedures. The field of operation often comprises anatomical structures, which often present anomalies. Computer-assisted navigational endoscopic surgery consists of routine tomography with the possibility of 3-axis projection allowing for localization of surgical instruments in proper relation to anatomic structures. This potential permits the surgeon to penetrate specific structures with surgical instruments and visualize their localization on computer tomography, which was earlier entered to the computer and projected. Projection of the images and endoscopic picture on the same monitor provides comfort to the operator and feeling of safety to the operated patient. The image analysis feature supplies a set of information necessary for safer and more effective procedure conduction and decreased number of complications. This technique may considerably contribute to training programs in endoscopic surgery. Computer-aided navigation in surgical procedures allows for precise biopsy specimen uptake for pathological examination, even in cases requiring precision up to 1 mm. The authors present an overview of surgical computer-aided navigation systems and their own experience in endoscopic ethmoid and maxillary sinus surgery performed with the use of computer-assisted navigation system.