The Practicioner’s View: Sinus Surgery with Image Guidance

Abstract

Objective: 1) Learn about the cost (time necessary to get an image guidance system ready to use), and 2) understand the benefits of using image guidance for routine cases of microscopic-endoscopic sinus surgery as an attending physician. Method: A prospective case series of 24 consecutive patients undergoing FESS with image guidance from April to December 2011 was conducted. The technical and patient related setup time was measured, and minor and major complications were recorded. The benefit of a safer or more complete surgery was estimated by the surgeon. Results: Among the 24 patients were 3 tumor cases (12.5%) and 21 cases of chronic sinusitis (87.5%). Six patients were revision cases (25%). The technical setup time shows a mean value of 245 seconds (minimum 170, maximum 330 seconds). The patient related setup time shows a mean of 192 seconds (minimum 25, maximum 595 seconds). The total mean value of the time necessary is 437 seconds. There were no minor or major complications. The advantages as estimated by the surgeon are a more complete or safer surgery (16.6%) and the educational value for the surgeon and staff. Conclusion: In this study the cost of time (mean value 7 minutes and 17 seconds) in 24 consecutive routine cases of FESS is highlighted against the benefits of a more complete or safer surgery and the educational value for the surgeon and staff.