Kacker Ashutosh, Tabaee Abtin, Anand Vijay
Department of Otorhinolaryngology-Head and Neck Surgery, Weill Cornell Campus of New York Presbyterian Hospital, Weill Medical College of Cornell University, 525 East 68th Street, New York, NY 10021, USA.
Otolaryngol Clin North Am. 2005 Jun;38(3):473-82, vi. doi: 10.1016/j.otc.2004.10.021.
The anatomical variations of surgical landmarks associated with revision endoscopic sinus surgery (ESS) represent a significant challenge even to the most experienced surgeon. Multiple studies have demonstrated higher rates of both minor and major complications associated with revision cases. In the past decade, the availability of multiple computer-assisted surgical navigation systems has resulted in its widespread adoption as a tool in ESS.Computer-aided surgery (CAS) allows for triplanar anatomic localization, which may improve spatial orientation and help avoid trauma to vital structures, namely the orbit and anterior skull base.Theoretically, this would result in a lower rate of complications and a more complete surgical exploration. Future advances in CAS involve real-time computer-assisted surgical navigation using an operating room-based CT, C-arm, or MRI unit.
与翻修性鼻内镜鼻窦手术(ESS)相关的手术标志的解剖变异,即使对最有经验的外科医生来说也是一项重大挑战。多项研究表明,翻修病例的轻微和重大并发症发生率都更高。在过去十年中,多种计算机辅助手术导航系统的出现使其作为ESS中的一种工具得到了广泛应用。计算机辅助手术(CAS)允许进行三维解剖定位,这可能会改善空间定向并有助于避免对重要结构(即眼眶和前颅底)造成创伤。从理论上讲,这将导致更低的并发症发生率和更彻底的手术探查。CAS的未来进展包括使用基于手术室的CT、C形臂或MRI设备进行实时计算机辅助手术导航。