Fuoco Gabriel, Chiodo Albino, Smith Oakley, El Masri William, Guirgis Ramy
Toronto East General Hospital, Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON.
J Otolaryngol. 2005 Oct;34(5):317-22. doi: 10.2310/7070.2005.34504.
Image-guided surgery of the paranasal sinuses has become a valuable tool in endoscopic sinus surgery. Optical image-guided systems using infrared tracking technology are widely used. We present our experience with new angulated, hand-activated, wireless instruments in an optical tracking system for endoscopic sinus surgery.
Case series.
Community university teaching hospital.
Sixty-five consecutive patients underwent computer-assisted endoscopic sinus surgery using a Stryker Navigation System (Stryker Canada LP, Burlington, ON). Patients underwent preoperative fine-cut axial computed tomography. At the time of surgery, anatomic fiducials were registered and the measured fiducial registration error (FRE), which is an indicator of the accuracy of the optical system, was recorded. Angulated battery-powered active instrumentation was used during the surgery.
FRE, the number of anatomic fiducials used, complication rates pre- and postuse of computer-assisted sinus surgery.
The mean FRE was 2.02 +/- 0.48 mm. The mean number of anatomic fiducials used for registration was 5.98. There were no major orbital or intracranial complications. Use of angulated instruments rarely caused a line of sight problem.
The new optical system has a measured FRE comparable to that of other image guidance systems. Our clinical experience shows that the instrumentation decreases the "line of sight" problem and is easy to navigate and manipulate without a wire attachment to the main computer.
鼻窦的图像引导手术已成为内窥镜鼻窦手术中的一项重要工具。使用红外跟踪技术的光学图像引导系统被广泛应用。我们介绍了在用于内窥镜鼻窦手术的光学跟踪系统中使用新型成角、手动激活、无线器械的经验。
病例系列。
社区大学教学医院。
连续65例患者使用史赛克导航系统（史赛克加拿大有限公司，安大略省伯灵顿）接受计算机辅助内窥镜鼻窦手术。患者术前行精细轴向计算机断层扫描。手术时，记录解剖基准点并测量基准点配准误差（FRE），FRE是光学系统准确性的指标。手术期间使用成角电池供电的有源器械。
FRE、使用的解剖基准点数量、计算机辅助鼻窦手术前后的并发症发生率。
平均FRE为2.02±0.48毫米。用于配准的解剖基准点平均数量为5.98个。没有发生重大眼眶或颅内并发症。使用成角器械很少引起视线问题。
新的光学系统测量的FRE与其他图像引导系统相当。我们的临床经验表明，该器械减少了“视线”问题，易于操作且无需连接到主机的电线。
