Department of Otorhinolaryngology, Ludwig Maximilian University, Munich, Germany.
Rhinology. 2011 Oct;49(4):429-37. doi: 10.4193/Rhino11.035.
Many sinus surgeons report improved spatial orientation after using a navigation system. This study investigates the surgical, ergonomic and economic aspects of using a navigation system in training and teaching.
Eight rhino-surgeons in training and 32 patients with bilateral diseases of the paranasal sinus system were included. After randomisation, one patient`s side was operated on with a navigation system while the other side was operated on without navigation. It was monitored how often the surgeon used the navigation pointer and then changed the procedures. A standardised and validated interview recorded the cognitive load when using the navigation system and the application efficiency.
The operations lasted on average 16 minutes longer with the navigation. Five paranasal sinuses could not be found in the control group without navigation. In only 10-13% of cases did the surgical procedure change after the use of the pointer. Most of the surgeons admitted that particular steps of the operation were more reliable and safer to carry out with the navigation system. The general trust in the system rose in proportion to intraoperative accuracy and repeated use.
Overall, there was an overwhelming level of trust in the navigation system. Trainee sinus surgeons seeing their more experienced colleagues using a navigation device tend to overestimate the possibilities of the system and to underestimate the risks. The assistance system was used particularly effectively in the group of slightly more experienced surgeons. In this group, the additional expenditure of time was less and the navigation substantially contributed to reinforcing the anatomical sense of direction.
许多鼻窦外科医生在使用导航系统后报告说空间定位能力得到了提高。本研究调查了导航系统在培训和教学中的手术、人体工程学和经济方面。
纳入 8 名受训的鼻科外科医生和 32 名双侧鼻窦系统疾病患者。随机分组后，一侧患者采用导航系统进行手术，另一侧不采用导航系统进行手术。监测外科医生使用导航指针的频率，然后改变手术程序。采用标准化和验证的访谈记录使用导航系统时的认知负荷和应用效率。
使用导航系统的手术平均延长了 16 分钟。在没有导航的情况下，对照组有 5 个鼻窦无法找到。使用指针后，只有 10-13%的手术程序发生了改变。大多数外科医生承认，使用导航系统进行手术时，特定步骤更加可靠和安全。随着术中准确性和重复使用的提高，对系统的总体信任度也相应提高。
总的来说，对导航系统的信任度非常高。看到经验丰富的同事使用导航设备的受训鼻窦外科医生往往会高估系统的可能性，并低估风险。在经验稍多的外科医生组中，辅助系统的使用效果尤其显著。在该组中，额外花费的时间较少，导航系统极大地增强了空间定位感。
