Department of Otorhinolaryngology-Head and Neck Surgery, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA.
Ann Otol Rhinol Laryngol. 2025 Jan;134(1):38-41. doi: 10.1177/00034894241290928. Epub 2024 Oct 15.
Virtual endoscopy (VE) is the computer-based reprocessing of diagnostic imaging to simulate endoscopy of an anatomic region of interest. VE of the Frontal Sinus Outflow Tract (FSOT) may assist surgical planning and education.
VE was performed on 16 normal sinus computed tomography (CT) scans for a total of 32 sides using the "path-to-target" tool on the TruDi surgical navigation system (ver. 2.3; Acclarent, Irving, CA, USA). To aid orientation during VE, planning points were placed on the middle turbinate, ethmoidal bulla, and skull base. The VE representation of anatomy and FSOT accuracy was manually confirmed by reviewing the corresponding orthogonal CT images and comparing them to the computed pathway.
Of the 32 sides, the software successfully calculated the FSOT in 22 sides (69%). Of those 22 sides, the calculated FSOT, depicted in the VE sequences accurately represented the FSOT. Among sides with an accurately calculated FSOT, the VE sequences depicted a "fly-through" from a starting point in the middle meatus around various frontal recess cells to the end point in the frontal sinus.
This pilot study demonstrates that software-generated VE of the FSOT is indeed feasible but requires confirmation by the surgeon for accuracy. Instances in which the software did not achieve its objective may drive further refinements of the protocol. VE of the FSOT should be explored as a tool for preoperative planning and surgical education.
虚拟内镜（VE）是基于计算机的诊断成像后处理，以模拟对感兴趣的解剖区域进行内镜检查。鼻窦额窦流出道（FSOT）的 VE 可辅助手术规划和教育。
使用 TruDi 手术导航系统（版本 2.3；Acclarent，Irving，CA，USA）上的“路径到目标”工具，对 16 例正常鼻窦计算机断层扫描（CT）进行了总共 32 侧的 VE。为了在 VE 期间辅助定向，在中鼻甲、筛泡和颅底上放置了规划点。通过查看相应的正交 CT 图像并将其与计算路径进行比较，手动确认 VE 对解剖结构的表示和 FSOT 的准确性。
在 32 侧中，软件成功计算出 22 侧（69%）的 FSOT。在这 22 侧中，计算出的 FSOT 在 VE 序列中的表示准确地代表了 FSOT。在计算出的 FSOT 准确的侧中，VE 序列描绘了从中鼻甲中部的起点围绕各个额隐窝细胞到额窦终点的“飞越”。
这项初步研究表明，FSOT 的软件生成 VE 确实可行，但需要外科医生确认准确性。软件未达到其目标的情况可能会推动协议的进一步改进。FSOT 的 VE 应作为术前规划和手术教育的工具进行探索。
