CT Image Guided Sinus Procedures
Computerized Tomography (CT) Image Guided Sinus Procedures allows the surgeon to simultaneously visualize 4 different views on a monitor: the coronal, sagittal and axial CT scan images at the same time as the real time surgical endoscopic view. It is then possible to compare the surgically visualized anatomy with the same anatomy of the CT scans. The unique aspect of these systems is that the surgeon knows by looking at the monitor exactly where his or her instruments are during the procedure under CT visualization and guidance. This allow for a more accurate positioning of instruments and decreased likelihood of complications.
How the technique works:
Initially, CT scans are obtained of the sinuses. The CT images are then processed and then downloaded onto the computer where all 3 CT sinus views are displayed simultaneously on a monitor in the procedure room along with the endoscopic view.
The system is used during procedures and the CT scan can be viewed on the monitor while the surgeon inserts a special probe tip into the nasal cavity. The probe may be any sinus instrument including but not limited to the Sinus balloons, Suctions, Seekers, or Microdebrider. The position of the probe can be seen on the monitor using standard endoscopic instruments. The position of the probe inside the nasal cavity can be pin-pointed exactly and visualized precisely on the CT image Guidance System. This exciting new concept has made a dramatic difference in endoscopic sinus surgery, especially in more difficult cases by helping reduce complications. It may also become the standard of practice in Endoscopic Sinus Procedures.
There are an increasing number of otolaryngologists who have started and maintained the use the Image Guidance machines. It is typically possible for the CT scan to be done so that any of the systems can be used, but that must be known at the time of the CT scan. Just as with other forms of endoscopic procedures and surgery, it is important to realize that the skill of the surgeon is paramount in determining whether you get a good result.
There are certain circumstances when image guided surgery is more important. It is like having a GPS navigational unit when hiking. If landmarks are missing such as when there is a blizzard, it is helpful to have a GPS unit to know exactly where you are. If previous surgery has been done and much of the tissue has been removed, there may not be clear landmarks to show the surgeon where to operate. Image guidance via a CT sinus scan can provide additional confirmation that a Sinus Balloon is in the correct location when inflated and also that the Balloon is inserted through the natural sinus opening instead of a false tract. This exciting new technology has improved the accuracy of sinus procedures while decreasing the risk of complications especially with difficult anatomy.