Archive February 2017 XVIII, No. 2

Image-guided ENT: The New Standard?

How surgical navigation takes the guesswork out of delicate ENT procedures.

Bill Donahue, Senior Editor

Category: Outpatient Surgery > ENT
surgical navigation system GPS FOR ENT Surgical navigation systems give ENT surgeons a roadmap for procedures that require the utmost precision.

Image-guided surgery is not currently considered the standard of care in ENT. But should it be? To Jeffrey M. Gallups, MD, FACS, there's really no question.

"If I'm having sinus surgery of any sort, I'd want them to use navigation on me," says Dr. Gallups, the founder and medical director of The Ear, Nose & Throat Institute in Alpharetta, Ga., which has 13 locations throughout Georgia. "If I tell a patient, 'I'm going to use a device that tells me within 1 to 2 mm where I am at every moment in the sinus cavity,' they come to understand it's pretty important."

Sometimes likened to a GPS for the anatomy of the human head, ENT surgical navigation systems give surgeons a real-time roadmap so they know exactly "where they're going" when directing instrumentation. As a result, Dr. Gallups says surgeons tend to maneuver more efficiently and confidently even in the tightest of quarters, often within just a few hair widths of the brain, the orbital walls and other vital structures.

Although not necessary for more routine procedures, image-guided ENT has become increasingly popular for ENT surgeons, particularly in functional endoscopic sinus surgery (FESS), revision sinus surgery and cases marked by unusual anatomy. If you haven't yet made the investment, should you? Following are a few variables to consider.

  • Functionality. In the past, an image-guided ENT system was an either/or scenario, meaning it worked off either an MRI or a CT scan taken before surgery. But today's newer systems have made it so you no longer have to choose between the two. In cases in which views of both bony and soft-tissue detail is essential — say, thinning of the bone between the sinuses and the brain or the eyes — CT scans, for bone detail, can be merged with MRIs, which offer superior soft-tissue detail, to offer a more comprehensive picture.
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