Archive April 2016 XVII, No. 4

Test-Driving the Newest ENT Navigation Systems

Precision and convenience are the hallmarks of the 5 latest offerings.

Jim Burger

Jim Burger, Senior Editor


Category: Outpatient Surgery > ENT
computer guidance HELP WELCOME Computer guidance adds an additional layer of safety during difficult cases, says Nathan E. Nachlas, MD.

One surgeon describes the area of focus for ENT specialists as 'high-priced real estate' that includes or borders on many critical anatomical features — the eyes, the brain, the olfactory nerve, the tear duct — that can easily be injured. With so much at stake, and so little room for error, precision and safety are paramount for otolaryngologists. Before the advent of CT image guidance, surgeons couldn't be as thorough as they'd have liked, says Keith Matheny, MD, FARS, who practices at the Baylor Medical Center in Frisco (Texas). 'We just didn't know exactly where we were in relation to those important structures,' he says. Dr. Matheny believes image guidance 'is a breath of fresh air,' because anatomical features don't just vary from person to person, they often vary from side to side in the same person.

Convenience and efficiency are also key considerations. How long does the system take to set up and calibrate? How do systems overcome line-of-sight issues? What kind of OR footprint do they have? What additional benefits are gained via computer guidance? The 5 latest navigation systems offer a package of benefits that address all of the above.

Brainlab Kick EM
The Brainlab Kick EM's versatility is a big selling point for David Edelstein, MD, chief of otolaryngology at the Manhattan (N.Y.) Eye, Ear, and Throat Hospital. 'The beauty of it is that once you learn how to attach the equipment, you can attach any equipment in a set — as long as it's calibrated,' he says. With some other systems, surgeons are limited to one right-angle suction device, 'but I have about 8 different versions of right angles depending on the patient, and I can use any one of them.' Calibration is done with a small laser device, which is another positive, says Dr. Edelstein. 'I don't have to touch the patient's face or skin, which I don't really like to do.'

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