Archive October 2017 XVIII, No. 10

The Latest in Image-Guided ENT Surgery

Technology and techniques are improving for the treatment of advanced sinus surgeries.

Daniel Cook

Daniel Cook, Executive Editor


Category: Outpatient Surgery > ENT
sinus anatomy IN THE NOSE Developing technology lets surgeons follow their preferred surgical track through delicate sinus anatomy.

Think back to this morning's commute. You knew where you were headed and the best route to take, but perhaps you still relied on your Waze app to help you avoid traffic snarls and speed traps along the way. Surgeons, even experienced ones, enjoy the same reassurance when they lean on image-guided software as they drive their probes through the twists and turns of the sinus cavity. Watching exactly where their instruments are located as they operate mere millimeters from delicate structures gives them the confidence they need to perform safer and more complete surgery.

"Seeing how far you're operating from the orbit and skull base provides a little more confidence that you won't blow through a sinus wall," says Gopi Bipin Shah, MD, an ENT-otolaryngologist at Children's Health in Dallas, Texas.

Is image guidance needed for every procedure? No, says, Dr. Shah, but it's especially helpful during revision surgery — "because anatomical landmarks have changed slightly," she says — and for complicated cases, such as the removal of polyps and sinonasal tumors.

"Navigation will let surgeons move beyond our current limits to help treat more advanced disease," says Dr. Shah.

As the technology continues to develop, here are some of the latest advancements you and your surgeons need to know about.

1. Streamlined performance
Brent Senior, MD, FACS, FARS, chief of the division of rhinology, allergy and endoscopic skull base surgery at the University of North Carolina at Chapel Hill, says the makers of image guidance platforms are designing newer systems for the clinic setting to address the increased demand for in-office use of the technology during balloon sinus surgery.

The stripped-down units, which don't feature the bells and whistles of more advanced and expensive platforms, are available at a lower cost, which is also attractive to surgery centers operating on a tight budget. The units' electromagnetic systems track a single instrument, probe or balloon dilation device, says Dr. Senior. They also boast a thin profile and small footprint, making them ideally suited for settings with limited clinical space.

"Most of the units ENT surgeons use in the OR contain targeting software capabilities that let you use the platforms during complex neurologic procedures," says Dr. Senior, who points out the new streamlined image guidance platforms don't have advanced software, meaning they're designed for use during relatively basic sinus procedures.

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