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Archive September 2015 XVI, No. 9

Image-Guided Sinus Surgery: The New Standard of Care?

A growing number of surgeons and patients are demanding the game-changing technology.

Brett Scotch, DO, FAOCO


Category: Outpatient Surgery > ENT
image-guided technology SEEING IS BELIEVING Many surgeons prefer to use image-guided technology during both routine and complex cases.

Image-guided navigation is evolving into the standard of care for sinus surgery. Patients demand it and surgeons want the tool that increases the safety and efficiency of some of surgery's most delicate operations. The question isn't whether you can afford to sink $100,000 to $125,000 into the technology, but whether you can afford not to.

Unparalleled accuracy
Image guidance lets surgeons operate more efficiently, which results in decreased surgical times, less time under anesthesia for patients and, most importantly, improved outcomes. With it, I'm able to pinpoint instruments with 1 to 2 mm of accuracy and confirm their placement visually and radiographically in real time.

The technology is perfectly suited for complex primary surgeries or difficult revisions. While image guidance can't replace a surgeon's expertise or knowledge of facial anatomy, it can provide them with added confidence as they watch live images of exactly where their instruments are and where they're headed. Anatomical landmarks that are tracked in real time let surgeons move more precisely and visualize anatomy they normally couldn't see before getting into it. They can see what's behind bony walls, evaluate the density of what lies ahead and have the confidence to perform dissections in locations of fine bony anatomy that they may have shied away from before, such as the lamina papyracea (the bone that separates the eye from the sinuses), the superior ethmoid and the cribriform plate (the bone that separates the nasal sinuses from the brain). The technology helps skilled physicians navigate around potential trouble, but it can't eliminate complication risks completely. Still, knowing how close your instruments are to sensitive areas — and potentially devastating complications — provides an added level of comfort that surgeons truly appreciate.

Surgeons who use the technology are able to operate with increased safety and precision when, for example, they're faced with extensive nasal polyposis. Polyps typically obscure and distort the anatomy and normal anatomic landmarks. With 3D image-guided navigational systems, surgeons can maneuver through these anatomically distorted areas with increased confidence and safety. They can take more of the diseased tissue while safely avoiding areas of danger. That targeted approach can result in better outcomes.

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