Role of navigation system in functional endoscopic sinus surgery
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20203204Keywords:
FESS, FESS with navigation, Surgeon’s satisfactionAbstract
Background: Functional endoscopic sinus surgery (FESS) is a challenging procedure for otorhinolaryngologists. Navigation can reassure the surgeon’s judgement and enhance surgical performance and prevent complication. The study done with aim of comparison between FESS with navigation and conventional FESS and explore other indication of navigation in endoscopic sinus surgery in difficult clinical scenario.
Methods: This is a cross-sectional study on patients with sino-nasal disease. 100 patients in whom the ability to identify surgical site is assumed to be compromised by various conditions like previous surgery, massive/ recurrent polyposis, front oethmoidal mucocele, frontal, sphenoid sinus disease were included in the study. Patients were randomly allocated into two groups, group A (50 patients) FESS with navigation and group B (50 patients) conventional FESS. Pre-operative preparation time, intraoperative time, blood loss (Fromme–Boezzaart scoring), surgeon satisfaction, patient satisfaction (SNOT-20), complications were documented on a preformed, pretested proforma. Equipments used were –StealthStation S7 system, CD for recording intraoperative findings.
Results: Preoperative preparation time duration was applicable for group A only. Intraoperative time was slightly and insignificantly higher in group A. Blood loss according to Fromme-Boezzaart scoring had lesser scoring values in group A and difference among gradings was statistically insignificant. Surgeons satisfaction and confidence was statistically significant higher in group A. The SNOT-20 score values were lower and insignificant in group A.
Conclusions: FESS with navigation is more convenient to surgeon, appears to be safer tool.
References
Slack R, Bates G. Functional endoscopic sinus surgery. Am Fam Physician. 1998;58(3):707-18.
Cazzavillan A, Castelnuovo P, Berlucchi M, Baiardini I, Franzetti A, Nicolai P, et al. Management of chronic rhinosinusitis. Pediatr Allergy Immunol. 2012;23 Suppl 22:32-44.
Sukato DC, Abramowitz JM, Boruk M, Goldstein NA, Rosenfeld RM. Endoscopic Sinus Surgery Improves Sleep Quality in Chronic Rhinosinusitis: A Systematic Review and Meta-analysis. Otolaryngol Head Neck Surg. 2018;158(2):249-56.
Meccariello G, Deganello A, Choussy O, Gallo O, Vitali D, Raucourt DD, et al. Endoscopic nasal versus open approach for the management of sinonasal adenocarcinoma: A pooled-analysis of 1826 patients. Head Neck. 2016;38Suppl 1:E2267-E2274.
Hemmerdinger SA, Jacobs JB, Lebowitz RA. Accuracy and cost analysis of image-guided sinus surgery. Otolaryngol Clin N Am. 2005;38:453-60.
Smith TL, Stewart MG, Orlandi RR, Setzen M, Lanza DC. Indications for image-guided sinus surgery: The current evidence. Am J Rhinol. 2007;21:80-3.
Ramakrishnan VR, Orlandi RR, Citardi MJ, Smith TL, Fried MP, Kingdom TT. The use of imageguided surgery in endoscopic sinus surgery: an evidence-based review with recommendations. Int Forum Allergy Rhinol. 2013;3:236-41.
Farhadi M, Jalessi M, Sharifi G, Khamesi S, Bahrami E, Hammami MR, et al. Use of image guidance in endoscopic endonasal surgeries: a 5-year experience. B-Ent. 2011;7:277-82.
Eloy JA, Svider PF, Setzen M. Clinical pearls in endoscopic sinus surgery: Key steps in preventing and dealing with complications. Am J Otolaryngol. 2014;35(3):324-8.
Kelly EA, Gollapudy S, Riess ML, Woehlck HJ, Loehrl TA, Poetker DM. Quality of surgical field during endoscopic sinus surgery: a systematic literature review of the effect of total intravenous compared to inhalational anesthesia. Int Forum Allergy Rhinol. 2013;3(6):474-81.
Friedman M, Schalch P, Lin HC, Mazloom N, Neidich M, Joseph NJ. Functional endoscopic dilatation of the sinuses: patient satisfaction, postoperative pain, and cost. Am J Rhinol. 2008;22(2):204-9.
Carrau RL, Snyderman CH, Curtin HD, Janecka IP, Stechison M, Weissman JL. Computer-assisted intraoperative navigation during skull base surgery. Am J Otolaryngol. 1996;17(2):95-101.
Strauss G, Limpert E, Strauss M, Hofer M, Dittrich E, Nowatschin S, et al. Evaluation of a daily used navigation system for FESS. Laryngo- Rhino- Otologie. 2009;88(12):776-81.
Dixon BJ, Chan H, Daly MJ, Vescan AD, Witterick IJ, Irish JC. The effect of augmented real‐time image guidance on task workload during endoscopic sinus surgery. Int Forum Allergy Rhinol. 2012;2:405-10.
Fried MP, Moharir VM, Shin J, Taylor-Becker M, Morrison P. Comparison of endoscopic sinus surgery with and without image guidance. Am J Rhinol. 2002;16(4):193-7.
Heermann R, Schwab B, Issing PR. Image-guided surgery of the anterior skull base. Acta Otolaryngol. 2001;121(8):973-8.
Al-Swiahb JN, Al Dousary SH. Computer-aided endoscopic sinus surgery: a retrospective comparative study. Ann Saudi Med. 2010;30(2):149-52.
Eliashar R, Sichel J, Gross M, Hocwald E, Dano I, Biron A, et al. Image guided navigation system—a new technology for complex endoscopic endonasal surgery. Postgraduate Med J. 2003;79:686-90.
Tabaee A, Hsu AK, Shrime MG, Rickert S, Close LG. Quality of life and complications following image-guided endoscopic sinus surgery. Otolaryngol Head Neck Surg. 2006;135(1):76-80.