3-D CT-Guided Endoscopic Sinus Surgery
About the Procedure:
3-D CT-guided sinus surgery permits a level of precision
and safety never before achieved in operations for chronic sinusitis.
In the procedure, surgeons use infrared technology to stereotactically
coordinate their surgical instruments with three-dimensional CT
images, as they explore the sinus by direct view through their endoscopes.
Malformations, polyps, scarring, or other obstructions can prevent
paranasal sinuses from draining normally. People with this type
of sinus pathology are more likely to experience infections in these
areas. An estimated 35 million people develop sinusitis annually,
making this health condition one of the most common in the United
States. For a large portion of these people, the discomfort goes
beyond congestion, pressure, and breathing difficulties to include
significant symptoms of infection. For many, these infections are
so frequent that medical therapy alone is not an adequate solution.
“In earlier years, surgery to remove blockages from these
patient’s sinuses often required making an open incision on
the face or oral cavity,” notes William M. Keane, MD, Professor
and Chair of Otolaryngology-Head and Neck Surgery at Jefferson Medical
College of Thomas Jefferson University. This operation gave limited
access to the surgeon and meant significant discomfort and recovery
time for the patient. The advent of endoscopy, however, permitted
surgeons to see and operate on sinuses by inserting – through
the opening of the nose – small tubes that carry fiber optics
and small surgical instruments. As a result, sinus surgery became
much less invasive. And yet, this approach in the complex confines
of the sinuses, with delicate areas of the brain, nerves, or blood
vessels immediately adjacent, remains challenging.
In the state-of-the-science approach now in use at Jefferson, surgeons
not only use CT images of the sinuses to guide their operation but
take advantage of several additional refinements. Sophisticated
CT equipment has the computing power to reassemble its cross-sectional
scans into three-dimensional images of the sinus cavities that the
team can rotate for different views, in order to plan and conduct
the surgery. The surgeons place guides on the patient’s head
in the operating room as part of an infrared-technology system that
correlates the position of their endoscopic surgical instruments
with the CT images on screen. The specialists simultaneously view
the sinus anatomy directly through the endoscope. The three-dimensional
mapping component allows the team to more safely navigate the passages
of the nose and sinuses and to precisely locate those structures
that need to be removed to alleviate obstruction.
“With 3-D CT-guided sinus surgery, we have much greater assurance
of resecting precisely the tissue we have identified as needing
removal,” explains Marc R. Rosen, MD, Assistant Professor of
Otolaryngology-Head and Neck Surgery at Jefferson Medical College
of Thomas Jefferson University. Even compared to patients who receive
conventional endoscopy, patients undergoing image-guided endoscopy
have the prospect of less pain and shorter recovery time as a result
of the improved technique.
If you are a physician and would like to refer a patient to a Jefferson
surgeon for this procedure, please call 215-955-0215.
If you are a patient and would like to make an appointment with
a Jefferson surgeon or would like more information about this procedure,
please call 1-800-JEFF-NOW.
|
