3-D CT-Guided Endoscopic Sinus Surgery
Surgeons at Jefferson Hospital will Explore the Sinuses on the
Web and Demonstrate High-Tech Procedure to Treat Chronic Sinus Problems
A combination of futuristic computer technology and traditional surgery is
allowing surgeons at Thomas Jefferson University Hospital to successfully treat
chronic sinus problems less invasively.
"Stealth" or image-guided surgery incorporates technology such as infrared
optics, electromagnetic beams, "interactive" CT scans and sophisticated
computers to treat sinusitis or sinus infection.
William Keane, M.D. |
Jefferson Hospital, one of the first hospitals in the Philadelphia area to
offer stealth surgery, will provide an in-depth demonstration of this innovative
procedure during a live Webcast on Tuesday, Sept. 17.
Sinusitis or sinus infection is an inflammation and infection of the sinus
cavities that occur when mucus that normally drains into nasal passages begins
collecting in the facial sinuses instead. It is estimated that 35 million people
develop sinusitis annually, making it one of the most common health conditions
in the United States.
Mark R. Rosen, M.D. |
Symptoms of sinusitis include postnasal drip, nasal congestion,
fatigue, dental pain, troubled breathing and loss of smell.
Image-guided endoscopic surgery is usually recommended for patients with
chronic sinus infections, not responding to medications for this condition.
This three-dimensional mapping allows otolaryngologists-- head and neck
surgeons-- to see more clearly as they make their way through the sinus
cavities, thus minimizing the chance of sinus surgery complications and allowing
surgeons to perform more thorough and safer procedures. This technique has been
used extensively at Jefferson for the past six to seven years.
“The sinuses are entered through the nasal passageway much like going through
a corridor and gaining access to rooms off the corridor,” explained William
Keane, M.D., professor and chairman, Otolaryngology-Head and Neck Surgery,
Jefferson Medical College of Thomas Jefferson University.
“Sinus surgery, in earlier years, required making an open incision on the
face, or through the mouth to gain access to the sinus cavities,” Dr. Keane
said. These approaches require prolonged recovery time with greater discomfort
and less successful results than with functional endoscopic sinus surgery
(FESS).”
In the hands of a surgeon experienced with this procedure, FESS involves the
insertion of an endoscope, a very thin fiber-optic tube, into the nose for
visual examination of the openings into the sinuses.
“Stealth” surgery, however, enhances FESS, said Marc R. Rosen, M.D.,
assistant professor of Otolaryngology-Head and Neck Surgery, Jefferson Medical
College of Thomas Jefferson University.
“The ‘stealth’ system provides the surgeon with a more precise ability to
maintain orientation as he operates through the relatively complex anatomy of
the sinuses,” said Dr. Rosen.
After taking a special computed tomography (CT) scan of the patient's sinuses
to create a "road map" of the patient's skull, the surgeon can correlate the CT
image with the position of a probe. The surgeon places a hand-held probe in the
patient's nose, while correlating the probe’s position with the scan on a
computer screen. This image-guidance system shows the location of the probe's
tip so the surgeon can safely navigate through trouble spots.
The technology is particularly useful if a patient's sinus anatomy is unusual
or the patient has already had one or more sinus procedures. In these cases,
there is greater risk due to altered anatomy and loss of landmarks due to
scarring left from the previous surgery.
The Webcast is approved for AMA PRA Category 1 credit. Jefferson Medical
College of Thomas Jefferson University, as a member of the Consortium for
Academic Continuing Medical Education, is accredited by the ACCME to provide
continuing medical education for physicians. The Webcast can be viewed at www.JeffersonHospital.org/webcast.
Published: 9-3-2002
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.
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