ISSN: 1300 - 6525 E-ISSN: 2149 - 0880
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ORIGINAL RESEARCH

Surgical Navigation Usage in Revision Endoscopic Sinus Surgery
Revizyon Endoskopik Sinüs Cerrahisinde Navigasyon Kullanımı
Received Date : 09 Aug 2020
Accepted Date : 09 Oct 2020
Available Online : 23 Dec 2020
Doi: 10.24179/kbbbbc.2020-78433 - Makale Dili: EN
KBB ve BBC Dergisi. 2020;28(3):222-7
Copyright © 2020 by Turkey Association of Society of Ear Nose Throat and Head Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: Endoscopic sinus surgery is one of the most frequently performing surgery among otolaryngologists. Even if accepted as safe, efficient and effective surgery, still it has revision risks to a certain extent. Revision surgery requirement is related with many factors such as natural process of disease, inefficacious of primary surgery due to excess bleeding, inadequate postoperative care or synechia. Technological advancements in biomedical field should be integrated in medical procedures. One of the most obvious examples of this is surgical navigation usage in endoscopic sinus surgery. In this study we aimed to investigate the usage of surgical navigation. Material and Methods: In this study, 16 patients (11 male, 5 female) who were operated with guidance of surgical navigation between 2016 and 2019, were retrospectively investigated and analyzed. Results: Ages ranged from 32 to 74 years with a mean 51.93 (±11.22) years. The follow-up periods ranged from 4 to 49 months with a mean 20 (±14.51) months. One patient (6.25%) diagnosed with ethmoid mucocele and rest 15 of them (93.75%) were diagnosed with chronic rhinosinusitis with nasal polyps. In one patient (6.25%) lacrimal sac was exposed during surgery and easily identified by surgical navigation. No ophthalmologic problems were encountered during or after the surgery. Except this no intraoperative or postoperative complications observed among patients. Conclusion: Because of the disturbed anatomical landmarks revision endoscopic sinus surgeries carry more risk than the primary surgeries. In order to decrease the morbidity and achieving safer and effective surgeries surgical navigation is one of the most important and helpful technology in sinus surgeries.
ÖZET
Amaç: Endoskopik sinüs cerrahisi (ESC), kulak-burun-boğaz hekimleri tarafından oldukça sık uygulanan cerrahi uygulamalardandır. Başarılı, etkili ve güvenilir bir cerrahi uygulama olarak kabul edilmesine rağmen belli oranlarda revizyon ihtiyacı bulunmaktadır. Revizyon ihtiyacı; hastalığın doğal ilerleyişi, aşırı kanama veya başka sebeplerle primer cerrahinin başarısız olması, yetersiz postoperatif bakım veya sineşi oluşması gibi birçok faktöre bağlı olabilmektedir. Daha güvenli ve etkili cerrahiler açısından biyomedikal alandaki teknolojik ilerlemelerin, tıbbi uygulamalara entegre edilmesi gerekmektedir. Bunun en güzel örneklerinden biri ESC’de navigasyon kullanımıdır. Bu çalışmada, revizyon ESC yapılan hastalarımızda, navigasyon kullanımını incelemeyi amaçladık. Gereç ve Yöntemler: Çalışmada, 2016-2019 yılları arasında cerrahi navigasyon kullanarak, revizyon ESC uyguladığımız 16 hasta (11 erkek, 5 kadın) retrospektif olarak incelendi. Bulgular: Hastaların yaşları 32 ile 74 arasında değişmekteydi. Ortalama yaş 51,93 (±11,22) olarak bulundu. Hastaların takip süreleri 4 ile 49 ay arasındaydı. Ortalama takip süresi 20 ay (±14,51) olarak bulundu. Hastaların 1 (%6,25)’inin tanısı etmoid mukoseli diğer 15 (%93,75)’inin tanısı nazal polipli kronik rinosinüzit idi. Hastaların sadece 1 (%6,25)’inde cerrahi sırasında, lakrimal kese açığa çıktı ve navigasyon yardımı ile tespit edildi. Ancak hastada görme veya gözyaşıyla ilgili herhangi bir patolojik durum gözlenmedi. Bunun dışında, intraoperatif veya postoperatif herhangi bir komplikasyon gelişmedi. Sonuç: Revizyon ESC bozulmuş anatomik belirteçler nedeniyle daha yüksek oranlarda komplikasyon riski taşımaktadır. Daha güvenli ve etkili bir cerrahi için cerrahi navigasyon kullanımı morbiditeyi azaltmak için önemli ve oldukça yararlı bir yöntemdir.
KAYNAKLAR
  1. Levine CG, Casiano RR. Revision functional endoscopic sinus surgery. Otolaryngol Clin North Am. 2017;50(1):143-64.[Crossref] [PubMed] 
  2. Krings JG, Kallogjeri D, Wineland A, Nepple KG, Piccirillo JF, Getz AE. Complications of primary and revision functional endoscopic sinus surgery for chronic rhinosinusitis. Laryngoscope. 2014;124(4):838-45.[Crossref] [PubMed] [PMC] 
  3. Vicaut E, Bertrand B, Betton JL, Bizon A, Briche D, Castillo L,et al. Use of a navigation system in endonasal surgery: Impact on surgical strategy and surgeon satisfaction. A prospective multicenter study. Eur Ann Otorhinolaryngol Head Neck Dis. 2019;136(6):461-4.[Crossref] [PubMed] 
  4. American Academy of Otolaryngology-Head and Neck Surgery. PositionStatement:Intra-Operative Use of Computer Aided Surgery. Revised 3/2/2014 Available at:[Link] 
  5. Musy PY, Kountakis SE. Anatomic findings in patients undergoing revision endoscopic sinus surgery. Am J Otolaryngol. 2004;25(6):418-22.[Crossref] [PubMed] 
  6. Ramadan HH. Surgical causes of failure in endoscopic sinus surgery. Laryngoscope. 1999;109(1):27-9.[Crossref] [PubMed] 
  7. Chu CT, Lebowitz RA, Jacobs JB. An analysis of sites of disease in revision endoscopic sinus surgery. Am J Rhinol. 1997;11(4):287-91.[Crossref] [PubMed] 
  8. McMains KC. Safety in endoscopic sinus surgery. Curr Opin Otolaryngol Head Neck Surg. 2008;16(3):247-51.[Crossref] [PubMed] 
  9. Dalziel K, Stein K, Round A, Garside R, Royle P. Endoscopic sinus surgery for the excision of nasal polyps: A systematic review of safety and effectiveness. Am J Rhinol. 2006;20(5):506-19.[Crossref] [PubMed] 
  10. Ramakrishnan VR, Orlandi RR, Citardi MJ, Smith TL, Fried MP, Kingdom TT. The use of image-guided surgery in endoscopic sinus surgery: an evidence-based review with recommendations. Int Forum Allergy Rhinol. 2013;3(3):236-41.[Crossref] [PubMed] 
  11. Gibbons MD, Gunn CG, Niwas S, Sillers MJ. Cost analysis of computer-aided endoscopic sinus surgery. Am J Rhinol. 2001;15(2):71-5.[Crossref] [PubMed] 
  12. 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.[Crossref] [PubMed] 
  13. Tschopp KP, Thomaser EG. Outcome of functional endonasal sinus surgery with and without CT-navigation. Rhinology. 2008;46(2):116-20.[PubMed] 
  14. Javer AR, Genoway KA. Patient quality of life improvements with and without computer assistance in sinus surgery: outcomes study. J Otolaryngol. 2006;35(6):373-9.[Crossref] [PubMed] 
  15. 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.[Crossref] [PubMed] 
  16. Dalgorf DM, Sacks R, Wormald PJ, Naidoo Y, Panizza B, Uren B, et al. Image-guided surgery influences perioperative morbidity from endoscopic sinus surgery: a systematic review and meta-analysis. Otolaryngol Head Neck Surg. 2013;149(1):17-29.[Crossref] [PubMed] 
  17. Vreugdenburg TD, Lambert RS, Atukorale YN, Cameron AL. Stereotactic anatomical localization in complex sinus surgery: A systematic review and meta-analysis. Laryngoscope. 2016;126(1):51-9.[Crossref] [PubMed]