Computer image guided endoscopic surgery
With introduction of the CT in medicine, the process of digital imaging offers more and more possibilities to surgeons and clinicians. Tridimensional reconstruction from tomo-graphical cuts, introduced a few years ago with the helicoidal CT, allows constructing virtual images of any anatomical region and manipulate them. Advancements in telecommunication technology have made it possible to connect the information obtained from machines to our common-use desktop computers. Because of the complex anatomy of the lateral nasal wall and its proximity with vital vascular and nervous structures, it is important that the paranasal sinus surgeon have prior radiological references before doing a procedure. Until very recently, the dissection of the lateral nasal wall depended solely on the surgeon’s ability, and his knowledge of the anatomy. This is not enough in cases of re-do’s or when disease have altered the normal anatomical references and would lead to doubt in selecting which structures need to be dissected, making an endoscopic nasal surgery a potentially dangerous procedure. To have a real-time tomography to know the exact site in which one is working was Utopia until the appearance of image guided surgery. Nowadays there are several systems for image guided surgery, some based on the use of electromagnetic waves and others on infrared light (the same used by TV remote controls). All use the information obtained by previous CT or MRI so as to make 3-D models of the nasal anatomy and that can be checked at all times during the surgery (Fig. 1).
KeywordsEndoscopic Surgery Frontal Sinus Lateral Nasal Wall Lamina Papyracea Posterior Ethmoid
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