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Missed paranasal sinus compartments in sinus surgery with and without image-guidance systems: a pilot feasibility study

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

Image-guidance systems (IGS) have gained widespread use in endoscopic sinus surgery (ESS) and have been thoroughly analysed. In this study, we looked for a new parameter to determine if patients could directly benefit from the use of IGS during primary ESS. We questioned if IGS could improve the quality of ESS in chronic rhinosinusitis (CRS) patients via allowing a more comprehensive treatment of all involved sinus compartments.

Methods

In a pilot feasibility study, we evaluated uncomplicated CRS patients following primary ESS with and without IGS between January 2011 and June 2012 using preoperative and postoperative CT scans. The preoperative CT scans identified the sinus compartments requiring surgery. The postoperative CT scans were used to evaluate the treatment effect in these compartments. From these data, we calculated a missing ratio (missed compartments/compartments requiring surgery) for each patient.

Results

Of the 169 ESS patients who were treated, ten patients were retrospectively identified as complying with the inclusion and exclusion criteria following ESS with IGS. Ten patients treated without IGS were then randomly chosen. The median missing ratio for non-IGS patients was 36%, and for IGS patients, the median missing ratio was 0% (p = 0.046). However, the missing ratio was depended on the number of compartments requiring surgery. Stratification of the number of compartments requiring surgery resulted in an exact p value of 0.13.

Conclusions

IGS could help the surgeon to more completely address diseased sinus compartments. For better scientific merit, a comparative study of ESS with and without IGS seems feasible, using the proposed failing score missed compartments/compartments requiring surgery as the primary outcome parameter.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria

    Aris Ι. Giotakis, Florian Kral, Wolfgang Freysinger, Stefan Markart & Herbert Riechelmann

  2. Division of Otolaryngology, Hospital Kardinal Schwarzenberg, Schwarzach, Austria

    Florian Kral

  3. Department of Radiology and Nuclear Medicine, Kantonsspital St. Gallen, St. Gallen, Switzerland

    Stefan Markart

Authors
  1. Aris Ι. Giotakis
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  2. Florian Kral
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  3. Wolfgang Freysinger
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  4. Stefan Markart
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  5. Herbert Riechelmann
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Correspondence to Aris Ι. Giotakis.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Giotakis, A.Ι., Kral, F., Freysinger, W. et al. Missed paranasal sinus compartments in sinus surgery with and without image-guidance systems: a pilot feasibility study. Int J CARS 14, 895–902 (2019). https://doi.org/10.1007/s11548-019-01930-4

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  • DOI: https://doi.org/10.1007/s11548-019-01930-4

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