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首页> 外文期刊>日本耳鼻咽喉科学会会報 >Image-guided endoscopic sinus surgery: a comparison of two navigation systems
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Image-guided endoscopic sinus surgery: a comparison of two navigation systems

机译：影像引导内窥镜鼻窦手术：两种导航系统的比较

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We evaluated the effectiveness of two navigation systems with optical tracking in endoscopic sinus surgery (ESS). The Signa SP/i Intraoperative navigation system (General Electric Co., Intraoperative NS) is advantageous in acquiring both real time and high-resolution images during surgery, compared to conventional image-guided navigation (Stealth Station TREON, Medtronic Inc., IGNS) that rely entirely on preoperative three-dimensional images. We studied the following in 14 patients treated with intraoperative NS and 19 treated with IGNS: 1) additional time for navigation system implementation, 2) available instrumentations in ESS, and 3) navigation system accuracy. Navigation systems required additional time to prepare ESS. The time lapse from admittance to the operating room to ESS onset was measured in patients under both systems and controls undergoing ESS without any image guidance. Preparation of the intraoperative NS required an additional 52 min and IGNS required 17 min compared to the control group. Based on operative instruments, the intraoperative NS has some limitations arising from the application of a high magnetic field. Surgical instruments must not be attracted by the magnetic field in the operating room. So those used in our study were thoroughly examined and some remanufactured using MR safe materials. All instruments in ESS could be used in surgical guidance during surgery in the IGNS. Anatomic landmarks were accurately visualized using intraoperative NS and IGNS. Intraoperative NS renews the image during surgery, so surgeons could confirm the surgical outcome during ESS. Since the average distant error in both systems was between 1 mm and 2.5 mm, we confirmed that accuracy obtained with both navigation system was suitable for ESS completion. The intraoperative NS renewed the image during navigation. In conclusion, both navigation systems are sufficient for accurate image navigation in ESS, but navigation systems must be selected based on the individual case.
机译：我们评估了内窥镜鼻窦手术（ESS）中具有光学跟踪功能的两个导航系统的有效性。与传统的图像引导导航（Stealth Station TREON，Medtronic Inc.，IGNS）相比，Signa SP / i术中导航系统（通用电气公司，术中NS）在手术期间获取实时和高分辨率图像方面具有优势完全依赖于术前三维图像。我们对14例接受术中NS治疗的患者和19例IGNS治疗的患者进行了以下研究：1）导航系统实施需要额外的时间，2）ESS中可用的仪器，以及3）导航系统的准确性。导航系统需要更多时间来准备ESS。在没有任何图像指导的情况下，在接受ESS的系统和对照患者中测量从入院到手术室到ESS发作的时间。与对照组相比，术中NS的准备需要额外的52分钟，而IGNS则需要17分钟。基于手术器械，术中NS由于强磁场的应用而具有一些局限性。手术器械不得被手术室中的磁场吸引。因此，对我们研究中使用的那些材料进行了彻底检查，并使用MR安全材料对其进行了重新制造。 ESS中的所有器械均可用于IGNS手术期间的手术指导。使用术中NS和IGNS可以准确地可视化解剖标志。术中NS在手术过程中会更新图像，因此外科医生可以在ESS期间确认手术结局。由于两个系统的平均远距离误差在1毫米至2.5毫米之间，因此我们确认，使用两个导航系统获得的精度均适合完成ESS。术中NS在导航过程中更新了图像。总之，两个导航系统都足以在ESS中进行精确的图像导航，但是必须根据具体情况选择导航系统。

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