Our Summary

This research paper proposes a method to improve the success of endoscopic sinus surgery (ESS) - a common procedure for treating sinusitis and other sinus issues. Typically, ESS is guided by a pre-surgery scan (CT) of the patient’s sinus, but as the surgery progresses, the actual anatomy can differ from the preoperative scan. This discrepancy can lead to incomplete surgeries, with a revision rate of 28-47%.

The researchers have developed three new methods that use data from the surgical instruments and the patient’s anatomy to predict changes in the sinus during surgery. This allows them to update the pre-surgery scan in real time, giving surgeons a more accurate picture of what’s happening.

The researchers tested these methods on eight cadaver cases, involving five surgeons and a variety of typical ESS procedures. The results were promising, with accuracy rates well above acceptable clinical standards.

The method with the highest precision involved tracking the path of the surgical instrument. Importantly, this approach doesn’t require any changes to existing surgical protocols, additional equipment, or extra radiation exposure for the patient. It also doesn’t extend the surgery time.

In simpler terms, this research is about developing a way to give surgeons a more accurate ‘map’ during ESS, which could reduce the number of repeat surgeries.

FAQs

  1. What is the problem with the current method of using pre-surgery scans for endoscopic sinus surgery (ESS)?
  2. How do the new methods proposed by the researchers improve the success rate of endoscopic sinus surgery?
  3. What were the results when the new methods were tested and what does this mean for future ESS procedures?

Doctor’s Tip

One helpful tip a doctor might tell a patient about sinus surgery is to follow all pre-operative instructions carefully, such as fasting before the procedure and avoiding certain medications that can interfere with the surgery. It is also important to communicate any concerns or symptoms with your surgeon before the surgery to ensure the best possible outcome. Additionally, following post-operative care instructions, such as taking prescribed medications and attending follow-up appointments, is crucial for a successful recovery.

Suitable For

Patients who may benefit from sinus surgery include those with chronic sinusitis that does not respond to other treatments, recurrent acute sinusitis, nasal polyps, sinus tumors, sinus cysts, deviated septum, and sinus blockages. Additionally, patients with severe symptoms such as facial pain, pressure, congestion, headaches, and loss of smell may also be recommended for sinus surgery. It is important for patients to discuss their symptoms and treatment options with an ENT specialist to determine if sinus surgery is the best course of action for their specific condition.

Timeline

Before sinus surgery:

  1. Patient experiences chronic sinusitis symptoms such as nasal congestion, facial pain, headaches, and difficulty breathing.
  2. Patient may undergo a physical examination and imaging tests such as a CT scan to determine the extent of the sinus issues.
  3. Surgeon discusses the surgical procedure, risks, and benefits with the patient and obtains informed consent.
  4. Surgery date is scheduled and patient may be given preoperative instructions such as fasting and medication guidelines.

After sinus surgery:

  1. Patient undergoes endoscopic sinus surgery to remove blockages, polyps, or other issues in the sinuses.
  2. Patient is monitored in the recovery room for a few hours before being discharged home.
  3. Patient may experience some pain, swelling, and nasal congestion in the days following surgery.
  4. Patient follows postoperative care instructions such as using saline nasal rinses, taking prescribed medications, and attending follow-up appointments.
  5. Over time, patient experiences improvement in sinus symptoms and overall quality of life as the sinuses heal and inflammation decreases.

What to Ask Your Doctor

  1. How will this new method of predicting changes in the sinus during surgery improve the success rate of endoscopic sinus surgery?

  2. Will this new method require any additional procedures, equipment, or radiation exposure for me as the patient?

  3. How will the accuracy of the updated surgical map impact the overall outcome and recovery time of the surgery?

  4. What are the potential risks or limitations associated with using this new method during endoscopic sinus surgery?

  5. How does this new method compare to traditional methods of guiding endoscopic sinus surgery, such as relying solely on pre-surgery scans?

  6. Will all surgeons performing endoscopic sinus surgery be trained in using this new method, or is it only available at certain medical facilities?

  7. Are there any additional costs associated with using this new method during endoscopic sinus surgery?

  8. How soon after the surgery will I know if the procedure was successful, and how will the effectiveness of the surgery be monitored in the long term?

  9. Are there any specific post-operative care instructions or precautions I should follow after undergoing endoscopic sinus surgery with this new method?

  10. What are the potential benefits of using this new method for predicting changes in the sinus during surgery, and how will it impact my overall quality of life following the procedure?

Reference

Authors: Li Y, Konuthula N, Humphreys IM, Moe K, Hannaford B, Bly R. Journal: Int J Comput Assist Radiol Surg. 2022 Feb;17(2):249-260. doi: 10.1007/s11548-021-02536-5. Epub 2021 Dec 9. PMID: 34888754