Our Summary

This study looks at the problems that can occur when using image-guided navigation during sinus surgery. Researchers used a database from the Food and Drug Administration (FDA) to see what kind of issues were reported between 2018 and 2022. They found over 1800 problems reported, with the majority being related to the device itself. The most common device problems were the system not working, being inaccurate, or having sensing issues. In terms of problems that affected patients, leaks of cerebrospinal fluid (the fluid around your brain and spine), brain injuries, and bleeding were the most common. They also found that when the navigation device was inaccurate, there was a higher chance of fluid leaks and the surgeon having to stop the procedure. So, health care providers need to be aware of these potential complications when deciding to use this type of technology for sinus surgery.

FAQs

  1. What kind of problems were reported with the use of image-guided navigation during sinus surgery between 2018 and 2022?
  2. What were the most common issues related to the navigation device used in sinus surgeries?
  3. How can inaccuracies in the navigation device affect the patient during sinus surgery?

Doctor’s Tip

A doctor might tell a patient undergoing sinus surgery to be aware of potential complications that can occur with image-guided navigation technology, such as leaks of cerebrospinal fluid, brain injuries, and bleeding. It is important for healthcare providers to carefully monitor the accuracy of the navigation system during the procedure to prevent these issues from occurring.

Suitable For

Sinus surgery is typically recommended for patients who have chronic sinusitis that does not respond to other treatments, such as medication or nasal sprays. Other conditions that may warrant sinus surgery include nasal polyps, deviated septum, sinus tumors, and sinus infections that cause complications such as recurrent sinusitis, vision problems, or severe headaches. Patients with severe symptoms such as difficulty breathing through the nose, frequent sinus infections, facial pain or pressure, and loss of sense of smell may also be recommended for sinus surgery. It is important for patients to have a thorough evaluation by an otolaryngologist (ear, nose, and throat specialist) to determine if sinus surgery is the best course of treatment for their specific condition.

Timeline

Before sinus surgery:

  1. Patient experiences chronic sinusitis symptoms such as facial pain, pressure, congestion, and difficulty breathing.
  2. Patient may undergo imaging tests such as CT scans to determine the extent of sinus blockages.
  3. Patient may try conservative treatments such as antibiotics, nasal sprays, and saline rinses to alleviate symptoms.
  4. If symptoms persist, patient may be recommended for sinus surgery by an ENT specialist.

After sinus surgery:

  1. Patient undergoes sinus surgery, which may be done endoscopically or with image-guided navigation technology.
  2. Patient may experience some discomfort, swelling, and nasal drainage immediately after surgery.
  3. Patient is typically able to return home the same day or after a short hospital stay.
  4. Patient follows post-operative care instructions such as using saline rinses, avoiding strenuous activities, and attending follow-up appointments.
  5. Patient gradually experiences improvement in sinus symptoms as the sinuses heal and inflammation decreases.
  6. Patient may need to continue using nasal sprays or other medications to maintain sinus health in the long term.

What to Ask Your Doctor

Some questions a patient should ask their doctor about sinus surgery and the use of image-guided navigation technology include:

  1. What are the potential risks and complications associated with using image-guided navigation during sinus surgery?
  2. How experienced are you and your team in using this technology for sinus surgery?
  3. How accurate is the navigation system in guiding the surgical instruments during the procedure?
  4. What measures are in place to prevent complications such as leaks of cerebrospinal fluid, brain injuries, and bleeding?
  5. What happens if the navigation system malfunctions or is inaccurate during the surgery?
  6. How will you ensure that the navigation system is properly calibrated and functioning correctly before and during the surgery?
  7. Are there alternative surgical techniques or technologies that could be used instead of image-guided navigation?
  8. How will you monitor my condition during and after the surgery to detect any complications early on?
  9. What is the success rate of using image-guided navigation for sinus surgery, and what outcomes can I expect?
  10. Can you provide any references or case studies of patients who have undergone sinus surgery with image-guided navigation technology?

Reference

Authors: Reyes Orozco F, Ulloa R, Lin M, Xepoleas M, Paoletti M, Liu X, Hur K. Journal: Otolaryngol Head Neck Surg. 2023 Mar;168(3):501-505. doi: 10.1177/01945998221107547. Epub 2023 Jan 27. PMID: 35727630