[Intraoperative navigation system in endoscopic sinus surgery]

Abstract

Intraoperative navigation systems have been developed to increase the safety and efficiency of endoscopic sinus surgery. The objective of this study was to compare the application and utilization of optical and electromagnetical navigation systems in our own experience during the endoscopic surgery.

Material and methods: An optical-based image guidance systems (MatrixPolar Navigation System, Xion, Germany; Karl Storz Surgical Cockpit Navigation Panel Unit, Karl Storz, Germany; Stryker Navigation CartII ENT, Stryker, USA) and electromagnetic (Fusion ENT Navigation System, Medtronic, USA; Fiagon, fiagon GmbH, Germany) was used to performed 40 sinonasal and skull base surgeries. We compared the precision and accuracy of both types of systems and additional time necessary for setting up the system and real operating room time. We also analysed the convenience of navigation according to possibilities of easy instruments manipulation and fluency of navigation process.

Results: The mean measured accurancy of anatomical localization at start of the surgery for optical systems was 1.62 ± 0.4mm and for electromagnetic respectively 1.79 ± 0.39 mm. The time to set up the optical system was longer than for electromagnetic one (12 vs 5 minutes). Operating room time was increased for both systems, for optical to 22 vs 8 minutes for electromagnetic one. Surgeon's working comfort during operation was better for electromagnetic systems and allowed for fluently movements with instruments.

Conclusions: Intraoperative navigation systems assist the surgeon with anatomical localization during endoscopic sinus surgery and improve its safety and efficacy. The choice of optical or electromagnetic system should be compared of effective costs and surgeon's preferences.