Computer Guided Sinus Surgery

Computer guided sinus surgery is a technology introduced in the mid 1990s and is basically a GPS system to navigate complicated sinus anatomy.  Dr. Karanfilov has been using computer guidance since 1998.  He has trained and used every system on the market and serves as an expert consultant for technologies and instrument development for three of the major companies promoting this technology.  Computer guidance is used when available in revision surgery or complicated cases to provide a safer and more effective procedure.  Navigation systems are available at all facilities Dr. Karanfilov operates including the Avery Road office where he has been using navigation since 2008 for office based procedures.  Ohio Sinus Institute to our knowledge was the first practice in the country to employ this technology for office use.

Rhinologists (Ear nose and throat surgeons who have further specialized in surgery of the sinuses and skull base) perform procedures with the aid of small rigid telescopes (called endoscopes) and cameras to magnify and illuminate the nasal and sinus tissue. The most important structures surrounding the sinuses are the eyes, the tear ducts, the optic nerves (nerves of vision), the brain, and carotid arteries (the vessels carrying the main blood supply to the brain).  While years of training, knowledge of anatomy, and skill are vital to performing safe surgery,  image-guidance allows surgeons to know precisely where any given structure is within and surrounding the nose and sinuses, compared to where the instrument is, at any given point during surgery.

The term “image-guidance” refers to the use of a probe or instrument, which is generally placed within the nose, that is tracked by a machine as that probe moves through the nose and sinuses.  A computer, which is either physically or remotely attached to that probe, provides the surgeon with a map of the nose and sinuses. This map is provided by a specialized CT scan which is performed prior to your surgery.

Computer guided systems are used for a number of surgeries. The following is a list of some surgeries that might benefit from image-guided surgery

  • Primary frontal or sphenoid sinus surgery
  • Revision sinus surgery
  • Nasal polyp surgery
  • Sinus tumor surgery
  • CSF (brain fluid) leaks
  • Optic nerve decompression
  • Surgery around or within the orbit(eye)

Computer guided surgery has been a tremendous advance in the field of nasal and sinus surgery.  The overwhelming agreement among expert rhinologists is that image-guidance makes many surgical procedures safer and more complete.  You will have to discuss with your surgeon whether you would be a candidate for computer guided surgery.

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