[鼻内镜手术中影像引导58例临床分析]。

PubMed ID
发表日期 2004年Mar月

原始出处 中华二鼻咽喉科杂治
Zhonghua er bi yan hou ke za zhi
作者 Qiu  Jian-hua  Chen  Fu-quan  Huang  Hua  Gao  Xiao-juan 

文献标题 [鼻内镜手术中影像引导58例临床分析]。
[Clinical analysis of 58 cases intraoperative image-guidance in nasal endoscopic surgery].

文献摘要 OBJECTIVE

目的探讨鼻内镜手术中图像引导的有效性及经验。

METHODS

回顾性分析58例鼻内窥镜手术患者的临床资料,其中慢性鼻窦炎伴或不伴鼻息肉39例,坏死性上颌窦炎3例,蝶窦囊肿6例,鼻咽血管纤维瘤2例,颅鼻脑膜瘤1例;外伤性脑脊液鼻漏1例,外伤性视神经病变1例。所有患者均采用脑实验室影像导航系统和鼻内窥镜手术。

RESULTS

术前准备时间10-20分钟,包括协调、头托定位、常规器械注册。在我们的病例中,导航系统的三维图像地标与实际解剖地标之间的定位精度小于1.5mm。术中能准确定位视神经及其他解剖点。无并发症发生。

CONCLUSIONS

鼻内窥镜结合图像引导系统可对鼻腔、鼻窦和前颅底进行精确的解剖定位,扩大手术范围。在鼻内窥镜手术中,外科医生可以观察周围重要的解剖结构。可提高疗效,减少手术并发症,尤其是复杂病例。


OBJECTIVE

To evaluate the availability and our experience of intraoperative image-guidance in endoscopic nasal surgery.

METHODS

Fifty-eight cases of endoscopic nasal surgery with intraoperative image-guidance were retrospectively reviewed, including 39 cases of chronic sinusitis with or without nasal polyp; 3 cases of necrotizing maxillary sinusitis; 6 cases of sphenoid sinus cyst; 2 cases of nasopharyngeal angiofibroma; 1 case of cranio-nasal meningioma; 1 case of traumatic cerebrospinal rhinorrhea; 1 case of traumatic optic nerve lesion. All patients were operated on with Brain Lab operation imaging navigation system and nasal endoscope.

RESULTS

The preoperative preparatory time would take 10-20 minutes, including coordination, head holder localization, conventional instrument registration. In our cases, the localization accuracy between 3-D image landmarks of navigation system and actual anatomical landmarks was less than 1.5 mm. The optic nerve and other anatomical points could be orientated accurately in intraoperative procedures. No complication occurred.

CONCLUSIONS

Nasal endoscope combined with image-guidance systems provides accurate anatomical localization of nasal cavity, sinuses and anterior skull base with enlarged operation field. It is possible for surgeons to observe the surrounding important anatomical structures during endoscopic nasal surgery. It could increase the effectiveness and decrease surgical complications, especially in complicated cases.