"It's an extra level of confirmation and certainty that you're actually
in the spaces you want to be," says Brent Senior, MD, FACS, FARS,
chief of rhinology, allergy, and endoscopic skull base surgery, oto-
laryngology/head and neck surgery at University of North Carolina at
Chapel Hill, and vice president for development and strategic initia-
tives with the American Rhinologic Society. He adds that the technol-
ogy could be particularly useful for navigating around dangerous
areas like the sphenoid sinus.
The system also provides the ability to preoperatively mark anatomi-
cal targets and anti-targets. "For example, you would mark the anterior
ethmoidal artery, which is dangerous if it were injured during sinus
surgery," says Dr. Senior. "We mark that on the CT scan, and the sys-
tem will make an auditory ping to let us know we're getting close to
that vessel."
Dr. Senior uses the technology to see what he removed from the
sinuses. "It keeps track of the movement of your suctions inside the
sinuses during the case, and gives you a virtual picture of areas where
the suction has traversed," he says. "That gives you a good sense of all
the areas you've operated in, and a general picture of the completeness
of the surgery."
Dr. Senior also touts facial recognition technology for the preopera-
tive registration process, which prepares a 3D reconstruction of the
face for the image guidance system to display during surgery. "All of
the systems require that you register the patient's CT image to the true
anatomy of the patient," he explains. For facial mapping, some systems
run a laser over the face, while others require a physical touching of
the face. Dr. Senior's system uses a smartphone. "You can use your
iPhone or iPad to take a picture of the patient's face, and it registers in
the system," he says.
Surgeons can use image guidance software, the patient's pre-op CT
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