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E N T
N A V I G A T I O N
ASSESSING YOUR OPTIONS
Which Image-Guided ENT
System Is Right for You?
(continued from previous page)
ing. That's especially important when
working deep in the skull base, which
demands intricate maneuvers that
draw the hands tight together as you
move deeper into the surgical cavity.
• Infrared guidance. Passive systems have fiducial markers placed on
the patient and instruments that reflect
infrared light back to the system's
camera. Active systems have infraredemitting diodes on operating instruments that are actively tracked by an
overhanging camera. With both types
of technology, you must maintain a
clear line of sight between instruments and imaging unit. These systems are highly accurate and especially helpful and convenient during
routine sinus cases because the small
markers placed on the distal ends of
individual instruments easily track
their locations during dissection.
Passive systems do not require wiring
of instruments to the machine, giving
surgeons freedom of movement in the
surgical cavity.
It's a definite plus if you can rapidly
and effectively adapt surgeons' preferred instrumentation for use with a
navigation system. However, surgeons
using these systems must learn how to
hold instruments — particularly the
endoscope — in such a way that the
system can always read the markers.
— Brent A. Senior, MD
images, giving them tremendous
amounts of information they'd
normally have to mentally piece
together from separate imaging
sources and computer screens.
Working off of superimposed
images helps surgeons truly understand the anatomy and relationships of anatomical landmarks
they're working around.
Proving that the technology
reduces complications is difficult
to do because standard complication rates of routine sinus surgery
are already exceedingly low —
around 1%, and much less than
that for major mishaps.
Conducting research that demonstrates the technology's direct
impact on improved safety would
require such a large number of
patients that it's near impossible
to study.
Anecdotally, however, surgeons
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