can be some distinct advantages to having reusable instruments." Storz
also offers both infrared- and electromagnetic-based systems, depend-
ing on surgeon preference. The system footprint is also smaller than
most, with a tablet-sized screen that can be attached to a standard pole.
1 0 0 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • A P R I L 2 0 1 6
When it comes to diagnosing and understanding paranasal diseases, the answers are rarely as
plain as the nose on your face.
"We're still trying to understand what allows people to sense that they're breathing, and what
contributes to nasal obstruction," says Alex Farag, MD, assistant professor of skull-base rhinol-
ogy and skull-base surgery in the department of otolaryngology at Ohio State University at
Wexler Medical Center in Columbus.
To unlock those secrets, Dr. Farag and his colleagues are creating 3D models of patients' nasal
cavities based on CT scans. The goal is to be able to simulate airflow through the sinus cavity, to
see how it will be affected by surgery and to achieve better and more predictable outcomes.
"We feel this is the next paradigm shift — the next level in understanding the true physiology
of the sinus nasal cavity and paranasal diseases," says Dr. Farag. "Smelling is actually a very
complex process. And these 3D models are really helping us."
Failure to understand the complex interactions in the nasal cavity can lead to a host of post-
surgical complications. "For example, if you make too much room in the nose, you could be
talking about empty nose syndrome," says Dr. Farag, describing a condition in which patients
feel as if they're struggling to breathe, even though their passages are wide open.
The 3D modeling also helps surgeons see and understand what are often significant variations
among patients "Chronic sinusitis and diseases like it are actually more complex than some-
times recognized," says Dr. Farag. "There are genetic and anatomical variations that affect how
patents interact with the environment. Everyone is born a little different and treatment needs to
be tailored to the individual." — Jim Burger
BREATHING AND SMELLING
3D Modeling Dives Inside the Nasal Cavity
