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Computer-Assisted Navigation System in Pediatric Intranasal Surgery
Florence Postec, MD;
Denis Bossard, MD;
François Disant, MD;
Patrick Froehlich, MD
Arch Otolaryngol Head Neck Surg. 2002;128:797-800.
Objectives To introduce a computer-assisted navigation system and to evaluate its
application in pediatric sinusonasal surgery.
Methods A commercially available wireless passive marker system that allows
the calibration and tracking of virtually any instrument was adapted to children
and used during pediatric endoscopic sinusonasal surgery.
Results The headset localizer that was initially used in computed tomographic
scanning was not well accepted by children. Correlation of the preoperative
computed tomographic scan to the actual patient was made possible by a laser
device. Setup time was able to be decreased from an initial 20 minutes to
3 minutes. The average recording accuracy was 1.1 mm. The advantages of the
system became apparent as experience increased in cases involving sinus polyposis,
choanal atresia, nasopharyngeal fibroma removal, tumor biopsy, and minimally
invasive maxillary, frontal, and sphenoidal surgery.
Conclusions The computer-assisted navigation system was used first as a control
system and then, as experience increased, as a true surgical guide. Indications
for its use also increased. Pediatric intranasal surgery was performed using
2 complementary guides: an endoscopic view and a computed tomographic view
of the instrument's position.
From the Department of Otorhinolaryngology, Hôpital E. Herriot,
Lyon, France.
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