Image-Guided Endoscopic Sinus Surgery

Endoscopic sinus surgery (ESS) is a minimally invasive outpatient procedure used in the treatment of many nasal and sinus conditions. A rigid endoscope or telescope is used. One end of the scope has a lens. The camera is connected to the other end and is linked to a monitor. The endoscope is inserted into the nose to view the nasal cavity and sinuses.

The endoscope provides the surgeon with technical precision by providing a magnified image so the surgeon can operate on problem areas without damaging healthy surrounding tissue. The surgeon can remove diseased tissue or nasal polyps using micro instruments while viewing the enlarged image on the monitor.

In certain circumstances, a special image-guidance protocol technique is used when performing a computed tomography (CT) scan of the sinuses. During endoscopic sinus surgery, the CT scan images are digitally linked to a computerized image-guidance system displayed on the monitor and also coupled to the surgical instruments using telemetry.

This gives the surgeon the ability to real-time navigate the surgical instruments to and in the diseased sinuses, correlating their position therein and around vital structures while watching the monitor. This is particularly useful when a patient has polyps or needs revision surgery in which the normal anatomy may be distorted. Not all sinus surgeries require image guidance.

For more information, visit the American Rhinologic Society website.

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