摘要
目的 探讨影像导航技术在鼻内镜手术中应用的有关问题。方法 回顾性分析 5 8例患者 ,其中慢性鼻窦炎、鼻息肉 39例、孤立性蝶窦炎 6例、坏死性上颌窦炎 3例、蝶窦囊肿 5例、鼻咽纤维血管瘤 2例 ;鼻颅沟通性脑膜瘤、外伤性脑脊液鼻漏、外伤性视神经损伤各 1例。所有病例均采用BrainLab影像导航系统及鼻内镜实施手术。结果 影像导航术前准备时间 (包括配准、头架定位、常规器械注册等 ) 10～ 2 0min ,平均 15min。 5 2例手术区域影像标志与实体解剖标志间的误差≤ 1 5mm ,6例 >3mm。影像导航可准确定位视神经等解剖标志 ,无手术并发症发生。结论 影像导航系统与内镜相驳接 ,不仅可以帮助术者在术中定位鼻腔、鼻窦、颅底的解剖结构 ,并可使手术视野扩展到内镜之外 ,使术者在术野中进行手术操作的同时 ,能顾及到术野周围的重要结构。特别是在复杂的手术中 。
Objective To evaluate the availability and our experience of intraoperative image guidance in endoscopic nasal surgery. Methods Fifty eight cases of endoscopic nasal surgery with intraoperative image guidance were retropectively reviewed, including 39 cases of chronic sinusitis with or without nasal polyp; 3 cases of necrotizing maxillary sinusitis; 6 cases of sphenoid sinus cyst; 2 cases of nasopharyngeal angiofibroma; 1 case of cranio nasal meningioma;1 case of traumatic cerebrospinal rhinorrhea;1 case of traumatic optic nerve lesion. All patients were operated on with Brain Lab operation imaging navigation system and nasal endoscope. Results The preoperative preparatory time would take 10 20 minutes, including coordination, head holder localization, conventional instrument registration. In our cases, the localization accuracy between 3 D image landmarks of navigation system and actual anatomical landmarks was less than 1 5 mm. The optic nerve and other anatomical points could be orientated accurately in intraoperative procedures. No complication occurred. Conclusions Nasal endoscope combined with image guidance systems provides accurate anatomical localization of nasal cavity, sinuses and anterior skull base with enlarged operation field. It is possible for surgeons to observe the surrounding important anatomical structures during endoscopic nasal surgery. It could increase the effectiveness and decrease surgical complications, especially in complicated cases.
出处
《中华耳鼻咽喉科杂志》
CSCD
北大核心
2004年第3期131-134,共4页
Chinese Journal of Otorhinolaryngology
