Instrumentennavigation in der endonasalen Stirnhöhlenchirurgie: Gibt es eine Operation unter "reiner Navigationsführung"?: Instrument Navigation in Endonasal Sinus Surgery

Background: It is to be expected that, microsurgical operations in ENT must be partially performed without direct vision, e. g. without the possibility of controlling the preparation progress. This study provides a clinical example of how instrument navigation may be used in a safe and reasonable manner to the benefit of treatment quality. It is assumed that a median frontal sinus drainage procedure may be performed by means of a tracked sinus drill using solely instrument navigation. Material and Methods: The sinus drill was registered using an optoelectric navigation system. An optical registration device was attached to the drill. In the period from 1 December 2011 to 30 April 2012 (5 months) 24 patients underwent a median frontal sinus drainage. 12 of the surgeries were performed under the condition operation navigation. The other 12 surgeries were performed using solely instrument navigation. Results: When applying mode Instrument Navigation (IN), a significantly reduced incision-to-suture time was registered within both groups. Within the group Draf IIB, it was reduced to 68.5 % (from 67.1 min to 46.0 min). Resection efficiency, i. e., the ratio between the width of the frontal sinus ostium and the required total surgery time, widely diff ered to the benefit of group IN. Within both groups, the questionnaire revealed a high level of confidence in Surgical Management and Guidance Systems (SMGS) functionalities (100 %). Conclusion: The present study was designed to show for the first time a median frontal sinus drainage under the condition solely instrument navigation.