ADVANTAGES AND DISADVANTAGES OF 3-DIMENSIONAL COMPUTED-TOMOGRAPHY INTRAOPERATIVE LOCALIZATION FOR FUNCTIONAL ENDOSCOPIC SINUS SURGERY

Intraoperative three-dimensional computed tomography (3-D CT) localiza tion has been available for use during functional endoscopic sinus sur gery (FESS) for several years, although relatively few otolaryngologis ts operate in conjunction with this technology, Proponents of intraope rative localization believe that operating with stereotaxis enhances s urgical precision and reduces complications. A 1-year review was condu cted at the University of Pennsylvania from January 1994 through Janua ry 1995. During this period 5% of sinus operations were performed in c onjunction with intraoperative localization. The advantage's and disad vantages of using intraoperative localization were evaluated for each case. Also examined were type and indication for surgery, anesthesia u sed, added time, and cost. Overall, intraoperative localization was fo und to be helpful when anatomy was distorted or obscured. However, sel ecting patients who may have benefited hom localization was often not possible using preoperative data, Ideally, localization should be avai lable for all FESS. Criteria are outlined which will need to be met pr ior to localization becoming a significant aspect of FESS.