INTRAOPERATIVE IMAGE GUIDANCE DURING ENDOSCOPIC SINUS SURGERY

Endoscopic sinus surgery (ESS) is one of the most commonly performed p rocedures in otorhinolaryngology and is associated with a definite ris k for both intraoperative and postoperative complications. Intraoperat ive image guidance is expected to have a major effect on procedures su ch as ESS by allowing the clinician to more efficiently remove patholo gy and by improving surgeon confidence and knowledge of anatomy, parti cularly in revision procedures or in patients with altered anatomy. As a consequence, complications during these procedures will decrease an d patient safety well increase. Several guidance modalities are availa ble including computed tomography (CT), magnetic resonance imaging (MR I), and fluoroscopy. This article will describe current applications o f each of these three techniques with respect to ESS while focusing on innovative techniques that use MRI and CT to provide intraoperative g uidance with unmatched convenience, reliability, and utility.