Video-endoscope versus endoscope for paranasal sinus surgery: Influence onstereoacuity

A matter of debate is whether the use of a video-endoscope impairs visual o rientation and manual precision in endonasal surgery. We investigated the i nfluence of videoendoscopy compared to endoscopy on stereoacuity in a model of the nasal cavity. Twenty medical staff members were asked to touch defi ned points in a spatial model of the nasal cavity as quickly as possible an d in correct order using 0 degrees and 30 degrees endoscopes, looking direc tly through the endoscope or looking at a video monitor connected to a CCD camera on the endoscope. Time, number of omissions of points and faults in point sequence were recorded. Manipulations were significantly quicker when the "operative field" was seen directly through the endoscope compared to orientation from the monitor for both 0 degrees endoscope 96 +/- 4.7 s. vs. 108 +/- 5.6 s. and 30 degrees endoscope 84 +/- 3.9 s. vs. 96 +/- 5.5 s. (/-SEM). There was no difference in number of omissions and faults in sequen ce between "endoscope" and "video-endoscope." The fact that the use of a vi deo-endoscope did not increase the number of faults in our experiment does not support the notion that performing endoscopic sinus surgery using a mon itor is unsafe. In the hands of the participants who were experienced with the endoscope, however, the use of a video-endoscope slowed down manipulati ons to a significant degree. To which extent this may be due to the effect of training or to superiority of the endoscope per se will remain a matter of discussion until a group of experienced video-endoscopists will have rep eated the study.