Use of computer-aided surgery for frontal sinus ventilation

Objectives: To review our experience and evaluate the utility of computer-a ided surgery for frontal sinus and frontal recess disease. Study Design: A retrospective review of 31 consecutive patients undergoing computer-aided s urgery for frontal sinus ventilation, Methods: The hospital charts of 31 pa tients were reviewed. Previous sinonasal procedures, etiology of sinonasal disease, preoperative computed tomography(CT) scan findings, preoperative s ymptoms, endoscopic and intraoperative findings, type of frontal sinus vent ilation procedure, complications, imaging system registration method or acc uracy, and postoperative course were noted. Results: In all 31 patients the surgery was successfully completed, and no intracranial or orbital complic ations were encountered during or after surgery. Six patients required addi tional surgery including revision transnasal. endoscopic frontal sinus vent ilation or osteoplastic flaps with fat obliteration. In the six cases requi ring additional surgery, disease severity, most commonly, aspirin triad dis ease, predisposed to failure of frontal sinus ventilation. Conclusions: Com puter-aided surgery is a useful adjunctive device for safe, efficient ident ification and surgery of the frontal sinus. However, it is not a replacemen t for sound surgical technique, anatomical knowledge, and experience. In pa rticular, patients with aspirin triad disease with frontal recess and front al sinus involvement are highly suited for computer-aided surgery and thoro ugh removal of disease, although failures occur despite this technique. The long-term benefit of computer-aided surgery of the frontal sinus has not y et been demonstrated by this or other studies.