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Computer or not? Use of image guidance during endoscopic sinus surgery for chronic rhinosinusitis at St Paul's Hospital, Vancouver, and meta-analysis

Published online by Cambridge University Press:  12 March 2013

V S Sunkaraneni ,
D Yeh ,
H Qian  and
A R Javer
V S Sunkaraneni*
Affiliation:
St Paul's Sinus Centre, St Paul's Hospital, Vancouver, British Columbia, Canada
D Yeh
Affiliation:
Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
H Qian
Affiliation:
Centre for Health Evaluation and Outcomes Sciences, St Paul's Hospital, Vancouver, British Columbia, Canada
A R Javer
Affiliation:
St Paul's Sinus Centre, St Paul's Hospital, Vancouver, British Columbia, Canada
*
Address for correspondence: Mr V S Sunkaraneni, Consultant Rhinologist/Skullbase Surgeon, ENT Department, Royal Surrey County Hospital, Egerton Rd, Guildford GU2 7XX, UK E-mail: drsan911@gmail.com
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Abstract

Background:

The advantages and limitations of image guidance systems for endoscopic sinus surgery are unclear. We report our experience and present a meta-analysis of the evidence.

Methods:

We performed a retrospective analysis of endoscopic sinus surgery procedures performed with versus without image guidance. A total of 355 cases was included. Primary outcomes included complication rates and time to revision surgery. A literature search was conducted to enable identification and analysis of studies of similar comparisons.

Results:

Within 1.5 years of the index sinus surgical procedure, the risk of revision surgery was significantly higher for patients treated with non-assisted versus computer-assisted endoscopic sinus surgery (p = 0.001). Meta-analysis did not indicate a reduction in complications or revision surgery procedures with the use of image guidance systems, although the majority of included studies showed a non-significant reduction in revision surgery.

Conclusion:

Our study offers some evidence that computer-assisted endoscopic sinus surgery may delay residual disease and reduce the requirement for revision surgery. Although this finding was not borne out in the meta-analysis, the majority of identified studies demonstrated a trend towards fewer revision procedures after computer-assisted endoscopic sinus surgery. This type of surgery may offer other advantages that are not easily measurable.

Keywords

EndoscopySinusitisTechnologyReviewSystematicComplications

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 4 , April 2013 , pp. 368 - 377
Copyright
Copyright © JLO (1984) Limited 2013

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Footnotes

Presented at the Combined Otolaryngological Spring Meeting 2011, 27 April to 1 May 1 2011, Chicago, Illinois, USA

References

1Anon, JB, Klimek, L, Mosges, R, Zinreich, SJ. Computer-assisted endoscopic sinus surgery. An international review. Otolaryngol Clin North Am 1997;30:389–401CrossRefGoogle ScholarPubMed
2Govindaraj, S, Adappa, ND, Kennedy, DW. Endoscopic sinus surgery: evolution and technical innovations. J Laryngol Otol 2010;124:242–50CrossRefGoogle ScholarPubMed
3Anon, JB. Computer-aided endoscopic sinus surgery. Laryngoscope 1998;108:949–61CrossRefGoogle ScholarPubMed
4Labadie, RF, Davis, BM, Fitzpatrick, JM. Image-guided surgery: what is the accuracy? Curr Opin Otolaryngol Head Neck Surg 2005;13:27–31CrossRefGoogle ScholarPubMed
5Casiano, RR, Numa, WA Jr.Efficacy of computed tomographic image-guided endoscopic sinus surgery in residency training programs. Laryngoscope 2000;110:1277–82CrossRefGoogle ScholarPubMed
6Mueller, SA, Caversaccio, M. Outcome of computer-assisted surgery in patients with chronic rhinosinusitis. J Laryngol Otol 2010;124:500–4CrossRefGoogle ScholarPubMed
7Tabaee, A, Hsu, AK, Shrime, MG, Rickert, S, Close, LG. Quality of life and complications following image-guided endoscopic sinus surgery. Otolaryngol Head Neck Surg 2006;135:76–80Google ScholarPubMed
8Fried, MP, Moharir, VM, Shin, J, Taylor-Becker, M, Morrison, P. Comparison of endoscopic sinus surgery with and without image guidance. Am J Rhinol 2002;16:193–7CrossRefGoogle ScholarPubMed
9Kherani, S, Javer, AR, Woodham, JD, Stevens, HE. Choosing a computer-assisted surgical system for sinus surgery. J Otolaryngol 2003;32:190–7CrossRefGoogle ScholarPubMed
10Sunkaraneni, VS, Nair, SB. Complications of endoscopic sinus surgery and their management. The Otorhinolarygologist 2010;3:48–51Google Scholar
11Sweeting, MJ, Sutton, AJ, Lambert, PC. What to add to nothing? Use and avoidance of continuity corrections in meta-analysis of sparse data. Stat Med 2004;23:1351–75CrossRefGoogle ScholarPubMed
12Diamond, GA, Bax, L, Kaul, S. Uncertain effects of rosiglitazone on the risk for myocardial infarction and cardiovascular death. Ann Intern Med 2007;147:585–7CrossRefGoogle ScholarPubMed
13Higgins, JPT, Thompson, SG. Quantifying heterogeneity in a meta-analysis. Stat Med 2002;21:1539–58CrossRefGoogle ScholarPubMed
14Al-Swiahb, JN, Al-Dousary, SH. Computer-aided endoscopic sinus surgery: a retrospective comparative study. Ann Saudi Med 2010;30:149–52CrossRefGoogle ScholarPubMed
15Eliashar, R, Sichel, JY, Gross, M, Hocwald, E, Dano, I, Biron, A et al. Image guided navigation system – a new technology for complex endoscopic endonasal surgery. Postgrad Med J 2003;79:686–90CrossRefGoogle ScholarPubMed
16Reardon, EJ. Navigational risks associated with sinus surgery and the clinical effects of implementing a navigational system for sinus surgery. Laryngoscope 2002;112:1–19CrossRefGoogle ScholarPubMed
17Tschopp, KP, Thomaser, EG. Outcome of functional endonasal sinus surgery with and without CT-navigation. Rhinology 2008;46:116–20Google ScholarPubMed
18Lee, JM, Chiu, AG. Role of maximal endoscopic sinus surgery techniques in chronic rhinosinusitis. Otolaryngol Clin North Am 2010;43:579–89, ixCrossRefGoogle ScholarPubMed
19Stankiewicz, JA. Complications of endoscopic intranasal ethmoidectomy. Laryngoscope 1987;97:1270–3CrossRefGoogle ScholarPubMed
20May, M, Levine, HL, Mester, SJ, Schaitkin, B. Complications of endoscopic sinus surgery: analysis of 2108 patients – incidence and prevention. Laryngoscope 1994;104:1080–3CrossRefGoogle ScholarPubMed
21American Academy of Otolaryngology–Head and Neck Surgery. Intra-Operative Use of Computer Aided Surgery – Update. In: http://www.entnet.org/Practice/policyIntraOperativeSurgery.cfm. [2 March 2011]Google Scholar
22Orlandi, RR, Petersen, E. Image guidance: a survey of attitudes and use. Am J Rhinol 2006;20:406–11CrossRefGoogle ScholarPubMed
23Musy, PY, Kountakis, SE. Anatomic findings in patients undergoing revision endoscopic sinus surgery. Am J Otolaryngol 2004;25:418–22CrossRefGoogle ScholarPubMed
24Thong, JF, Lee, J, Yeak, S, Siow, JK. Use of image guidance in endoscopic sinus surgery. Clin Otolaryngol 2007;32:500CrossRefGoogle ScholarPubMed
25Philpott, CM, Dharamsi, A, Witheford, M, Javer, AR. Endoscopic management of inverted papillomas: long-term results – the St. Paul's Sinus Centre experience. Rhinology 2010;48:358–63Google ScholarPubMed
26King, JM, Caldarelli, DD, Pigato, JB. A review of revision functional endoscopic sinus surgery. Laryngoscope 1994;104:404–8CrossRefGoogle ScholarPubMed
27Hepworth, EJ, Bucknor, M, Patel, A, Vaughan, WC. Nationwide survey on the use of image-guided functional endoscopic sinus surgery. Otolaryngol Head Neck Surg 2006;135:68–73CrossRefGoogle ScholarPubMed
28Metson, RB, Cosenza, MJ, Cunningham, MJ, Randolph, GW. Physician experience with an optical image guidance system for sinus surgery. Laryngoscope 2000;110:972–6CrossRefGoogle ScholarPubMed
29Zuckerman, JD, Wise, SK, Rogers, GA, Senior, BA, Schlosser, RJ, DelGaudio, JM. The utility of cadaver dissection in endoscopic sinus surgery training courses. Am J Rhinol Allergy 2009;23:218–24CrossRefGoogle ScholarPubMed
30Gibbons, MD, Gunn, CG, Niwas, S, Sillers, MJ. Cost analysis of computer-aided endoscopic sinus surgery. Am J Rhinol 2001;15:71–5CrossRefGoogle ScholarPubMed
31Smith, TL, Stewart, MG, Orlandi, RR, Setzen, M, Lanza, DC. Indications for image-guided sinus surgery: the current evidence. Am J Rhinol 2007;21:80–3CrossRefGoogle ScholarPubMed
32Javer, AR, Genoway, KA. Patient quality of life improvements with and without computer assistance in sinus surgery: outcomes study. J Otolaryngol 2006;35:373–9CrossRefGoogle ScholarPubMed
33Anon, JB, Lipman, SP, Oppenheim, D, Halt, RA. Computer-assisted endoscopic sinus surgery. Laryngoscope 1994;104:901–5CrossRefGoogle ScholarPubMed