• Home
  • Practice Focus
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
    • How I Do It
    • TRIO Best Practices
  • Business of Medicine
    • Health Policy
    • Legal Matters
    • Practice Management
    • Tech Talk
    • AI
  • Literature Reviews
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Career
    • Medical Education
    • Professional Development
    • Resident Focus
  • ENT Perspectives
    • ENT Expressions
    • Everyday Ethics
    • From TRIO
    • The Great Debate
    • Letter From the Editor
    • Rx: Wellness
    • The Voice
    • Viewpoint
  • TRIO Resources
    • Triological Society
    • The Laryngoscope
    • Laryngoscope Investigative Otolaryngology
    • TRIO Combined Sections Meetings
    • COSM
    • Related Otolaryngology Events
  • Search

Image Guidance: A Useful Adjunct to Endoscopic Sinus Surgery

by Gretchen Henkel • May 1, 2007

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
Print-Friendly Version

Now, however, said Sanjay R. Parikh, MD, Chief of the Division of Pediatric Otorhinolaryngology-Head and Neck Surgery and Assistant Professor of ORL-HNS and Pediatrics, Montefiore Medical Center and the Albert Einstein College of Medicine in New York, the learning curve is very quick, once you feel comfortable with the accuracy of the instrumentation within the nasal cavity. Dr. Parikh has been performing pediatric sinus surgery using image guidance for the past seven years.

You Might Also Like

  • Understanding Use of Image Guidance Technology in Endoscopic Sinus Surgery
  • Case Studies in Endoscopic Sinus Surgery
  • Drugs, Surgery, Endoscopic Sinus Surgery As Remedies for Chronic Rhinosinusitis
  • The Evolution of Endoscopic Sinus Surgery
Explore This Issue
May 2007

Dr. Kennedy cautions that the image guidance is not foolproof. The headsets can slip, he pointed out, creating potential inaccuracies during a case.

The Evidence Conundrum

Sanjay R. Parikh, MD

Sanjay R. Parikh, MD

Despite their belief in and conversance with the new image guidance systems, surgeons have been unable to prove that the technology actually reduces complication rates and improves outcomes for patients. I don’t think there is good evidence that it reduces complications, said Dr. Kennedy. However, the technology continues to evolve and the use of image guidance will increase, say experts interviewed for this article.

Although case series are accumulating that support the use of image guidance in ESS, full-scale randomized trials are not feasible. Dr. Parikh explained the dilemma: It’s impossible to do a prospective, randomized, controlled trial to establish this [image guidance in ESS] as the gold standard. This would have to be a multi-institutional study, and it would be a real issue to accrue the numbers of patients required. We are a tertiary referral center and we are doing five to six pediatric cases per year using the navigation.

Dr. Senior agrees that attempting such a trial would be extremely difficult. No one is pursuing that, he said. It’s a chronic problem we deal with in surgical trials. It’s not as if you can blind it and have some sort of sham image guidance system to use during the surgery.

A recent review of the current evidence in the American Journal of Rhinology also concluded that randomized trials of image guided sinus surgery are not practical, ethical, or feasible, but added that clinical experience, expert opinion and case series do support indications for the technology.1 Marvin P. Fried, MD, Professor and University Chairman of the Department of Otorhinolaryngology-Head and Neck Surgery at Montefiore Medical Center, Albert Einstein College of Medicine in New York, serves on the GE Scientific Advisory Board and was one of the people who helped to develop an image guidance system using intraoperative fluoroscopy. I concur with the expert opinion on this. Image guidance is really beneficial, because it gives surgeons a sense of confidence that supplements their own knowledge.

Pages: 1 2 3 4 | Single Page

Filed Under: Articles, Clinical, Cover Article, Features Issue: May 2007

You Might Also Like:

  • Understanding Use of Image Guidance Technology in Endoscopic Sinus Surgery
  • Case Studies in Endoscopic Sinus Surgery
  • Drugs, Surgery, Endoscopic Sinus Surgery As Remedies for Chronic Rhinosinusitis
  • The Evolution of Endoscopic Sinus Surgery

Leave a Reply Cancel reply

Your email address will not be published. Required fields are marked *

The Triological SocietyENTtoday is a publication of The Triological Society.

Polls

Do you use AI-powered scribes for documentation?

View Results

Loading ... Loading ...
  • Polls Archive

Top Articles for Residents

  • Applications Open for Resident Members of ENTtoday Edit Board
  • How To Provide Helpful Feedback To Residents
  • Call for Resident Bowl Questions
  • New Standardized Otolaryngology Curriculum Launching July 1 Should Be Valuable Resource For Physicians Around The World
  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Popular this Week
  • Most Popular
  • Most Recent
    • How to: Positioning for Middle Cranial Fossa Repair of Superior Semicircular Canal Dehiscence

    • Endoscopic Ear Surgery: Advancements and Adoption Challenges 

    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment

    • Rating Laryngopharyngeal Reflux Severity: How Do Two Common Instruments Compare?

    • Otolaryngologists Are Still Debating the Effectiveness of Tongue Tie Treatment

    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment

    • Rating Laryngopharyngeal Reflux Severity: How Do Two Common Instruments Compare?

    • Is Middle Ear Pressure Affected by Continuous Positive Airway Pressure Use?

    • Otolaryngologists Are Still Debating the Effectiveness of Tongue Tie Treatment

    • Complications for When Physicians Change a Maiden Name

    • The Importance of Time Away
    • Endoscopic Ear Surgery: Advancements and Adoption Challenges 
    • Reflections from a Past President of the Triological Society
    • ENT Surgeons Explore the Benefits and Challenges of AI-Powered Scribes: Revolutionizing Documentation in Healthcare
    • How To: Open Expansion Laryngoplasty for Combined Glottic and Subglottic Stenosis

Follow Us

  • Contact Us
  • About Us
  • Advertise
  • The Triological Society
  • The Laryngoscope
  • Laryngoscope Investigative Otolaryngology
  • Privacy Policy
  • Terms of Use
  • Cookies

Wiley

Copyright © 2025 by John Wiley & Sons, Inc. All rights reserved, including rights for text and data mining and training of artificial technologies or similar technologies. ISSN 1559-4939