Intraoperative Volume CT Demonstrates Appeal, but Questions Remain

Overall, intraoperative volume CT scanning could potentially serve as an important adjunct that can facilitate critical decision making in endoscopic sinonasal and skull-based surgery, Dr. Batra said.

How Well Can Residents Use Technology?

In a related study, researchers from Emory University in Atlanta and the Medical University of South Carolina examined how well otolaryngology residents were able to identify anatomical features within and around the paranasal sinuses using various combinations of imaging devices. The study was performed on cadavers.

According to Patrick Sheehan, MD, a rhinology fellow at the Medical University of South Carolina, who presented his results at COSM, endoscopy with IGS registered to intraoperative CT showed the highest accuracy in anatomic identification in the study.

In the study, 11 otolaryngology residents were asked to identify 20 different anatomic sites in partially dissected cadaver heads. They were given one minute at each technology level. The technology levels were endoscopy alone, endoscopy with access to preoperative CT scan, endoscopy plus IGS based on a preoperative scan, and finally endoscopy plus IGS registered to an intraoperative CT scan.

Overall, it was found that use of endoscopy alone was the least accurate, whereas endoscopy plus IGS registered to an intraoperative CT scan was the most accurate in terms of the residents being able to identify sites. For many sites, endoscopy plus IGS registered to preoperative CT came in a close second.

However, while this, and other, studies have shown excellent anatomic accuracy with intraoperative CT and IGS, increased intraoperative safety with these technologies has not been definitively shown, Dr. Sheehan said.

©2008 The Triological Society