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目的评价影像导航系统在复杂鼻颅底内镜手术中的作用。方法26例中额窦复发性内翻性乳头状瘤2例,鼻腔鼻窦肿瘤侵及颅底5例,垂体腺瘤7例,创伤性视神经病12例,均应用影像导航系统行鼻内镜手术。结果影像导航术前准备时间(包括配准、头架定位、常规器械注册等)5～10min,平均7min。手术区域影像标志与实体解剖标志间的误差≤1.5mm,手术均顺利完成,术中、术后未出现并发症。结论导航系统定位准确,能帮助术者确定术区周围重要解剖结构,可以实时判定肿瘤切除程度,能够最大限度地切除肿瘤,减少并发症。尤其在有既往手术史或病变破坏了鼻鼻窦及颅底解剖标志的情况下,导航系统对术者的帮助更大,增强了术者自信心,提高了手术的安全因素,保证了肿瘤切除的彻底性。
Objective To evaluate the role of imaging navigation system in the treatment of complex nasal skull base endoscopic surgery. Methods 26 cases of frontal sinus recurrent inverted papilloma in 2 cases, nasal sinus tumor invasion and skull base in 5 cases, 7 cases of pituitary adenoma, traumatic optic neuropathy in 12 cases, were applied image navigation system under endoscopic sinus surgery . Results Video navigation preoperative preparation time (including registration, head frame positioning, conventional equipment registration, etc.) 5 ~ 10min, an average of 7min. The error between the image sign of the operation area and the anatomical sign of the operation was less than or equal to 1.5 mm. All the operations were successfully completed. No complications occurred during or after operation. Conclusion The navigation system has the advantages of accurate positioning and can help the surgeon to determine the important anatomical structures around the operation area. It can determine the extent of tumor resection in real time, and can remove the tumor to the maximum and reduce the complications. Especially in the past history of surgery or lesions of the damaged nose and sinus skull base anatomical landmarks, the navigation system to help the surgeon greater and enhance the surgeon self-confidence and improve the safety of the operation to ensure that the tumor resection Thoroughness