When you have problems with your nasal passages or sinuses it feels like a cold that does not ever really go away.

Blocked sinuses, nasal polyps and other growths are among the problems that can lead to such breathing difficulties. Now patients can literally breathe easier, thanks to sophisticated computer image-guidance technology.

 

Image-guided Functional Endoscopic Sinus Surgery (FESS) has proven to be a safer, more effective approach than more invasive open techniques and traditional endoscopic sinus surgery in many cases. This technique has quickly become known in medical circles as the state-of-the-art in effective treatment for sinus problems.

Computer image-guidance FESS combines CT scans with a sophisticated computerized guidance system so the source of the sinus trouble can be precisely addressed. The three-dimensional image created by the guidance system allows the surgeon to conduct the surgery via an exact view of the patient’s anatomy.

Traditional endoscopic surgery has been the leading method of correcting sinus problems. For traditional FESS, the surgeon has to correlate details of the patient’s anatomy from more limited two-dimensional CT scans. The endoscope is a miniature periscope that illuminates the surgeon’s view of the nasal passages and allows us to see around comers. Still, many anatomical structures are obstructed from view and delicate partitions with adjacent vital structures are often difficult to discern.

The image-guided technique improves on FESS. On the computer monitor the surgical instruments are viewed in real time as cross-hairs allowing the surgeon not only to view the anatomy directly through the endoscope but also in all three dimensions – face-on, from the side and from below – giving the surgeon the ability to “see” the deeper structures. This provides more safety to vital surrounding organs. It shows the doctor exactly where the instrument is in relation to the sinus cavity and delicate adjoining structures such as the brain and eyes. This degree of accuracy reduces the chance of complications while making it possible to more precisely pinpoint and eliminate disease.

In advance of surgery the patient has a detailed CT scan of the sinuses this allows the computer’s software to develop a precise model of each individual’s anatomy from the CT scan. In the operating room these coordinates serve as a guide for the surgeon, ensuring each patient of the utmost precision in treatment.

The technique may be combined with balloon sinuplasty in which some of the sinus openings may be enlarged by stretching them with a balloon rather than cutting tools, reducing the possibility of the opening scarring closed in the future.

Recovery is rapid, with most patients returning home a few hours after surgery and often resuming normal activities in one or two days.