WIML

The Polish Journal of Aviation Medicine, Bioengineering and Psychology

Kwartalnik Polskiego Towarzystwa Medycyny Lotniczej

2020, Volume 26, Issue 2

OWN EXPERIENCES IN THE APPLICATION OF INTRAOPERATIVE 3D SPATIAL IMAGING IN THE ENDOSCOPIC SURGERY OF THE PARANASAL SINUSES


ANDRZEJ WOJDAS1, ROMAN STABLEWSKI1
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1Department of Otolaryngology, Military Institute of Aviation Medicine


Autor korenspondencyjny: ANDRZEJ WOJDAS; Department of Otolaryngology, Military Institute of Aviation Medicine; email: awojdas@wiml.waw.pl



Streszczenie

Introduction: Intraoperative spatial imaging with the use of a high-resolution 3D camera is the most modern technique used in endoscopic surgery of the paranasal sinuses. It enables the operator to better visualise the surgical field, improves depth perception and facilitates tissue identification. All 3D endoscopy options are still under review. The aim of the study is to compare analogous endoscopic operations performed with the 3D technique and operations performed with the traditional 2D technique, based on the analysis of the time of the operation, blood loss, the occurrence of intraoperative complications and the length of stay in the hospital.

Material: The material included 346 patients who underwent endoscopic surgery of the paranasal sinuses with unilateral or bilateral opening of the paranasal sinuses. In addition, 152 patients underwent correction of the nasal septum. Patients were divided into two groups (group 2D and group 3D) of 173 patients, who had the opening of the paranasal sinuses with the use of endoscopic two-dimensional and three-dimensional visualization. Each group was divided into four subgroups: the first were patients after bilateral paranasal sinus surgery (BPSS), the second were patients after bilateral endoscopic surgery of the paranasal sinuses and nasal septum correction (BPSS + S), the third were patients after unilateral surgery of the paranasal sinuses (UPSS), and the fourth group of patients after unilateral endoscopic surgery of the paranasal sinuses and correction of the nasal septum (UPSS + S).

Methods: A TipCam 3D endoscope by Storz, Germany, 18 mm in diameter, 4 mm in diameter, with 30° optics, with a built-in camera capable of transmitting and classic 2D endoscopes 16 mm in length, 4 mm in diameter and 30° optics with a vision track and set was used for the operation. tools. The patients underwent unilateral or bilateral endoscopic surgery with the opening of the maxillary, frontal, anterior and posterior sinuses, and correction of the nasal septum.

Results: Surgery times in the 2D group were as follows: group 2D / BPSS + S - 107 min. (± 22); group 2D / BPSS - 95 min (± 24); ); group 2D / UPSS + S - 68 min (± 21); group 2D / UPSS - 53 min (± 14); Surgery times in the 3D group were as follows: group 3D / BPSS + S - 91 min. (± 17); 3D / BPSS group - 83 min (± 20); ); group 3D / UPSS + S - 68 min (± 21); group 2D / UPSS - 49 min (± 1);
The complications included: early and late postoperative bleeding, eyelid or orbital hematomas, eyelid edema. There were 17 complications (0.85%) in the 2D group and 7 complications (0.41%) in the 3D group.

Conclusions: It was found that 3D endoscopic surgery significantly shortened the operation time, especially in large bilateral paranasal sinus surgeries, and contributed to a decrease in perioperative complications. 3D endoscopic operations had no significant effect on the amount of blood loss and the length of the patient's stay at the clinic.


Słowa kluczowe

chronic sinusitis, endoscopic surgery of the paranasal sinuses, intraoperative 3D imaging