Impact of Image Guidance on Complications During Osteoplastic Frontal Sinus Surgery

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Abstract
OBJECTIVES: To evaluate the impact of image-guidance technology on intraoperative complications during frontal sinus obliteration surgery. STUDY DESIGN AND SETTING: Retrospective case control. Twenty-four patients underwent frontal sinus obliteration with image-guidance technology (n = 15) or conventional instrumentation (n = 9) between 1992 and 2003. The image-guidance system was used to delineate the frontal sinus perimeter and direct cuts through the frontal bone. RESULTS: Intraoperative complications occurred in none of the patients in the image-guidance group and in 3 patients in the control group (P = 0.042). Adverse events included dural tear with CSF leak in 2 patients and exposure of orbital fat in 1 patient. The incidence of postoperative complications was similar between groups (P = 0.326). No patients required revision surgery. Mean follow-up was 5.2 years. CONCLUSIONS: The use of surgical navigation during frontal sinus obliteration appears to improve intraoperative safety. SIGNIFICANCE: This is the first report to document a reduction in the rate of intraoperative complications when image guidance is utilized for frontal sinus surgery.