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Image-guided sinus surgery: practical and financial experiences from a UK centre 2001–2009

Published online by Cambridge University Press:  16 October 2012

L Masterson*
Affiliation:
Department of ENT, Cambridge University Hospitals NHS Foundation Trust, UK
E Agalato
Affiliation:
Department of ENT, Dorset County Hospital NHS Foundation Trust, Dorchester, UK
C Pearson
Affiliation:
Institute of Naval Medicine, Portsmouth, UK
*
Address for correspondence: Mr L Masterson, Department of ENT, Cambridge University Hospitals NHS Foundation Trust, Hills Rd, Cambridge CB2 0QQ, UK Fax: +44 (0)207 188 1369 E-mail: [email protected]

Abstract

Background:

Image guidance surgery is an emerging technology that may allow more efficient treatment of sinus disease. This retrospective study examines National Health Service and military patients who underwent procedures using image guidance surgery during the period 2001–2009.

Methods:

Medical records were reviewed in terms of indications for surgery, incidence of major complications and need for revision following image guidance surgery. An attempt was also made to determine the cost-effectiveness of purchasing this navigational system.

Results:

A total of 132 patients underwent 147 procedures using image guidance surgery over the 8-year period. The indications for surgery ranged from severe nasal polyposis and chronic rhinosinusitis to malignant tumours in the paranasal sinus and skull base region. Average length of follow up was 17.6 months. Four patients had a major complication. Fourteen patients underwent revision surgery. The cost of providing an image guidance surgery service was estimated to be £110,000–120,000 during the study period. The economic model for the subgroup of nineteen military patients (with non-polypoid chronic rhinosinusitis) suggests that use of this technology will reduce overall costs by approximately £70,000 when compared with conventional sinus surgery.

Conclusion:

This study provides some evidence that image-guided sinus surgery is cost effective, safe and may decrease surgical revision rates.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2012

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References

1Graham, SM. Complications of sinus surgery using powered instrumentation. Operative Techniques in Otolaryngology-Head and Neck Surgery 2006;17:73–7CrossRefGoogle Scholar
2Metson, R, Gray, ST. Image-guided sinus surgery: practical considerations. Otolaryngol Clin North Am 2005;38:527–34CrossRefGoogle ScholarPubMed
3Medtronic In: http://www.medtronic.co.uk [6 December 2011]Google Scholar
4Hemmerdinger, SA, Jacobs, JB, Lebowitz, RA. Accuracy and cost analysis of image guided sinus surgery. Otolaryngol Clin North Am 2005;38:453–60CrossRefGoogle ScholarPubMed
5Department of Health. Hospital Episode Statistics: Main Operations 2005 to 2006. Leeds: The Information Centre, 2007Google Scholar
6Sillers, MJ, Lay, KF. Principles of revision functional endoscopic sinus surgery. Operative Techniques in Otolaryngology-Head and Neck Surgery 2006;17:612CrossRefGoogle Scholar
7Doshi, J, Youngs, R. Navigational systems in rhinology: should we all be using them? J Laryngol Otol 2007;121:818–21CrossRefGoogle Scholar
8Klimek, L, Mösqes, R, Schöndorff, G, Mann, W. Development of computer aided surgery for otorhinolaryngology. Comput Aided Surg 1998;3:194201CrossRefGoogle ScholarPubMed
9Labadie, RF, Davis, BM, Fitzpatrick, JM. Image guided surgery: what is the accuracy? Curr Opin Otolaryngol Head Neck Surg 2005;13:2731CrossRefGoogle ScholarPubMed
10Metson, R. Image guidance sinus surgery: lessons learned from the first 1000 cases. Otolaryngol Head Neck Surg 2003;128:813CrossRefGoogle ScholarPubMed
11Stelter, K, Andratschke, M, Leunig, A, Hagedorn, H. Computer-assisted surgery of the paranasal sinuses: technical and clinical experience with 368 patients, using the Vector Vision Compact system. J Laryngol Otol 2006;120:1026–32CrossRefGoogle ScholarPubMed
12Loehrl, TA, Toohill, RJ. Use of computer aided surgery for frontal sinus ventilation. Laryngoscope 2000;110:1962–7CrossRefGoogle ScholarPubMed
13Reardon, EJ. Navigational risks associated with sinus surgery and the clinical effects of implementing a navigational system for sinus surgery. Laryngoscope 2002;112:119CrossRefGoogle ScholarPubMed
14Fried, MP, Moharir, VM, Shin, J, Taylor-Becker, M, Morrison, P. Comparison of endoscopic sinus surgery with and without image guidance. Am J Rhinol 2002;16:193–7CrossRefGoogle ScholarPubMed
15Jiang, RS, Hsu, CY. Revision functional endoscopic sinus surgery. Ann Otol Rhinol Laryngol 2002;111:155–9CrossRefGoogle ScholarPubMed
16Dessi, P, Castro, F. Major complications of sinus surgery: a review of 1192 procedures. J Laryngol Otol 1994;108:212–15CrossRefGoogle ScholarPubMed
17King, JM, Caldarelli, DD. A review of revision functional endoscopic sinus surgery. Laryngoscope 1994;104:404–8CrossRefGoogle ScholarPubMed