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Computer or not? Use of image guidance during endoscopic sinus surgery for chronic rhinosinusitis at St Paul's Hospital, Vancouver, and meta-analysis

Published online by Cambridge University Press:  12 March 2013

V S Sunkaraneni ,
D Yeh ,
H Qian  and
A R Javer
V S Sunkaraneni*
Affiliation:
St Paul's Sinus Centre, St Paul's Hospital, Vancouver, British Columbia, Canada
D Yeh
Affiliation:
Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
H Qian
Affiliation:
Centre for Health Evaluation and Outcomes Sciences, St Paul's Hospital, Vancouver, British Columbia, Canada
A R Javer
Affiliation:
St Paul's Sinus Centre, St Paul's Hospital, Vancouver, British Columbia, Canada
*
Address for correspondence: Mr V S Sunkaraneni, Consultant Rhinologist/Skullbase Surgeon, ENT Department, Royal Surrey County Hospital, Egerton Rd, Guildford GU2 7XX, UK E-mail: [email protected]
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Abstract

Background:

The advantages and limitations of image guidance systems for endoscopic sinus surgery are unclear. We report our experience and present a meta-analysis of the evidence.

Methods:

We performed a retrospective analysis of endoscopic sinus surgery procedures performed with versus without image guidance. A total of 355 cases was included. Primary outcomes included complication rates and time to revision surgery. A literature search was conducted to enable identification and analysis of studies of similar comparisons.

Results:

Within 1.5 years of the index sinus surgical procedure, the risk of revision surgery was significantly higher for patients treated with non-assisted versus computer-assisted endoscopic sinus surgery (p = 0.001). Meta-analysis did not indicate a reduction in complications or revision surgery procedures with the use of image guidance systems, although the majority of included studies showed a non-significant reduction in revision surgery.

Conclusion:

Our study offers some evidence that computer-assisted endoscopic sinus surgery may delay residual disease and reduce the requirement for revision surgery. Although this finding was not borne out in the meta-analysis, the majority of identified studies demonstrated a trend towards fewer revision procedures after computer-assisted endoscopic sinus surgery. This type of surgery may offer other advantages that are not easily measurable.

Keywords

EndoscopySinusitisTechnologyReviewSystematicComplications
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 4 , April 2013 , pp. 368 - 377
Copyright
Copyright © JLO (1984) Limited 2013

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Footnotes

Presented at the Combined Otolaryngological Spring Meeting 2011, 27 April to 1 May 1 2011, Chicago, Illinois, USA

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