COMPUTER-AIDED SURGERY FOR FRONTAL MUCOCELE
We evaluated the treatment of frontal mucocele using a computer-aided endoscopic approach. The 21 subjects involved 27 sides operated on. Using an electromagnetic tracking (InstaTrakTM Visualization Technology) and an optical tracking (LandmarX Xomed), we accurately identified mucocele position, ran...
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| Published in | JIBI INKOKA TEMBO Vol. 45; no. 5; pp. 355 - 361 |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
Society of Oto-rhino-laryngology Tokyo
2002
耳鼻咽喉科展望会 |
| Subjects | |
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| ISSN | 0386-9687 1883-6429 |
| DOI | 10.11453/orltokyo1958.45.355 |
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| Abstract | We evaluated the treatment of frontal mucocele using a computer-aided endoscopic approach. The 21 subjects involved 27 sides operated on. Using an electromagnetic tracking (InstaTrakTM Visualization Technology) and an optical tracking (LandmarX Xomed), we accurately identified mucocele position, range, the site to be opened, and risk areas. Except of 1 case of cerebrospinal fluid leakage, no complications occurred, and surgery was safe, especially in the following situations : 1) previous surgery with anatomical distortion and no landmarks in the nasal cavity, 2) frontal sinus cyst with bony wall formation, 3) laterally located cysts, and 4) multiple cysts. The computer-aided system was useful and valuable. In follow-up from 5 months to 42 months, 18 (66.7%) sides had a large patency. Compared to previous studies, we consider results good. Bone exposure during surgery was, however, related to a poor postoperative result, as we observed in 9 (33%) sides with restenosis and obstruction of the opened ostium. |
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| AbstractList | We evaluated the treatment of frontal mucocele using a computer-aided endoscopic approach. The 21 subjects involved 27 sides operated on. Using an electromagnetic tracking (InstaTrakTM Visualization Technology) and an optical tracking (LandmarX Xomed), we accurately identified mucocele position, range, the site to be opened, and risk areas. Except of 1 case of cerebrospinal fluid leakage, no complications occurred, and surgery was safe, especially in the following situations : 1) previous surgery with anatomical distortion and no landmarks in the nasal cavity, 2) frontal sinus cyst with bony wall formation, 3) laterally located cysts, and 4) multiple cysts. The computer-aided system was useful and valuable. In follow-up from 5 months to 42 months, 18 (66.7%) sides had a large patency. Compared to previous studies, we consider results good. Bone exposure during surgery was, however, related to a poor postoperative result, as we observed in 9 (33%) sides with restenosis and obstruction of the opened ostium. We evaluated the treatment of frontal mucocele using a computer-aided endoscopic approach.The 21 subjects involved 27 sides operated on. Using an electromagnetic tracking (InstaTrakTM Visualization Technology) and an optical tracking (LandmarX Xomed), we accurately identified mucocele position, range, the site to be opened, and risk areas. Except of 1 case of cerebrospinal fluid leakage, no complications occurred, and surgery was safe, especially in the following situations : 1) previous surgery with anatomical distortion and no landmarks in the nasal cavity, 2) frontal sinus cyst with bony wall formation, 3) laterally located cysts, and 4) multiple cysts. The computer-aided system was useful and valuable. In follow-up from 5 months to 42 months, 18 (66.7%) sides had a large patency. Compared to previous studies, we consider results good. Bone exposure during surgery was, however, related to a poor postoperative result, as we observed in 9 (33%) sides with restenosis and obstruction of the opened ostium. 前頭洞嚢胞に対する経鼻的な交通路作製にナビゲーションシステムを導入し, その有効性について検討した。前頭洞嚢胞21例27側全例に磁気式ナビゲーションシステムInsta TrakTM (米国Visualiza-tion Technology社製), 光学式ナビゲーションシステムのLandmarX (米国XOMED社製) を導入し, 嚢胞の位置, 範囲および鼻腔への開放部位が周辺の危険部位とともに的確に確認された。術中, 硬膜損傷 (髄液漏) 1例の合併症を生じたが, その他の症例では手術操作を安全かつ円滑に施行できた。特に, 1) 既往の手術により鼻腔形態が変貌している症例, 2) 前頭洞 (嚢胞壁) が骨性に閉鎖している症例, 3) 外側に位置する前頭洞嚢胞, 4) 多胞性嚢胞などではナビゲーションが威力を発揮した。術後経過として5ヵ月-3年6ヵ月の期間で18側 (66.7%) に良好な開存を維持しており, 以前の報告に比べ開放が十分に行われたため手術成積の向上が認められた。しかし, 術後交通路の閉鎖あるいは狭窄した症例が全体の9側 (33.3%) に存在し, とくに骨性閉鎖例に対し骨を削開した症例などでは術後経過が不良であった。 |
| Author | Nakanishi, Marcio Otori, Nobuyoshi Haruna, Shin-ichi Moriyama, Hiroshi Wada, Kota |
| Author_FL | 森山 寛 春名 眞一 和田 弘太 マルシオ 中西 鴻 信義 |
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| References | 12) 鴻信義, 吉川衛, 春名眞一, 森山寛 : ナビゲーションシステムを利用した内視鏡下鼻内手術.日耳鼻 103 : 1-6, 2000. 17) 柳清 : 慢性副鼻腔炎に対する内視鏡下鼻内手術後の予後に関する研究-上顎洞粘膜の組織像と内視鏡所見から.耳展41 : 15-37, 1998. 14) Fried MP, Kleefield J, Gopal H : Image-guided endoscopic surgery. Laryngoscope 107 : 594-601, 1997. 16) 月舘利治, 柳清, 飯田誠, 森山寛 : 前頭洞嚢胞に対する手術法の検討とその予後.耳展41 : 609-619, 1998. 4) 森山寛 : 内視鏡下鼻内副鼻腔手術一進歩と定着耳喉頭頸 68 : 287-298, 1996. 9) Andreas RG, Wolfgang F, Walter FT : Computer-assited surgery in the frontal and maxillary sinus. Larygoscope 107 : 631-633, 1997. 13) 鴻信義, 春名眞一, 森山寛 : ナビゲーションシステムを利用した内視鏡下前頭洞嚢胞開放術.耳展44 : 42-45, 2001. 3) Moriyama H, Fukami M, Yanagi K, Otori N : Endoscopic endonasal treatment of ostium of the frontal sinus and results of endoscopic surgery. Am J Rhinol 8 : 67-68, 1994. 11) 鴻信義, 春名眞一, 森山寛 : ESSにおけるナビゲーションシステムの利用.JOHNS 16 : 52-56, 2000. 7) Zinreich SJ, Tebo SA, Long DM, Brem H, Mattox DE, et al : Frameless stereotaxic integration of CT imaging data. Radiology 188 : 735-742, 1993. 6) 春名眞一, 鴻信義, 森山寛 : 下垂体腫瘍に対する篩骨洞・蝶形骨洞経由内視鏡手術の有用性.日耳鼻 103 : 789-795, 2000. 8) Citardi MJ : Computer-aided frontal sinus surgery. Otolaryngol Clin North Am 34 : 110-122, 2001. 10) 友田幸一, 村田英之, 下出祐造, 本城史郎, 石政寛, 他 : 耳鼻咽喉科頭頸部外科におけるナビゲーション手術.耳展 41 : 502-507, 1998. 5) Moriyama H : Are there still indications for primary external approaches for frontal sinusitis? ERS ISIAN, 1998. 1) 荻野朝市 : 余の骨形成前頭洞手術法.耳鼻咽喉科28 : 968-980, 1956. 2) 吉田智子, 湯川尚哉, 川村繁樹, 久保伸夫, 山下敏夫 : 前頭洞手術へのナビゲーションの応用.耳展43 : 444-446, 2000. 15) 友田幸一, 村田英之, 宮澤徹 : 鼻副鼻腔領域のナビゲーション手術の現状.日鼻誌 40 : 69-71, 2001. |
| References_xml | – reference: 3) Moriyama H, Fukami M, Yanagi K, Otori N : Endoscopic endonasal treatment of ostium of the frontal sinus and results of endoscopic surgery. Am J Rhinol 8 : 67-68, 1994. – reference: 12) 鴻信義, 吉川衛, 春名眞一, 森山寛 : ナビゲーションシステムを利用した内視鏡下鼻内手術.日耳鼻 103 : 1-6, 2000. – reference: 6) 春名眞一, 鴻信義, 森山寛 : 下垂体腫瘍に対する篩骨洞・蝶形骨洞経由内視鏡手術の有用性.日耳鼻 103 : 789-795, 2000. – reference: 9) Andreas RG, Wolfgang F, Walter FT : Computer-assited surgery in the frontal and maxillary sinus. Larygoscope 107 : 631-633, 1997. – reference: 1) 荻野朝市 : 余の骨形成前頭洞手術法.耳鼻咽喉科28 : 968-980, 1956. – reference: 5) Moriyama H : Are there still indications for primary external approaches for frontal sinusitis? ERS ISIAN, 1998. – reference: 10) 友田幸一, 村田英之, 下出祐造, 本城史郎, 石政寛, 他 : 耳鼻咽喉科頭頸部外科におけるナビゲーション手術.耳展 41 : 502-507, 1998. – reference: 11) 鴻信義, 春名眞一, 森山寛 : ESSにおけるナビゲーションシステムの利用.JOHNS 16 : 52-56, 2000. – reference: 14) Fried MP, Kleefield J, Gopal H : Image-guided endoscopic surgery. Laryngoscope 107 : 594-601, 1997. – reference: 17) 柳清 : 慢性副鼻腔炎に対する内視鏡下鼻内手術後の予後に関する研究-上顎洞粘膜の組織像と内視鏡所見から.耳展41 : 15-37, 1998. – reference: 16) 月舘利治, 柳清, 飯田誠, 森山寛 : 前頭洞嚢胞に対する手術法の検討とその予後.耳展41 : 609-619, 1998. – reference: 8) Citardi MJ : Computer-aided frontal sinus surgery. Otolaryngol Clin North Am 34 : 110-122, 2001. – reference: 4) 森山寛 : 内視鏡下鼻内副鼻腔手術一進歩と定着耳喉頭頸 68 : 287-298, 1996. – reference: 2) 吉田智子, 湯川尚哉, 川村繁樹, 久保伸夫, 山下敏夫 : 前頭洞手術へのナビゲーションの応用.耳展43 : 444-446, 2000. – reference: 7) Zinreich SJ, Tebo SA, Long DM, Brem H, Mattox DE, et al : Frameless stereotaxic integration of CT imaging data. Radiology 188 : 735-742, 1993. – reference: 13) 鴻信義, 春名眞一, 森山寛 : ナビゲーションシステムを利用した内視鏡下前頭洞嚢胞開放術.耳展44 : 42-45, 2001. – reference: 15) 友田幸一, 村田英之, 宮澤徹 : 鼻副鼻腔領域のナビゲーション手術の現状.日鼻誌 40 : 69-71, 2001. |
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| Snippet | We evaluated the treatment of frontal mucocele using a computer-aided endoscopic approach. The 21 subjects involved 27 sides operated on. Using an... We evaluated the treatment of frontal mucocele using a computer-aided endoscopic approach.The 21 subjects involved 27 sides operated on. Using an... |
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| SubjectTerms | computer-aided endoscopic sinus surgery frontal mucocele ナビゲーション 内視鏡下鼻内副鼻腔手術 前頭洞嚢胞 鼻外前頭洞手術 |
| Title | COMPUTER-AIDED SURGERY FOR FRONTAL MUCOCELE |
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