Head north-west, drive straight ahead and turn left into the mouth of the frontal sinus....

Endoscopic surgical techniques combined with modern imaging studies have revolutionised surgical methods for sinus surgery. The introduction of CHNO, which combines the advantages of endoscopic techniques and imaging studies, has made it possible to obtain a three-dimensional, three-plane anatomical orientation in the surgical field. In ENT, there are several structures that are often difficult to reach.

The anatomy of the sinuses and its individual variability can often be a challenge for the surgeon. Navigation has been used especially in frontal sinus surgery, orbital surgery, wedge sinus surgery, tumours of the base of the anterior cranial fossa with significant destruction of surrounding structures, especially around the course of the internal carotid artery or optic nerves.

All these anatomical structures are characterised by difficult surgical access, which is why the navigation system comes to the rescue. Difficult access is not the only problem. Direct proximity to important nerves, vessels or ganglia significantly increases the difficulty of surgery and the risk of serious complications, e.g. damage to the angular artery during sinus surgery. Damage to these elements can cause massive haemorrhage, paralysis or denervation of various facial regions.

What are the benefits of navigated surgery?

For a patient, the decision to undergo any procedure, even one that the surgeon has described as 'minimally invasive' or 'routine', is a difficult one. This is why laparoscopic procedures are easier for us to accept than classic surgery. However, before every operation, the surgical plan. If it tells the patient that the procedure will be supported by modern technology that will minimise the occurrence of complications it will make the decision much easier. In medicine today, the aim is to increase the safety of medical procedures, reduce complications but also patient comfort, especially after surgery.

It is logical that the less tissue traumatisation during surgery, the quicker the patient's return to full function. During surgery, it is difficult to achieve maximum selectivity so as to remove only the diseased cells. However, the use of endoscopic techniques, especially using the described navigation, makes it possible to significantly reduce damage to the adjacent lesion area. Saving the structures unaffected by the lesions significantly reduces the recovery time.

photo: shutterstock

The availability of this method is increasing in Poland, but it is nevertheless more popular in Western countries. The still low prevalence of image-guided surgery in our country is certainly related to the cost of the equipment but also the lack of well-trained operators. Appropriate training is usually available abroad.