Image-Guided Surgery in the Paranasal Sinus and Skull Base Lesion

Kim, Kag; Lim, Sang Chul

Abstract

BACKGROUND AND OBJECTIVES
Endoscopic paranasal sinus surgery is effective for the treatment of paranasal sinus lesion and reduction of invasiveness enabling the surgeon to perform precise procedures with minimal tissue traumatization. But, some studies showed that there was a risk of invasive management and major complications occurring in 0.5% to 1% of all procedures. The aim of this study was to assess the usefulness and effectiveness of image-guided endoscopic surgery in reducing the complication and treating the disease suitably.
SUBJECTS AND METHOD
The image-guided paranasal sinus surgery was performed in 12 patients from 2000 to 2005 who had difficulty in endoscopic surgery for the diagnosis and treatment of the inaccessible location such as skull base, sphenoid and clivus, infratemporal fossa etc. and the uncertain lesion such as severe distorted lesion due to previous sinus operation, congenitally underdeveloped anatomic lesion, nearby vital organ-lesion and submucosal lesion in our experiences. We retrospectively reviewed radiologic evaluations and medical records in our patients.
RESULTS
We included 6 oncogenic lesions such as craniopharyngioma, chordoma in clivus and sphenoid sinus, 5 infectious lesions such as invasive aspergillosis and 1 cystic lesion. The accuracy we could achieve varied between 0.9 and 2.0 mm. CSF rhinorrhea occurred in 2 cases after management. But, only one case was not only related to image-guided surgery but also resolved spontaneously.
CONCLUSION
Image-guided endoscopic surgery is a safe and effective tool in paranasal sinus and skull base lesion for maximizing surgical results and limiting complications.