Stereotactic Image Guided Sinus Surgery

For complex or revision sinus surgery, there is a three-dimensional mapping system that can be used during surgery. This allows the surgeon another tool to let him verify where he is inside the sinuses at any time. Stereotactic Image Guided Sinus Surgery combines a previous computed tomography (CT) scan and real-time information about the exact position of surgical instruments. Infrared signals help map the facial structures which are compared to the known CAT scan to provide a near perfect match. This allows the surgeon to more accurately navigate instruments through complex sinus passages to allow more precise intranasal localization of surgical instruments.

Dr. Bennett can see the CT scan in three dimensions while viewing the sinus structures through a camera on a large LCD monitor. The tip of the instrument is seen as a point on the CT scan in 3-dimensions. Concurrently, a camera shows real-time intranasal anatomy and progression of the surgery. The additional knowledge of location can allow for a more effective surgery in selected patients.

BrainLAB® Stereotactic Imaging Equipment

Stereotactic Image Guided Sinus Surgery

Dr. Bennett receives a three dimensional scan on CD with every patient’s CT scan, saving you the time and expense of obtaining a separate scan later. The CD is covered by insurance at no additional charge. Most sinus CAT scans require pre-certification. Dr. Bennett’s staff will usually be able to not only pre-certify your sinus CT scan while you are at your office visit, we can also schedule your CT scan on the same visit at an imaging center less than a block away from our office.

Not all sinus surgeries require stereotactic image guidance. Image guidance is best used for surgery on the frontal sinuses, sphenoid sinuses, nasal polyps, or revision sinus surgery:

1. Frontal sinuses may have complicated entrances with the entrance located adjacent to the eyes and brain.

2. Sphenoid sinuses are bordered by the brain, the carotid artery and multiple important nerves including for the eyes.

3. Nasal polyps can obscure or remodel existing anatomy. Stereotactic Image Guided Sinus Surgery can be used to prevent disorientation when normal anatomy is difficult to determine.

4. Revision sinus surgery may have normal anatomy removed and additional localization can be valuable.

Image Guided Surgery Case #1

This 53 year old female suffered from severe nasal polyps for 10 years. She was unable to breathe from the left side of her nose and slept very poorly. Her polyps pushed the septum to the right and extended from the nostril on the left. Stereotactic Image Guided Sinus Surgery was used to remove polyps from all of her sinuses. In the week following surgery, the patient’s breathing had significantly improved. She also reported a significant boost in her energy level.

Stereotactic image guided sinus surgery with removal of nasal polyps in the left sphenoid sinus. Clockwise from top left: Live video of the nose interior; axial (top of head) view of patient’s CT scan; coronal (front of head) view of patient’s CT scan; sagittal (side of head) view of patient’s CT scan.

Image Guided Surgery Case #2

This 27 year old male had had 4 previous sinus surgeries. He continued to have yellow nasal discharge on his left side. A nasal endoscopy and review of his CT scan showed that he had an isolated frontal sinus infection. Stereotactic Image Guided Sinus Surgery was used to open the sinus and cure his sinusitis.

Stereotactic Image Guided Sinus Surgery showing left frontal sinus open after removal of infected cell.

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Meet Dr. Garrett Bennett

Learn more about New York City's double board certified Sinus and Nasal Surgery Expert. 

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