Simion J. Zinreich
Professor, Johns Hopkins University, USA
Title: Static and dynamic application of Multiâ€Planar Reconstructed (MPR), and 3D CT images to improve image guidance for FESS, based on lamellae landmarks
Biography
Biography: Simion J. Zinreich
Abstract
For 3 decades, Coronal sinus CT along with MPR reconstructions/ displays have guided surgeons performing Functional endoscopic Sinus Surgery (FESS) in their procedures.
Image guided surgery (IGS) has improved the familiarity of the surgeon with the surgical field and correlation between the regional morphology and the imaging information.
Unfortunately, image guidance is not always or universally available. For these situations, it is our aim to provide the FESS surgeons more dynamic use of the imaging information to guide their surgical approach in a systematic and safe manner, using landmarks they are already familiar with.
Teaching Points:
• The Surgical approach for FESS is systematic, as it progressively follows sequential surgical steps and landmarks, based on the four lamellae from anterior to posterior:
• Uncinate process
• Ethmoidal bulla
• Basal lamella
• Superior turbinate.
The aim of this communication is to highlight the CT evaluation of the structures related to each of these 4 lamellae, and the important role that dynamic multiplanar reformatting can play.
Imaging evaluation will specifically focus on the structures involved in the performance of the 4 steps of the surgery, namely Uncinectomy, anterior and posterior ethmoidectomy, sphenoidotomy and frontal sinusotomy.