ナビゲーションシステムを利用した術後性上顎嚢胞開放術

抄録

We have used a navigation system to identify location of cysts in paranasal surgery. Usually a navigation system is employed in neurosurgery via a neuronavigator, which allows the surgical site to be visualized in real time by CT or MRI images.
By using this system, we can approach the surgical site more safely and accurately.
The cyst location in nasal cavity must be identified. However, some cysts are difficult to identify by endoscopy only because they do not show a bulged cyst wall. We regard these cases as good indications for the navigation system.
Our device, EVANS (TOMIKI Medical Instrument Corporation) has mechanical arm system. To date, we have used this system in six patients with paranasal cyst. All patients are confirmed post operative maxillary cysts. In all cases, we could navigate the cyst accurately, and open. To avoid risk areas in the nasal cavity, especially in revision surgery, we have used this system with an accuracy of about 2mm as a guide through the critical points of sinuses such as the orbital wall, ethomoid tegmen, and optic canal. Based on our experience, this navigation system has the potential to make operations more accurate and safely, and particulary in improving the surgeon's confidence in endoscopic paranasal cyst surgery.