Virtual Endoscopic Imaging Based on 3D-CT Data in Endoscopic Sinus Surgery Practice

Abstract

Injuries to the lamina papyracea, the ethmoid sinus roof, the optic canal, and the carotid artery are examples of severe damage caused by endoscopic sinus surgery. To conduct endoscopic sinus surgery safely and correctly, the clinician must be acquainted with the anatomy and have a clear image of the paranasal sinus. We constructed virtual endoscopic imaging for endscopic sinus surgery using 3 dimensional imaging based on multislice CT scan data. In the reconstructed virtual endoscopic image, soft tissue density was indistinct and we could not demonstrate the anatomical details of the ethmoid sinus. In bone tissue density reconstruction, we could demonstrate the general ethmoid sinus structure, but defects occurred in bone imaging of the lamina papyracea and the ethmoid sinus roof, so we could not demonstrate the location of points that must not be injured. Imaging in which the lamina papyracea and the ethmoid sinus roof were rendered in color were thought to be the most valuable, since the location of the lamina papyracea and the ethmoid sinus roof could be determined. In some cases, the optic canal and the carotid artery could be discerned, but even under these conditions, we could not distinguish anatomical details of the ethmoid sinus due to inherent limitations in multislice CT scan data.