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Eur Ann Otorhinolaryngol Head Neck Dis. 2019 Aug 29. pii: S1879-7296(19)30141-3. doi: 10.1016/j.anorl.2019.08.002. [Epub ahead of print]

Use of a navigation system in endonasal surgery: Impact on surgical strategy and surgeon satisfaction. A prospective multicenter study.

Author information

1
Unité de recherche clinique Lariboisière-Saint Louis, hôpital Fernand-Widal, Assistance Publique Hôpitaux de Paris, Université Paris 7, 200, rue du Faubourg Saint Denis, 75010 Paris, France.
2
Clinique de l'Atlantique, 26, rue du Moulin des Justices, 17138 Puilboreau, France.
3
Clinique du Pré, 13, avenue René-Laënnec, 72000 Le Mans, France.
4
Centre Hospitalier Universitaire, 4, rue Larrey, 49100 Angers, France.
5
Clinique Saint-Barbe, 29, rue du Faubourg National, 6700 Strasbourg, France.
6
Institut Universitaire de la Face et du Cou, 31, avenue de Valombrose, 06100 Nice, France.
7
Institut Arthur-Vernes, 36, rue d'Assas, 75006 Paris, France.
8
Hôpital privé Robert-Schuman, rue du Champ Montoy, 57070 Vantoux, France.
9
Hôpital d'Instruction des Armées Desgenettes, 108, boulevard Pinel, 69003 Lyon, France.
10
Centre Hospitalier Universitaire, 1, place Alexis-Ricordeau, 44000 Nantes, France.
11
Hôpital Robert-Debré, avenue du Général-Koenig, 51092 Reims, France.
12
Clinique du Tondu, 143, rue du Tondu, 33000 Bordeaux, France.
13
Polyclinique de Courlancy, 38, rue de Courlancy, 51100 Reims, France.
14
Centre Hospitalier, 179, avenue du Maréchal-Juin, 26000 Valence, France.
15
Centre Hospitalier Intercommunal, CHU Henri-Mondor, 40, avenue de Verdun, 94000 Créteil, France.
16
CH de Metz, Hôpital de Mercy, 1, allée du Château, 57085 Metz, France.
17
Hôpital Lariboisière, Assistance Publique - Hôpitaux de Paris, Inserm U1141, Université de Paris, 2, rue Ambroise-Paré, 75010 Paris, France. Electronic address: benjamin.verillaud@gmail.com.

Abstract

OBJECTIVES:

Surgical navigation systems (SNS) are now widely used in endoscopic endonasal surgery. Benefit, however, has not been fully studied. The objective of this study was to evaluate the impact of an SNS in terms of performance of the surgical procedure and of surgeon satisfaction, in a prospective multicenter study.

MATERIALS AND METHODS:

A multicenter prospective study included patients undergoing endoscopic endonasal surgery using the electromagnetic DigiPointeur® (DGP) SNS in 16 French hospitals. An observation form, completed by the surgeon immediately at end of procedure, included type of procedure, and any changes in strategy or extent of surgery related to use of the SNS. Surgeon satisfaction was rated on an analog scale, with self-assessment of stress experienced during the procedure.

RESULTS:

The study included 311 patients operated on by 36 surgeons in 16 French hospitals. Ethmoidectomy was the most frequent procedure (90%); tumor resection was performed in 5.1% of cases. The SNS enabled more extensive surgery in 81% of cases, in particular by identifying and opening additional cells (57% of cases). Mean satisfaction was 8.6/10; surgeons reported decreased surgical stress thanks to the SNS in 95% of cases.

CONCLUSION:

In this observational study, the use of an SNS increased the extent of surgery in 81% of cases, and had a positive impact on the stress perceived by the surgeon in 95% of cases.

KEYWORDS:

Computer-assisted surgery; Endoscopic sinus surgery; Ethmoidectomy; Frontal sinus; Image-guided navigation system; Sphenoidotomy; Surgical navigation system

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