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Science articles
Science articlesUse of intraoperative navigation in endoscopic surgery of benign fibro-osseous lesions of paranasal sinuses and skull base
V. A. Doronina (1), E. V. Shelesko (1), N. A. Chernikova (1), A. I. Batalov (1), I. N. Pronin (1), M. V. Nersesyan (2), Yu. V. Strunina (1), D. N. Zinkevich (1)
(1) Burdenko National Medical Research Center for Neurosurgery, Moscow, 125047, Russia, (2) Ilyinsky Hospital, Glukhovo, 143421, Russia
UDK: УДК 616.22-216+616.14.3-006.34.03-089-072.1
DOI: https://doi.org/10.18692/1810-4800-2022-5-8-18
ABSTRACT
Objective. Evaluation of the effectiveness and safety of the use of electromagnetic computer navigation in endoscopic surgery of benign fibro-osseous mass of the paranasal sinuses and skull base. Materials and methods. The retrospective study included 21 patients who underwent endoscopic removal of fibro-osseous mass of paranasal sinuses and skull base at the Burdenko Center from 2010 to 2021. The patients were divided into 2 groups: the 1st group included 10 patients with the use of electromagnetic navigation intraoperatively, the 2nd group included 11 patients who were treated without the use of navigation. Median follow-up was 24 months [IQR 12,00, 48,00]. Results. Most often, patients complained of headache (15; 71,4%). In 14 (66,7%) cases, the ethmoid labyrinth was involved; in 11 (52,3%) cases, the sphenoid sinus; in 15 (71,4%) cases, the base of the skull, with intracranial distribution in 5 (23,8%) cases; and in 8 (38%) cases, the wall of the orbit. Surgical treatment was performed radically in 10 (47,6%) patients. The median intraoperative blood loss was 100.00 mL. Intraoperative complications occurred in 3 (14,3%) patients; postoperative complications, in 2 (9,5%) patients. Pathology recurrence occurred in 4 (19,0%) patients, more often in young people (median age 19,50, р = 0,179). The median duration of hospital stay was 3,00 bed-days. It was found that the localization of pathology in the sphenoid sinus is associated with an increased risk of nonradical removal of the formation (р = 0.009). Factors that could influence the choice of the surgeon in favor of intraoperative navigation include visual impairment in the clinical picture of the disease (p = 0,090) or the absence of difficulty in nasal breathing (p = 0.024); localization of the mass only in the sphenoid sinus (p = 0,063) or with involvement of the base of the skull (p = 0.149). The use of intraoperative navigation slightly increases the radicalness of surgical treatment and reduces the incidence of perioperative complications.
Publication date:
18.09.2022
Keywords:
fibrous dysplasia, ossifying fibroma, aneurysmal bone cyst, osteoma, electromagnetic navigation, endoscopic surgery. For citation:
Doronina V. A., Shelesko E. V., Chernikova N. A., Batalov A. I., Pronin I. N., Nersesyan M. V., Strunina Yu. V., Zinkevich D. N. Use of intraoperative navigation in endoscopic surgery of benign fibro-osseous lesions of paranasal sinuses and skull base. Rossiiskaya otorinolaringologiya. 2022;21(5):8-18. https://doi.org/10.18692/1810-4800-2022-5-8-18