Dr. Sterling performs endoscopic sinus surgical procedures with the aid of endoscopes and cameras to magnify and illuminate the nasal and sinus tissue. Surrounding the sinuses are organs that are vital to a person’s health and wellbeing. The most important structures surrounding the sinuses are the eyes, the tear ducts, the optic nerves (nerves of vision), the brain, and carotid arteries (the vessels carrying the main blood supply to the brain). While years of training, knowledge of anatomy, and skill are vital to an understanding of anatomy, a tool known as image-guidance allows Dr. Sterling to know almost precisely where any given structure is within and surrounding the nose and sinuses, compared to where the instrument is, at any given point during surgery.
The term “image-guidance” refers to the use of a probe or instrument, which is generally placed within the nose, that is tracked by a machine as that probe moves through the nose and sinuses. A computer, which is either physically or remotely attached to that probe, provides Dr. Sterling with a map of the nose and sinuses. This map is provided by a CT scan or an MRI, which is performed prior to your surgery. This CT scan or MRI is commonly referred to as an “image-guidance scan.”
In some respects, image-guidance is similar to a GPS system, constantly calculating the position of the probe within a patient’s nose and sinuses and displaying that location on a “3-dimensional” layout of the sinuses provided by the patient’s own CT scan or MRI. This is most helpful when Dr. Sterling is operating very close to those very important structures surrounding the sinuses mentioned above, when patients have had surgery in the past which has changed their normal anatomy and thus taken away some of the usual landmarks surgeons use to know where they are in the sinuses, or when tumors or infections have changed the normal anatomy so as to remove those landmarks as well.
The advantages of such systems are obvious: they can help Dr. Sterling know the precise anatomy of each patient’s nose and sinuses (even if prior surgery or tumors/infections/inflammation have changed the normal anatomy) and help him identify important landmarks during surgery.
Image-guided surgery has been a tremendous advance in the field of endoscopic sinus and tumor surgery. The overwhelming agreement among experts in the field is that image-guidance makes some surgical procedures safer and more complete. You will have to discuss with Dr. Sterling whether you would be a candidate for image-guided surgery during your surgical procedure, as not all endoscopic procedures require this technology.