The picture in the right lower quadrant demonstrates the balloon inflating within a sinus drainage pathway. This action occurs while the surgeon is watching through a telescope with the image on a TV screen. The inflation process provides improved drainage from a blocked sinus cavity by widening the drainage pathway. Balloon treatment is not appropriate for all blocked sinuses and can be used with traditional surgical instruments in combination.
This short video displays how a balloon can expand the connection of a blocked sinus cavity into the nose. We can clearly see the balloon expand and displace the surrounding bone to provide a wider communication. This instrument or technique is not appropriate for all blocked sinuses. It can be utilized with or without traditional sinus surgical instruments.
Revision Left Sided Sinus Procedure with Computer Assistance and a Shaver Instrument
Surgical shaver device can be seen moving within the left sided sinus cavities as the Cat Scan images on the upper two sections of the screes and the lower left move within the cat scan images as well. This movement on the cat scan tracks the instantaneous location of the tip of the surgical shaver. The intersection of the vertical and horizontal yellow lines on the cat scan designates the location of the tip of the shaver.
Endoscopic View of Left Nasal Cavity in a Patient with Previous Sinus Surgery
This view demonstrates the anatomy of the left sided sinus after a previous surgical procedure to remove a tumor. This patient developed persistent sinusitis many years after the first procedure. The viewer can see the injection taking place into the sinus site. The patient is asleep but we still use anesthesia medicine with epinephrine mixed in to diminish bleeding during the procedure.
Computerized Sinus Surgery Demonstrating Shaver Removing a Benign Nasal Tumor
This video demonstrates a shaver, which is a surgical tool, removing a benign nasal tumor from the right sided sinuses. Computerized sinus surgery is being utilized so that the location of the tip of the surgical instrument is constantly updated on the cat scan as the location of the intersection of the vertical and horizontal yellow lines changes location. Therefore the surgeon has instant feedback concerning the location of the instrument in relation to surrounding structures.
Computer Assisted Sinus Surgery with a Surgical Shaver
This video displays a surgical tool called a shaver in the left nasal cavity which is gently removing tissue and thin bone from the sinus passages to open blocked sinuses. The image, on the lower right, is recorded off a TV screen, while the other 3 images are the patients cat scan. The tip of the surgical tool is noted on the cat scan images at the intersection of the vertical and horizontal green lines. As the tip of the shaver moves in the nasal cavity so does the green lines constantly updating the surgeon on the location of the surgical tool. This information provides additional feed back to the surgeon concerning the location of the tool. This instantaneous feedback, in combination with the surgeons skill and judgement , provides added safety.
Left Nasal Polyp
The telescope is entering the left nasal cavity and the camera attached to the telescope is transferring the image or view to a TV screen. This recording is taken from the TV image. The surgeon uses the TV view to evaluate the problem in the office. This same view can be used in the operating room and can be combined with image guidance which is demonstrated in the other videos. The large polyp noted in the video is in the left nasal airway and is glistening and graying in color compared to the more reddish or pinkish nasal tissues. The later portion of the video shows the polyp in back of the nose. Since the back of the nose is a large common space we can see the polyp on the right side as well extending from the left side.
Computer Assisted or Image Guided Sinus Surgery
The upper left and upper right as well as the lower left picture are a typical ct scan of a patient in 3 different views while the lower right is the telescopic video picture of the left nasal cavity of the same patient. As the tip of the instrument in the video picture is moving so is the intersection of the horizontal and vertical green lines in the 3 cat scan images of the patient. The location of the tip of the surgical instrument is displayed on the cat scan views and moves with the instrument. This provides instant feedback to the surgeon as to the location of various instruments in relation to the sinus structure.