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Head and neck
Published in David A Lisle, Imaging for Students, 2012
Chronic sinusitis is defined as sinus inflammation of over 12 weeks’ duration. Clinical presentation may include facial pain, nasal obstruction and reduced sense of smell. Chronic sinusitis may be bacterial, allergic or fungal. Functional endoscopic sinus surgery (FESS) is used to treat cases that do not respond to medical therapy. Imaging is performed to quantitate disease and to define relevant underlying anatomical anomalies that may restrict sinus drainage, as well as to assist in presurgical planning and postoperative follow-up. CT is the investigation of choice. The key images in assessing chronic sinusitis and planning FESS are coronal CT scans of the osteomeatal unit, i.e. the region of the drainage pathways of the maxillary, frontal and anterior ethmoid sinuses (Fig. 11.8).
Virtual reality based hybrid simulation for functional endoscopic sinus surgery
Published in IISE Transactions on Healthcare Systems Engineering, 2020
Saurabh Jain, Seunghan Lee, Samuel R. Barber, Eugene H. Chang, Young-Jun Son
Recently, the use of Virtual Reality (VR) technology has been widely adopted throughout training systems in different applications including healthcare. With recent advances in VR technology, virtual simulation training can provide a realistic and immersive environment with haptic feedback. Relevant studies show that the use of immersive VR is growing in training programs at an annual rate of 30%, while it is also increasingly adopted by medical residency programs (Freina & Ott, 2015; Seymour et al., 2002). Hence, a VR simulation-based training system can be incorporated in surgical residency programs to provide a novel modality that facilitates the repetitive practice for patient-specific anatomy at reduced costs, all while eliminating financial and logistical concerns of the current gold standard with cadaveric dissections (Lipman & Ritter, 2018). The learning curve for complex and challenging endoscopic procedures is steep, and requires specialized skills obtained through extensive training (Küttner-Magalhaes et al., 2018). Functional Endoscopic Sinus Surgery (FESS) is one example of a complicated minimally invasive approach common to otolaryngologists, which is used to treat severe acute and chronic sinusitis, as well as head and neck cancers (Corbett, O'Connor, Byrne, Thornton, & Keogh, 2019; Fetta, Tsilis, Segas, Nikolopoulos, & Vlastarakos, 2017; Ramadan & Allen, 1995). This procedure requires a higher level of training primarily for the following reasons: (1) variability in the location of sinuses near the orbit and intracranial space (Chen et al., 2016), and (2) bimanual dexterity with the handling of an endoscope in one hand and surgical tools in the other hand while referencing the endoscopic video display. The proposed system hypothesizes that VR models can provide a realistic simulation model for FESS.