StealthStation™ ENT Navigation System
I routinely use an intraoperative navigation system both in the operating room and in the office. This technology not only allows for high precision during sinus procedures, but may also decrease the likelihood of rare complications. Not all surgeons use a navigation system. Routine cases often do not require this technology. Personally, I was largely trained to perform sinus surgery strictly using anatomic landmarks and without the need for navigation. I believe this is the best way to train and that this has allowed me to be a more skilled and confident endoscopic surgeon. However, I do realize the advantages that navigation systems provide and often have a navigation system available both in the operating room and in the office as a backup and confirmatory tool.
There are multiple companies that offer real-time navigation for sinonasal procedures. Currently, the main systems for otolaryngology are:
Each of these systems have individual advantages and disadvantages that is beyond the scope of this article. For example, the Stryker system allows for a unique augmented reality technology. The Acclarent system also allows for additional complex software features that provides additional unique perspectives. The bottom line is that they are all effective for sinus procedures and the best system to use is largely based on surgeon preference and compatibility with other equipment.
An actual case of mine: this navigation system employs AI features to show me at the end of the case that I have dissected along the limits of anatomic boundaries. This patient had severe sinus disease and my goal is to avoid a revision surgery in the future. This sytem confirms that I have truly dissected along the skull base and eye and left no disease behind.
Prior to deciding on any sinus procedure, I first order a CT scan for my patient. If we decide on surgery, we load my patient’s CD into the our navigation system at the beginning of the procedure. Next, we begin the calibration phase. I place a calibration sticker on m patient’s forehead, and we perform a “tracing.” The navigation system is then checked for real-time accuracy where the margin of error is usually confirmed to be less than 1 mm. During the procedure, various navigation-enabled instruments are tracked in real-time with my patient’s CT scan. This technology is especially useful at the borders of the anatomic surgical dissection: namely the skull base at the brain-sinus interface, and the lamina papryacea at the eye-sinus interface. Furthermore, the navigation system gives me greater confidence that I have been appropriately aggressive enough to eradicate the patient’s disease while still maintaining a high margin of safety with a low likelihood of complications.