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InstaTrak®  Image-Guided Surgery



A revolutionary improvement in sinus surgery
is computer image-guided sinus surgery, the ability to see inside the head in 3 dimensions while operating.

In sinus surgery one is working in the area of the eyes, major veins, major arteries, and the brain. The best way to avoid complications is for the surgeon to know exactly where the instruments are in relation to the these structures in the patient's body. Now this is possible with the computer directed surgery using the InstaTrak® system.

Here  a careful CT scan (x ray) of the patient's sinuses is taken using a special head marker that looks like a plastic crown. Then, when the patient is brought to the operating room, that same head marker is placed in the same position as it was when the CT scan was done. The edges of the crown device are structured so that when a magnet is placed near the sinus, the crown measures a signal from the magnet, and produces precise 3 dimensional coordinates for the magnet. In surgery, the magnet is attached to the surgical instruments, which are then located precisely within the patient's body. This location is projected onto the cat scan images, so the surgeon can see the precise location of the instrument relative to the patient's body structure while the operation is being performed. At every moment, the surgeon knows, for example, how far from the eye, how near a large blood vessel, and how near the brain the instrument is.

It is especially valuable in revision surgery when normal landmarks may not be present. In severe sinus disease, regular anatomy may be distorted. Nasal polyps may thin the bones, infectious swelling may move a structure to a different place; even in the normal sinus the anatomy can vary. Patients who have had a previous surgery are difficult to operate because of the loss of normal structures, scar tissue and other changes.  For these reasons, being able to track the position of the instruments can make for a much safer surgery for the patient. Often the actual surgery time is reduced because of the better visualization.

Endoscopic surgery has been a big step forward in performing sinus surgery. Here, telescopes are inserted with various angles so that the farthest reaches of the disease can be visualized and removed. Endoscopic surgery allowed safer and more thorough sinus procedures. This computer-directed system is the next step towards even safer and more thorough surgery.

Of course the surgeon still must have ability and knowledge. More important he must know the indications for surgery. Be sure to consult with a qualified physican when considering surgical options.  Consider every non- surgical method first (especially pulsatile irrigation) before recommending the surgical route. Many patients respond to non-surgical treatments and avoid surgery.

When Is Surgery Not Indicated?

Commonly a patient has an MRI for a reason unrelated to surgery. If the patient doesn't have a clear history of sinus disease, it is possible the MRI is too sensitive and will appear to show horrible disease when only mucus is present. Often, no treatment is needed.

A patient may be referred because he has had a sinus infection that won't respond to antibiotics. But the CT scan doesn't look too bad. This patient may respond to office treatment or pulsatile irrigation with or without an antibiotic.

Some patients are referred because they can't breathe and because they sneeze, and their CT scan shows thickening. If examination shows that the nose looks allergic this patient can respond to allergy management without surgery.

Patients are often referred who suffer from overuse of nose drops. This can also be treated without surgery.

When Is Surgery Indicated?

When infection is due to diseased tissue and can't be cleared except by removal of the diseased tissue.
When polyps block the sinuses and don't respond to medication.
When there is a long history of sinus infection and the CT shows serious sinus blockage. These patients may not respond to medical management because the infected material can't get out of the sinus.
When a bad tooth has caused major tissue changes.
When repeated sinus infections are aggravating a chest condition - bronchitis, asthma, and others.

For more information on sinuses and pulsatile irrigation, Click HERE

Copyright ©2002 content.  The information provided by Health Solutions Medical Products Corp. is not intended to replace the medical advice of your doctor or health-care provider. Please consult your health-care provider for advice about a specific medical condition.

© 2002 Health Solutions Medical Products Corp.  All rights reserved.


Health Solutions Medical Products Corp.
P.O. Box 4278
Culver City, CA   USA  90231-4278
Tel. 800.305.4095 Fax 310.837.1065
Copyright © 2000 Health Solutions Medical Products Corp. All Rights Reserved
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