부비동 및 두개저 병변에서 항법장치를 이용한 비내시경적 진단과 치료: 증례분석 12예
Image-Guided Surgery in the Paranasal Sinus and Skull Base Lesion
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Abstract
Background and Objectives：Endoscopic paranasal sinus surgery is effective for the treatment of paranasal sinus lesion andreduction of invasiveness enabling the surgeon to perform precise procedures with minimal tissue traumatization. But, somestudies showed that there was a risk of invasive management and major complications occurring in 0.5% to 1% of all procedures.The aim of this study was to assess the usefulness and effectiveness of image-guided endoscopic surgery in reducing the complicationand treating the disease suitably. Subjects and Method：The image-guided paranasal sinus surgery was performed in12 patients from 2000 to 2005 who had difficulty in endoscopic surgery for the diagnosis and treatment of the inaccessiblelocation such as skull base, sphenoid and clivus, infratemporal fossa etc. and the uncertain lesion such as severe distorted lesiondue to previous sinus operation, congenitally underdeveloped anatomic lesion, nearby vital organ-lesion and submucosal lesionin our experiences. We retrospectively reviewed radiologic evaluations and medical records in our patients. Results：We included6 oncogenic lesions such as craniopharyngioma, chordoma in clivus and sphenoid sinus, 5 infectious lesions such as invasiveaspergillosis and 1 cystic lesion. The accuracy we could achieve varied between 0.9 and 2.0 mm. CSF rhinorrhea occurred in 2cases after management. But, only one case was not only related to image-guided surgery but also resolved spontaneously.Conclusion：Image-guided endoscopic surgery is a safe and effective tool in paranasal sinus and skull base lesion for maximizingsurgical results and limiting complications. (Korean J Otolaryngol 2006;49:1082-6)
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