영상유도 내비게이션을 이용한 귀 수술의 안전성과 유효성: 체계적 문헌고찰
Safety and Effectiveness of Image-Guided Navigation in Otologic Surgery: A Systematic Review
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The aim of study was to evaluate the safety and effectiveness of image-guided navigation in otologic surgery. Methods: We searched 3 international databases (Ovid-MEDLINE, Ovid-EMBASE, and Cochrane Central Register of Controlled Trials) and 5 domestic databases (KoreaMed, KMbase, KISS, RISS, and KISTI). By two authors independently, comparative studies or case series were selected based on predefined inclusion criteria. Safety was assessed by procedure-related complication rates. Effectiveness was analyzed using surgery-related variables (mortality, success rate, surgery accuracy, rate of revision surgery, rate of recurrence, and alteration rate of surgical plan), health system-related variables (operation time, intraoperative blood loss, and length of hospital stay), patient-related variables (objective assessment of symptoms, subject assessment of symptoms, quality of life, patient satisfaction), and surgeon-related variables (impacts on surgeons - surgical performance, situation awareness or workload). After data extraction, narrative analysis was conducted. Results: In this review, 4 non-randomized controlled study (NRS) and 16 cases series were selected. With regards to safety, postoperative complication rates did not differ regardless of image-guided navigation. No major complications such as facial nerve damage occurred during the procedure. As concerned with effectiveness, clinical variables were not reported well, or they were not different between groups. Otherwise, in two NRS and 5 case series, image-guided navigation was consistently reported as the useful technique which supported surgeons to exactly find the surgery spots. Conclusion: Image-guided navigation in otologic surgery was regarded as a safe technique. However, no definite conclusions could be drawn as to its effectiveness. Due to limitations of the current evidence, further research is needed to explore the safety and effectiveness of image-guided navigation applied in ear surgery.
Abstract
The aim of study was to evaluate the safety and effectiveness of image-guided navigation in otologic surgery. Methods: We searched 3 international databases (Ovid-MEDLINE, Ovid-EMBASE, and Cochrane Central Register of Controlled Trials) and 5 domestic databases (KoreaMed, KMbase, KISS, RISS, and KISTI). By two authors independently, comparative studies or case series were selected based on predefined inclusion criteria. Safety was assessed by procedure-related complication rates. Effectiveness was analyzed using surgery-related variables (mortality, success rate, surgery accuracy, rate of revision surgery, rate of recurrence, and alteration rate of surgical plan), health system-related variables (operation time, intraoperative blood loss, and length of hospital stay), patient-related variables (objective assessment of symptoms, subject assessment of symptoms, quality of life, patient satisfaction), and surgeon-related variables (impacts on surgeons - surgical performance, situation awareness or workload). After data extraction, narrative analysis was conducted. Results: In this review, 4 non-randomized controlled study (NRS) and 16 cases series were selected. With regards to safety, postoperative complication rates did not differ regardless of image-guided navigation. No major complications such as facial nerve damage occurred during the procedure. As concerned with effectiveness, clinical variables were not reported well, or they were not different between groups. Otherwise, in two NRS and 5 case series, image-guided navigation was consistently reported as the useful technique which supported surgeons to exactly find the surgery spots. Conclusion: Image-guided navigation in otologic surgery was regarded as a safe technique. However, no definite conclusions could be drawn as to its effectiveness. Due to limitations of the current evidence, further research is needed to explore the safety and effectiveness of image-guided navigation applied in ear surgery.
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