Cone-beam Computed Tomography Guidance in Functional Endoscopic Sinus Surgery: A Retrospective Cohort Study

Introduction: Using image-guided intra-operative navigation systems in surgeries like functional endoscopic sinus surgery (FESS) has become widely accepted as an effective tool for improvement of surgical outcomes and reduction of complication. Cone-beam CT (CBCT) is a variant of computed tomography imaging that has developed as a cross-sectional and potentially low-dose technique to visualize bony structures in the head and neck. In current study, it was tried to evaluate surgeons’ satisfaction with CBCT intra-operative navigation imaging as well as image quality prior to FESS and post-operative complications.

Methods: In this prospective study, the included patients who were candidates for FESS underwent CBCT from January to June 2019. The data regarding demographic information, CBCT findings and diagnosis were extracted. The surgeons’ satisfaction with intra-operative navigation imaging and image quality was quantified using Visual Analogue Scale (VAS) (ranging 0 – 10). Furthermore, patients were contacted 3 months later to ask for their satisfaction with the operation using VAS and post-operative complications evaluated.

Results: Totally, 39 patients were included. The mean age was 40.74±5.75 and 20 patients (51.28 percent) were male. Two surgeons performed this operation separately; one of the surgeons performed 20 (51.28 percent) FESS and the other performed 19 (48.71 percent). The mean satisfaction of the surgeons of CBCT guided FFESS was 8.69±0.92. After the 3-month follow up, patients’ satisfaction score was 8.21±1.89. No postoperative complications were reported.

Conclusion: Based on the surgeons’ point of view, CBCT was shown to be reliable for image-guided FFESS. Furthermore, the outcome and complications of performed surgeries were similar to those performed with computed tomography intra-operative navigation imaging.