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Intra-operative image guidance in otolaryngology – The use of the ISG viewing wand

Published online by Cambridge University Press:  29 June 2007

A. S. Carney ,
N. Patel ,
D. L. Baldwin ,
H. B. Coakham  and
D. R. Sandeman
A. S. Carney*
Affiliation:
Department of Otolaryngology, Southmead Hospital, Bristol
N. Patel
Affiliation:
Department of Neurosurgery, Frenchay Hospital, Bristol
D. L. Baldwin
Affiliation:
Department of Otolaryngology, Southmead Hospital, Bristol
H. B. Coakham
Affiliation:
Department of Neurosurgery, Frenchay Hospital, Bristol
D. R. Sandeman
Affiliation:
Department of Neurosurgery, Frenchay Hospital, Bristol
*
Address for correspondence: Mr A. S. Carney, F.R.C.S.Ed., Department of Otolaryngology, Queens Medical Centre, Nottingham NG7 2UH.
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Abstract

The ISG viewing wand is an intra-operative guidance system with a proprioceptive robotic-like jointed arm. It provides surgeons with almost instantaneously reconstructed computer-generated CT or MRI images in two or three dimensions and can correlate any point within the operative field to its corresponding locus on the reformatted scan images. In addition to having been used in over 400 neurosurgical patients in Bristol, 14 patients with skull-base, cerebello-pontine angle or temporal bone lesions have also undergone wand-guided resections. The wand has proved to be particularly useful in pre-operative planning, allowing minimally-invasive incisions, providing per-operative navigation, identifying the relationship and proximity of important anatomical structures and in assessing the extent of lesion resection. We illustrate the advantages of intra-operative image-guidance by discussing four cases. The potential applications of this form of imaging technology to other otolaryngological procedures are discussed.

Keywords

Image processing, computer assistedStereotaxic techniquesTemporal boneCholesteatomaGlomus jugulare tumourChordoma
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 110 , Issue 4 , April 1996 , pp. 322 - 327
Copyright
Copyright © JLO (1984) Limited 1996

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Footnotes

Presented in part to the Royal Society of Medicine, Section of Otology, 3 March 1995.

References

Anon, J. B., Lipman, S. P., Oppenheim, D., Halt, R. A. (1994) Computer-assisted endoscopic sinus surgery. Laryngoscope 104: 901–905.CrossRefGoogle Scholar
Barnett, G. H., Kormos, D. W., Steiner, C. P., Weisenberger, J. (1993) Intraoperative localisation using an armless, frameless stereotactic wand. Technical note. Journal of Neurosurgery 78: 510–514.Google Scholar
Brodwater, B. K., Roberts, D. W., Nakajima, T., Friets, E. M., Strohbehn, J. W. (1993) Extracranial application of the frameless stereotactic operating microscope: experience with lumbar spine.Neurosurgery 32: 209–213.Google Scholar
Carrau, R. L., Snyderman, C. H., Curtin, H. B., Weissman, J. L. (1994) Computer-assisted frontal sinusotomy. Otolaryngology, Head and Neck Surgery 111: 727–732.Google Scholar
Davis, R. E., Levoy, M., Rosenman, J. G., Fuchs, H., Pizer, S. M., Skinner, A., Pillsbury, H. C. (1991) Three-dimensional high-resolution volume rendering (HRVR) of computed tomography data: Applications to Otolaryngology – Head and Neck Surgery. Laryngoscope 101: 573–582.CrossRefGoogle ScholarPubMed
Dyer, P., Patel, N., Pell, G. M., Cummins, B., Sandeman, D. R. (1995) The neurosurgical wand: An application to atlantoaxial cervical surgery using the Le Fort I maxillary osteotomy. British Journal of Oral and Maxillofacial Surgery 33: 370–374.CrossRefGoogle Scholar
Friedman, M., Mafee, M., Ray, C., Venkatesan, T. K. (1993) Three-dimensional imaging for evaluation of head and neck tumours. Archives of Otolaryngology, Head and Neck Surgery 119: 601–607.Google Scholar
Galloway, R. L., Maciunas, R. J., Latimer, J. W. (1991) The accuracies of four stereotactic frame systems: an independent assessment. Biomedical Instrumentation and Technology 25: 457–460.Google Scholar
Hobson, S., Snyderman, C. H. (1996) Endoscopic orbital decompression using 3-D imaging techniques (Abstract). Proceedings of the Joint International Congress on Minimally Invasive Techniques in Neurosurgery and Otolaryngology, Pittsburgh. Skull Base Surgery. (In press.)Google Scholar
Laborde, G., Gilsbach, J., Klimek, L., Moesges, R., Krybus, W. (1992) Computer-assisted localiser for planning of surgery and intra-operative orientation. Acta Neurochirurgica 119: 116–170.Google Scholar
McGovern, K. T. (1994) Applications of virtual reality to surgery. British Medical Journal 308: 1054–1055.Google Scholar
Pillay, P., Luber, J. (1996) A frameless stereotactic microscope for image-guided surgery: preliminary experience with the Zeiss MKM (Abstract). Proceedings of the Joint International Congress on Minimally Invasive Techniques in–Neurosurgery and Otolaryngology, Pittsburgh. Skull Base Surgery. (In press.)Google Scholar
Pollack, I. F., Welch, W., Jacobs, G. B., Janecka, I. P. (1995) Frameless stereotactic guidance: an intraoperative adjunct in the transoral approach for ventral cervicomedullary junction decompression. Spine 20: 216–220.Google Scholar
Reinhardt, H. F., Zweifel, H. J. (1990) Interactive sonar operated device for stereotactic and open surgery. Stereotactic and Functional Neurosurgery 54: 393–397.Google Scholar
Sandeman, D. R., Patel, N., Chandler, C., Nelson, R. J., Coakham, H. B., Griffith, H. B. (1994) Advances in imagedirected neurosurgery: preliminary experience with the ISG Viewing Wand compared with the Leksell G frame. British Journal of Neurosurgery 8: 529–544.Google Scholar
Takizawa, T. (1993) Isocentric stereotactic three-dimensional digitizer for neurosurgery. Stereotactic and Functional Neurosurgery 60: 175–193.CrossRefGoogle ScholarPubMed
Torrens, M. I., Sandeman, D. R. (1994) Minimally invasive endoscopic pituitary surgery. Proceedings of the 2nd International skull base symposium.St Petersburg.Google Scholar
Valavanis, A., Fisch, U. (1989) Glomus tumors of the temporal bone. In Neurological Surgery of the Ear and Skull Base. (Fisch, U., Valavanis, A., Yasargil, M. G., eds.), Kugler and Ghedini Publications, Amsterdam, pp 63–68.Google Scholar
Zinreich, S. J., Robles, H. A., Long, D. M., Bryan, R. N. (1991) 3D Imaging for Neurosurgery. In Acoustic Neuroma. (Tos, M., Thomsen, J., eds.), Kugler Publications, Amsterdam/New York, pp 109–118.Google Scholar
Zinreich, S. J., Tebo, S. A., Long, D. M., Brem, H., Mattox, D. E., Loury, M. E., Vander Kolk, C. A., Koch, W. M., Kennedy, D. W., Bryan, R. N. (1993) Frameless stereotaxic integration of CT imaging data: Accuracy and initial applications. Radiology 188: 735–742.Google Scholar