Interactive navigation-guided ophthalmic plastic surgery: the utility of 3D CT-DCG-guided dacryolocalization in secondary acquired lacrimal duct obstructions
| Autor: | Mohammad Javed Ali, Tarjani Vivek Dave, Milind N. Naik, Swathi Kaliki, Swati Singh |
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| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Lacrimal duct Ophthalmic plastic surgery nasolacrimal duct obstruction powered endoscopic DCR Electromagnetic mode 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Ophthalmology medicine image guidance navigation Sinus (anatomy) Original Research lacrimal drainage CT-dacryocystography Nasolacrimal duct business.industry Lacrimal drainage Clinical Ophthalmology medicine.disease Lacrimal sac Surgery Nasolacrimal duct obstruction medicine.anatomical_structure 030221 ophthalmology & optometry business |
| Zdroj: | Clinical Ophthalmology (Auckland, N.Z.) |
| ISSN: | 1177-5483 |
| DOI: | 10.2147/opth.s127579 |
| Popis: | Mohammad Javed Ali,1 Swati Singh,1 Milind N Naik,1 Swathi Kaliki,2 Tarjani Vivek Dave1 1Govindram Seksaria Institute of Dacryology, 2The Operation Eyesight Universal Institute for Eye Cancer, LV Prasad Eye Institute, Hyderabad, Telangana, India Aim: The aim of this study was to report the preliminary experience with the techniques and utility of navigation-guided, 3D, computed tomography–dacryocystography (CT-DCG) in the management of secondary acquired lacrimal drainage obstructions.Methods: Stereotactic surgeries using CT-DCG as the intraoperative image-guiding tool were performed in 3 patients. One patient had nasolacrimal duct obstruction (NLDO) following a complete maxillectomy for a sinus malignancy, and the other 2 had NLDO following extensive maxillofacial trauma. All patients underwent a 3D CT-DCG. Image-guided dacryolocalization (IGDL) was performed using the intraoperative image-guided StealthStation™ system in the electromagnetic mode. All patients underwent navigation-guided powered endoscopic dacryocystorhinostomy (DCR). The utility of intraoperative dacryocystographic guidance and the ability to localize the lacrimal drainage system in the altered endoscopic anatomical milieu were noted.Results: Intraoperative geometric localization of the lacrimal sac and the nasolacrimal duct could be easily achieved. Constant orientation of the lacrimal drainage system was possible while navigating in the vicinity of altered endoscopic perilacrimal anatomy. Useful clues with regard to modifications while performing a powered endoscopic DCR could be obtained. Surgeries could be performed with utmost safety and precision, thereby avoiding complications. Detailed preoperative 3D CT-DCG reconstructions with constant intraoperative dacryolocalization were found to be essential for successful outcomes.Conclusion: The 3D CT-DCG-guided navigation procedure is very useful while performing endoscopic DCRs in cases of secondary acquired and complex NLDOs. Keywords: CT-dacryocystography, image guidance, navigation, lacrimal drainage, nasolacrimal duct obstruction, powered endoscopic DCR |
| Databáze: | OpenAIRE |
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