ỨNG DỤNG PHẦN MỀM DỰNG HÌNH 3 CHIỀU TRONG PHẪU THUẬT NỘI SOI XOANG TRÁN

Abstract

Background: Endoscopic frontal sinus surgery is considered as the most difficult and challenging procedure for rhinologists due to the complex and anatomic variants of the frontal sinus. Scopis Building Blocks converts radiological data into an understandable 3D anatomical pictures. The surgeons are able to draw building blocks and frontal sinus drainage pathway on the CT scan itself in all three dimensions, then they can perform the surgery with additional safety and orientation for a complete dissection and optimal results. Methods: A case series reports of 86 frontal recesses of 51 chronic frontal sinusitis patients, who underwent endoscopic frontal sinus surgery at Ear Nose Throat hospital of Ho Chi Minh city. Scopis Building Blocks software was used to indentified the frontal cells and the frontal drainage pathway and applied to endoscopic frontal sinus surgery. Results: Agger nasi cell (ANC) presented in 98,8% of cases. The frontal cells prevalence was as follows: supra agger cells (SAC) 19,8%, supra agger frontal cell (SAFC) 8,1%, supra bulla cell (SBC) 74,4%, supra bulla frontal cell (SBFC) 15,1%, supraorbital ethmoid cell (SOEC) 12,8%, and frontal septal cell (FSC) 16,3%. Regarding anteriorly based cells, the most common drainage pathway in relation to frontal cells was posterior to ANC (57,7%), posterior to SAC (52,9%), medial to SAFC (71,4%). Regarding posteriorly based cells, the most common drainage pathway in relation to frontal cells was anterior to SBC (100%), anterior to SBFC (84,6%),  anterior to SOEC (100%). The frontal cells and frontal drainage pathways were indentified in all cases intra-operatively in accordance with preoperatively software analysis results. Instruments were placed to dissect the frontal cells completely. No major complications were noted in our study. Conclusion: The Scopis Building Blocks software is a very useful tool to identify the frontal cells and frontal sinus drainage pathway types in relation to frontal cells preoperatively. It helps surgeons know exactly where to place the instrument to perform the dissection safely and effectively.