影像导航下鼻内窥镜眼眶手术影像漂移的分析

目的:总结影像导航下鼻内窥镜眼眶手术的经验,分析产生影像漂移的原因,提出避免及解决此问题的方法。方法:回顾研究影像导航下鼻内窥镜眼眶手术的病例,按一定的导航操作规范进行术前计划及术中导航,记录、分析并解决所发生的影像漂移现象。结果:在2008-08/2010-12我们共完成影像导航下鼻内窥镜眼眶手术13例,发生影像漂移4例,发生率为31%。其中2例为标记点影像漂移,2例为术中组织改变性影像漂移。标记点影像漂移全部得到纠正,术中组织改变性影像漂移未能得到纠正,但手术亦顺利完成。结论:对于标记点影像漂移,可通过严格导航及手术操作,选择最佳注册点来避免,并可通过体表标志的增加注册加以纠正;对于组织改变性影像漂移,主要通过术中细致操作以预防其发生。

Analysis of image-drifting in intraoperative image-guidance in endoscopic nasocular operation

AIM:To analyse the cause of image-drifting and to resolve it during image-guidance endoscopic nasocular operation.METHODS:The pre-operative plan and intra-operative navigation were rigorously processed according to the criteria of endoscopic nasocular operation.The occurrence of image-drifting was recorded,analyzed and resolved.RESULTS:The image-guidance system in endoscopic nasocular operation was used in 13 cases from August 2008 to December 2010,and image-drifting happened in 4 cases(31%).Among them,2 cases were systemic image-drifting,2 cases were structural image-drifting.Systemic image-drifting were resolved,while structural image-drifting were not resolved.But the operation was completed smoothly.CONCLUSION:The systemic image-drifting can be prevented through rigorous neuronavigative procedure,and it could be resolved by selecting a better landmark and adding more landmarks.The best way to prevent structural image-drifting is careful operation.