Computer-assistierte Chirurgie (CAS) in der HNO-Heilkunde

摘要

BACKGROUND: Computer-Assisted-Surgery (CAS) names a method that allows intraoperative navigation in the surgical field based on digital image data like CT, MRT, MRA, DSA and others. A computer processes the image data in real time and is intraoperatively connected to a measuring system for coordinate determination. CAS is used in ENT surgery since 1986. The authors developed several generations of CAS systems. METHODS: In a first approach, a passive robot arm was applied. Self-developed electromechanical and infrared optical coordinate measuring devices followed. RESULTS: CAS was applied to several fields of otorhinolaryngologic surgery including the paranasal sinuses, the orbit, the rhinobasis and otobasis and other. CAS was found to be useful for surgery of acoustic neuromas, the paranasal sinuses in cases of massive disease or revision surgery, decompression of orbit or optiv nerve, extraction of deep seated foreign bodies, stereotaxy-like biopsies, for educational purposes and others. CONCLUSIONS: CAS in its current state of development is a useful tool that can be routinely applied. However, further technical development is necessary.