BALLOON SINUPLASTY WITH USE OF INTRA-OPERATIVE NAVIGATION IN CHILDREN - PRELIMINARY REPORT

Summary Introduction. Since eighties a dynamic development of sinus surgical techniques has started. In the beginning the functional endoscopic sinus surgeries were introduced in adults. With gaining experience this technique with modifications was also in- troduced in children as pediatric endoscopic sinus surgery. Most authors in publications state that stenosis of natural ostium of sinuses is one of the main causes of chronic rhinosinusitis. For this reason further researches went in the direction of minimal- ization of intra-operative trauma and increasing precision of surgeries. In 2005 and 2006 there were first reports about using balloon sinuplasty. This technique is based on introducing a balloon in the natural ostium of sinus and extending the balloon. Due to identify the localization of balloon C arm or fluorescence are used. Aim. Due to better intra-operative orientation and decreasing the dose of X radiation in the intra-operative period authors were using intra-operative navigation during balloon sinuplasty. Material and methods. Between 2009 and 2010 in the Pediatric Otolaryngology Clinic authors conducted 10 operations with use of balloon sinuplasty and intra-operative navigation. During operation data of guide catheter were introduced to navigation to gain a possibility of intra-operative navigation. To navigate standard instruments were used. Then through sinus guide cath- eter the optic fibre-sinus illumination was introduced. This system was a guide and enabled the fluorescence of sinus. At then the Balloon Catheter was introduced and the ostium was widened. With the use of navigation the localization of guide catheter was determined and with use of standard instruments localization of balloon was determined. Conclusions. 1. Balloon sinuplasty seems to be optimal method of treatment for children with stenosis of natural ostia of sinus and limited mucous lesions. 2. Intra-operative navigation enables to gain better orientation in operating area when using bal- loon sinuplasty and to decrease the dose of X radiation in the peri-operative period. 3. The use of navigation with standard instruments gives minor measuring error than the use of navigation with instruments additionally introduced into the system.