影像导航在鼻内镜下眼眶手术的临床研究  

Clinical study of intraoperative image-guidance in endoscopic nasocular operation

作　　者：窦晓燕[1,2] 卢永田[1,3] 郭疆[1,2] 司马晶[1,2] 李林[1,2] 杨浩江[1,2] 张蕊石[1,2] 陈伽俐[1,2] 

机构地区：[1]广东省深圳市第二人民医院 [2]深圳大学第一附属医院眼科,广东深圳518035 [3]深圳大学第一附属医院耳鼻喉科,广东深圳518035

出　　处：《中国内镜杂志》2010年第9期964-967,共4页China Journal of Endoscopy

基　　金：2008年深圳市科技计划资助项目(NO:200802052)

摘　　要：目的探讨影像导航技术在鼻内镜眼眶微创手术中的应用。方法回顾性分析7例患者,其中视神经损伤3例;眶内球后异物3例;球后肿瘤1例(血管瘤)。所有病例均采用Brain Lab影像导航系统及鼻内镜实施手术。结果影像导航术前准备时间(包括配准、头架定位、常规器械注册等)10～20min,平均15min。手术区域影像标志与实体解剖标志间的误差≤1.3mm。影像导航可准确定位视神经等解剖标志,无手术并发症发生。结论影像导航系统可以帮助术者在术中定位眼眶内重要的解剖结构,并可使手术视野扩展到内镜之外,使术者在术野中进行手术操作的同时,能顾及术野周围的重要结构,特别是在复杂的手术中,可提高手术的精确性和安全性。【Objective】 To evaluate the availability and our experience of intraoperative image-guidance in endoscopic nasocular operation.【Methods】 Seven cases of endoscopic nasal surgery with intraoperative image—guidance were retropectively reviewed,including 3 cases of Optic nerve injury;3 cases of foreign object of Optic Behind the Eyeball;1 cases of retrobulbar tumor（angeioma）.【Results】 The preoperative preparatory time would take 15 minutes including coordination,head holder localization,conventional instrument registration.In our cases,the localization accuracy between 3-D image landmarks of navigation system and actual anatomical landmarks was less than 1.3 mm.The optic nerve and other anatomical points could be orientated accurately in intraoperative procedures.No complication occurred.【Conclusions】 Nasal endoscope combined with image—guidance systems provides accurate anatomical localization of anterior skull base with enlarged operation field.It is possible for surgeons to observe important anatomical structures during endoscopic surgery.It could increase the effectiveness and decrease surgical complications,especially in complicated cases.

关 键 词：眼眶手术 影像导航 鼻内镜 

分 类 号：R779.6[医药卫生—眼科]