Ludzkie koronawirusy - autor: Krzysztof Pyrć z Zakładu Mikrobiologii, Wydział Biochemii, Biofizyki i Biotechnologii, Uniwersytet Jagielloński, Kraków

Zastanawiasz się, jak wydać pracę doktorską, habilitacyjną lub monografię? Chcesz dokonać zmian w stylistyce i interpunkcji tekstu naukowego? Nic prostszego! Zaufaj Wydawnictwu Borgis – wydawcy renomowanych książek i czasopism medycznych. Zapewniamy przede wszystkim profesjonalne wsparcie w przygotowaniu pracy, opracowanie dokumentacji oraz druk pracy doktorskiej, magisterskiej, habilitacyjnej. Dzięki nam nie będziesz musiał zajmować się projektowaniem okładki oraz typografią książki.

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© Borgis - New Medicine 3/2008, s. 77-79
*Lechosław P. Chmielik, Anna Chmielik1, Jolanta Jadczyszyn, Magdalena Żabicka1, Mieczysław Chmielik
USEFULNESS OF INTRAOPERATIVE NAVIGATION IN SINUS OPERATIONS ON CHILDREN
Department of Paediatric ENT, Warsaw Medical University, Poland
Head of Department: Prof. Mieczysław Chmielik, MD, PhD
1Medical Radiology Unit, Military Medical Institute, Warsaw, Poland
Head of Radiology Unit: Ass. Prof. Romana Bogusławska, MD
Summary
Introduction: Progress in medicine depends largely on development in the fields of engineering and computer science. It the nineteen seventies, the invention of computed tomography allowed the possibility of identifying previously unknown pathological situations.
Among actions designed to reduce the risk of complications during PESS, we must include appropriate training for the surgeon and the application of instrumentation adapted specially for children. In the very difficult operative field found in children intraoperative navigation facilitates intervention. The navigation can operate on the optical or electromagnetic principle, and is mainly applied in neurosurgery and ENT.
Aim: To analyse the value of intraoperative navigation during PESS.
Material and method: Ten children underwent PESS with the use of intraoperative navigation in the Paediatric ENT Department of the Warsaw Medical University.
Results: All parameters significantly improved postoperatively compared to the preoperative values. During measurements made in 95% the error of the measurement was 0 mm. In 5% the error of the measurement did not exceed 2 mm. The operative strategy was changed by the introduction of navigation.
Conclusions:
1. Intraoperative navigation is a method considerably facilitating the sense of direction in the operative field. 2. Applying it can reduce the risk of post-operative complications appearing. 3. Error of the measurement reaching 2 mm is a limitation.
Key words: navigation, PESS, FESS.
INTRODUCTION
Progress in medicine depends largely on developments in the fields of engineering and computer science. It the nineteen seventies, the invention of computed tomography allowed the possibility of identifying previously unknown pathological situations. This resulted in the introduction of new therapeutic methods such as endoscopic operation techniques.
However, every medical action carries the risk of complications. Among actions designed to reduce the risk of complications during PESS, we must include appropriate training for the surgeon and the application of instrumentation adapted specially for children. In the very difficult operative field found in children intraoperative navigation facilitates intervention. The navigation can operate on the optical or electromagnetic principle, and is mainly applied in neurosurgery, ENT and maxillofacial surgery (1, 2, 3, 4, 6, 7, 8, 9, 10, 11).
aim
To analyse the value of intraoperative navigation during PESS.
MATERIAL
Ten children underwent PESS with the use of intraoperative navigation in the Paediatric ENT Department of the Warsaw Medical University.
METHOD
Children were qualified for paranasal sinus surgery due to chronic inflammation. They had a CT examination directly before the operation. Spiral computed tomography with secondary multilevel reconstruction was used, with slice thickness of 0.625 mm, at the Medical Radiology Unit of the Military Medical Institute in Warsaw. The examination results were taken on CD for installation in FUSION ENT Navigation (electromagnetic navigation) equipment (Medtronic). During the operation the accuracy of the navigation in locating anatomical structures and identifying pathological changes was assessed.
RESULTS

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Piśmiennictwo
1. Chen CH, Lee HT,Shen CC, et al.: Aspiration of Hypertensive Intracerebral Hematoma with Frameless and Fiducial-Free Navigation System: Technical Note and Preliminary Result .Stereotact Neurosurg, 2008 Jan 30; 86 (5): 288-291. 2. Cobb JP, Kannan V, Dandachli W, et al.: Learning how to resurface cam - type femoral heads with acceptable accuracy and precision: the role of computed tomography-based navigation. Jbone Joint Surg Am 2008 Aug; 90 Suppl 3: 57-64. 3. Enchev YP, Popov RV, Romansky KV, et al.: Neuronavigated surgery of intracranial cavernomas - enthusiasm for high technologies or a gold standard ? Folia Med. (Plovdiv), 2008 Apr-Jun; 50 (20): 11-7. 4. Ewers R, Schicho K, Undt G, et al.: Basic research and 12 years of clinical experience in computer-assisted navigation technology: a review . Int J Oral Maxillofac Surg, 2005 Jan; 34 (1): 1-8. 5. Heiland M, Habermann CR, Schmelzle R.: Indications and limitations of intraoperative navigation in maxillofacial surgery. J Oral. Maxillofac Surg. 2004 Sep; 62 (9): 1059-63. 6. Jurkiewicz D, Rapiejko P.: Zastosowanie nawigacji komputerowej w chirurgii endoskopowej nosa i zatok . Otolaryngologia Polska 2005, 59, 2, 289-297. 7. Lapeer R, Chen MS, Gonzalez G, et al.: Image-enhanced surgical navigation for endoscopic sinus surgery: evaluating calibration, registration and tracking. Int J Med. Robot. 2008 Mar; 4 (1): 32-35. 8. Schramm A, Suarez-Cunqueiro MM, Barth EL, et al.: Computer - assisted navigation in craniomaxillofacial tumors. J. Craniofac Durg. 2008 Jul; 19 (4): 1067-74. 9. Straub G, Spitzer C, Dittrich E, et al.: Modified procedure for patient registration for navigation control instruments in ENT surgery. HNO, 2008 Aug 20. 10. Stuehmer C, Essig H, Schramm A, et al.: Intraoperative navigation assisted reconstruction of a maxillo-facial gunshot wound. Oral Maxillofac Surg. 2008 Jul 25. 11. Tschopp KP, Thomader EG.: Outcome of functional endonasal sinus surgery with and without CT-navigation . Rhinology, 2008 Jun; 46 (2): 116-20.
Adres do korespondencji:
*Lechosław P. Chmielik
Klinika Otolaryngologii Dziecięcej WUM
00-576 Warszawa, ul. Marszałkowska 24
tel./fax: + 48 22 628 05 84
e-mail: laryngologia@litewska.edu.pl

New Medicine 3/2008
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