CALL US 1-888-888-8888
 

Use technology that enhances safety

When we discuss “sinus surgery”, the vast majority is performed in a “minimally invasive” fashion through the nostrils (endonasal) with visualization through a telescope (endoscopic) resulting in the label “Endoscopic Endonasal Sinus Surgery”. This surgery can be relatively minor and use only an inflatable balloon to expand the natural sinus drainage openings (Balloon Sinuplasty), or it can be extensive resulting in surgery around the eye sockets and the undersurface of the brain case.

Whether simple or complex, Endoscopic Endonasal Sinus surgery should always be done with the following safety measures in place:

1. The use of Surgical Navigation Systems
2. The use of high-resolution Surgical Visualization Systems
3. Employing Skull Base Surgery operative techniques.

Dr. Costantino using a high resolution, fiberoptic visualization system to perform brain surgery through the nose & sinuses and into the base of the skull.

Dr. Costantino using a high resolution, fiberoptic visualization system to perform brain surgery through the nose & sinuses and into the base of the skull.

Surgical Navigation Systems

Because the sinuses are located between the eyes, and under the surface of the brain case, it is critical that the targeting of sinus problems be done accurately. Given the sinus surgery is most frequently performed through the nostrils using a telescope attached to a camera without any external incisions, it is critical that the surgeon knows where their instruments are within the head at all times to a very narrow limit, optimally 1-3 millimeters, to prevent injury to the eyes or entry into the brain case. Surgical navigation systems help experienced surgeons remain in safe locations within the head. All sinus surgery performed by Dr. Costantino is done so with continuous surgical navigation. The system that he uses is the Stryker CranialMap and the CranialMap Stryker NAV 3i System.

Dr. Costantino has no commercial relationship with Stryker and uses their systems because he believes that they are the most accurate in defining the anatomy inside the head & sinuses while operating. The accuracy is usually within 0.4-0.6 millimeters during the surgical procedure.

Cranial Map
Stryker Nav 3i

High Resolution Surgical Visualization Systems

The safety of endonasal, endoscopic sinus surgery is dependent on the telescopes and cameras that are used for the procedure. Dr. Costantino use only state of the art visualization systems. These do not include three dimensional systems as he firmly believes that these are unnecessary and represent a distraction during surgery. In his opinion, though these systems have a certain “marketing value” they do not improve the safety of the surgery particularly given that many of the camera systems are heavy and actually represent an impediment to the facile use of the scopes during the procedure.