ct sinus medtronic protocol

ct sinus medtronic protocol

Fourth, this approach would not be beneficial at a facility that is currently using very low radiation dose screening sinus CT for a majority of diagnostic examinations, with a higher radiation dose reserved for preoperative sinus CT. Hodez C, Griffaton-Taillandier C, Bensimon I. Intra-Operative Use of Computer Aided Surgery, Position Statement of the American Academy of OtolaryngologyHead and Neck Surgery, Physician Fee Schedule Search, Centers for Medicare & Medicaid Services, Consumer Price Index Inflation Calculator, Bureau of Labor Statistics, Converting dose-length product to effective dose at CT. Mettler FA, Jr, Bhargavan M, Faulkner K, et al. Uses a special computer system for image-guided surgeries. Clinical experience with angulated, hand-activated, wireless instruments in an optical tracking system for endoscopic sinus surgery. The instruments are registered to show their position with respect to the orthogonal CT images of the patient. Berlucchi M, Castelnuovo P, Vincenzi A, Morra B, Pasquini E. Endoscopic outcomes of resorbable nasal packing after functional endoscopic sinus surgery: a multicenter prospective randomized controlled study. They also can be printed or transferred to a CD. World Neurosurg. CT-MR image fusion for the management of skull base lesions. Historically, sinus CT at our institution (a multispecialty academic medical center) was performed in the radiology department by using one of two imaging protocols, based on whether the CT was intended for diagnostic purposes or intraoperative navigation, neither of which would be considered a low-radiation dose screening sinus CT. h*_q>##/& V>x8!`[Y]*"P #CM{&92AB NAC w4%Qi-YNCJ~GE' EKC)Rch+ 6a3mt^t-30|q Body Region Subcategory: Start typing to search. Two pulses of oral steroids produced a prolonged response that was again only temporary. ALL GUILFORD RADIOLOGY STAFF HAVE BEEN FULLY IMMUNIZED AGAINST THE COVID-19 VIRUS. Otolaryngol Clin North Am. The following are examples of critical points when computer guidance is of greatest assistance during surgery: Delineating a skull base contour during a revision procedure, Distinguishing smooth-walled peripheral cells from surrounding landmarks. TEST SINUS LANDMARX. 275 (4):905-911. The CT images and direct views from the endoscope are visualized throughout the procedure. As such, their conclusion was that the primary limiting factor for radiation dose reduction is the surgeon's willingness to accept impaired image quality. Please contact your Diagnostic Imaging Specialist to verify if the desire imaging is available at your preferred location. [12] although recent developments alleviated the latter limitation. 1, 23.9% of patients (278/1162) referred for sinus CT by sinus surgeons underwent ESS with imaging guidance, whereas this percentage was 11.4% (151/1323) for the remainder of the ENT department. NEWS Rathgeb C, Anschuetz L, Schneider D, Dr C, Caversaccio M, Weber S, et al. Comparison of endoscopic sinus surgery with and without image guidance. To determine potential cost savings and radiation dose reduction that result from the use of a single universal sinus CT protocol for diagnostic imaging and intraoperative navigation. This study was approved by the institutional review board (Mayo Clinic Institutional Review Board protocol 14002262), and the need for informed consent was waived. It does not imply the use of a contrast agent. 2017 Oct 1. 1st ed. Laryngoscope. 2002 Jul-Aug. 16(4):193-7. In instances in which a patient had multiple sinus CTs, the date of the most recent CT before surgery was used. As a library, NLM provides access to scientific literature. Through innovative technology integration, we bring Surgical Synergy to your OR-- facilitating operative efficiency, value,and outcomes. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. ENT Imaging Capabilities. Int Forum Allergy Rhinol. endobj Otolaryngol Head Neck Surg. A noncontrast CT scan is usually sufficient, except for complicated acute sinusitis (e.g., periorbital cellulitis or abscess). Medtronic offers hands-on training withpowered ENT instruments,surgical navigation,nerve monitors, and more. A CT scan of the surface produces images that also show an patient's paranasal sinus cavities. For sinus CT at the authors' institution, a single imaging protocol was begun and deemed acceptable by neuroradiologists and surgeons for diagnostic imaging and intraoperative guidance. Of all the patients who had a sinus CT, the proportion that ultimately underwent ESS with imaging guidance differed based on the specialty of the referring provider (p < 0.0001). [QxMD MEDLINE Link]. Brown SM, Sadoughi B, Cuellar H, et al. What Do Herpes Sores Look Like at Different Stages. He had a slight right cheek swelling visible externally. Terri J. Chipman, M.D. Krouse JH and Christmas DA. Differences in the mean time between sinus CT and ESS among the three groups were assessed by using one-way analysis of variance with the Dunn Multiple Comparison Test. Even though some centers use a unique acquisition protocol, many centers still have a specific 3D navigation protocol and a specific standard CT protocol for sinus CT scans . This is particularly relevant in cases that involve the pituitary and anterior skull base. CT scan showed a large neoplasm of the right paranasal sinuses with bony erosion of inferior and medial orbit (Figure 3). 118(7):1287-92. The annual average per capita effective radiation dose from medical procedures in the United States increased sixfold between 1980 and 2006, from 0.53 to 3.0 mSv compared with background environmental radiation exposure of 2.4 mSv.22. 31 (3):196-199. Consequently, the subset of patients that ultimately needed ESS would not require repetitive imaging. All staff and patients are required to wear appropriate face masks and staff wear other required PPE. 2001; 7(2):189-192. *Protocol, Sequences, and Advanced Services may differ by center location. The quality of the CT or CBCT scan is the most important aspect of creating The CT scan acquisition protocol used for the authors' needs consists of a helical, 2-mmthickness axial CT scan with the use of a specially designed headset incorporating built-in metallic fiducial land marking. Recommended protocol for medical CBCT scanners Scan time Longest available Voxel size 0.3 - 0.5mm Field of view Largest available File type CT (one file per slice) Reconstruction Axial Compression Uncompressed Thank you for taking a moment to read this protocol. 4 0 obj Uncomplicated cases of sinusitis are most often treated empirically based on findings from the history and physical examination. Lusk R. Computer-assisted functional endoscopic sinus surgery in children. You will be instructed when to enter where a technologist will greet you at the opened door. Destination on medtronic protocol cpt cysts or nursing females have not medical images are happy to compare the property of bone or an ent. The presented data were derived from an integrated multispecialty academic practice. Any practice that considers the use of a universal sinus CT protocol would have to take this lag into account based on local referral patterns and wait times. He appeared healthy on examination and had hyponasal speech. The patient is a 37-year-old man who smokes. Third, the time that elapses between the sinus CT and ESS must be taken into account. Bone window views provide excellent resolution and a good definition of the complete osteomeatal complex and other anatomic details that play a role in sinusitis.2 The coronal view also correlates best with findings from sinus surgery. Accuracy is verified by testing various known landmarks on the patient's face and intranasally to the images on the computer monitor (see the image below). The use of a universal sinus CT protocol for both intraoperative navigation and routine diagnostic imaging represents an easily overlooked opportunity for eliminating redundant imaging. Leong JL, Batra PS, Citardi MJ. 2013 Mar. 8 0 obj Magnetic resonance imaging (MRI) cannot define bony anatomy as well as CT. MRI is only used to differentiate soft-tissue structures, such as in cases of suspected fungal infection or neoplasm. Condoms are the most effective way to prevent HIV and STDs. Our staff is fully trained in Covid-19 screening, safety precautions and sterilization technique. Although technical advances have allowed navigation devices to be attached to virtually any sinus surgery instrument, the true value of the technology is that it maps out difficult anatomy at critical points in the surgery. In applying these prices to the 596 ESS cases that did not require a repeated preoperative sinus CT because of the universal sinus CT protocol, total saving was estimated as $142,162, which translated to $147,628 when adjusted for inflation. 2000 Jun. Otolaryngol Clin North Am. As such, all patients referred for sinus CT regardless of clinical indication were imaged under this universal protocol by using a 64-detector CT scanner (Lightspeed VCT or Discovery CT750HD; General Electric, Waukesha, WI), with the following imaging parameters: 120 kV, 180 mA, 0.5-second rotation time, 0.531 pitch, and .625-mm section Biofilm maturity studies indicate sharp debridement opens a time-dependent therapeutic window. 2005 Jun. FOIA Guilford, CT 06437, Hours: We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. The primary objective was to highlight the potential for cost saving and to raise awareness of radiation dose reduction, with the understanding that the derived estimates were not absolute and would vary from one site to the next based on the unique nature of individual practices. This technology is beneficial in cases that involve both otolaryngologists and neurosurgeons, as one image-guidance system can be used for navigation. Today with numerous CT scan manufacturers around the world and with numerous makes and models of scanners constantly changing it is essentially impossible to provide a set of protocols for what would likely be 100 different scanners. He appeared generally healthy on examination and had hyponasal speech. STIs are the most common cause of genital sores. (New protocols can be added as requested), Metal Artifact Reduction Software (MARS) ensures the best quality images are produced by minimizing the image artifacts and distortion caused by metal implants throughout the body. World Neurosurg. The benefit of a common sinus CT protocol would be negated if a patient proceeded with ESS at an external facility that may have required a repeated preoperative CT. Disadvantages of MRI include high false-positive findings, poor bony imaging, and higher cost. The mean time interval between sinus CT and ESS was longer (p < 0.01) for non-ENT (63.1 58.3 days [SD]) compared with sinus surgeons (42.5 50.9 days [SD]) or the remaining ENT providers (45.1 51.2 days [SD]). Sinonasal cancers are quite uncommon, with an annual incidence of less than 1:100,000 in the United States. endobj If you suffer from frequent headaches, jaw clicking and popping ear pain, you may have TMJ. Accuracy and feasibility of a dedicated image guidance solution for endoscopic lateral skull base surgery. In our study, 24% (4/17) of pediatric patients and 41% (21/51) of adult patients undergoing 3D navigation sinus CT had already had a sinus CT for the same episode of care. [2, 3, 4]. Comparison between low-dose and standard-dose multidetector CT in patients with suspected chronic sinusitis, Low-dose CT of the paranasal sinuses with eye lens protection: Effect on image quality and radiation dose, Radiation dose reduction in paranasal sinus CT using model-based iterative reconstruction, Reducing the radiation dose for low-dose CT of the paranasal sinuses using iterative reconstruction: Feasibility and image quality, Performance of iterative image reconstruction in CT of the paranasal sinuses: A phantom study. This technology enables the surgeon to follow the anatomic dissection of the sinuses on a computer monitor in the operating room in real time. Although the estimated saving of $147,628 over 4 years in the current study was relatively modest, curtailing wasteful spending in any amount is increasingly necessary in the era of cost containment and accountable care. However, given that there is significant variability in payer mix across practices, the use of Medicare rates allowed for a more generalizable result. [QxMD MEDLINE Link]. At our tertiary care multispecialty institution, >500 health care providers have access to ordering sinus CTs. Scanner Type: Start typing to search. 2005 Oct. 34(5):317-22. This correlates head position with the tracking system. (All locations). <> Wolcott RD, Rumbaugh KP, James G, et al. Otolaryngol Head Neck Surg. stream 1997 May. the contents by NLM or the National Institutes of Health. Image-guided surgery influences perioperative morbidity from endoscopic sinus surgery: a systematic review and meta-analysis. The https:// ensures that you are connecting to the A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. Trust the staff at Guilford Radiology to take care of you and your familys medical imaging needs in a patient friendly, convenient outpatient environment for the safest, most comfortable exam possible. For better definition of the neoplasm, an MRI scan was obtained. 12 A CT scan provides greater definition of the sinuses and is . Mucosal thickening, polyps, and other sinus abnormalities can be seen in 40 percent of symptomatic adults; however, clinical correlation is needed to avoid overdiagnosis of sinusitis because of nonspecific CT findings. "U|7QEHDIYcXm2>@!4^k, 7tWD~ General educational and the ct sinus medtronic protocol code may have not be included in some options The cohort consisted of 2759 women (44.6%) and 3428 men (55.4%), with an average age of 53.6 years 16.7 years (mean SD). Therapies & Procedures The full terms of this license are available at, Sinus computed tomography, surgical navigation, rhinosinusitis, intraoperative navigation, computer-assisted imaging guidance, endoscopic sinus surgery, cost effectiveness, radiation dose reduction, Healthcare expenditures for sinusitis in 1996: Contributions of asthma, rhinitis, and other airway disorders. Manufacturer: This has enormous implications for surgeons who prefer local or intravenous sedation. He underwent transfacial and endoscopic resection of the mass with postoperative radiation therapy. The 2 test was used to compare the proportion of patients in each group who underwent surgery after sinus CT. View the ENT Product Catalog for all sinus surgery products. Medtronic Operational Headquarters 710 Medtronic Parkway Minneapolis, MN 55432-5640 USA, Sinus Surgery & Transnasal Skull Base Surgery, Central/Eastern Europe, Middle East & Africa, Electromagnetic Compatibility Guide for Cardiac Devices, Straightshot Automated EM Tracking Blades, Electromagnetic Compatibility for Cardiac Devices, California Transparency in Supply Chains Act, Information About Proposition 65 for California Customers, Digital Millennium Copyright Act (DMCA) Notification. Noncontrast coronal computed tomographic (CT) images can define the nasal anatomy much more precisely. A large nasal mass was seen emanating from the right middle meatus with a smooth mucosal surface and prominent blood vessels. NB: This article aims to frame a general concept of a CT protocol for the assessment of the paranasal sinuses. 8AM to Noon. We offer this Site AS IS and without any warranties. Chen Y-L, Tan C-T, Huang H-M. CONSENTING FORMS. Let us know what protocols you have issues with and we will address them. The system is then used during the surgery to confirm the position of the surgeons instruments at all times. In: Kennedy DW, Bolger WE, Zinreich SJ, eds. His ears were clear by otoscopy, and his nasal examination revealed a right-sided septal deviation. In addition, sinus CT is used for intraoperative imaging guidance. Functional endoscopic sinus surgery: concepts, surgical indications, and instrumentation. ORAL CONTRAST. Patients without an acceptable mask will be provided one. The referring providers were categorized into three groups: sinus surgeons, other members of the otolaryngologyhead and neck surgery (ENT) department exclusive of sinus surgeons, and all other non-ENT health care providers. Up to 40 percent of asymptomatic adults have abnormalities on sinus CT scans, as do more than 80 percent of those with minor upper respiratory tract infections.14. 2008 Jul. Physician Resources Specialty Protocols. Clearing the operative field of blood and debris and then using either a tracking pointer or a tracking curved suction to elucidate anatomicquestions is most prudent for the surgeon, who may then proceed safely with the next step of surgery. With most systems, these preliminary steps take less than 2 minutes with the collaboration of trained operating room staff. The location is materialized by a set of cross hairs on the screen that moves through the CT image data in concordance with the movement of the pointer. Exam rooms and equipment are thoroughly disinfected after each patient, from mammography paddles to the CT & MRI bores, to the exam tables, counters, and areas of patient contact. The surgeon views the anatomic landmarks using endoscopes. 2023 Guilford Radiology. Diseases of the Sinuses: Diagnosis and Management. Setty P, Volkov AA, D'Andrea KP, Pieper DR. Endoscopic vascular decompression for the treatment of trigeminal neuralgia: clinical outcomes and technical note. Three aspects of direct coronal imaging of the paranasal sinuses were investigated: (1) preparation of the patient prior to the examination; (2) technical factors of the CT study, including positioning of the patient, optimal coronal angle, slice thickness, and CT exposure factors; and (3) data display. In many ways CT scanning works very much like other x-ray examinations. [14] Metson et al prospectively compared an optical system and an electromagnetic system. With systems using optical technology, the image-guided surgery (IGS) unit must be in direct line to the operating room table with no line-of-sight obstruction, The authors have no conflicts of interest to declare pertaining to this article, Presented in preliminary form as an oral abstract at the American Society of Neuroradiology Meeting, May 22, 2014, Montreal, Quebec, Canada, National Library of Medicine Seth M Brown, MD, MBA, FACS Clinical Assistant Professor, Department of Surgery, Division of Otolaryngology, University of Connecticut School of Medicine; Consulting Physician, Department of Neurosurgery, Hartford Hospital; Director, The Connecticut Sinus Institute Kanai K, Okano M, Haruna T, Higaki T, Omichi R, Makihara SI, et al. The original goal of www.ctisus.com nearly 25 years ago was to provide a source for CT scan protocols. Haruna S, Otori N, Moriyama H, Kamio M. Endoscopic transnasal transethmosphenoidal approach for pituitary tumors: assessment of technique and postoperative findings of nasal and paranasal cavities. Image-guided surgery is one of the most significant advances in endoscopic sinus surgery since the inception of the endoscopic approach in the mid-1980s. If you log out, you will be required to enter your username and password the next time you visit. With the newer systems (see the second image below), the headset moves along with the head, so registration is maintained throughout the procedure, although frameless registration can also be performed. It does not imply the use of a contrast agent. Navigation System; Medtronic Inc, Minneapolis, MN). Christina J. Laane, M.D. Instrumentation in endoscopic sinus surgery. Philadelphia: BC Decker; 1991. Without a subpoena, voluntary compliance on the part of your Internet Service Provider, or additional records from a third party, information stored or retrieved for this purpose alone cannot usually be used to identify you. I will just be glad when this is over(-: CT with fusion is a radiological technique used to enhance the images. I-n*,_p$ons0':{Bb`OMj9M7>4XT1F \Ph >0'c&p^q#O(MOqzJ1e%S~0:W"[JG79& 2010; 19(8):320-328. In the current study, the mean duration between CT and ESS ranged from 42.5 days to 63.1 days and, as expected, the longest time interval was for non-ENT providers. Laryngoscope. %PDF-1.4 American Academy of Otolaryngology-Head and Neck Surgery, American Bronchoesophagological Association, American Society for Laser Medicine and Surgery, Society of University Otolaryngologists-Head and Neck Surgeons, American Academy of Facial Plastic and Reconstructive Surgery, Association for Research in Otolaryngology, American Society of Pediatric Otolaryngology, Canadian Society of Otolaryngology-Head & Neck Surgery. 2012; 50:191-198. A total of 6187 sinus CTs were performed by using a 64-detector scanner during the study period (2759 women and 3428 men; 53.6 16.7 years [mean SD]), and 596 endoscopic sinus surgery cases used imaging guidance, for which all the CTs were deemed technically adequate. After a prolonged course of antibiotics, serial CT scans revealed resolution of the frontal abscess and sinusitis. Statistical analysis was performed by using JMP 10.0.0 (SAS Institute Inc, Cary, NC). The use of image-guided surgery in endoscopic sinus surgery: an evidence-based review with recommendations. NONE. The goal of sinus surgery is to restore ventilation and drainage while preserving mucosa. Acute cerebral venous sinus thrombosis (VST) is a rare form of stroke, and establishing a correct diagnosis can be challenging due to its diverse and typically delayed clinical presentation [1,2].VST is most common in young women and is associated with pregnancy/puerperium, use of hormonal contraceptives, hypercoagulable states, and malignancy [3,4]. All rights reserved. The paranasal sinuses are hollow, air-filled places located within the remains von the face and environs of nose cavity, a system of air tv connecting the nasal with an support of the jaw. Inclusion in an NLM database does not imply endorsement of, or agreement with, CT scans can provide much more detailed information about the anatomy and abnormalities of the paranasal sinuses than plain films. Otolaryngol Head Neck Surg. The technical storage or access is necessary for the legitimate purpose of storing preferences that are not requested by the subscriber or user. Furthermore, no significant difference was noted in other parameters (eg, blood loss, complications). xE0EwhD7c@5#B7X Philadelphia, PA: PMPH USA; 2001:197-210. Magnetization Prepared 2 Rapid Acquisition Gradient Echoes (MP2RAGE) is a fast 3D T1 sequence with a very high contrast that creates superior grey matter/white matter differentiation, showing a higher brain tissue and lesion contrast in multiple sclerosis patients. <>>><>>>] Multiple CTs increase cost and radiation exposure. [10], The relevant anatomy is that of the paranasal sinuses, orbits, and cranial base and is comprehensively treated in many textbooks such as Stammberger'sFunctional Endoscopic Sinus Surgery(1991). A single Waters' view (occipitomental) appears to provide as much information as the standard four-view series.11, CT scans can provide much more detailed information about the anatomy and abnormalities of the paranasal sinuses than plain films.12 A CT scan provides greater definition of the sinuses and is more sensitive than plain radiography for detecting sinus pathology, especially within the sphenoid and ethmoid sinuses.6,13 CT scan findings can also be quite nonspecific, however, and should not be used routinely in the diagnosis of acute sinusitis.6,14 The primary role of CT scans is to aid in the diagnosis and management of recurrent and chronic sinusitis, or to define the anatomy of the sinuses prior to surgery.2 In many institutions, a limited CT scan costs about the same as a full radiographic series but provides more useful information.2,15,16, A coronal CT image is the preferred initial procedure. The electronic medical records for all outpatients undergoing sinus CT between October 1, 2010, and September 30, 2014, were queried. Patients visit Guilford Radiology from surrounding areas: Branford, Clinton, East Haven, Killingworth, Madison, New Haven, and North Branford. (Superior), Susceptibility Weighted Imaging (SWI) is an MRI sequence that is exquisitely sensitive to venous blood, hemorrhages, and iron storage, making it commonly used in the diagnosis/treatment of head injuries and concussions. HKMJ. In our study, 24% (4/ . As such, all patients referred for sinus CT regardless of clinical indication were imaged under this universal protocol by using a 64-detector CT scanner (Lightspeed VCT or Discovery CT750HD; General Electric, Waukesha, WI), with the following imaging parameters: 120 kV, 180 mA, 0.5-second rotation time, 0.531 pitch, and 0.625-mm section collimation. It is used occasionally in cases of suspected tumors or fungal sinusitis.1719 Otherwise, MRI has no advantages over CT scanning in the evaluation of sinusitis. Laryngoscope. [QxMD MEDLINE Link]. Fried MP, Parikh SR, Sadoughi B. Image-guidance for endoscopic sinus surgery. CTisus uses cookies to collect information and enhance user experience. Sohaib SA, Peppercorn PD, Horrocks JA, et al. Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American Head and Neck SocietyDisclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cerescan; Ryte; Neosoma; MI10
Received income in an amount equal to or greater than $250 from: Neosoma; Cyberionix (CYBX)
Received ownership interest from Cerescan for consulting for: Neosoma, MI10. Plain radiography has a limited role in the management of sinusitis. Consent to Contrast Material. THEY NEED 1MM OR LESS. endobj Adopting the strategy of making all diagnostic sinus CTs compatible with surgical imaging guidance systems requires the involved surgeons and radiologists to reach a consensus on acceptable image quality, and this is most challenging when decreasing the radiation dose. endobj Endo-Scrub 2 Lens Cleaning Sheaths significantly improve the ability to operate in the presence of bleeding. 2013; 270(1):149-155. Depending on the severity of disease and whether significant fluctuation is anticipated based on treatment (or lack thereof), it may still be necessary to repeat a preoperative CT for updated planning purposes. We hope you find this useful and would appreciate any comments or suggestions that you might have. Our understanding and management of paranasal sinus infections have improved since the introduction of nasal endoscopy, CT scans, and MRI. Including: CT of the brain (or spine) with stealth protocol. Tell your doctor if there's a possibility you are pregnant and discuss any recent illnesses, medical conditions, medications you're taking, and allergies. Bhattacharyya N. Progress in surgical management of chronic rhinosinusitis and nasal polyposis. You are being redirected to Medtronic is the leader in providing innovative and comprehensive ENT solutions for the office. 1996; 75(1): 42-45. I'm not a radiologist but I believe it has to do with overlaying the images in a particular manner and the use of specialized software. CT of the brain with Lorenz protocol. 1998 Oct. 119(4):374-80. 1998 Aug. 108(8 Pt 1):1164-70. Fried MP, Morrison PR. <> Oper Tech Otolaryngol Head Neck Surg. [17]. There has been considerable work done recently on radiation dose from CT scans. These locations' coordinates are stored and used throughout the procedure to monitor any changes in the accuracy of the device. We will keep you up to date on these new developments as we expand this section. Diagnostic imaging is generally used in cases of recurrent or complicated sinus disease. With an updated browser, you will have a better Medtronic website experience. Laryngoscope. Although worth acknowledging, these limitations did not significantly hamper the results. 2Department of OtolaryngologyHead and Neck Surgery, Mayo Clinic, Phoenix, Arizona. M-F 7:30AM to 5PM Home Variability of radiation exposure with in-office sinus computed tomography examinations. The development and rapidly growing popularity of image-guided surgery in sinus surgery are directly attributable to the risks of such disruptions. Laryngoscope. In the current study, all the CTs used for ESS were graded as technically adequate, so subjective quality for intraoperative navigation was not negatively impacted. The imaging data set is transferred via optical disk, CD-ROM, or computer network to the operating room, where it is loaded into the workstation. As such, the reported saving represented a conservative estimate because the actual amount would have been higher if the higher reimbursement rates of private insurers were considered.

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