Sinus tumours and nasal polyposis: we operate using 3D
The surgeon works with special glasses that allow three-dimensional visualisation.
The surgeon enters the operating room and wears special black glasses inside.
They look like sunglasses but on closer inspection, they are different. They are essential to watch the monitor that projects the surgical images in 3D. It is the three-dimensional FESS endoscopic sinus surgery and is the novelty that has recently made its entrance in the operating rooms of the otolaryngologist, an technological innovation that can make a difference - especially for the removal of tumours in the sinuses and in some cases of advanced nasal polyposis.
Scar-free surgery
For some time now, scarless surgery has been achieved using surgical endoscopes that are inserted into the nostrils.
'These are less invasive procedures which exploit the natural access of the airways to address nasal polyposis, now it is also used to remove tumours' - explains Alberto Dragonetti - Otolaryngologist -. 'When possible, there are no fractures of the bones of the face so to achieve shorter hospital stays and recovery times and excellent results. For this type of surgery, we have many miniaturised instruments such as pliers, drills and lasers to be able to operate in an area of a few millimetres with a very limited room for manoeuvre. Even the evolution of images is making continuous steps forward. Today, we can count on video cameras and screens that offer 4K images with ever sharper details. In addition, the 3D display system allows us to have images in which the surgeon has the perception of depth. The system uses the combination of a dedicated monitor and three-dimensional viewers worn by surgeons. All this translates into greater precision.'
The advanced intraoperative navigation system is also of fundamental importance, using both the CT images that can be fused with the resonance images, offering greater precision and safety.
Tumours that develop in the nasal cavity and sinuses are rare and account for less than 1% of all cancers and about 3-5% of upper respiratory tract cancers. These cancers mainly affect adults after a certain age (in four out of five cases over 55) and men are slightly more likely to get sick than women. The most common forms of cancer are those affecting the nasal cavity and the maxillary sinuses; tumours of the ethmoid sinuses are less common; those of the frontal and sphenoid sinuses are very rare.
Risk factors
Among the risk factors are the inhalation of some dusts, such as those deriving from the processing of wood, leather, fabrics, flour, or nickel and chromium powders and others. For people employed in these industries, the risk of developing one of these neoplasms increases if there is not adequate airway protection. Smoking also contributes to the onset of these cancers. Among the less certain risk factors are glues, formaldehyde and organic solvents but care should still be taken around these substances.
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