The last thing a patient wants to hear after undergoing surgery is that disease remains inside their body all because the surgery was cut short. With the disease lying in wait, that patient will likely face more surgery down the road -- a painful, dangerous and costly reality. In chronic sinus disease which affects 29.5 million Americans and often requires surgery, revision surgery is common. So why are these complicated surgeries being cut short? Simply because a surgeon cannot see beyond the area that has been surgically explored. In the O.R., a surgeon's evaluation of disease is limited without access to advanced imaging that provides an ability to see beyond tissue, blood, and bones. A decision of whether revision surgery may be necessary occurs post-surgery with the assistance of diagnostic images, or computed tomography (CT or CAT) scans. While the possibility of multiple surgeries may be alarming to sinus patients, help has arrived and the risk of those revision surgeries is about to be dramatically reduced.

A team of Ear, Nose and Throat surgeons (ENT) at the University of Pennsylvania (U Penn) set out to demonstrate that use of a unique, small and literally mobile CT scanner, called xCAT® ENT, will decrease those percentages significantly, making them a statistic of the past. Those surgeons revealed that use of xCAT® ENT in the O.R. led to alteration in the surgical plan in 30% of patients. Personalizing this to an individual, without xCAT® ENT, there is a 30% chance of some disease being left, even in the hands of the most experienced surgeons, and therefore a greater chance of needing to undergo additional surgery. "We believe that it is very important to avoid leaving pockets of disease during sinus surgery and this is a significant advance in terms of making sure the surgery is complete," said David W. Kennedy, M.D. Professor, Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania. The study is published in the American Journal of Rhinology, a peer-reviewed medical journal (April, 2008).

A limited blueprint

Surgeries are performed using CT scans of the patient taken days or weeks before. Since the anatomy of the patient is changing during surgery and since the surgery is performed close to the eye and to the brain, surgeons walk a tight rope between leaving disease and, at the same time, minimizing the risks to these vital areas. The surgery itself reduces the accuracy and usefulness of those CT scans as blueprints for the surgeon. . The result is that surgeons who are unable to see beyond the surgically explored area may frequently leave disease during the surgery. To see beyond the area, the surgeon needs real-time updated images of surgical anatomy, particularly in complex surgeries close to the brain which require extreme accuracy.

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