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Surgeons at Jefferson Hospital demonstrate high-tech procedure for treating chronic sinus problems in a live internet broadcast (Archived version now available).
Original broadcast: September 17, 4:30 pm, ET

As a special educational offering, Thomas Jefferson University Hospital is providing an archived version of a real-time webcast of an advanced, high-tech form of sinus surgery. Top-ranked ENT surgeons, William M. Keane, MD, and Marc R. Rosen, MD, perform and explain the procedure from Jefferson’s O.R., as they operate on one of their patients. This opportunity offers a close-up look at the latest update to surgical treatment for chronic sinus infections. The surgeons demonstrate an image-guided approach that minimizes both risk of complications and post-operative pain and recovery time. Physicians may obtain continuing medical education credits for viewing this special program.

Physicians and the public can now watch the 60-to-90-minute webcast in archived form

About the Procedure:
3-D CT-guided sinus surgery permits a level of precision and safety never before achieved in operations for chronic sinusitis. In the procedure, surgeons use infrared technology to stereotactically coordinate their surgical instruments with three-dimensional CT images, as they explore the sinus by direct view through their endoscopes.

Malformations, polyps, scarring, or other obstructions can prevent paranasal sinuses from draining normally. People with this type of sinus pathology are more likely to experience infections in these areas. An estimated 35 million people develop sinusitis annually, making this health condition one of the most common in the United States. For a large portion of these people, the discomfort goes beyond congestion, pressure, and breathing difficulties to include significant symptoms of infection. For many, these infections are so frequent that medical therapy alone is not an adequate solution.

“In earlier years, surgery to remove blockages from these patient’s sinuses often required making an open incision on the face or oral cavity,” notes William M. Keane, MD, Professor and Chairman of Otolaryngology-Head and Neck Surgery at Jefferson Medical College of Thomas Jefferson University. This operation gave limited access to the surgeon and meant significant discomfort and recovery time for the patient. The advent of endoscopy, however, permitted surgeons to see and operate on sinuses by inserting – through the opening of the nose – small tubes that carry fiber optics and small surgical instruments. As a result, sinus surgery became much less invasive. And yet, this approach in the complex confines of the sinuses, with delicate areas of the brain, nerves, or blood vessels immediately adjacent, remains challenging.

In the state-of-the-science approach now in use at Jefferson, surgeons not only use CT images of the sinuses to guide their operation but take advantage of several additional refinements. Sophisticated CT equipment has the computing power to reassemble its cross-sectional scans into three-dimensional images of the sinus cavities that the team can rotate for different views, in order to plan and conduct the surgery. The surgeons place guides on the patient’s head in the operating room as part of an infrared-technology system that correlates the position of their endoscopic surgical instruments with the CT images on screen. The specialists simultaneously view the sinus anatomy directly through the endoscope. The three-dimensional mapping component allows the team to more safely navigate the passages of the nose and sinuses and to precisely locate those structures that need to be removed to alleviate obstruction.

“With 3-D CT-guided sinus surgery, we have much greater assurance of resecting precisely the tissue we have identified as needing removal,” explains Marc R. Rosen, MD, Assistant Professor of Otolaryngology-Head and Neck Surgery at Jefferson Medical College of Thomas Jefferson University. Even compared to patients who receive conventional endoscopy, patients undergoing image-guided endoscopy have the prospect of less pain and shorter recovery time as a result of the improved technique.

CME Information from Jefferson Medical College:
Continuing Medical Education (CME) credits are available to physicians who sign up at www.JeffersonHospital.org/webcast for the simulcast of 3-D CT guided Endoscopic Sinus surgery via the Internet. Viewers will be able to ask questions online as well. A replay version of the procedure will be available for viewing at this site beginning September 19.

Jefferson Medical College of Thomas Jefferson University, as a member of the Consortium of Continuing Medical Education, is accredited by the ACCME to provide continuing medical education for physicians.

Jefferson Medical College designates this educational activity for a maximum of 1.0 hours in Category 1 credit towards the AMA Physician’s Recognition Award. Each physician should claim only those hours of credit that he/she actually spent in the educational activity.

All faculty participating in continuing medical education activities sponsored by Jefferson Medical College are expected to disclose to the activity audience any real or apparent conflict(s) of interest related to the content of their presentation(s). Full disclosure of faculty relationships will be made at the activity.

If you are a physician and would like to refer a patient to a Jefferson otolaryngologist for this procedure, please call 215-955-0215.

If you are a patient and would like to make an appointment with a Jefferson Otolaryngologist or would like more information about this procedure, please call 1-800-JEFF-NOW.