Image Guided Endoscopic Sinus Surgery

October 17 2005

As with all surgery, accuracy is of utmost importance when dealing with the body. Image Guided Endoscopic Sinus Surgery utilises scan images transmitted into the computer, to guide the surgeon during surgery.

This half-a-million-dollar cutting-edge technology allows the ENT surgeon to work around tight corners in small holes without losing track of his position in the patient's nose, crucial when work is constantly next to critical structures like the eye and brain. The technology also overcomes many of the line-of-sight problems frequently encountered with the older infrared technology.

CT scan images are used to show bony architecture clearly and to ensure complete clearance of disease, as well as to protect against brain and eye injury since these vital structures form the boundaries of the sinuses.

The ENT Department at the National Healthcare Group's Tan Tock Seng Hospital (TTSH) is the first and only department in Singapore and the region offering the new image guidance surgery with electromagnetic technology. Currently, 99 per cent of endoscopic sinus surgeries at TTSH are carried out with image guidance. TTSH was also the first hospital in Singapore to use the infrared technology in endoscopic sinus surgery more than ten years ago.

Initially designed for use in complex ENT revision surgery, image guidance is now routinely used in all endoscopic sinus surgery at TTSH. Besides ensuring complete clearance of disease and enhancing safety. - Image Guided Endoscopic Sinus Surgery at TTSH is government funded and offered at no extra cost, even for foreign patients.

Latest research in this technology sees the miniaturising of transmitters for placement on tips of instruments and catheters, enabling true tracking to take place anywhere inside the body.

"The most significant difference with image guided endoscopic sinus surgery is accuracy. It takes away educated guesses commonly used in surgery and helps push surgery to the limits, yet maintaining high standards of safety"

Obstructive Sleep Apnoea

Recent advances in treating snoring and mild Obstructive Sleep Apnoea (OSA) include the use of synthetic Palatal Pillar Implants and the Modified Cautery Assisted Palatal Stiffening (CAPSO), which involves "reshaping" of the palatal anatomy and structure. Both outpatient procedures are available at the National Healthcare Group's Tan Tock Seng Hospital (TTSH), and can be done in just 15 minutes under local anaesthesia with minimal pain and a short recovery time. Results have been very impressive and encouraging.

OSA is differentiated from simple snoring with an overnight polysomnogram (sleep study). Recent advances provide maximal surgical benefit with minimal surgical access. The minimally invasive hyoid suspension technique is currently being offered at the TTSH ENT Department, Sleep Service. For patients with severe OSA, this procedure may be incorporated with the minimally invasive Rapose Tongue Suspensio, also known as a tongue base sling suture. TTSH's ENT Department currently has the only surgeon in South East Asia fully trained in this tongue suspension suture technique.

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