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Abstract
Background and Objectives
Three-dimensional (3D) imaging is gaining popularity and has been partially used in robotic surgery but not in sinonasal surgery owing to technical problems. This is not only the first pilot study to evaluate the usefulness of newly-developed ‘twin lens’ HD-3D endoscope (Machida), but also the first clinical study to compare this instrument with the pre-existing ‘insect eye’ 3D endoscope (Visionsense).
Materials and Method
A total of 45 surgeries for cerebrospinal fluid leakage, angiofibroma, or sinonasal malignancy were performed using a 3D endoscope between November 2011 and October 2013 (‘insect eye’ Visionsense VSII 3D: 29 cases, ‘twin lens’ Machida HD-3D: 16 cases).
Results
Depth perception and recognition of anatomical structures were all excellent in the two 3D methods. The ‘twin lens’ HD-3D endoscope provided better image resolution and naturalness of color and showed less unfavorable phenomena such as image blurring and blackout than the ‘insect eye’ 3D endoscope.
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Fig. 1.
Visionsense ‘insect eye’ VSII video tower combining with 32” high-resolution display monitor and 3D imaging processing unit (A1). 4-mm 0º, 30º 3D endoscope and cable with LED light source (A2). 40” high-definition display monitor (Sony, Tokyo, Japan), Machida ‘twin lens’ 3D video camera unit and 3D converter (B1). 4.7-mm 0º 3D endoscope consisting of twin-lens (B2). 0º, 30º 3D endoscope and xenon light cable (B3).
Fig. 2.
Left ethmoid sinus view in 2 different patients with ‘insect eye’ 3D endoscope (Visionsense) (A) and ‘twin lens’ HD-3D endoscope (Machida) (B). Reconstructed right (A1) and left (A2) images using single video chip. Separate, independent right (B1) and left (B2) images using twin lens and dual video chip.
Table 1.
Specification comparison of 3D endoscopes
Table 2.
Patients’ demographic and procedural details for ‘insect eye’ Visionsense VSII 3D endoscope
Pt: patient, Op.: operation, Navi: navigation, L: left, R: right, B: both, CSF: cerebrospinal fluid, CCRTx: concurrent chemoradiation, SCC: squamous cell carcinoma, CFR: craniofacial resection, MM: medial maxillectomy, MFDA: midfacial degloving approach, w/: with, lumbar D: lumbar drainage, SRP: septorhinoplasty
Table 3.
Patients’ demographic and procedural details for ‘twin lens’ Machida HD-3D endoscope
Table 4.
Causes of switch from 3D to 2D endoscope
Table 5.
Comparison of qualitative assessments for 3D endoscopes
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