Table 1. Qualitative synthesis of the included studies.
| Study | Population | n | Results | Conclusion |
|---|---|---|---|---|
| Javer and Genoway 23 | CRS | IGS: 80 ESS: 15 |
A significant improvement in quality of life was observed following IGS compared with ESS in the sub-groups of nasal symptoms, ear symptoms, general symptoms, and practical problems. | The improvement in overall quality of life six months post-ESS appeared to be further enhanced when computer assistance was added to endoscopic sinus surgery. |
| Jiang and Liang 28 | CRS (revision surgery) | IGS: 51 ESS: 30 |
IGS: 83 out of 91 sphenoid sinuses were successfully opened. ESS: 35 out of 51 sphenoid sinuses were successfully opened. |
IGS was a beneficial procedure for opening the sphenoid sinus, especially in revision cases. |
| Lorenz et al. 26 | CRS | IGS: 35 ESS: 35 |
IGS: Two patients had complications. ESS: Six patients had complications. |
The question, whether by using IGS a higher security can be reached with a lower complication rate, cannot be answered so far. |
| Singh et al. 20 | CRS | IGS: 30 ESS: 30 |
IGS: No complications. Operating room time: 165.68 (±6.55) ESS: One complication (orbital swelling) Operating room time: 163.33 (±5.43) |
The additional time taken for device setup and registration was effectively overcome by the reduced intraoperative time. Complications did not differ significantly with or without IGS. |
| Stelter et al. 27 | CRS | IGS: 80 ESS: 77 |
IGS: Two missed paranasal sinuses/three complications ESS: Five missed paranasal sinuses/three complications. |
Navigation should have an assured place in training and teaching for paranasal sinus operations. Even if this new technology means extra costs, it was welcomed by all study participants (surgeons and patients). |
| Strauss et al. 24 | CRS | IGS: 150 ESS: 150 |
Incision-suture time: 10.1 min less with IGS. Preparation time: 7 min more with IGS. Successful sinusotomy: IGS: 31/31 | ESS: 9/40. Patient assessment: General feeling of well-being: 73% IGS/69% ESS; Minimal improvement, no improvement, or worsening 16% IGS/30% ESS; Would have the surgery again: 96% IGS/85% ESS. |
The advantages of the examined navigation system compared to the gold standard of ESS are proven. Navigation assistance led to reduced intraoperative time, increased postoperative results, and lowered the workload of the surgeons. |
CRS: chronic rhinosinusitis; IGS: image-guided surgery; ESS: endoscopic sinus surgery.