Skip to main content
SpringerLink
Log in

Three-dimensional endoscopic visualization in functional endoscopic sinus surgery

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Three-dimensional (3D) stereoscopic vision in sinus surgery has been achieved with the microscope so far. The introduction of two-dimensional (2D) endoscopes set a milestone in the visualization of the surgical field and paved the way to functional endoscopic sinus surgery (FESS), although the 2D endoscopes cannot provide a stereoscopic visualization. The latest technology of 3D endoscopes allows stereoscopic vision. We provide a clinical investigation of all commercially available 3D endoscopes in FESS to compare their clinical value and efficacy to routinely used conventional 2D HD endoscopes. In this prospective, randomized, controlled clinical study, 46 patients with polypoid chronic rhinosinusitis underwent FESS with one of the following three endoscopes: 2D 0° high definition (HD), 3D 0° standard definition (SD) and 3D 0° HD. Four surgeons qualitatively assessed endoscopes on stereoscopic depth perception (SDP) of the surgeon, sharpness and brightness of the image, as well as their comfort in use during surgery. Surgeons assessed the brightness of the control (2D HD) significantly better than 3D SD (p = 0.009) and brightness of 3D HD was rated significantly better than 3D SD (p = 0.038). Stereoscopic depth perception (SDP) of 3D SD was assessed highly significantly better than the control (2D HD) (p = 0.021), whereas 3D HD displayed best SDP (p = 0.0001). The comfort in use was rated significantly higher in the 3D HD group compared to the control group (p = 0.025). No significant differences in sharpness could be seen among all endoscopes. 3D HD endoscopy provides an improvement in SDP and brightness of the surgical field. It enhances the intraoperative visualization and is therefore an important and efficient development in endoscopic sinus surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Barkhoudarian G, Del Carmen Becerra Romero A, Laws ER (2013) Evaluation of the 3-dimensional endoscope in transsphenoidal surgery. Neurosurgery 73(1 Suppl Operative):ons74–ons78. doi:10.1227/NEU.0b013e31828ba962 (discussion on s78–79)

    PubMed  Google Scholar 

  2. Fraser JF, Allen B, Anand VK, Schwartz TH (2009) Three-dimensional neurostereoendoscopy: subjective and objective comparison to 2D. Minim Invas Neurosurg 52(1):25–31. doi:10.1055/s-0028-1104567

    Article  CAS  Google Scholar 

  3. Shah RN, Leight WD, Patel MR, Surowitz JB, Wong YT, Wheless SA, Germanwala AV, Zanation AM (2011) A controlled laboratory and clinical evaluation of a three-dimensional endoscope for endonasal sinus and skull base surgery. Am J Rhinol Allergy 25(3):141–144. doi:10.2500/ajra.2011.25.3593

    Article  PubMed  Google Scholar 

  4. Tabaee A, Anand VK, Fraser JF, Brown SM, Singh A, Schwartz TH (2009) Three-dimensional endoscopic pituitary surgery. Neurosurgery 64(5 Suppl 2):288–293. doi:10.1227/01.NEU.0000338069.51023.3C (discussion 294–285)

    PubMed  Google Scholar 

  5. Marcus HJ, Hughes-Hallett A, Cundy TP, Di Marco A, Pratt P, Nandi D, Darzi A, Yang GZ (2014) Comparative effectiveness of 3-dimensional vs 2-dimensional and high-definition vs standard-definition neuroendoscopy: a preclinical randomized crossover study. Neurosurgery 74(4):375–380. doi:10.1227/NEU.0000000000000249 (discussion 380–371)

    Article  PubMed  Google Scholar 

  6. Szold A (2005) Seeing is believing: visualization systems in endoscopic surgery (video, HDTV, stereoscopy, and beyond). Surg Endosc 19(5):730–733. doi:10.1007/s00464-004-8272-8

    Article  CAS  PubMed  Google Scholar 

  7. Al Kadah B, Bumm K, Charalampaki P, Schick B (2012) First experience in endonasal surgery using a new 3D-Chipendoscope. Laryngorhinootologie 91(7):428–433. doi:10.1055/s-0032-1309051

    Article  CAS  PubMed  Google Scholar 

  8. Van Gompel JJ, Tabor MH, Youssef AS, Lau T, Carlson AP, van Loveren HR, Agazzi S (2014) Field of view comparison between two-dimensional and three-dimensional endoscopy. Laryngoscope 124(2):387–390. doi:10.1002/lary.24222

    Article  PubMed  Google Scholar 

  9. Howarth PA (2011) Potential hazards of viewing 3-D stereoscopic television, cinema and computer games: a review. Ophthalmic Physiol Opt 31(2):111–122. doi:10.1111/j.1475-1313.2011.00822.x

    Article  PubMed  Google Scholar 

  10. Brown SM, Tabaee A, Singh A, Schwartz TH, Anand VK (2008) Three-dimensional endoscopic sinus surgery: feasibility and technical aspects. Otolaryngol Head Neck Surg 138(3):400–402. doi:10.1016/j.otohns.2007.12.007

    Article  PubMed  Google Scholar 

  11. Inoue D, Yoshimoto K, Uemura M, Yoshida M, Ohuchida K, Kenmotsu H, Tomikawa M, Sasaki T, Hashizume M (2013) Three-dimensional high-definition neuroendoscopic surgery: a controlled comparative laboratory study with two-dimensional endoscopy and clinical application. J Neurol Surg A Cent Eur Neurosurg 74(6):357–365. doi:10.1055/s-0033-1345100

    Article  PubMed  Google Scholar 

  12. Roth J, Singh A, Nyquist G, Fraser JF, Bernardo A, Anand VK, Schwartz TH (2009) Three-dimensional and 2-dimensional endoscopic exposure of midline cranial base targets using expanded endonasal and transcranial approaches. Neurosurgery 65(6):1116–1128. doi:10.1227/01.NEU.0000360340.85186.7A (discussion 1128–1130)

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We would sincerely like to thank Stephan Engelhardt from Medical Diagnostic Systems Vertriebs GmbH, for the generous supply of the devices and his technical support.

Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology, Head and Neck Surgery, University of Heidelberg, Heidelberg, Germany

    Tobias Albrecht, Ingo Baumann, Peter K. Plinkert & Serkan Sertel

  2. Service d’oto-rhino-laryngologie (ORL), Centre Hospitalier Universitaire Vaudois (CHUV), Université de Lausanne, Lausanne, Switzerland

    Christian Simon & Serkan Sertel

Authors
  1. Tobias Albrecht
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ingo Baumann
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Peter K. Plinkert
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Christian Simon
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Serkan Sertel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Serkan Sertel.

Ethics declarations

Conflict of interest

Neither the Department of Otorhinolaryngology of the University of Heidelberg nor the surgeons received funding or grants for this study. The companies had neither influence on the analysis of the data, nor on the writing of this article.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Albrecht, T., Baumann, I., Plinkert, P.K. et al. Three-dimensional endoscopic visualization in functional endoscopic sinus surgery. Eur Arch Otorhinolaryngol 273, 3753–3758 (2016). https://doi.org/10.1007/s00405-016-4040-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-016-4040-3

Keywords

Search

Navigation