They will cover the tiny hole made by the needle with a small dressing. 70480- CT Orbits without contrast 2. Wear comfortable, loose-fitting clothing to your exam. NB: This article aims to frame a general concept of a CT protocol for the assessment of the paranasal sinuses. The surgeon should ensure the desired patient, date of study, and anatomical location are obtained. CT is the most reliable imaging technique for determining if the sinuses are obstructed. For better definition of the neoplasm, an MRI scan was obtained. This content is owned by the AAFP. Doctors do not generally recommend CT scanning for pregnant women unless medically necessary because of potential risk to the unborn baby. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ <> At the time the article was created Fabio Macori had no recorded disclosures. Computed tomography, more commonly known as a CT or CAT scan, is a diagnostic medical imaging test. Mucoceles are usually round hypodense lesions in CT scan commonly associated with sinus wall expansion and erosion (8, 16,18) . Optimal CT evaluation for functional endoscopic sinus surgery Image 5: The power station is secured to the bed with the EMG cord plugged in (shown here), along with the power cord and base unit connection cords (see fig. Next-Generation Surgical Navigation Systems in Sinus and Skull Base Surgery. This is especially true for soft tissues and blood vessels. Products Use of bone anchoring device in electromagnetic computer-assisted navigation in lateral skull base surgery. Managing Editors: Sarah Elliott, Kay Klein, Claire Davis Dalgorf M, et al. endstream Acute Stroke - Brain. A conventional x-ray exam directs a small amount of radiation through the body part under examination. The CT scans (Figure 1, part A and C) revealed bilateral pansinusitis with evidence of polyposis. Women should always tell their doctor and x-ray or CT technologist if there is any chance they are pregnant. N 4: Sinus CT without contrast N 4C: Sinus CT with contrast N 5: Orbit CT without contrast N 5C: Orbit CT with contrast N 6: Mastoid CT without contrast N 6C: Mastoid CT with contrast N 7: Soft tissue neck CT with contrast . 2016;126(1):51-59. <> Please type your comment or suggestion into the text box below. CT Protocols | Radiology Key To locate a medical imaging or radiation oncology provider in your community, you can search the ACR-accredited facilities database. Number along the monitor exactly where a soft tissue or the sinuses. Endoscopic Sinus Surgery | Iowa Head and Neck Protocols Navigation and non-navigation CT scan of the sinuses: comparison of the Surgeon and OR staff ensure the appropriate equipment are available and present in or near the OR room prior to transport of the patient to the OR. If you have a hard time staying still, are claustrophobic, or have chronic pain, you may find a CT exam to be stressful. Image 3: The equipment shown here is required for the positioning the Electromagnetic Field Generator (EMG seen in figure 4) within the space adjacent to the surgical field. 74170, 72194, 76376 Ste nt Protocol Question of: diverticulitis, appendicitis, abscess, cancer, prior abdominal surgery. 256 Slice CT - Updated 01-25-2022 Sinus: Head Boney Sinus (Flash Spiral) 256 Slice CT - Updated 01-25-2022 Sinus: Landmarx Sinus. There was no seasonal variation to his symptoms, and allergy testing was negative. CT Landmark Sinus without IV Contrast 70486 Pre-Surgical Scan- Sinus . In emergency cases, they can reveal internal injuries and bleeding quickly enough to help save lives. Meta-analyses on commercial image-guided navigation systems suggest a reduction in major complications during endoscopic sinus surgery compared with non-image guided procedures. Who interprets the results and how do I get them? Women should always inform their physician and the CT technologist if there is any possibility that they may be pregnant. What are some common uses of the procedure? All anatomic landmarks were found to be well defined in all three groups, with the exception of the ethmoid foramen (for identification of the ethmoid artery), which was indistinct or . 70482- CT Orbits with and without contrast 4. Healthcare Professionals 50, and 75% sinus-length landmark slices, as shown in Fig. The University of Iowa does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on this web site. A radiologist, a doctor specially trained to supervise and interpret radiology exams, will analyze the images. Figure 3A, 3B shows the CT appearance after FESS. x@Qhm@0%\&'HD(qQCn,nG>ioR}lwlk~lo x8v?f\[/v]d\m~yKl;~L~~ncOxpb,}0Ng|n}08OSD_@@@@@t2?~axNO|vw7}0sgAew-xW q>6>w7Wrn sm@@@@@g>GnG?'@uX x[o~7|'l_/}@t_c_v@@@@@.5>O7ao/?FA?[c}R}qO?45}O,5G[?n{=]_T_Yo!ISK5h_|0x>h\_TAov/O}yiNn_)4X>y+OW? CT because of the universal sinus CT protocol, total saving was estimated as $142,162, which translated to $147,628 when adjusted for inflation. %PDF-1.4 His nasal symptoms improved after he started taking decongestants and antibiotics, but a persistent headache prompted a visit back to his family physician. 1. These measure the amount of radiation being absorbed throughout your body. Our CT scanner uses cone beam technology to focus just on the sinuses. The patient is a 45-year-old healthy white man with longstanding right-sided nasal obstruction associated with postnasal discharge and cheek pressure. Two pulses of oral steroids produced a prolonged response that was again only temporary. CT-paranasal sinuses are a vital tool in the assessment of patients with CRS. The optical capability refers to the infrared light based camera that monitors reflections from the spheres placed on the surgical instrumentation. You may need to change into a gown for the procedure. PDF CT scanning protocol - Stryker Corporation An advanced navigation protocol for endoscopic transsphenoidal surgery. How to Read CT Sinus Scans - A Layperson's Guide - YouTube CPT for ENT: Stereotactic Computer Assisted Navigation `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Straps and pillows may be used to help the patient maintain the correct position and to hold still during the exam. It is the best imaging modality for sinusitis. What is a stealth ct of sinuses? | HealthTap Online Doctor 1 0 obj Some CT exams use a contrast material to enhance visibility in the body area under examination. FIND RELIEF. In general, intravenous contrast material is not necessary. Scanning and registration protocols that enable accuracy StealthMerge ENT software that fuses different imaging modalities (CT, MRI) together for improved visualization Instruments that are designed and calibrated for use in image-guided surgery Benefits of image-guided surgery for ENT procedures In addition, in the case of planned surgery, imaging can provide the surgeon with necessary information regarding any anatomical variants and allow the diagnosis of clinically silent diseases, e.g. The aim of FESS is to preserve mucosa while restoring drainage and ventilation of the sinuses. endstream How the Test is Performed If you have a known allergy to contrast material, your doctor may prescribe medications (usually a steroid) to reduce the risk of an allergic reaction. Strauss G, et al. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. A CT scan generates images that can be reformatted in multiple planes. endobj STEALTH PROTOCOL REQUEST. Keep in mind that the images provided are based on the anatomy at the time of CT scan and the surgical anatomy may have changed prior to the start of the procedure (resolution/progression of infection, change in size of masses, etc). The patient may also be positioned face-down with the chin elevated. Any motion, including breathing and body movements, can lead to artifactson the images. If you have a known allergy to contrast material, your doctor may prescribe medications to reduce the risk of an allergic reaction. 2. CT is beneficial in studying chronic disease of the paranasal sinuses, not least to assess whether it has spread to surrounding structures. To use the navigation system, a computer tomography (CT) scan of the sinuses or the skull base of the patient is performed using a specific navigation protocol (in some cases the CT scan is saved into a DICOM format). Int Forum Allergy Rhinol. The technologist or nurse, under the direction of a physician, may offer you some medication to help you tolerate the CT scanning procedure. 17742 Beach Boulevard, Suite 345, Huntington Beach, CA 92647. They should not have repeated CT exams unless necessary. This website does not provide cost information. The preferred initial procedure is a coronal CT image (13). `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ After this treatment, his symptoms improved approximately 50 percent, and he received a limited CT scan of the sinuses. Learn more about our additional products for FESS and their potential benefits for you and your patients. Though the scanning itself causes no pain, there may be some discomfort from having to remain still for several minutes. 256 Slice CT - Updated 01-25-2022 Head: Temporal Bones. Although the standards discussed herein reflect the University of Iowa's head and neck protocols, reliance on any information provided herein is solely at your own risk. Siemens Definition AS 20 Protocols. Copyright 2023 Radiological Society of North America, Inc. (RSNA). Read More Created for people with ongoing healthcare needs but benefits everyone. Preoperative computed tomography (CT) affords radiologists the opportunity to prospectively identify anatomic variants that predispose patients to major surgical complications; however, these critical variants are not consistently evaluated or documented on preoperative imaging reports. DISCUSSION The use of a universal sinus CT protocol for both intraoperative navigation and routine diagnostic imag-ing represents an easily overlooked opportunity for eliminating redundant imaging. Centrifugal frontal sinus dissection technique: addressing anterior and posterior frontoethmoidal air cells. A motor turns the ring so that the x-ray tube and x-ray detectors revolve around the body during the scan. The technologist may ask you to hold your breath during the scanning. He had a slight right cheek swelling visible externally. Air appears black. ENT Navigation Solutions `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ It is usually performed as a non-contrast study. However. x] xE DFOV: 25cm . End Location: 1 cm superior to Skull vertex. Mucosal thickening, polyps, and other sinus abnormalities can be seen in 40 percent of symptomatic adults; however, clinical correlation is needed to avoid overdiagnosis of sinusitis because of nonspecific CT findings. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ The study involved 60 patients aged 15-67 years whose paranasal sinuses were imaged with this modality using one of three different low-dose CT-scan protocols. A CT of the sinus can help your physician to assess any injury, infection or other abnormalities. In many protocols a standard dose is given related to the weight of the patient: Weight < 75kg : 100cc. The technologist will be able to hear and talk to you using a speaker and microphone. CT of the sinuses - Radiologyinfo.org A coronal CT image is the preferred initial procedure. Persistent or progressive symptoms after maximal medical therapy, in combination with CT evidence of paranasal sinus disease, should prompt referral. <> The MRI showed extension of the neoplasm into the medial anterior maxilla and septum (Figure 4). `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ However in chronic rhinosinusitis, the lining will be thickened and the sinuses are outlined by grey soft . ADVERTISEMENT: Supporters see fewer/no ads. Optimal contrast enhancement is important for a succesful diagnostic CT-scan. Your doctor can review these images on a computer monitor, print them on film or via a 3D printer, or transfer them to a CD or DVD. PDF Multiplanar Sinus CT: A Systematic Approach to Imaging Before `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ J Craniomaxillofac Surg. Image 2: AxiEM system power box with power cord and base unit cords attached. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ CT Sinus Scan. The risk of serious allergic reaction to contrast materials that contain iodine is extremely rare, and radiology departments are well-equipped to deal with them. Sinuses - Landmark Protocol Indications o Pre-surgical planning Sequences The IGS equipment requires positioning of a registration unit on the patient. Weight 75-90kg: 120cc. He continued his nasal steroids and systemic decongestants, and began nasal saline irrigations (recipe: 1 quart water, 2 teaspoons salt, 1 teaspoon baking soda). Wanted to be landmarx try a much lower radiation exposures for the symptoms may need while remaining at the site. The Images should be loaded onto the base unit prior to the registration process and the appropriate exam selected. All Rights Reserved. An intranasal biopsy revealed an adenoid cystic carcinoma of the paranasal sinuses. Surgical 3D Head. Total amount of contrast. Sphenoid sinuses are normal. Paranasal sinuses CT anatomy - W-Radiology `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Women will need to remove bras containing metal underwire. 28K views 4 years ago This video provides a basic tutorial for anybody without a medical background to look at a CT Sinus scan and understand what they are looking at. Video-Telemedicine for Salivary Gland Swelling (Sialadenitis), The AAO-HNS currently maintains surgical navigation systems are deemed appropriate in "select cases to assist the surgeon in clarifying complex anatomy during sinus and skull base surgery.". % MRI scans take considerably longer to accomplish than CT scans and may be difficult to obtain in patients who are claustrophobic. The CT protocols listed are generic versions of scan protocols and need to be modified for scanner make and model. Jewelry and ct sinus protocol without being aware of the normal. Soft tissue, such as the heart or liver, shows up in shades of gray. He had left maxillary and frontal tenderness to palpation on examination. From the raw data, we reformat coronal, axial, and sagittal 2.5-mm-thick contiguous images with bone and soft-tissue algorithms. The Preoperative Sinus CT: Avoiding a "CLOSE" Call with Surgical Noninvasive allergic sinus congestion and resolution assessments using At the time the article was last revised Joshua Yap had Ct sinus with and without contrast | HealthTap Online Doctor See permissionsforcopyrightquestions and/or permission requests. Plain radiography has a limited role in the management of sinusitis. This allows us to minimize radiation while providing a high tech three-dimensional image of the sinuses. Radiology department of the Rijnland Hospital in Leiderdorp, the Netherlands. If you are having sinusitis symptoms that don't respond to medication, contact CT Sinus Center at (203) 574-5997 for further workup to see if endoscopic sinus surgery is right for you. Follow-up exams are often the best way to see if treatment is working or if a problem needs attention. Figure 2A, 2B, 2C, 2D shows the steps of the FESS technique. . Then, the table will move slowly through the machine for the actual CT scan. CT exams are fast and simple. inbqo@O[nF{su:t(//A (hA222=h)D'@/w8}{aaaEB[xxeqJyg-w3h7 . It can even generate three-dimensional images. Roy J. and Lucille A. Recommended protocol for medical CBCT scanners Scan time Longest available Voxel size 0.3 - 0.5mm Field of view Largest available File type CT (one file per slice) Reconstruction Axial Compression Uncompressed Thank you for taking a moment to read this protocol. It is used occasionally in cases of suspected tumors or fungal sinusitis.1719 Otherwise, MRI has no advantages over CT scanning in the evaluation of sinusitis. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ You may feel a need to urinate. The CT images and direct views from the endoscope are visualized throughout the procedure. Head CT Protocols - CTisus.com CT Scanning the ct also deployed in the surgical system. Our studies are done in the axial plane and reconstructed in the coronal and sagittal planes. Disadvantages of MRI include high false-positive findings, poor bony imaging, and higher cost. Three aspects of direct coronal imaging of the paranasal . A single Waters' view (occipitomental) appears to provide as much information as the standard four-view series.11, CT scans can provide much more detailed information about the anatomy and abnormalities of the paranasal sinuses than plain films.12 A CT scan provides greater definition of the sinuses and is more sensitive than plain radiography for detecting sinus pathology, especially within the sphenoid and ethmoid sinuses.6,13 CT scan findings can also be quite nonspecific, however, and should not be used routinely in the diagnosis of acute sinusitis.6,14 The primary role of CT scans is to aid in the diagnosis and management of recurrent and chronic sinusitis, or to define the anatomy of the sinuses prior to surgery.2 In many institutions, a limited CT scan costs about the same as a full radiographic series but provides more useful information.2,15,16, A coronal CT image is the preferred initial procedure. A: Stereotactic computer assisted navigation (SCAN), also known as image guidance, is typically used by otolaryngologist - head and neck surgeons when performing functional endoscopic sinus surgery (FESS) and skull base approaches. 3-D reconstructions are done as needed. This unit has both electromagnetic and optical capabilities. It is usually performed as a non-contrast study. Although first developed for neurosurgery, endoscopic sinus surgery (ESS) rapidly became one . 2). `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ HRCT imaging of acquired cholesteatoma: a pictorial review The system displays the images on a computer monitor. With modern CT scanners, you may hear slight buzzing, clicking and whirring sounds. His ears were clear by otoscopy, and his nasal examination revealed a right-sided septal deviation. Pre-surgical planning for sinus surger y Patient position Supine, IOML perpendicular to table Contrast NONE Injection rate NONE Respiration Breath hold Scan parameters FOV must cover ducials and/or skull landmarks (tip of nose, ears, chin). The paranasal sinusesare hollow, air-filled spaces located within the bones of the face and surrounding the nasal cavity, a system of air channels connecting the nose with the back of the throat. 2015;5(8):761-763, Bernardeschi D, et al. Otolaryngol Clin North Am. These scans enable surgeons to identify the presence/absence of disease as well as the extent of disease and potential pitfalls if surgery is deemed necessary. CT for Sinus with 3D and Landmarks - AAPC Risk factors for complicated infections include prolonged tobacco use and chronic occupational exposure to wood dust, nickel, or chrome pigment. Sinus CT scan: MedlinePlus Medical Encyclopedia 5 Common Findings to Look For in a Sinus CT Scan The surgeon should ensure the desired patient, date of study, and anatomical location are obtained. The anatomy will certainly change with the progression of the procedure. Recurrent or refractory symptoms, despite treatment, or suspicion of complicated infection, abscess, or neoplasm, warrants further evaluation. endstream CT paranasal sinus (protocol) | Radiology Reference Article Otolarnygology. PDF CT Pre-Authorization Guide Categories - McLaren Health Care Corporation You also may have a metallic taste in your mouth. Immunocompromised persons and smokers are at increased risk for serious sinusitis complications. Copyright 2023 American Academy of Family Physicians. While it is most frequently used by the Otolaryngology service for endoscopic sinus surgery, it can also be utilized for skull base or other H/N cancer cases, ophthalmology, neurosurgical, and joint procedures involving these services. Weight > 90kg : 150cc. Mert A, et al. Created for people with ongoing healthcare needs but benefits everyone. The system is then used during the surgery to confirm the position of the surgeon's instruments at all times. A CT scan of the face produces images that also show a patient's paranasal sinus cavities. necessary to evaluate the sinuses on CT. Excellent test to evaluate for sinus disease including acute and chronic sinusitis, polyps, masses, postoperative evaluation. Laryngoscope. The patient was started on a four-week course of broad-spectrum antibiotics in combination with an oral steroid pulse. Creates 3-D imaging models for surgical procedures. CT Protocols Frequently used policies (MCN links) Creatinine Testing Prior to Injecting Intravenous Iodinated Contrast Media Iodinated Contrast Administration in Patients Receiving Metformin Management of Acute Contrast Reactions IV Contrast Extravasation Patient Sedation Guidelines for Periprocedural Coagulation Management Post Mortem CT Patient Position: Supine. 2014;82(6 Suppl):S95-105. The CT paranasal sinus protocol serves as an examination for the assessment of the study of the mucosa and bone system of the sinonasal cavities. Reference article, Radiopaedia.org (Accessed on 04 Mar 2023) https://doi.org/10.53347/rID-92692, see full revision history and disclosures, shoulder (modified transthoracic supine lateral), acromioclavicular joint (AP weight-bearing view), sternoclavicular joint (anterior oblique views), sternoclavicular joint (serendipity view), foot (weight-bearing medial oblique view), paranasal sinus and facial bone radiography, paranasal sinuses and facial bones (lateral view), transoral parietocanthal view (open mouth Waters view), temporomandibular joint (axiolateral oblique view), cervical spine (flexion and extension views), lumbar spine (flexion and extension views), systematic radiographic technical evaluation (mnemonic), foreign body ingestion series (pediatric), foreign body inhalation series (pediatric), pediatric chest (horizontal beam lateral view), neonatal abdominal radiograph (supine view), pediatric abdomen (lateral decubitus view), pediatric abdomen (supine cross-table lateral view), pediatric abdomen (prone cross-table lateral view), pediatric elbow (horizontal beam AP view), pediatric elbow (horizontal beam lateral view), pediatric forearm (horizontal beam lateral view), pediatric hip (abduction-internal rotation view), iodinated contrast-induced thyrotoxicosis, saline flush during contrast administration, CT angiography of the cerebral arteries (protocol), CT angiography of the circle of Willis (protocol), cardiac CT (prospective high-pitch acquisition), CT transcatheter aortic valve implantation planning (protocol), CT colonography reporting and data system, CT kidneys, ureters and bladder (protocol), CT angiography of the splanchnic vessels (protocol), esophageal/gastro-esophageal junction protocol, absent umbilical arterial end diastolic flow, reversal of umbilical arterial end diastolic flow, monochorionic monoamniotic twin pregnancy, benign and malignant characteristics of breast lesions at ultrasound, differential diagnosis of dilated ducts on breast imaging, musculoskeletal manifestations of rheumatoid arthritis, sonographic features of malignant lymph nodes, ultrasound classification of developmental dysplasia of the hip, ultrasound appearances of liver metastases, generalized increase in hepatic echogenicity, dynamic left ventricular outflow tract obstruction, focus assessed transthoracic echocardiography, arrhythmogenic right ventricular cardiomyopathy, ultrasound-guided biopsy of a peripheral soft tissue mass, ultrasound-guided intravenous cannulation, intensity-modulated radiation therapy (IMRT), stereotactic ablative radiotherapy (SBRT or SABR), sealed source radiation therapy (brachytherapy), selective internal radiation therapy (SIRT), preoperative pulmonary nodule localization, transjugular intrahepatic portosystemic shunt, percutaneous transhepatic cholangiography (PTC), transhepatic biliary drainage - percutaneous, percutaneous endoscopic gastrostomy (PEG), percutaneous nephrostomy salvage and tube exchange, transurethral resection of the prostate (TURP), long head of biceps tendon sheath injection, rotator cuff calcific tendinitis barbotage, subacromial (subdeltoid) bursal injection, spinal interventional procedures (general), transforaminal epidural steroid injection, intravenous cannulation (ultrasound-guided), inferomedial superolateral oblique projection, breast ultrasound features: benign vs malignant, 1. For some systems, a special mask or markers are placed on the patient's face during the scan to serve as reference points. The patient should be positioned in the bed, head generally positioned to the right for FESS. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Citardi MJ, et al. CT with fusion is a radiological technique used to enhance the images. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ The x-rays used for CT scanning should have no immediate side effects. Multiplanar Sinus CT: A Systematic Approach to Imaging Before A prospective, randomized clinical study. Fusion: Standalone, electromagnetic based ENT image guidance system. World Neurosurg. landmark ge ombl siemens breathing scouts ap and lateral parameter scan start below mandible end above frontal sinuses dfov 18 prep group ge siemens indication trauma / face pain oral prep scan 1. non-contrast recon 0.625mm or 1.25mm axial recon - bone algorithm 1.25mm axial recon - standard algorithm Galletti, et al. He was started on intravenous antibiotics and underwent external frontal sinusotomy to decompress the adjacent infected frontal sinus. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Vreugdenburg TD, et al. Normally you cannot actually see the lining of the sinuses on a CT because it is so thin. 150 to 400 HU). The American Academy of Otolaryngology Head and Neck Surgery (AAO-HNS) endorses the use of image-guided surgery for procedures including4: Medtronic offers powered and manual instruments that are specially designed for a broad variety of FESS procedures. Which test, procedure or treatment is best for me? 2017;50(3):617-632. Practice Essentials. The Department of Otolaryngology and the University of Iowa wish to acknowledge the support of those who share our goal in improving the care of patients we serve. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ No radiation remains in a patient's body after a CT exam. Indenting and outdenting in richtext should work as well. His ears were clear bilaterally. Such speed is beneficial for all patients. Alternatively, 4% cocaine (no more than 4 ml) may be used for pre-surgical vasoconstriction and to assist with hemostasis. This study should be downloaded from the server or onto a CD to be taken to the OR. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Image-guided navigation systems used in endoscopic sinus surgery have shown a reduction in the need for revision surgeries. What will I experience during and after the procedure? However, the technologist will always be able to see, hear and speak with you through a built-in intercom system. Depending on the type of CT scan, the machine may make several passes. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Repairs to author landmarx protocol: sedo nor does ct sinus tumours or the advice.
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