Application of surgical navigation in treatment of Eagle's syndrome

Abstract

Abstract: PURPOSE: To evaluate the feasibility, accuracy and clinical effect of intra-operative navigation for resection of elongated styloid process (ESP) in Eagle's syndrome. METHODS: Twelve patients with Eagle's syndrome with clinically and radiologically established diagnosis of ESP were enrolled. Preoperatively, the patients' Dicom data of skulls were input into the navigation system workstation to mark the ESP and make surgical plan in advance. During surgery, the intraoperative navigation was performed on all patients to excise the ESP accurately through both intraoral (without tonsillectomy) and extraoral approach following the operative plan. Postoperatively, the amount of bleeding, duration of operation and hospitalization and the length of resected SP were measured and compared with those through traditional styloidectomy without assistance of surgical navigation. A questionnaire and a simple visual analogue scale (VAS) was also used to assess patient's satisfaction and the surgical effect 3 months after surgery using SPSS 19.0 software package. RESULTS: In total, 17 styloid processes from 12 patients were precisely resected by intraoral parapharyngeal approach and small cervical approach with aid of surgical navigation. No severe surgical complications occurred in all patients. The length of resected styloid processes was (21.93±14.26) mm. The average amount of bleeding and duration of operation were (22.50±8.54) mL and (40.35±11.81) min, respectively, which are lower than traditional operation without aid of surgical navigation. VAS analysis showed that discomfort in all patients were relieved, while 10 patients' symptoms were improved obviously and 2 patients had some improvement. CONCLUSIONS: The high accuracy of surgery, lesser amount of bleeding, shorter duration of surgery and hospitalization, minimal complications and improved subjective symptoms certify that surgical navigation is a more effective and minimally invasive surgical procedure to treat Eagle's syndrome.

Key words: Elongation of styloid process, Surgical navigation, Oral and maxillofacial surgery, Computer aided surgery, Parapharyngeal route

CLC Number:

R782.2

DOU Geng, ZHANG Yu, TIAN Lei. Application of surgical navigation in treatment of Eagle's syndrome[J]. China Journal of Oral and Maxillofacial Surgery, 2016, 14(3): 244-248.

References

[1] Bouzaïdi K, Daghfous A, Fourati E, et al. Eagle's syndrome [J]. Acta Radiol Short Rep, 2013, 2(5): 2047981613495676.
[2] Müderris T, Bercin S, Sevil E, et al.Surgical management of elongated styloid process: intraoral or transcervical? [J]. Eur Arch Otorhinolaryngol, 2014, 271(6): 1709-1713.
[3] Williams JV, McKearney RM, Revington PJ. Eagle's Syndrome: a novel surgical approach to the styloid process using a preauricular incision [J]. J Oral Maxillofac Surg, 2011, 69(6): 1617-1622.
[4] 孙坚. 计算机辅助外科技术在口腔颌面外科中的应用 [J].中国实用口腔科杂志, 2014, 7(6): 329-334.
[5] Chrcanovic BR, Custódio AL, de Oliveira DR. An intraoral surgical approach to the styloid process in Eagle's syndrome[J]. J Oral Maxillofac Surg, 2009, 13(3): 145-151.
[6] Sudhakara Reddy R, Sai Kiran C, Sai Madhavi N, et al. Prevalence of elongation and calcification patterns of elongated styloid process in south India[J]. J Clin Exp Dent, 2013, 5(1): e30-35.
[7] 李梅生, 高素花. 茎突综合征17例临床分析 [J]. 河南外科学杂志, 2006, 12(1): 23-24.
[8] 刘运良, 高卫仁. 茎突综合征的诊断与治疗 [J]. 现代保健·医学创新研究, 2007, 4(9): 48-49.
[9] 董明福, 李菊琴, 王晓光, 等. 茎突综合征治疗方法的探讨(附68例报告) [J]. 贵州医药, 2001, 25(3): 209-210.
[10] Scheller K, Eckert A, Scheller C. Transoral, retromolar, para-tonsillar approach to the styloid process in 6 patients with Eagle's syndrome [J]. Med Oral Patol Oral Cir Bucal, 2014, 19(1): e61-66.
[11] Baharudin A, Rohaida I, Khairudin A. Transoral surgical resection of bilateral styloid processes elongation (Eagle's syndrome) [J]. Acta Inform Med, 2012, 20(2): 133-135.
[12] 高超, 汤炜, 田卫东. 手术导航系统在口腔颌面外科中的应用 [J].国际口腔医学杂志, 2008, 35(4): 447-449.
[13] 吴锦阳, 张诗雷, 沈国芳, 等. 光学导航技术在口腔颌面深部间隙异物取出术中的应用 [J]. 中国口腔颌面外科杂志, 2013, 11(2): 124-127.
[14] 张文斌, 沈国芳. 导航手术在颅颌面外科的应用及误差控制 [J].中国口腔颌面外科杂志, 2012, 10(2): 170-173.
[15] 陈敏洁, 杨驰. 手术导航系统在颅颌面外科的应用 [J].中国口腔颌面外科杂志, 2007, 5(1): 70-72.