Navigation-Guided Transnasal Endoscopic Delineation of the Posterior Margin for Maxillary Sinus Cancers: A Preclinical Study.

3D-virtual endoscopy intraoperative navigation (NIV) maxillary sinus cancers surgical margins transnasal endoscopic surgery

Journal

Frontiers in oncology
ISSN: 2234-943X
Titre abrégé: Front Oncol
Pays: Switzerland
ID NLM: 101568867

Informations de publication

Date de publication:
2021
Historique:
received: 25 07 2021
accepted: 12 10 2021
entrez: 3 12 2021
pubmed: 4 12 2021
medline: 4 12 2021
Statut: epublish

Résumé

The resection of advanced maxillary sinus cancers can be challenging due to the anatomical proximity to surrounding critical anatomical structures. Transnasal endoscopy can effectively aid the delineation of the posterior margin of resection. Implementation with 3D-rendered surgical navigation with virtual endoscopy (3D-SNVE) may represent a step forward. This study aimed to demonstrate and quantify the benefits of this technology. Four maxillary tumor models with critical posterior extension were created in four artificial skulls (Sawbones 3D-SNVE for the transnasal delineation of the posterior margin in maxillary tumor models significantly improved the rate of margin-negative clearance around the tumor and reduced damage to the carotid artery. "Green" cuts occurred in 52.4% in the unguided setting This preclinical study has demonstrated that 3D-SNVE provides a substantial improvement of the posterior margin delineation in terms of safety and oncological adequacy. Translation into the clinical setting, with a meticulous assessment of the oncological outcomes, will be the proposed next step.

Sections du résumé

BACKGROUND BACKGROUND
The resection of advanced maxillary sinus cancers can be challenging due to the anatomical proximity to surrounding critical anatomical structures. Transnasal endoscopy can effectively aid the delineation of the posterior margin of resection. Implementation with 3D-rendered surgical navigation with virtual endoscopy (3D-SNVE) may represent a step forward. This study aimed to demonstrate and quantify the benefits of this technology.
MATERIAL AND METHOD METHODS
Four maxillary tumor models with critical posterior extension were created in four artificial skulls (Sawbones
RESULTS RESULTS
3D-SNVE for the transnasal delineation of the posterior margin in maxillary tumor models significantly improved the rate of margin-negative clearance around the tumor and reduced damage to the carotid artery. "Green" cuts occurred in 52.4% in the unguided setting
CONCLUSIONS CONCLUSIONS
This preclinical study has demonstrated that 3D-SNVE provides a substantial improvement of the posterior margin delineation in terms of safety and oncological adequacy. Translation into the clinical setting, with a meticulous assessment of the oncological outcomes, will be the proposed next step.

Identifiants

pubmed: 34858824
doi: 10.3389/fonc.2021.747227
pmc: PMC8632239
doi:

Types de publication

Journal Article

Langues

eng

Pagination

747227

Informations de copyright

Copyright © 2021 Taboni, Ferrari, Daly, Chan, Eu, Gualtieri, Jethwa, Sahovaler, Sewell, Hasan, Berania, Qiu, de Almeida, Nicolai, Gilbert and Irish.

Déclaration de conflit d'intérêts

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Auteurs

Stefano Taboni (S)

Department of Otolaryngology-Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padua-"Azienda Ospedaliera di Padova", Padua, Italy.
Guided Therapeutics (GTx) Program, Techna Institute, University Health Network, Toronto, ON, Canada.
University Health Network (UHN) Guided Therapeutics (GTx) Program International Scholar, Toronto, ON, Canada.
Artificial Intelligence in Medicine and Innovation in Clinical Research and Methodology (PhD Program), Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.

Marco Ferrari (M)

Department of Otolaryngology-Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padua-"Azienda Ospedaliera di Padova", Padua, Italy.
Guided Therapeutics (GTx) Program, Techna Institute, University Health Network, Toronto, ON, Canada.
University Health Network (UHN) Guided Therapeutics (GTx) Program International Scholar, Toronto, ON, Canada.
Technology for Health (PhD Program), Department of Information Engineering, University of Brescia, Brescia, Italy.

Michael J Daly (MJ)

Guided Therapeutics (GTx) Program, Techna Institute, University Health Network, Toronto, ON, Canada.

Harley H L Chan (HHL)

Guided Therapeutics (GTx) Program, Techna Institute, University Health Network, Toronto, ON, Canada.

Donovan Eu (D)

Department of Otolaryngology-Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Guided Therapeutics (GTx) Program, Techna Institute, University Health Network, Toronto, ON, Canada.

Tommaso Gualtieri (T)

Department of Otolaryngology-Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Guided Therapeutics (GTx) Program, Techna Institute, University Health Network, Toronto, ON, Canada.
Unit of Otorhinolaryngology-Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, University of Brescia-"ASST Spedali Civili di Brescia", Brescia, Italy.

Ashok R Jethwa (AR)

Department of Otolaryngology-Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.

Axel Sahovaler (A)

Department of Otolaryngology-Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Guided Therapeutics (GTx) Program, Techna Institute, University Health Network, Toronto, ON, Canada.
Head & Neck Surgery, University College London Hospital, London, United Kingdom.

Andrew Sewell (A)

Department of Otolaryngology-Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.

Wael Hasan (W)

Department of Otolaryngology-Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Guided Therapeutics (GTx) Program, Techna Institute, University Health Network, Toronto, ON, Canada.

Ilyes Berania (I)

Department of Otolaryngology-Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.

Jimmy Qiu (J)

Guided Therapeutics (GTx) Program, Techna Institute, University Health Network, Toronto, ON, Canada.

John de Almeida (J)

Department of Otolaryngology-Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.

Piero Nicolai (P)

Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padua-"Azienda Ospedaliera di Padova", Padua, Italy.

Ralph W Gilbert (RW)

Department of Otolaryngology-Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.

Jonathan C Irish (JC)

Department of Otolaryngology-Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Guided Therapeutics (GTx) Program, Techna Institute, University Health Network, Toronto, ON, Canada.

Classifications MeSH