Image guidance: A survey of attitudes and use

Background: The aim of this study was to determine access to, usage of, and attitudes toward image guidance in endoscopic sinus and anterior skull base surgery. Methods: We performed a survey of American Rhinologic Society members. Results: Of 1050 surveys mailed, 340 (32.4%) were returned and scored. Image guidance was available to 86% of respondents. Eighteen percent of respondents did not use image guidance in any cases, and 25% used it in up to 10% of cases. Eight percent of respondents used image guidance in > 90% of cases. Respondents felt the primary indication for this technology is in revision or advanced cases. Seventy percent of respondents felt image guidance was not typically indicated for a primary total ethmoidectomy and > 90% of respondents felt it was either a relative or absolute indication for revision frontal sinus exploration, modified Lothrop procedure, or closure of cerebrospinal fluid leak. Attitudes of the respondents did not vary by year of residency completion or by the use of image guidance during residency. Current access to image guidance was associated with a higher likelihood of feeling it was indicated. Conclusion: The majority of respondents had access to image guidance. Many feel it is a relative or absolute indication for revision and advanced endoscopic sinus and skull base procedures. A very small minority used this technology in all cases. The results of this survey reflect the opinion of the respondents. They do not necessarily reflect the views of the American Rhinologic Society or of practicing otolaryngologists in general.