Virtual Endoscopy of the Nasal Cavity and the Paranasal Sinuses
Bibliographic record
Abstract
The ideal approach to sinus surgery has been a mystery that many Otolaryngologists have attempted to discover throughout their career. The intricate and complex anatomy of the nasal cavity and paranasal sinuses has challenged many in terms of adequate exposure during surgery, as well as proper relief of patient symptoms. From the days of Hirschmann, who used a modified cystoscope to examine the sinuses in 1901 (Draf, 1983, as cited in Rice & Schaefer, 2004), to the work of Messerklinger and Wigand in establishing operative techniques later in that century (Rice & Schaefer, 2004), surgeons have appreciated the obscurity and complexity of endoscopic sinus surgery for decades. Traditionally, pre-operative planning has consisted of imaging modalities, namely x-rays and computed tomography (CT) scans, as well as flexible or rigid endoscopy in the clinic. With the advent of helical CT in the late 1980s, pre-operative imaging has improved dramatically. It is faster than the conventional CT scanner and provides more details (Wood & Razavi, 2002). In fact, helical CT has provided physicians with the ability to attain reconstruction of axial images into coronal and sagittal views with resolution quality equivalent to the original axial cuts. Imaging for the paranasal sinuses is ideally viewed in coronal slices as Otolaryngologists enter the nasal cavity in an anterior-posterior direction rather than the cephalocaudal direction represented by axial slices. Furthermore, the coronal view allows the examination of critical relationships such as the osteomeatal complex, not provided by axial imaging. The use of MRI for better soft tissue examination and less artifacts has also improved imaging of the head and neck (Kettenbach et al., 2008). The dependence of Otolaryngologists on proper pre-operative imaging highlights the strong relationship between radiologists and otolaryngologists in endoscopic sinus surgery in order to precisely locate numerous vital structures, such as the orbits and the internal carotid arteries, surrounding the nasal cavity and the paranasal sinuses and to identify benign and pathologic anomalies. Recently, virtual endoscopy (VE) through reconstruction of CT images has interested Otolaryngologists that perform endoscopic sinus surgery. This contemporary technology facilitates the difficult task of mentally conceptualizing complex and intricate anatomy in a three-dimensional model from two-dimensional CT images, a task that requires years of experience to truly master. VE utilizes the technique of surface or volumetric rendering to process data provided by CT images to allow three-dimensional visualization of tubular
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.002 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".