Computer-assisted intraoperative navigation during skull base surgery

Purpose: In patients with diseases of the cranial base, anatomical landmarks are often obliterated by tumor inflammatory diseases or previous surgery. The surgeon may fail to recognize important anatomical structures or tumor margins, increasing the morbidity of the surgery and downgrading the oncological outcome. Materials and Methods: The ISG Viewing Wand is an intraoperative navigational device that uses a position-sensing articulated arm linked to a computer that allows the surgeon to correlate the anatomy of the patient with the computerized display of the reformatted images of preoperative computerized tomography or magnetic resonance. We used the ISG system in 20 patients undergoing skull base surgery for the treatment of tumor inflammatory diseases and trauma. Results: The use of the ISG wand translated into a decreased need for the resection of vital structures and provided reliable mapping of the boundaries of the paranasal sinuses and tumor margins. Conclusion: Intraoperative navigation is a promising technology that complements the surgeon's interpretation of the surgical field. Further refinements of this technology will ease the incorporation of these intraoperative navigation systems into other surgical procedures. Copyright (C) 1996 by W.B. Saunders Company.