[Skull base surgery with an opto-electronic navigation system].
OBJECTIVE
The exact localization of pathological anatomy is the basis of a successful operation. Malformations, tumors, or previous operations can make intraoperative orientation considerably more difficult. Navigation systems can be useful tools in such cases.


METHODS
The OTS is an optoelectrical navigation system which was used on 34 patients with disorders of the skull base region. Clinical accuracy, practicability, and intraoperative usefulness of the system were evaluated.


RESULTS
In clinical use, an accuracy of approximately 1.5 mm could only be achieved with the use of head fixation and bone-anchored reference markers. When using the VBH mouthpiece for dynamic referencing with flexible head positioning, deviations of less than 2 mm were observed. The preoperative preparation time was 15-25 min, depending on the operation schedule.


CONCLUSIONS
The intraoperative orientation system represents a significant aid for orientation, particularly where anatomical alterations are present. Further modifications to improve both accuracy and the integration of the system into working practice are, however, essential.
Heermann
R
R
HNO-Klinik, Medizinische Hochschule, Carl-Neuberg-Strasse 1, 30625 Hannover. hee@hno.mh-hannover.de
Mack
K F
KF
Issing
P R
PR
Haupt
C
C
Becker
H
H
Lenarz
T
T
D000328:Adult; D000368:Aged; D004867:Equipment Design; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation; D008297:Male; D008838:Microcomputers; D008875:Middle Aged; D010254:Paranasal Sinus Diseases / Q000473:pathology / Q000601:surgery*; D010255:Paranasal Sinus Neoplasms / Q000473:pathology / Q000601:surgery*; D019291:Skull Base / Q000473:pathology / Q000601:surgery; D019292:Skull Base Neoplasms / Q000473:pathology / Q000601:surgery*; D012984:Software; D013238:Stereotaxic Techniques / Q000295:instrumentation*; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*; D013525:Surgical Instruments