[Modification and application of anterior skull base microsurgery with navigation system].
OBJECTIVE
To investigate the accuracy and safety of the modified techniques in anterior skull base microsurgery with navigation system.


METHODS
Operation was performed upon 42 patients with benign and malignant tumor of anterior skull base involving both cerebral cranium and visceral cranium with the help of modified navigation system. A new arrangement was designed for stable maintenance of the headset with dynamic reference frame to avoid disturbance during emission of encoded infrared signal. Six reference points were used, distributed in the parietal, frontal, zygomatic, maxillary, and mastoid regions. The STN navigation system and SMN surgical microscope navigator were used to provide virtual pointer, virtual approach route and virtual contour as an orientation for stereotaxic guidance during surgery.


RESULTS
The modified technique could keep the accuracy of surgical guidance within 1 approximately 1.5 mm in comparison with the accuracy of 4 mm or more by the original design, thus guaranteeing the safety of surgery.


CONCLUSIONS
The modified techniques raise the accuracy and safety of anterior skull base microsurgery. However, the cost remains high.
Wang
Zhengmin
Z
Department of Otolaryngology, Eye, Ear, Nose and Throat Hospital, Fudan University  Shanghai 200031, China.
Wang
Dehui
D
Chen
Qi
Q
Luo
Daotian
D
Shen
Jianhua
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000191:economics / Q000379:methods*; D008875:Middle Aged; D012886:Skull / Q000601:surgery*