Initial experience with intraoperative ultrasound in navigated soft tissue operations of the neck and below the base of the skull.
OBJECTIVE
Ultrasound (US) is a cost effective and time saving examination method for diseases of the neck,and can be used without any known side effects or limitations. US tied into modern navigation devices may significantly improve intraoperative orientation in regions with soft tissue characteristics.


METHODS
22 patients with soft tissue tumours of the head and neck underwent surgical procedures assisted by CAS system LandmarX (Medtronic) in combination with the US system DynaVievP II (Aloka). Clinical feasibility of using intraoperative US in navigated surgical procedures has been investigated by paying particular attention to the surgical approach, possible interferences from surgical instruments and time consumption.


RESULTS
In the case of soft tissue shift, US can provide a sequence of a section of the operative field and, without delay, an instant comparison with the preoperative imaging data set. The feasibility of using this method is severely limited by the additional preparation required, the unfamiliar handling during surgery, and design-related matters.


CONCLUSIONS
Integrating US into a navigation device could provide additional useful information for a more controlled resection of soft tissue disease of the neck and below the base of the skull.
ENT Department, HNO-Gemeinschaftspraxis Sachsenhausen/Kopfklinik Frankfurt, Dreieichstrasse 59, 60594 Frankfurt, Germany. ecke@info@hno-doctor.de
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Ecke
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Gosepath
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WJ
Mann
D002574:Cervical Vertebrae; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D016343:Monitoring, Intraoperative / Q000379:methods*; D011187:Posture; D015203:Reproducibility of Results; D012983:Soft Tissue Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D012984:Software; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler / Q000295:instrumentation* / Q000379:methods*