Intraoperative surgical navigation for endoscopic sinus surgery: rationale and indications.
OBJECTIVE
The present review discusses the rationale and indications for image-guided surgery through a critical discussion of registration concepts as well as clinical reports.


RESULTS
The surgical navigation accuracy achieved by commercially available image-guided surgery systems is best reported as target registration error. Clinically achievable target registration error is probably in the 1.5-2.0 mm range. Dry lab studies of registration serve to highlight the principles of registration, the process through which image-guided surgery systems calculate the one-to-one mapping relationship between the preoperative imaging data and the intraoperative surgical volume. Reports on image-guided surgery have highlighted its usefulness in primary and revision endoscopic sinus surgery, osteoplastic frontal sinusotomy, transsphenoidal hypophysectomy, endoscopic cerebrospinal fluid leak repair and endoscopic pterygomaxillary fossa biopsy. Both three-dimensional computed tomography angiography and computed tomography-magnetic resonance fusion images have been incorporated into IGS for advanced minimally invasive endoscopic skull base procedures. The American Academy of Otolaryngology-Head and Neck Surgery policy statement accurately summarizes the current consensus for image-guided surgery applications.


CONCLUSIONS
Image-guided surgery has emerged as an important technology, which both general otolaryngologists and subspecialty rhinologists can employ for a wide variety of procedures.
Citardi
Martin J
MJ
Section of Nasal and Sinus Disorders, Head and Neck Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. citardm@ccf.org
Batra
Pete S
PS
D004724:Endoscopy / Q000379:methods*; D006801:Humans; D010256:Paranasal Sinuses / Q000601:surgery*; D018579:Patient Selection; D025321:Surgery, Computer-Assisted; D016896:Treatment Outcome