title: Intraoperative navigation in complex head and neck resections: indications and limits.
abstract: OBJECTIVE
  The surgical removal of head and neck tumors often represents a highly complex surgery. The three-dimensionality and the anatomy of the head and neck area make sometimes difficult a correct intraoperative orientation and the obtaining of an adequate oncological safety. In the present pilot study, the authors propose a protocol of application of intraoperative navigation in the resection of head and neck tumors. The purpose is to develop a methodology that can be helpful to ensure oncologic free margins of resection and to facilitate the orientation of the specimen by pathologists.
  
  
  METHODS
  A sample of 16 patients with head and neck tumors was selected, and they were differentiated into two groups: a "study group" treated with CT computer-assisted surgery and a "control group" surgically treated without the use of technology. The following data were analyzed: operative and pre-surgical planning times, issues related to the use of the technologies, respect of the planned landmarks, description and orientation of the surgical specimen and distance of the tumor from the margins of resection.
  
  
  RESULTS
  In the "study group" were noticed a reduced rate of errors in the specimen orientation and an increased distance of the tumor from the margins of resection. Similar operative times were observed in both groups.
  
  
  CONCLUSIONS
  Intraoperative navigation resulted to be a reliable method to improve oncological safety in a selected group of patients.
authors.affiliation: Operative Unit of Maxillo-Facial Surgery, Otolaryngology and Dentistry, Head and Neck Department, Hospital Casa Sollievo della Sofferenza, Viale dei Cappuccini 1, San Giovanni Rotondo, FG, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Catanzaro
authors.affiliation: Operative Unit of Maxillo-Facial Surgery, Otolaryngology and Dentistry, Head and Neck Department, Hospital Casa Sollievo della Sofferenza, Viale dei Cappuccini 1, San Giovanni Rotondo, FG, Italy. copkids@tin.it.
authors.forename: C
authors.identifier: http://orcid.org/0000-0003-2992-893X
authors.initials: C
authors.lastname: Copelli
authors.affiliation: Operative Unit of Maxillo-Facial Surgery, Federico II University, Naples, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Manfuso
authors.affiliation: Operative Unit of Maxillo-Facial Surgery, Otolaryngology and Dentistry, Head and Neck Department, Hospital Casa Sollievo della Sofferenza, Viale dei Cappuccini 1, San Giovanni Rotondo, FG, Italy.
authors.forename: K
authors.initials: K
authors.lastname: Tewfik
authors.affiliation: Operative Unit of Maxillo-Facial Surgery, Otolaryngology and Dentistry, Head and Neck Department, Hospital Casa Sollievo della Sofferenza, Viale dei Cappuccini 1, San Giovanni Rotondo, FG, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Pederneschi
authors.affiliation: Operative Unit of Maxillo-Facial Surgery, Otolaryngology and Dentistry, Head and Neck Department, Hospital Casa Sollievo della Sofferenza, Viale dei Cappuccini 1, San Giovanni Rotondo, FG, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Cassano
authors.affiliation: Operative Unit of Maxillo-Facial Surgery, Otolaryngology and Dentistry, Head and Neck Department, Hospital Casa Sollievo della Sofferenza, Viale dei Cappuccini 1, San Giovanni Rotondo, FG, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Cocchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D000072662:Margins of Excision; D008875:Middle Aged; D009333:Neck; D061646:Operative Time; D010865:Pilot Projects; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods
keywords: Complex head and neck resection; Computer-assisted surgery; Intraoperative navigation; Margins of resection; Orientation of the surgical specimen; Pre-surgical planning