Abstract:

To evaluate the effectiveness of an image-guided navigation system (IGNS) in complex endoscopic sino-nasal and anterior skull base surgery. Methods26 patients who underwent image-guided endoscopic surgery were involved in this study, including 2 patients with recurred frontal sinus inverted papilloma, 5 with nasal cavity and sinuses neoplasms that extended to the skull base, 7 with pituitary adenomas and 12 with traumatic diseases of the optic nerve. ResultsPreparation of intra-operative imaging guided navigation system (including registering, head rest positioning, and surgical instruments registration ) needed 5～10min (mean 7min). The localization error of image landmarks was less than 1.5mm to the entity anatomic landmarks. All operative procedures were successfully performed without any intra-operative or post-operative complications. ConclusionsIGNS provides  accurate anatomical localization, it can help the operator to make certain the locations of important anatomic structures in the operative region and to decide the excision extent for neoplasm in real time, so as to remove the neoplasm to the utmost extent and decrease the occurrence of complications. IGNS reinforces the self-confidence of the operators and enhances security of the operation,  especially when the patient has a history of operation or anatomic landmarks of the skull base are destroyed by sino-nasal disease.

Key words: Nasal sinuses; Endoscopy; Skull base surgery; Image-guided navigation system