Abstract: Objective To evaluate the clinical application of image-guided endoscopic techniques in the management of nasal sinus, skull base and orbital disease. Methods Retrospective review was performed in 751 transnasal endoscopic surgeries with the help of the image navigation system, including 565 cases with Medtronic Stealth Station^TM optical based system and 186 cases with Medtronic Fusion electromagnetic system. The accuracy of image navigation system, preoperative registration time, benefits and undesirable problems of intra-operative navigation and surgical complications were analyzed. Results Both platforms had been shown to be accurate to within 2 mm. The benefits of navigational technology were evaluated by VAS scores, which decreased to(8.3±1.2). The anatomic sites were frontal sinus, optic nerve and carotid artery,which the best guided effects applied by navigational orientation. The major undesirable problems in navigation procedures were image-drifting, failing to real-time orientation, and failing to registration. All surgeries completed successfully without any complications. Conclusion The image-guided techniques can assist endoscopic surgeons to identify surgical markers with precision and eliminate anatomic illusion possible under endoscopy. The incidence of undesirable problems in navigation procedures was low. The experience of surgeon for endoscopic and navigational operation was very important under this situation.

Key words: Endoscopic surgical procedures, operative, Skull base, Paranasal sinuses, Therapy, computer-assisted, Orbit