Abstract:

Objective  To discuss the value of image guidance system in anterior skull base operations, and its assistance on avoiding the damage of important nerves and vessels of cranial fossa, lowering rate of surgical complications and raising the curative rate. Methods  We performed 112 operations with the help of image guidance system, which included operations on 19 patients with traumatic fractures of optic canals, 15 with cerebrospinal rhinorrhea, 26 with tumors of middle skull base (3 with fibrous dysplasia, 6 with squamous cell carcinoma of sphenomaxillary fossa and middle skull base, 1 with metasellar neurofibroma, 4 with ostoma of posterioriethmoid and skull base and 12 with hypophysoma), 17 with sphenoid sinus cyst involving intracranial structure, 11 with mycotc sphenoiditis,18 with isolated sphenoiditis, and 6 with posterioriethmoiditis, sphenoiditis and nasal polyps. Results  Image guidance system was well configured in all 112 patients and with its help we can find the fracture, ventage or apertures, and the boundary in patients with tumors, and we can also locate the surrounding vital structures thus avoiding harming them. Conclusions  Image guidance system can help us accurately and clearly locate the destination and lower the rate of surgical complications, and excise the pathological tissues to the maximum extent, and compensate for the lack of 3 dimension locating of nasal endoscopes. But image guidance system is setup on preoperative images and can not reflect the change in the surgery. Accurate configure is the key to image guidance system and if the corresponding position is damaged, catastrophic results maybe occurs, so it is important to check the system timely.

Key words: Nose, Skull base, Image guidance, Surgery, Operations