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[Surgery of the skull base and paranasal sinuses assisted by a computerized navigation system without external
M Caversaccio1, M Nuyens, R Bächler
1Clínica Universitaria de Otorrinolaringología, Cirugía de Cabeza y Cuello, Inselspital Berna, Suiza.
Objective:
To present a new concept in computer-assisted surgery for the base of the skull and paranasal sinuses using a frameless navigation system.
Method And Materials:
This system is based on computer tomography images, which are displayed online on a workstation monitor. Using specially mounted infrared instruments, the patient's anatomic landmarks are visualized on the monitor. This system does not require invasive markers because it uses a reference system fixed to the patient with a silicone maxillary splint.
Patients:
From March 1997 to February 1998 we operated on 44 patients with this innovative system.
Results:
The clinical accuracy of this system was 0.5 to 2 mm for surgery of the anterior skull base and 1 to 2.5 mm for the lateral skull base. There were no intraoperative complications.
Conclusions:
This computer-assisted surgical aid made it possible to carry out complex and difficult skull-base surgery with reasonable intraoperative safety. It also allowed development of new minimally invasive surgical approaches.