[The NEN (Nicolet Electronic Naviation System) ENT navigation system. Initial clinical application]

Area of Science:

• Neurosurgery
• Medical Technology
• Surgical Navigation

Background:

• Intraoperative computer navigation is crucial for anterior and lateral skull base procedures.
• Electromagnetic navigation systems offer advantages over optical systems, including smaller hardware and greater surgeon mobility.

Purpose of the Study:

• To evaluate and optimize the accuracy of the Nicolet Electromagnetic Navigation (NEN) system for head and neck surgery.
• To assess the feasibility of electromagnetic navigation in microscopic/endoscopic endonasal sinus surgery.

Main Methods:

• The NEN system was utilized in 22 patients undergoing surgery for polypoid rhinosinusitis.
• Preoperative imaging involved 1 mm slice thickness CT scans.
• The system was modified with optimized marker placement, use of titanium instruments, and a maxilla-affixed adapter for enhanced tracking.

Main Results:

• Navigation accuracy was improved to 1.5 mm in the sphenoid bone plane through iterative modifications.
• A configuration of six markers provided optimal navigation precision.
• Free patient head movement was maintained throughout the procedures.

Conclusions:

• The modified NEN system demonstrates high accuracy for endoscopic sinus surgery.
• Electromagnetic navigation systems can be refined for improved precision and usability in skull base procedures.