[Navigation-supported surgery in the head and neck region]

Area of Science:

• Medical technology
• Surgical navigation systems
• Intraoperative anatomical orientation

Background:

• Pioneering surgical navigation systems faced market challenges.
• Early systems tracked mechanical displacement; optoelectronic and electromagnetic methods are now prevalent.
• Electrooptical systems require an unobstructed "line of sight," unlike electromagnetic systems.

Purpose of the Study:

• To review the technological evolution and current state of surgical navigation systems.
• To highlight advancements in imaging integration and registration methods.
• To emphasize the need for simplified handling and clinical evaluation for routine adoption.

Main Methods:

• Review of technological advancements in surgical navigation, including optoelectronic and electromagnetic tracking.
• Discussion of imaging integration (CT, MRI, sonography) and data fusion techniques.
• Analysis of registration and referencing methods for marker fixation (headsets, headbands, bone-anchored adapters).

Main Results:

• Integration of MRI and sonography with preoperative CT and intraoperative techniques enhances navigation.
• Bone-anchored referencing offers higher precision than headbands/headsets.
• Simplified system handling and clear menus are essential for surgeon usability.
• Preoperative segmentation enables minimally invasive procedures like biopsies and foreign body retrieval.

Conclusions:

• Surgical navigation systems have evolved significantly, integrating diverse imaging modalities and improving accuracy.
• Ease of use and surgeon training are key factors for successful implementation.
• Clinical evaluation based on Evidence-Based Medicine (EBM) standards is necessary to establish navigation systems as routine clinical practice.