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Updated: Jul 6, 2026
Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
Published on: July 5, 2021
The frontal bone skull post for image guided surgery of the nasopharynx
Alexander C Vlantis1, H S Chan, Terry Hung
1Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin NT, Hong Kong SAR, China. lexvlantis@cuhk.edu.hk
Background And Objectives:
To describe the use of the mastoid skull post of a surgical image guidance system for image guided surgery and intraoperative navigation of the nasopharynx. This adaptation overcomes the limitations of a headset frame or head clamp and can be applied to open and closed surgery of the nasal cavities, sinuses, orbits, midface and anterior skull base.
Methods:
A sterile mastoid skull post of a surgical image guidance system was securely screwed into the outer table of the frontal bone and a passive reference frame fixed to it. The position of the reference frame relative to the patient's head remained constant during surgery.
Results:
Between August 2002 and November 2006, 22 patients underwent a surgical nasopharyngectomy using an image guidance system and frontal bone skull post. No surgical complications or complications of the frontal bone skull post occurred.
Conclusion:
Using the skull post of a surgical image guidance system anchored to the frontal bone to carry a passive reference frame provides real-time visual information about the relationship of relevant anatomy to the surgical field on a fully mobile head in open or closed procedures of the midface and anterior skull base while accuracy and sterility are maintained.
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