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Updated: Jul 6, 2026

Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
Published on: July 5, 2021
[Computer-aided surgery of the paranasal sinuses and the anterior skull base]
M Caversaccio1, G Zheng, L-P Nolte
1Klinik für HNO, Kopf- und Halschirurgie, Inselspital, Universität Bern, Freiburgstrasse, 3010 Bern, Schweiz. marco.caversaccio@insel.ch
Abstract:
Endoscopic or microscopic surgery for chronic rhinosinusitis with or without nasal polyps is a routine intervention in daily practice. It is often a delicate and difficult minimally invasive intervention in a narrow space, with a tunnel view of 4 mm in the case of endoscopy and frequent bleeding in chronically inflamed tissue. Therefore, orientation in such a "labyrinth" is often difficult. In the case of polyp recurrence or tumors, the normal anatomical landmarks are often missing, which renders orientation even more difficult. In such cases, computer-aided navigation together with images such as those from computed tomography or magnetic resonance imaging can support the surgeon to make the operation more accurate and, in some cases, faster. Computer-aided surgery also has great potential for education.
