Computer-assisted surgical techniques: a vision for the future of otolaryngology-head and neck surgery

Our specialty relies increasingly on technologic advancements and increased knowledge of pathophysiology at the cellular and molecular level; these trends will continue. The consequences in the laryngologic, otologic, and rhinologic surgery are presented. Envision the surgeon positioned at a computer workstation to perform surgery. Following endoscopy and the placement of the microlaryngoscope, the only contact he or she will have with the patient is through robotic "hands" on the end of thin rods. These hands thread through the laryngoscope and hold tissue without any tremor. Multiple-wavelength lasers are available, each tuned to optimally incise particular tissue types. The laser beam will be delivered under computer control with active feed-back systems involving ultrasonic imaging, infrared thermography, and photoacoustic monitoring. Similar visions are presented in otology and rhinology with microinstrumentation and virtual reality.