Abstract
Objective To analyze the current clinical use of navigation at the lateral skull base among
skull base surgeons in Germany.
Methods A web-based questionnaire was provided to surgeons being head of the department and
member of one of the following scientific societies: German Society of Head and Neck
Surgery, Maxillo-Facial Surgery, Neurosurgery, and German Skull Base Society. Replies
were recorded anonymously. The questionnaire included the estimated case load per
year and percent of surgery performed with navigation (middle and posterior fossa),
type of navigation, estimates of intraoperative inaccuracy, and reasons for not using
navigation.
Results Eighty nine out of 99 replies met requirements for final analysis. Overall, 37% of
skull base surgeons use navigation on a regular basis (15% use no navigation). Optical
tracking is more frequently used than magnetic tracking (71 vs 19). At the middle
fossa, ENT surgeons split into routine users (n = 10/36) and rare users (n = 16/36), the latter stating navigation inaccuracy as a major reason for neglecting
navigation. Neurosurgeons use navigation at the middle fossa significantly more often
and criticize navigation inaccuracy less. At the posterior fossa, navigation is used
less frequently by both ENT and neurosurgeons with similar rates of estimated inaccuracy.
Conclusions A moderate use of navigation at the lateral skull base was demonstrated. Insufficient
accuracy causes ENT surgeons to frequently omit navigation at the middle fossa (not
neurosurgeons) and posterior fossa (also neurosurgeons). Higher intraoperative navigation
accuracy is needed to enhance the use of navigation at the lateral skull base.
Keywords
skull base - navigation - middle fossa - posterior fossa - accuracy - survey
