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Skull Base 2001; 11(4): 245-256
DOI: 10.1055/s-2001-18631
ORIGINAL ARTICLES

Copyright © 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Use of the LandmarX™ Surgical Navigation System in Lateral Skull Base and Temporal Bone Surgery

Hinrich Staecker1 , Bert W. O'Malley1 , Howard Eisenberg2 , B. Emmerich Yoder3
  • 1Department of Otolaryngology, Head and Neck Surgery, University of Maryland School of Medicine, Baltimore, Maryland
  • 2Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland
  • 3University of Maryland School of Medicine, Baltimore, Maryland
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Publication History

Publication Date:
28 November 2001 (online)

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ABSTRACT

Despite the widespread availability of surgical navigation devices, their use in lateral skull base and temporal bone surgery has been limited. Problems with current systems include difficulty of use and inadequate accuracy. We present a series of cases using the LandmarX™ surgical navigation system as an adjunct for lateral skull base and temporal bone procedures. This infrared emitting diodes (IRED)-driven system has a post that carries the IREDs and bypasses the need to place the patient in a Mayfield head holder. This configuration allows greater mobility of the surgical field. Registration of the patient can include a combination of fiducial and anatomic landmarks that significantly increase accuracy compared to fiducial calibration alone. We introduced the use of the lateral process of the malleus as a landmark, thereby increasing accuracy within the temporal bone to a range of 0.9 to 1.5 mm. We used the system on encephaloceles, glomus tumors, meningiomas, and schwannomas, and revision surgery for chronic otitis media. It decreased operating time, allowed more effective use of ``keyhole'' approaches, and increased safety. As the availability and flexibility of these systems increase, their use should become the standard of care in revision temporal bone and lateral skull base procedures.

KEYWORD

Lateral skull base surgery - temporal bone surgery

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