Comparison of Different Computer-Aided Surgery Systems in Skull Base Surgery

U. Ecke; B. Luebben; J. Maurer; S. Boor; W. J. Mann

doi:10.1055/s-2003-37552

Skull Base, Inhaltsverzeichnis

Skull Base 2003; 13(1): 043-050
DOI: 10.1055/s-2003-37552

ORIGINAL ARTICLE

Comparison of Different Computer-Aided Surgery Systems in Skull Base Surgery

U. Ecke¹ , B. Luebben¹ , J. Maurer¹ , S. Boor² , W. J. Mann¹

¹Department of Otolaryngology, Head and Neck Surgery, Mainz University Medical School, Mainz, Germany
²Department of Neuroradiology, Mainz University Medical School, Mainz, Germany

Abstract

ABSTRACT

Computer-aided surgery (CAS) based on high-resolution imaging techniques represents an important adjunct to precise intraoperative orientation when anatomical landmarks are distorted or missing. Several commercial systems, mostly based on optical or electromagnetic navigation principles, are on the market. This study investigated the application of EasyGuide;rM, VectorVision;rM, and InstaTrak;rM CAS systems in ENT surgery under practical and laboratory conditions. System accuracy, time required, handling, individual features, and practicality were examined in 155 patients who underwent endonasal sinus surgery and in 23 patients who underwent anterior or lateral skull base procedures. The VectorVision;rM and InstaTrak;rM CAS systems proved to be suitable for routine application in surgery involving the paranasal sinuses and various regions of the anterior skull base by helping to avoid critical structures and to determine minimally invasive approaches.

KEYWORDS

Endonasal sinus surgery - skull base surgery - computer-assisted surgery - computer-aided surgery - image-guided surgery - minimally invasive techniques

Volltext

Referenzen

REFERENCES

1 Friedman H M, Kern E B. Complications of intranasal ethmoidectomy: a review of 1000 consecutive operations. Laryngoscope . 1979; 89 421-434
2 Weber R, Draf W. Komplikationen der endonasalen mikroskopischen Siebbeinoperation. HNO . 1992; 40 170-175
3 Draf W. Endonasal micro-endoscopic frontal sinus surgery, the Fulda concept. Otolaryngol Head Neck Surg . 1991; 2 234-240
4 Moore C E, Ross D A, Marentette L J. Subcranial approach to tumors of the anterior cranial base: analysis of current and traditional surgical techniques. Otolaryngol Head Neck Surg . 1999; 120 387-390
5 Golfinos J G, Fitzpatrick B C, Smith L R, Spetzler R F. Clinical use of a frameless stereotactic arm: results of 325 cases. J Neurosurg . 1995; 83 197-205
6 Robinson Jr R J, Golfinos J G, Spetzler R F. Skull base tumors. A critical appraisal and clinical series employing image guidance. Neurosurg Clin North Am . 1996; 7 297-311
7 King A P, Edwards P J, Maurer Jr R C. A system for microscope-assisted guided interventions. Stereotact Funct Neurosurg . 1999; 72 107-111
8 Anon J B, Klimek L, Moesges R, Zinreich J. Computer-assisted endoscopic sinus surgery. An international review. Otolaryngol Clin North Am . 1997; 30 389-401
9 Christ C P, Haid C T, von Glass W. Computer-assisted surgery as an aid for orientation in surgery of the middle cranial fossa. Eur Arch Otorhinolaryngol . 1992; 249 408
10 Moesges R, Klimek L. Computer-assisted surgery of paranasal sinuses. J Otolaryngol . 1993; 22 69-71
11 Luxemberger W, Köle W, Stammberger H, Reittner P. Computerunterstützte Nasennebenhöhlenchirurgie- Der Standard von morgen?. Laryngorhinootologie . 1999; 78 318-326
12 Fried M P, Kleefield H V, Gopal H V. Image guided endoscopic surgery: results of accuracy and performance in a multicenter clinical study using an electromagnetic tracking system. Laryngoscope . 1997; 107 594-601
13 Grevers G F, Menauer F, Leunig M. Navigationschirurgie bei Nasennebenhoehlenerkrankungen. Laryngorhinootologie . 1999; 78 41-46
14 Klimek L, Ecke U, Luebben B, Witte J, Mann W. A passive marker-based optical system for computer-aided surgery (CAS) in otorhinolaryngology: development and first clinical experiences. Laryngoscope . 1999; 109 1509-1515
15 Schloendorff G, Moesges R, Meyer-Ebrecht D. CAS (computer assisted surgery). Ein neuartiges Verfahren in der Kopf-Halschirurgie. HNO . 1987; 37 187
16 Anon J B. Computer-aided-endoscopic sinus surgery. Laryngoscope . 1998; 108 949-961
17 Schloendorff G, Meyer-Ebrecht D, Moesges R. CAS-computer-assisted surgery. Arch Otorhinolaryngol . 1987; II 45-46
18 Ecke U, Khan M, Maurer J, Boor S, Mann W. Intraoperative navigation in surgery of paranasal sinus and anterior skull base. HNO . 2002; 50 928-934
19 Ecke U, Maurer J, Boor S, Khan M, Mann W. Common errors of navigation in lateral skull base surgery (in press). HNO. 2003;