INTRAOPERATIVE IMAGE GUIDANCE IN OTOLARYNGOLOGY - THE USE OF THE ISG VIEWING WAND

The ISG viewing wand is an intra-operative guidance system with a prop rioceptive robotic-like jointed arm. It provides surgeons with almost instantaneously reconstructed computer-generated CT or MRI images in t wo or three dimensions and can correlate any point within the operativ e field to its corresponding locus on the reformatted scan images. In addition to having been used in over 400 neurosurgical patients in Bri stol, 14 patients with skull-base, cerebello-pontine angle or temporal bone lesions have also undergone wand-guided resections. The wand has proved to be particularly useful in pre-operative planning, allowing minimally-invasive incisions, providing per-operative navigation, iden tifying the relationship and proximity of important anatomical structu res and in assessing the extent of lesion resection. We illustrate the advantages of intra-operative image-guidance by discussing four cases . The potential applications of this form of imaging technology to oth er otolaryngological procedures are discussed.