CLINICAL-APPLICATIONS OF FRAMELESS STEREOTAXIC DEVICES IN NEUROTOLOGY- PRELIMINARY-REPORT

Conventional stereotactic surgery has been utilized primarily for intr acranial neurosurgical procedures. Despite their utility, head-frame s ystems are restrictive and often inconvenient, thus they have not prov ed applicable for neurotologic surgery. Recently frameless stereotacti c navigational systems have been developed that employ three-dimension al digitizers to transform the coordinates in surgical space to the co rresponding image space, without the employment of head frames. This a llows the determination of position of a surgical instrument in real t ime during surgery, and its display on video-projected computed tomogr aphy or magnetic resonance imaging scanned images. This preliminary re port focuses upon an optoelectric referenced frameless stereotactic sy stem, the NeuroStation, as it relates to minimally invasive neurotolog ic surgery. Clinical applications, limitations, and future directions are discussed, and three representative surgical cases are presented. This device has potential as an adjunctive navigational tool for certa in neurotologic procedures.