Image-guided surgical navigation in otology and neurotology

Objective: To review the impetus for the development of image-guided surgic al navigation, its technologies, and the few prior outcome studies, and to make recommendations for its role. in otologic and neurotologic surgery. Data Sources: A Literature search of English language publications by Medli ne from 1966 to 1998, using the key words: stereotactic, stereotaxy, naviga tion, intraoperative, and surgery. Data Extraction: Attempted review of the literature on image-guided surgica l navigation in otology and neurotology revealed little relevant data. Conclusion: There are many possible applications for image guided surgical navigation in otology and neurotology, but technologic limitations preclude its extensive application. There are no data available that assesses wheth er image-guided surgical navigation can reduce operative time, hospital sta y, or cost. Clinical outcomes have not been studied inpatients with otologi c and neurotologic disease. In this scenario, image-guided surgical navigat ion is an adjuvant tool that aids in navigation of the skull base but is no t a substitute for sound surgical principles and knowledge of microsurgical anatomy.