3-DIMENSIONAL IMAGE-GUIDED ENDONASAL SURGERY WITH A MICRODEBRIDER

We report the first intraoperative use of a microdebrider as a stereot actic three-dimensional (3D) navigation instrument in paranasal and fr ontobasal surgery. The microdebrider uses rotating blades and an integ rated suction device for controlled removal of tissue under video-endo scopic view. The ISG Viewing Wand uses the patient's computed tomograp hy/magnetic resonance (CT/MR) data and a 3D reconstruction thereof and a high-precision position-sensitive mechanical arm for intraoperative three-dimensional navigation. We have linked the microdebrider to the Viewing Wand to transform it into a continuously available intraopera tive stereotactic localizing device. We discuss the problems related t o this extension of the Viewing Wand and demonstrate the practical use in an exemplary polypectomy.