APPLICATION OF A 3-DIMENSIONAL INTRAOPERATIVE NAVIGATIONAL SYSTEM IN CRANIOFACIAL SURGERY

Recent advances in imaging technology have prompted the development of new instrumentation that permits direct interactive visualization of image data in the operating room. The ISG Viewing Wand (ISG Technologi es, Mississauga, Ontario, Canada) is a frameless stereotactic system t hat combines three-dimensional computer-assisted imaging with a hand-g uided, position-sensing, articulated arm. In this article we describe the use of the ISG Viewing Wand as a three-dimensional intraoperative navigational system in craniofacial surgery and review our initial cli nical experience in 17 patients. The wand was used as an aid in the co rrection of craniofacial asymmetry in 12 patients and as a navigationa l device assisting in craniofacial skeletal resection in 5 patients. B y orienting the surgeon to his exact location throughout the procedure , the ISG Viewing Wand was found to be useful in defining intraorbital anatomy, in determining ocular globe position, and in delineating tum or margins. Excellent anatomical spatial correlation was obtained, and the probe tip position was within 2 mm of its actual position in all cases. Use of the system added minimal additional time, and overall no adverse effects were attributed to use of the wand.