Use of MRI in interventions in head and neck surgery.

Purpose: Presentation of new concepts and applications of MR-guided head an d neck surgery are presented. Examples of diagnostic and therapeutic proced ures such as evaluation of transseptal tumor biopsies, placement of afterlo ading catheters for brachytherapy, and microscopic surgery of paranasal sin uses in the open MRI are discussed. Material and Methods: 24 MRI-guided ENT -procedures (14 transsphenoidal biopsies, one transnasal biopsy, 6 placemen ts of brachytherapy catheters, and 3 operations of the paranasal sinuses) w ere performed in an open 0.5 T MR system. Results: Localisation and/or exte nsion of all lesions as well as the placement of biopsy needles or catheter s were determined with great precision during the interventions. Conclusion s: Surgical risk and postoperative morbidity are significantly reduced in M R-guided surgery of the petroclival region and the region of head and neck compared to other, conventional methods. Thus, interventional MRI-guidance optimizes minimal invasive surgery and catheter placement in difficult anat omical regions like the petroclival region.