Comparison of six three-dimensional navigation systems during sinus surgery

Three-dimensional (3D) navigation systems are routinely used in the fields of endoscopic skull base surgery, neurosurgery, maxillo-facial and endoscop ic sinus surgery. The use of such systems is associated with the following advantages: a better 3D orientation; a more confident surgeon; a more preci se surgical approach; and a reduced operation time. Six different brands of 3D navigation system were compared in order to find out if there are major differences in performance and whether the considerable financial investme nt required to purchase such a system would be justified by a noticeable im provement in surgical interventions and a realization of the above expectat ions. The 3D navigation systems were tested by performing endoscopic sinus surgery on 26 patients suffering from chronic sinusitis. The system accurac y, the confidence of the surgeon, the time of anaesthesia, the cost, the nu mber of personnel required (and their skills), and the technical resources were compared. No major differences in performance of the different brands of 3D navigation system were noticed. All of the systems showed high, but v arying, system precision, the surgeons felt more confident and the time of anaesthesia was prolonged by 5-15 min. A well-trained operating staff is re quired. Assuming that the initial costs are excluded and that data transfer occurs automatically, personnel costs and the extra time required still ha ve to be considered.