Navigation with the StealthStation (TM) in skull base surgery: An otolaryngological perspective

The introduction of computer-assisted navigation systems has played a signi ficant role in assuring the integration and consistent intraoperative use o f radiological information. We used a frameless stereotactic navigation sys tem to treat 62 patients with a variety of skull base pathologies. The opto electric appliance uses digital imaging information to locate surgical inst ruments in the operative area. The aim of this study was to evaluate the cl inical accuracy, practicality, and impact of this navigation system on otol aryngological procedures. In conjunction with rigid head fixation and bone- anchored registration markers, the precision of registration was 0.8 mm and the accuracy of clinical measurements was less than 2 mm. With conventiona l fiducials and flexible head positioning, deviations were as large as 4.5 mm. The additional use of surface registration increased the precision of r egistration. Preoperative preparations took 15 to 35 minutes, depending on the complexity of the planning. Intraoperative computer support is an impor tant aid to a surgeon's orientation, especially when a patient's anatomy is atypical. Navigation systems will likely improve the quality of surgery an d facilitate training.