In brief
Surgical navigation links the position of the instruments to the patient’s CT images in real time during endoscopic sinus surgery.
It is most useful in complex anatomy: revision surgery, frontal and sphenoid sinuses, extensive disease and areas close to the orbit and skull base.
It adds information but does not replace the surgeon’s knowledge of anatomy, as discussed in Dr Puya Dehgani-Mobaraki’s paper on image-guided ESS (2023).
Surgical navigation, or image-guided surgery (IGS), relates the position of the instruments used during surgery to the pre-operative CT images, giving the surgeon additional three-dimensional localisation during endoscopic sinus and skull base surgery.
How it works
After patient registration, the system matches the real anatomy with the imaging dataset. During the procedure the surgeon can check the position of the tip of a navigated instrument on multiplanar reconstructions. Accuracy must be checked during surgery and interpreted critically.
When it is particularly useful
IGS is used mainly in complex anatomy: revision surgery, frontal and sphenoid sinuses, extensive disease, close relationships with the orbit and skull base, CSF leak repair and advanced endoscopic approaches. The indication remains individual and depends on the case.
An aid, not a substitute for experience
Navigation increases the information available to the surgeon but does not remove the need to know endoscopic anatomy, read the CT directly and recognise surgical landmarks. This principle is central to Dr Dehgani-Mobaraki’s scientific work on image-guided ESS.
Research
Dehgani-Mobaraki P, Guarro G, Zaidi A. Image-guided endoscopic sinus surgery: a necessity or an advantage? Otorhinolaryngology. 2023;73(4):208-211. DOI: 10.23736/S2724-6302.23.02479-9. Article
Read more: Endoscopic sinus surgery (ESS/FESS).
Author: Dr Puya Dehgani-Mobaraki. This information is educational and does not replace a specialist consultation.