Computerassistierte Chirurgie an der Rhinobasis

Abstract

The procedure of instrument navigation has been an established one since its introduction in ENT by Schloendorff. It facilitates better intraoperative orientation. The opto-electric and electromagnetic procedures are sophisticated principles of intraoperative position recognition. It can be assumed that up to 30% of all ENT hospitals in Germany have access to navigation systems. These systems are used almost exclusively for functional endoscopic sinus surgery (FESS). The impact of instrument navigation is estimated by surgeons predominantly positively. A navigation system enables a saving of up to 10% in terms of operating time. Extended approaches in the frontal skull base appear to benefit from the use of navigation support to a high degree. However, scientific data are still lacking. The current boundaries of simple instrument navigation in the frontal skull base are set by the attainable accuracy of approx. 2 mm and the relatively simple representation of the information in planar sectional views. Instrument navigation should be used in the frontal skull base as frequently as possible, even in less complex procedures. Only in this way can familiarity with the system be achieved.

The transnasal approach to the skull base. From sinus surgery to skull base surgery

“…The availability and use of intraoperative navigation systems has to be seen as an obligatory prerequisite for the execution of endonasal, endoscopic skull base surgery [117], [118]. Of course, it can’t substitute detailed anatomical knowledge but it leads to improved orientation and thus safety.…”

Computer assisted skull base surgery: a contemporary review

“…In the late 1990s the introduction of surgical planning software, 3D printing, and intraoperative navigation/CT expanded the scope of skull base surgery to include the entire anterior and middle cranial fossa [ 9 ], [ 10 ], [ 11 ], [ 12 ], [ 13 ], [ 14 ], [ 15 ], [ 16 ], [ 17 ], [ 18 ], [ 19 ], [ 20 ], [ 21 ], [ 22 ]. More recent refinements in intraoperative navigation and CT have resulted in decreased operative times and improved clinical outcomes [ 13 , 14 , 23 ]. Augmented and virtual reality tools have shown efficacy in resident education and presurgical planning [ 10 , 24 ].…”

A Comparison of Processing Properties of Anatomic Facsimile Models (AFM) of the Temporal Bone with Original Human Bone Structures

“…However, only a few subjective characterizations of their processing properties exist. [1][2][3][4] The challenges involved in the selection of a model material and suitable manufacturing methods are defined by the reproduction of authentic processing properties when using otosurgical instruments, and the feasibility of integrating small structural details inside the bone model, respectively. Key structures include the fine auditory ossicles as well as closed cavities such as the cochlea and semicircular canals.…”