Experience With Various 3-Dimensional Navigation Systems in Head and Neck Surgery

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Abstract
AMONG OTHERS, Schlöndorff et al1 introduced 3-dimensional (3-D) navigation to otolaryngology in 1987 with a position-sensitive articulated arm. A successor thereof was the ISG Viewing Wand, which was for sometime considered the criterion standard in 3-D navigation. After initial scepticism of otolaryngologists, 3-D navigation emerged as an accepted and useful technique in nasal, paranasal, and skull base surgery. Minimally invasive surgery has gained enormous popularity because delicate structures at risk can be identified safely even when reliable landmarks are missing (tumors, revision, bleeding, etc).1-5 We have gained experience with different 3-D navigation systems in approximately 250 operations mainly at the paranasal sinuses and the frontal and lateral skull bases. We report some aspects of our work with 3-D navigation systems, emphasizing those that are crucial to obtaining optimal intraoperative results.