Comparison of Different Computer-Aided Surgery Systems in Skull Base Surgery.

Computer-aided surgery (CAS) based on high-resolution imaging techniques represents an important adjunct to precise intraoperative orientation when anatomical landmarks are distorted or missing. Several commercial systems, mostly based on optical or electromagnetic navigation principles, are on the market. This study investigated the application of EasyGuide(R), VectorVision(R), and InstaTrak(R) CAS systems in ENT surgery under practical and laboratory conditions. System accuracy, time required, handling, individual features, and practicality were examined in 155 patients who underwent endonasal sinus surgery and in 23 patients who underwent anterior or lateral skull base procedures. The VectorVision(R) and InstaTrak(R) CAS systems proved to be suitable for routine application in surgery involving the paranasal sinuses and various regions of the anterior skull base by helping to avoid critical structures and to determine minimally invasive approaches.