Nose and paranasal sinusesIntraoperative surgical navigation for endoscopic sinus surgery: rationale and indicationsCitardi, Martin J; Batra, Pete SAuthor Information Section of Nasal and Sinus Disorders, Head and Neck Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA Correspondence to Martin J. Citardi, MD, Head and Neck Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Desk A71, Cleveland, OH 44195, USA Tel: +1 216 444 4515; e-mail: [email protected] Disclosures: Dr Citardi was a member of the scientific advisory board of CBYON (Mountain View, CA) during 1999–2003. He currently is a member of the scientific advisory board of GE Healthcare Navigation & Visualization (Lawrence, MA). Current Opinion in Otolaryngology & Head and Neck Surgery: February 2007 - Volume 15 - Issue 1 - p 23-27 doi: 10.1097/MOO.0b013e3280123130 Buy Metrics Abstract Purpose of review The present review discusses the rationale and indications for image-guided surgery through a critical discussion of registration concepts as well as clinical reports. Recent findings The surgical navigation accuracy achieved by commercially available image-guided surgery systems is best reported as target registration error. Clinically achievable target registration error is probably in the 1.5–2.0 mm range. Dry lab studies of registration serve to highlight the principles of registration, the process through which image-guided surgery systems calculate the one-to-one mapping relationship between the preoperative imaging data and the intraoperative surgical volume. Reports on image-guided surgery have highlighted its usefulness in primary and revision endoscopic sinus surgery, osteoplastic frontal sinusotomy, transsphenoidal hypophysectomy, endoscopic cerebrospinal fluid leak repair and endoscopic pterygomaxillary fossa biopsy. Both three-dimensional computed tomography angiography and computed tomography–magnetic resonance fusion images have been incorporated into IGS for advanced minimally invasive endoscopic skull base procedures. The American Academy of Otolaryngology–Head and Neck Surgery policy statement accurately summarizes the current consensus for image-guided surgery applications. Summary Image-guided surgery has emerged as an important technology, which both general otolaryngologists and subspecialty rhinologists can employ for a wide variety of procedures. © 2007 Lippincott Williams & Wilkins, Inc.