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Navigation of Sinus and Skull Base Surgery

  • Sarah M. Kidwai
  • Arjun K. Parasher
  • Joshua B. Bederson
  • Satish Govindaraj
Chapter

Abstract

Given the complexity of the anatomy, proximity of critical orbital, vascular, and intracranial structures, diversity of pathology, and small surgical field, sinus and skull base surgery has often been limited by the degree of visualization and access. The nasal endoscope, initially introduced in the early nineteenth century by Hirschmann, and then developed into the modern rigid endoscope in the 1960s, revolutionized sinus and skull base surgery. Yet, its simple two-dimensional view impairs depth perception, hand-eye coordination, and size estimation. With the evolution of digital technology and the advent of computerized tomography (CT) or magnetic resonance imaging (MRI) navigation technology, a new era of surgical approaches has developed. These new technologies enable enhanced surgical visualization, detailed anatomical guidance, and accurate localization during surgical instrumentation. Combined, these technologies have expanded the scope of endoscopic surgery, while improving clinical outcomes. In this chapter, we describe the relevant sinus and skull base anatomy encountered during navigation-based endoscopic procedures and review the history, development, and future directions within the field.

Keywords

Endoscopic sinus surgery Skull base surgery Image-guided surgery Navigation technology 

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Sarah M. Kidwai
    • 1
  • Arjun K. Parasher
    • 1
  • Joshua B. Bederson
    • 2
  • Satish Govindaraj
    • 1
  1. 1.Department of OtolaryngologyThe Mount Sinai Hospital, Icahn School of Medicine at Mount SinaiNew YorkUSA
  2. 2.Department of Neurosurgery, The Mount Sinai HospitalIcahn School of Medicine at Mount SinaiNew YorkUSA

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