The use of CT localizer in endoscopic sinus surgery and potential applications in skull base and external sinus surgery

The widespread use of endoscopes over the past ten years has markedly improved our ability to visualize and treat inflammatory sinus disease. Nevertheless, major complications may occur from injury to surrounding structures. A similar problem exists with many skull base procedures where a narrow operative field, bleeding, distorted anatomy, or simple inability to sec in the ''third'' dimension may make identification of vital structures difficult. In an effort to reduce such complications. stereotactic guidance technology has recently been applied to both endoscopic sinus surgery and skull base surgery. We report our experience using the InstaTrak(TM) in 29 cases of endoscopic sinuses surgery. We also report our laboratory evaluation of, and initial clinical experience with, this system in selected skull base procedures.