Abstract
Image-guided navigational systems have been a useful adjunct for minimally invasive
surgery of the skull base. A novel miniature position sensor has been developed that
uses a low magnetic field for real-time tracking of surgical instruments. The 1.7-mm-diameter
sensor attached to the position and orientation system (Magellan®, Biosense, Inc.,
Johnson and Johnson Co., Baldwin Park, CA) was deployed through various surgical instruments
or used in a hand-held fashion with a malleable shaft probe. We report on our experience
using this electromagnetic system in a series of lesions of the sella and clivus.
After patient/image registration, the system was consistently accurate to within 2
mm. We have found this system to be particularly advantageous in endoscopic surgery
of cystic lesions of the skull base, where access is limited and anatomy may be distorted.
In three patients, this device obviated the need for an extensive external surgical
approach. Case histories are presented, which illustrate the specific advantages this
miniature system provides during skull base surgery.
