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Intra-operative image guidance in otolaryngology – The use of the ISG viewing wand

Published online by Cambridge University Press:  29 June 2007

A. S. Carney ,
N. Patel ,
D. L. Baldwin ,
H. B. Coakham  and
D. R. Sandeman
A. S. Carney*
Affiliation:
Department of Otolaryngology, Southmead Hospital, Bristol
N. Patel
Affiliation:
Department of Neurosurgery, Frenchay Hospital, Bristol
D. L. Baldwin
Affiliation:
Department of Otolaryngology, Southmead Hospital, Bristol
H. B. Coakham
Affiliation:
Department of Neurosurgery, Frenchay Hospital, Bristol
D. R. Sandeman
Affiliation:
Department of Neurosurgery, Frenchay Hospital, Bristol
*
Address for correspondence: Mr A. S. Carney, F.R.C.S.Ed., Department of Otolaryngology, Queens Medical Centre, Nottingham NG7 2UH.
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Abstract

The ISG viewing wand is an intra-operative guidance system with a proprioceptive robotic-like jointed arm. It provides surgeons with almost instantaneously reconstructed computer-generated CT or MRI images in two or three dimensions and can correlate any point within the operative field to its corresponding locus on the reformatted scan images. In addition to having been used in over 400 neurosurgical patients in Bristol, 14 patients with skull-base, cerebello-pontine angle or temporal bone lesions have also undergone wand-guided resections. The wand has proved to be particularly useful in pre-operative planning, allowing minimally-invasive incisions, providing per-operative navigation, identifying the relationship and proximity of important anatomical structures and in assessing the extent of lesion resection. We illustrate the advantages of intra-operative image-guidance by discussing four cases. The potential applications of this form of imaging technology to other otolaryngological procedures are discussed.

Keywords

Image processing, computer assistedStereotaxic techniquesTemporal boneCholesteatomaGlomus jugulare tumourChordoma
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 110 , Issue 4 , April 1996 , pp. 322 - 327
Copyright
Copyright © JLO (1984) Limited 1996

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Footnotes

Presented in part to the Royal Society of Medicine, Section of Otology, 3 March 1995.

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