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8 6 O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E | A P R I L 2 0 1 4 set up our navigation system. When the patient is wheeled into the room, I like to set up the machine myself. The key is for it to be easy to use, for surgeons and staff alike, accurate and reproducible so you always get the same outcomes. Being off by 5mm in the sinus cavity can result in a tragic injury. • Trained staff. Two of our surgical techs know our navigation machines as well as I do. If I'm busy, I can ask them to set it up for me. If you can, get 1 or 2 key staff members trained on your image- guidance system. Enroll them in courses and ask your reps to instruct them. Surgeons will appreciate a well-trained staff that can set up the machine for them. We call this is no-headache sinus surgery.This might seem obvious, but make sure your image-guided system can read the disc that contains the pre-operative CT scan the surgeon brings. Otherwise, you risk having to cancel surgery so you can send the patient out for a new CT scan. • Go wireless. I prefer a radiofrequency system to cut down on the S U R G I C A L N A V I G A T I O N T he American Academy of Otolaryngology – Head and Neck Surgery endorses the intraoperative use of computer-aided surgery in select cases to assist the surgeon in clarifying complex anatomy during sinus and skull base surgery. Examples of indications in which the use of computer-aided surgery may be deemed appropriate include: • Revision sinus surgery • Distorted sinus anatomy of development, postoperative or traumatic origin • Extensive sino-nasal polyposis • Pathology involving the frontal, posterior ethmoid and sphenoid sinuses • Disease abutting the skull base, orbit, optic nerve or carotid artery • CSF rhinorrhea or conditions where there is a skull base defect • Benign and malignant sino-nasal neoplasms WHEN TO USE Criteria for Image-Guided Surgery OSE_1404_part2_Layout 1 4/11/14 10:58 AM Page 86