Surgical Navigation and Nerve Monitoring
Computer aided surgery, surgical navigation, and image guided surgery are phases for similar methods of using stored diagnostic patient images, typically computed tomography (CT) or magnetic resonance (MR) images, or real time by fluoroscopy or intraoperative CT, to assist the surgeon with precision guidance of instruments in performing a pre-planned surgical procedure. Intraoperative neurophysiological monitoring is the use of electrophysiological methods such as electroencephalography (EEG), electromyography (EMG), and evoked potentials to monitor the functional integrity of certain neural structures (e.g., nerves, spinal cord and parts of the brain, laryngeal nerves) during surgery. The American Academy of Otolaryngology-Head and Neck Surgery has endorsed the intraoperative use of computer-aided surgical navigation, also called image guided surgery (IGS), in certain cases to assist the surgeon in identifying complex anatomy during sinus and skull base surgery. This document provides an overview of the products used in these types of procedures and current evidence regarding their use.