ABSTRACT
Although computer-assisted neurosurgery has much broader applications, skull base lesions remain an important indication. By their nature, skull base lesions require deep exposures that result in limited visibility within and around the target. The analogy of reading a road map through a dime-sized hole still applies. You may know which road you are on but are uncertain about which direction leads to your destination. Frameless surgical navigation provides a broad view of the map in the form of a CT or MRI slice with a marker that says, ‘‘You are here.’’ Experienced skull base surgeons developed their skills without the benefit of this technology. However, the learning curve for residents and other neurosurgeons to successfully operate in the skull base region can be significantly shortened by its use. The development of intraoperative MRI and CT scanning enables the surgeon to update the ‘‘map’’ in the middle of the operation to improve the accuracy of the navigation system. Surgical navigation in skull base surgery can reduce the incidence of complications, increase the extent of resections, and shorten the duration of procedures.
