Localized intraoperative virtual endoscopy (LIVE) for surgical guidance in 16 skull base patients.

ImportancePrevious preclinical studies of localized intraoperative virtual endoscopy–image-guided surgery (LIVE-IGS) for skull base surgery suggest a potential clinical benefit.ObjectiveThe first aim was to evaluate the registration accuracy of virtual endoscopy based on high-resolution magnetic resonance imaging under clinical conditions. The second aim was to implement and assess real-time proximity alerts for critical structures during skull base drilling.Design and SettingPatients consecutively referred for sinus and skull base surgery were enrolled in this prospective case series.ParticipantsFive patients were used to check registration accuracy and feasibility with the subsequent 11 patients being treated under LIVE-IGS conditions with presentation to the operating surgeon (phase 2).InterventionSixteen skull base patients were endoscopically operated on by using image-based navigation while LIVE-IGS was tested in a clinical setting.Main Outcome and MeasuresWorkload was quantitatively assessed using ...