Fluoroscopic Frameless Computer-Assisted Navigation for Transsphenoidal Surgery: A Clinical Assessment of Accuracy in Spatial Position and Trajectory

Abstract

Objective: Fluoroscopic navigation technique in transsphenoidal surgery on the one hand provides multi-planar (antero-posterior and lateral views) navigation while on the other hand it does not need any preoperative preparation. To assess the clinical accuracy of the above technique in the transsphenoidal surgery, we performed this study. Methods: 5 patients undergoing transsphenoidal surgery were assessed. Fluoroscopic images were compared with C-arm X-ray images for difference in spatial position and trajectory. Results: 26 sets of data were collected for analysis. Mean pointer tip difference was 0.6 mm. The 95% confidence interval was 1.3 mm. Mean trajectory difference was 1.2 degree. The 95 % confidence interval was 2.7 degree. Conclusion: With a good clinical accuracy, fluoroscopic navigation offers a distinct advantage to replace the traditional fluoroscopic approach for transsphenoidal surgery for its low X-ray exposure and multi-planar (antero-posterior and lateral views) navigation.