Advanced Navigation Systems for FESS: Enhancing Safety

[Dr. Raj Sindwani]:
Yes, that's a good point. Here, because I think the nature of my practice is more complex stuff, I don't have to check a box. They do have it in the room and the residents know to set it up pretty much with every single case. As a more broad question, when do we do, when does one use navigation? I would say it's whenever you're doing something complex enough, different enough, that you want to have a little bit more localization and orientation. That could take a lot of different forms, but usually when we're in the posterior ethmoids or sphenoid, most of us like to have navigation or doing final surgery.

Certainly, in this scenario of tumors, skull base orbit, when you know you're going to be up close to some pretty important landmarks, like the lamina or skull base, you want to have navigation then as well. We've done some complex maxillary sinus cases in the setting of trauma or tumors, where even for maxillary sinus surgery, you would want to have navigation. When you look at some of the position papers or even the academy's statement on navigation, it's purposely general and vague. The idea is really when you think it would help you to be more oriented, visualize better or localize better, you should use it.