Initial report of a cranial pin system for frameless image guidance

Abstract

The use of an intraoperative navigation device improves surgical accuracy, helps identify anatomic landmarks, and minimizes the risk of complications during surgery of the paranasal sinuses and skull base. Despite the benefits of image guidance, its use is limited by the headset, which precludes external surgical access. We report the successful use of a cranial pin placed into the outer table of the calvarium during surgery. This pin eliminates the need for a headset and permits unencumbered external surgical access. We describe a case that used a combined endoscopic and osteoplastic flap approach to the frontal sinus with this cranial pin system. There were no complications associated with placing the pin. The patient reported only minimal postoperative discomfort related to the temporal scalp incision. The cranial pin combines the benefits of surgical navigation with external surgical access to the paranasal sinuses and skull base.