Intraoperative navigation in complex head and neck resections: indications and limits

• DOI: 10.1007/s11548-016-1486-0
• Publication Date: 2016-09-22T08:47:57Z
• Authors: S. Catanzaro; C. Copelli; A. Manfuso; K. Tewfik; N. Pederneschi; L. Cassano; R. Cocchi
• Keywords: Adult; Male; Computer-assisted surgery; Operative Time; Pilot Projects; 03 medical and health sciences; 0302 clinical medicine; Humans; Aged; Aged, 80 and over; Complex head and neck resection; Computer-assisted surgery; Intraoperative navigation; Margins of resection; Orientation of the surgical specimen; Pre-surgical planning; Margins of Excision; Intraoperative navigation; Middle Aged; 3. Good health; Surgery, Computer-Assisted; Margins of resection; Pre-surgical planning; Head and Neck Neoplasms; Carcinoma, Squamous Cell; Female; Tomography, X-Ray Computed; Orientation of the surgical specimen; Neck; Complex head and neck resection

The surgical removal of head and neck tumors often represents a highly complex surgery. The three-dimensionality and the anatomy of the head and neck area make sometimes difficult a correct intraoperative orientation and the obtaining of an adequate oncological safety. In the present pilot study, the authors propose a protocol of application of intraoperative navigation in the resection of head and neck tumors. The purpose is to develop a methodology that can be helpful to ensure oncologic free margins of resection and to facilitate the orientation of the specimen by pathologists.A sample of 16 patients with head and neck tumors was selected, and they were differentiated into two groups: a "study group" treated with CT computer-assisted surgery and a "control group" surgically treated without the use of technology. The following data were analyzed: operative and pre-surgical planning times, issues related to the use of the technologies, respect of the planned landmarks, description and orientation of the surgical specimen and distance of the tumor from the margins of resection.In the "study group" were noticed a reduced rate of errors in the specimen orientation and an increased distance of the tumor from the margins of resection. Similar operative times were observed in both groups.Intraoperative navigation resulted to be a reliable method to improve oncological safety in a selected group of patients.