Image-guided procedures of the skull base.

The primary factor in determining the surgical approach to skull base pathology should not be the presence or absence of IGS. The knowledge and experience of the surgeon is far more important than any technology or instrumentation. As with any computerized system, IGS is susceptible to numerous human and technical errors that can lead a surgeon astray. IGS must be used solely as a preoperative planning instrument and an intraoperative confirmatory tool. Under no circumstances should a surgeon proceed with a procedure using only information obtained from an IGS system, nor should a surgeon feel compelled to perform operations for which they have not had adequate training simply because IGS is now widely available. Continued advances in endoscopic equipment, radio-graphic techniques, and IGS systems will permit the rhinologist to continue to stretch the minimally invasive boundaries in treating skull base pathology.