Based on open source software, an image guided surgical system for Ear-Nose-Throat (ENT) surgery was developed and evaluated. Real-time patient movement compensation and virtual CT was provided intraoperatively. Real-time updating was accomplished by an alternative display that represents the relative position of surgical instrument against moving patient. The proposed method was applied for 5 cochlea implantation surgeries, and 2 endoscopic sinus surgeries. The trace of surgical drill was recorded, and valid data was selected to compute the virtual intraoperative CT that reflects the status of temporal bone resection. Accurate insertion of electrodes and removal of cysts were performed successfully in all surgeries. The navigation accuracy was approximately 1-2 mm in fiducal registration error (FRE).
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