The field of otolaryngology—head and neck surgery encompasses the diagnosis and treatment of a wide variety of disease processes involving the ear, nose, and throat (ENT). In particular, surgeries involving the paranasal sinuses and skull base demand a high level of imaging accuracy because of the complexity of the regional anatomy and intimate association with both neurovascular, ocular and cerebral tissues. Improvements in the field of diagnostic imaging have driven a number of technological advancements in operative techniques, especially stereotactic surgical navigation. Image-guided systems (IGS) monitor surgical instruments relative to known patient anatomic landmarks. This chapter will discuss the origins and utility of this modality and highlight the particular use of in-office and intraoperative CBCT imaging for endoscopic paranasal sinus and skull base surgery
