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Abstract Functional endoscopic sinus surgery (FESS) is the most popular method for treating medicine-refractory sinonasal disease. However, there are some pitfalls with this technique that can result in serious complications. Under the assistance of a navigation system, surgeons can overcome such problems. Image guidance based on preacquired computed tomography scans of the patient is a technique used to assist the physician during endoscopic sinus surgery. Revision endoscopic sinus surgery (RESS) may be required for partially controlled or uncontrolled chronic rhinosinusitis. Studies that reported technical success, e.g., sinus ostia patency after RESS, do not address whether the patient’s symptoms and quality of life improve after surgery. Over the past decade, sinus surgeons have accepted intraoperative surgical navigation (also known as image-guided surgery, or IGS) as a technological means to improve surgical outcomes and reduce surgical morbidity. Initial applications were primary and revision functional endoscopic sinus surgery, but more recently rhinologists have used surgical navigation for a wide variety of minimally invasive endoscopic approaches to the anterior and middle cranial fossa skull base. Although the core technology has not changed meaningfully since its introduction, clinical experiences have grown considerably, and a few new applications [such as computed tomography–magnetic resonance (CT-MR) fusion] have been introduced. In addition, a few reports have highlighted the principles of registration protocols. |