We examined our experience of image guidance surgery in rhinology, and compared image guidance surgery cases with non-image guidance cases. We also audited our practice against the American Academy of Otolaryngology–Head and Neck Surgery image guidance surgery guidelines.

The study employed a single institution retrospective approach comprising 174 image guidance surgery patients (106 males and 68 females) and 134 non-image guidance surgery patients (75 males and 59 females).

In the image guidance surgery group, tumour operations represented 45 per cent of cases (55 per cent were non-neoplastic). Basic, intermediate and advanced (structured classification) procedures represented 19 per cent, 24 per cent and 61 per cent, respectively. Five minor complications were recorded. In non-image guidance surgery, tumour operations represented 8 per cent of cases (92 per cent were non-neoplastic). Basic, intermediate and advanced procedures represented 73 per cent, 12 per cent and 15 per cent, respectively. One minor complication was observed.

We report the largest series of image-guided ENT surgical procedures in the UK. In the cases we examined, image guidance surgery was predominantly used in advanced procedures and tumour surgery.