Background: Endoscopic sinus surgery in children has been used for treatment of chronic rhinosinusitis, complicated acute sinusitis,
sinus tumor, meningoceles and congenital sinonasal malformations. The use of imaging guidance during surgery will make it safer
and gives more intraoperative guidance with less complications. Methodology: A Retrospective study of all cases of image guided
pediatric endoscopic Sinus & Skull base Surgeries performed in King Fahad Specialist Hospital-Dammam from (2009 -2019) in a
group of patients between 4-15 years of age. Results: 47 of pediatric cases underwent endoscopic sinus and skull base surgeries
using the image guidance system. Conclusion: Image guidance system (IGS) is effective and safe tool that improve endoscopic
approach in pediatric sinonasal and skull base surgeries with minimal morbidity and intraoperative complications. Indications of
image guidance in our study includes allergic fungal sinusitis abutting orbit and skull base, different complicated sinusitis with
periorbital and brain abscesses, CSF leaks and meningocele and different benign and malignant tumors affecting the orbit,
infratemporal fossa and skull base.
Keywords: image guidance, pediatric, endoscopic sinus surgery, skull base