Intraoperative three-dimensional (3D) "navigation" has significantly improved patient safety during operative procedures on the paranasal sinuses and the frontal skull base. The ISG Viewing Wand (ISG Technologies, Mississauga, Ontario, Canada) is now used routinely for such procedures in our hospital at the present time. Current use with our radiological and intraoperative protocols has demonstrated a clinical accuracy of 1-2 mm. Initial experience with the ARTMA Virtual Patient (ARTMA Biomedical, Vienna, Austria) has allowed endoscopic 3D navigation by using augmented reality techniques and has been found to be very promising. We present our experience with these systems and discuss the impact of these unique techniques on computer-assisted surgery (CAS) in otorhinolaryngology and head and neck surgery.