목적: The technique of navigation image guide surgery (IGS) is getting highly prominent in endoscopic sinus surgery (ESS) due to its ability to increase accuracy and reduce complications of surgeries. Although IGS became one of the most important tools in ESS, its national data on clinical indication is still limited. The aims of this study are to define the incidence of indications and investigate the operation time and complications for each indication in IGS. 방법:One hundered-sixty seven patients who received ESS under IGS from January 2014 to January 2015. Indications were categorized into revision sinus surgery, anatomical variations, extensive sinonasal polyposis, specific sinus involvement such as frontal (Fs), posterior ethmoid (PEs), sphenoid sinus (Ss), disease abutting the cranial base, orbit, optic nerve, carotid artery, and benign or malignant sinonasal neoplasm. CT findings, navigation setup time, operation time, presence of complications, frequency and kinds of complications are investigated and classified. 결과:From analyzing 167 patients, the most common indication from IGS was found to be specific sinus involvement with PEs (93.4%), Fs (79%) and, followed by Ss (45.5%) followed by nasal polyposis (37.7%). Operation time in distorted anatomy was the longest (126.2535.67 min), followed by Fs involvement (122.72154.89 min) and PEs involvement (118.49143.46 min). Operation preparing time was getting decreased as time goes by. The most common complication was postoperative bleeding. And no major complication had been developed. 결론:According to these results, ESS using IGS is safe procedure in this specific disease conditions even though their operation time is a little longer.