This report will evaluate the feasibility of applying image-directed robotic technology to the field of otolaryngologic surgery. Image-directed robotic surgery uses a three-dimensional image to guide a robot in the removal of tissue. To demonstrate the future use of image-directed robotics in otolaryngologic surgery, five antrostomies will be performed on temporal bones. The accuracy of the surgical defect will be measured. It is the goal of this pilot study to achieve an average surgical error of less than 1.0 mm. Future applications of image-directed robotic surgery will be presented, along with technical modifications, and future areas of research necessary to adapt this technique to otology and rhinosinus surgery.