As I said in my recent post: it worked in Morrowind. Yes, there where intricate descriptions on where to go, but it worked, and it made for a better role-playing experience.
After all this time, the map is still basically a square made up of a lot of squares.
In Skyrim, as in Morrowind, all you really need to accurately describe any location is its position relative to two other locations.
Such as: West of
here and North of
there.
Any location on the Skyrim map can be pinpointed thus.
So a detailed and accurate description could go:
The cave is West of Whiterun and North of Falkreath.
The best way to travel there is to start from Falkreath and head North. Follow the road until you see (a landmark)
Just after that is a windy path East up a hill. The cave is at the end of the path.
And if you want, you can then
still turn on the markers.
Easy, immersive and ten times better than the opposite, designing a world around questmarkers and allowing them to be turned off.