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Intraoperative Navigation In Facial Plastic Surgery With Augmented Reality: A Pre-clinical Validation Study
Hayeem L. Rudy, BA, Jillian Schreiber, MD, Nicole Wake, PhD, Alex Gordon, BA, Evan Garfein, MD, Oren Tepper, MD.
Montefiore Medical Center, Bronx, NY, USA.

PURPOSE: Augmented reality (AR) technology is a type of 3D technology that enables visualization and interaction with holograms in the real environment. One critical application of this technology is the alignment of holograms onto patients to guide intraoperative surgical decision making. In the present study, the authors sought to investigate the accuracy with which aligned holographical markings could be translated on a patient.
METHODS:
15 trials were performed on a mannequin. To create a hologram, 14 surgical markings were placed on a mannequin and captured with 3D-photography. The resulting 3D-photograph was converted into a hologram and visualized using an AR headset. The holographic markings were aligned to a mannequin and the mannequin was marked based on the position of the overlaid holographical markings. The accuracy of markings was analyzed using 3D analysis software.
RESULTS:
Holographic overlay accurate guided intervention with an average error in placement of markings of 1.35 .24mm. In addition, there were no significant differences in the accuracy of landmark placement between trials (p=.64). ANOVA investigation identified a greater error in the accuracy of surgical markings that were further from the midline of the face (p < 0.05).
CONCLUSION:Holographic markings can be accurately translated onto a patient with an error of approximately one millimeter, suggesting that AR navigation in facial plastic surgery is feasible in a controlled setting. Future studies should investigate the feasibility of AR navigation in live surgery and assess the impact of intraoperative implementation of AR technology on operating room workflow and efficiency.


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