Intraoperative Three-dimensional Virtual Reality and Computed Tomographic Guidance in Temporomandibular Joint Arthroplasty of Syndromic Craniofacial Dysostoses

Bradley, Daniel; Willson, Thomas D.; Chang, Jessica B.; Gandolfi, Brad M.; Zhu, Tian Ran; Bradley, James P.; Lee, Justine C.

doi:10.1097/gox.0000000000002388

Cited by 10 publications

(5 citation statements)

References 10 publications

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“…They compared two patients with traditional intraoperative CT based navigation to two patients treated using 3D VR guidance. They found no difference in complications or hospitalization times, but did report improved anatomic visualization and a statistically significant reduction in operative times (300 min for traditional CT navigation vs. 134 min with 3D VR guidance) [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

Computer assisted skull base surgery: a contemporary review

Bartella

Hoshal

Lethaus

et al. 2022

Innovative Surgical Sciences

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Skull base surgery has evolved significantly since Harvey Cushing‘s first descriptions in the early 1900s. Computer aided surgery (CAS) applications continue to expand; they include virtual surgical planning, augmented and virtual reality, 3D printing of models/cutting guides/implants, surgical navigation, and intraoperative imaging. The authors will review the current skull base CAS literature and propose a computer aided surgical workflow categorizing these applications into 3 phases: 1) Virtual planning, 2) Surgical execution, 3) Intraoperative verification.

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Section: Discussionmentioning

confidence: 99%

Computer assisted skull base surgery: a contemporary review

Bartella

Hoshal

Lethaus

et al. 2022

Innovative Surgical Sciences

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show abstract

“…Preoperative planning with the Surgical Theater models was proven useful for optimizing the plan and led to improved safety and efficiency. 5,16 For aneurysms, a 29% reduction in time per clip used was observed after planning with SRP. 5 Intraoperatively, AR can provide improved visualization to guide microsurgical technique when the AR scene is injected into the oculars.…”

Section: Discussionmentioning

confidence: 99%

Early Experience With Virtual and Synchronized Augmented Reality Platform for Preoperative Planning and Intraoperative Navigation: A Case Series

et al. 2021

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BACKGROUND Virtual reality (VR) allows for presurgical planning. Intraoperatively, augmented reality (AR) enables integration of segmented anatomic information with neuronavigation into the microsurgical scene to provide guidance without workflow disruption. Combining VR and AR solutions may help guide microsurgical technique to improve safety, efficiency, and ergonomics. OBJECTIVE To describe a VR/AR platform that provides VR planning and intraoperative guidance via microscope ocular injection of a comprehensive AR overlay of patient-specific 360°/3D anatomic model aligned and synchronized with neuronavigation. METHODS Custom 360° models from preoperative imaging of 49 patients were utilized for preoperative planning using a VR-based surgical rehearsal platform. Each model was imported to SyncAR, the platform's intraoperative counterpart, which was coregistered with Medtronic StealthStation S8 and Zeiss or Leica microscope. The model was injected into the microscope oculars and referenced throughout by adjusting overlay opacity. For anatomic shifts or misalignment, the overlay was reregistered via manual realignment with known landmarks. RESULTS No SyncAR-related complications occurred. SyncAR contributed positively to the 3D understanding of patient-specific anatomy and ability to operate. Preoperative planning and intraoperative AR with 360° models allowed for more precise craniotomy planning and execution. SyncAR was useful for guiding dissection, identifying critical structures including hidden anatomy, understanding regional anatomy, and facilitating resection. Manual realignment was performed in 48/49 surgeries. Gross total resection was achieved in 34/40 surgeries. All aneurysm clipping and microvascular decompression procedures were completed without complications. CONCLUSION SyncAR combined with VR planning has potential to enhance surgical performance by providing critical information in a user-friendly, continuously available, heads-up display format.

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“…Preoperative planning included the formation of a 3D virtual model, joint restoration planning on that model followed by AR-guidance intraoperatively. Preoperative planning reduced operation time from an average of 300 minutes in the traditional procedure to an average of 134 minutes ( P =0.03) in the AR-guided procedure 19 .…”

Section: Surgical Disciplinesmentioning

confidence: 99%

“…For instance, the surgical plan (e.g. an incision site or osteotomy line) can be projected intraoperatively on the patient’s body for guidance, using AR (either displayed on a 2D smartphone screen through the camera or on a head mounted display (HMD) 19 , 20 .…”

Section: Introductionmentioning

confidence: 99%

Three-dimensional technologies in presurgical planning of bone surgeries: current evidence and future perspectives

Portnoy

Koren

Khoury

et al. 2023

International Journal of Surgery

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Background: The recent development of three-dimensional (3D) technologies introduces a novel set of opportunities to the medical field in general, and specifically to surgery. The preoperative phase has proven to be a critical factor in surgical success. Utilization of 3D technologies has the potential to improve preoperative planning and overall surgical outcomes. In this narrative review article, the authors describe existing clinical data pertaining to the current use of 3D printing, virtual reality, and augmented reality in the preoperative phase of bone surgery. Methods: The methodology included keyword-based literature search in PubMed and Google Scholar for original articles published between 2014 and 2022. After excluding studies performed in nonbone surgery disciplines, data from 61 studies of five different surgical disciplines were processed to be included in this narrative review. Results: Among the mentioned technologies, 3D printing is currently the most advanced in terms of clinical use, predominantly creating anatomical models and patient-specific instruments that provide high-quality operative preparation. Virtual reality allows to set a surgical plan and to further simulate the procedure via a 2D screen or head mounted display. Augmented reality is found to be useful for surgical simulation upon 3D printed anatomical models or virtual phantoms. Conclusions: Overall, 3D technologies are gradually becoming an integral part of a surgeon’s preoperative toolbox, allowing for increased surgical accuracy and reduction of operation time, mainly in complex and unique surgical cases. This may eventually lead to improved surgical outcomes, thereby optimizing the personalized surgical approach.

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Intraoperative Three-dimensional Virtual Reality and Computed Tomographic Guidance in Temporomandibular Joint Arthroplasty of Syndromic Craniofacial Dysostoses

Abstract: Supplemental Digital Content is available in the text.

Cited by 10 publications

References 10 publications

Computer assisted skull base surgery: a contemporary review

Computer assisted skull base surgery: a contemporary review

Early Experience With Virtual and Synchronized Augmented Reality Platform for Preoperative Planning and Intraoperative Navigation: A Case Series

Three-dimensional technologies in presurgical planning of bone surgeries: current evidence and future perspectives

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