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Scientific Oral Presentations

Facial Plastic and Reconstructive Surgery

Session: Scientific Oral Presentations 2 - Facial Plastic and Reconstructive Surgery

Using Augmented Reality in Craniomaxillofacial Surgery: A Case Series

Monday, September 30, 2024
10:00 AM – 10:06 AM EDT
Location: MBCC, 232
Disclosure(s):
Anuj U. Patel, MD, MS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Pelin Celiker, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Marianne Abouyared, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

E. Bradley -.- Strong, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Augmented reality (AR) has emerged as a promising technology for overlaying patient-specific data (i.e., CT, MRI) onto patients during surgery. While most current AR studies have been performed in controlled lab settings, we have begun using intraoperative AR for craniomaxillofacial (CMF) surgery. The purpose of this case series is to document the use of AR in CMF surgery at a single institution, identify barriers to translation, and identify procedure types that are enhanced by 3D AR overlays.

Methods: AR software was provided by Xironetic and deployed onto Microsoft HoloLens 2, a user-worn head-mounted display. The AR software was used intraoperatively in 3 CMF surgical cases to date at a single institution. Patient CT data was preoperatively segmented into 3D structures and registered to the patient using a stylus and landmark-based method.

Results: Thus far, AR has been used in 3 cases which required complex facial reconstruction and surgical planning at our institution. In the first case, AR was used to accurately implant orbital mesh for repair of an orbital floor fracture secondary to a gunshot wound. In the second case, AR was used for advanced surgical planning and to visually assess the accuracy of overlayed anatomic layers and planned resection margins of a temporal bone tumor. In the third case, AR was used intraoperatively for complex anatomic visualization in the process of reconstruction following resection of a destructive lesion of the zygoma and orbital wall.

Conclusions: AR was used intraoperatively in 3 complex facial reconstruction cases, varying from traumatic injury to tumor resection and reconstruction. AR provides the ability to visualize hidden underlying structures, navigate vessels/nerves, display virtual cutting and drill guides, and precisely place implants. This technology is targeted to be implemented in 10-15 additional cases prior to September 2024, based on our institution’s case volume. Through future use and investigation, AR has the potential to enhance, or even replace, some forms of intraoperative surgical navigation.

    Presenting Author(s)

  • Anuj U. Patel, MD, MS

    PGY2, Resident
    University of California, Davis
    Sacramento, California, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • ES

    E. Brandon Strong, MS

    University of California, Davis
    Sacramento, California, United States

    Disclosure information not submitted.

  • Pelin Celiker, MD

    Resident Physician
    University of California, Davis
    Sacramento, CA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Darin T. Johnston, DDS

    Volunteer Clinical Faculty
    University of California, Davis
    Sacramento, CA, United States

    Disclosure information not submitted.

  • MA

    Marianne Abouyared, MD

    Assistant Professor
    University of California Davis Medical Center
    Sacramento, California, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • ES

    E. Bradley Strong, MD

    Professor
    UC Davis Health-Otolaryngology
    Sacramento, California, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Senior Author(s)

  • ES

    E. Bradley Strong, MD

    Professor
    UC Davis Health-Otolaryngology
    Sacramento, California, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.