A new method for cranial vault reconstruction: Augmented reality in synostotic plagiocephaly surgery

Han, Wenqing; Yang, Xin; Wu, Shui-Hua; Fan, Shuang-Shi; Chen, Xiaojun; Aung, Zin Mar; Liu, Tianjia; Zhang, Yan; Gu, Shuo; Chai, Gang

doi:10.1016/j.jcms.2019.04.008

Cited by 30 publications

(26 citation statements)

References 14 publications

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“…Han et al had a comparable outcome 19 and showed that there was no significant difference of intracranial volume between the preoperative model and the actual outcome ( p > 0.05).…”

Section: Outcomes Technical Accuracy Of the Proceduresmentioning

confidence: 95%

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Virtual and augmented reality for preoperative planning in plastic surgical procedures: A systematic review

Vles

Terng

Zijlstra

et al. 2020

Journal of Plastic, Reconstructive & Aesthetic Surgery

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Background: Virtual and augmented reality (VR and AR) are fast-developing technologies that allow the three-dimensional visualization of digital information. Objective: This systematic review aimed to compare the application of VR and AR to conventional methods in preoperative planning of plastic surgical procedures. Method: A systematic literature search was conducted in Embase, Medline (Ovid), Web-of-Science, Cochrane, and Google Scholar databases on October 11, 2019. All literature comparing AR and/or VR with conventional methods for preoperative planning was collected. Only articles that studied at least one of the following outcomes were included: technical accuracy of the procedure, operative time, complications, and costs of total intervention. Results: No articles on VR were found. Six articles were found on interventions performed with AR assistance. AR showed to be significantly better for the accuracy of osteotomies in mandibular angle osteotomies and intraoral mandible distraction compared to conventional methods. For synostotic plagiocephaly and orbital hypertelorism correction, the use of AR demonstrated a precise osteotomy. Intraoperative perforator identification in DIEP flap procedures was more accurate with AR compared to Doppler ultrasound. Harvesting time (p < 0.012) and operative time (p < 0.01) in DIEP-flap procedures and mandibular angle osteotomies, respectively, were significantly reduced if AR was used. No articles were found regarding the costs of using AR for preoperative planning.

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“…Han et al had a comparable outcome 19 and showed that there was no significant difference of intracranial volume between the preoperative model and the actual outcome ( p > 0.05).…”

Section: Outcomes Technical Accuracy Of the Proceduresmentioning

confidence: 95%

“…Finally, one article described the operative time of a synostotic plagiocephaly procedure when AR was used. However, they did not compare the result with a control group 19 .…”

Section: Operative Timementioning

confidence: 99%

Virtual and augmented reality for preoperative planning in plastic surgical procedures: A systematic review

Vles

Terng

Zijlstra

et al. 2020

Journal of Plastic, Reconstructive & Aesthetic Surgery

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show abstract

“…This technology has already demonstrated to improve the accuracy and safety of surgical procedures [55]. Han et al [56] reported the use of AR technology for guidance during open cranial vault reconstructions for the correction of craniosynostosis. Their methodology is based on the attachment of AR markers using occlusal splints for the alignment of virtual models in the AR visualization.…”

Section: Image-guided Surgerymentioning

confidence: 99%

“…It uses structured light scanning and sterilizable AR markers attached to the bone surface to ensure accurate alignment of the virtual models in the AR visualization. This methodology presents a significant improvement with respect to previous approaches [56], since the AR markers can be located using structured light scanning and attached near the region of interest to minimize alignment error. This system enables the visualization of the virtual plan overlaid on the surgical field, indicating the planes for bone osteotomy and the target position of remodeled bone fragments (Figure 8).…”

Section: Image-guided Surgerymentioning

confidence: 99%

New Technologies to Improve Surgical Outcome during Open-Cranial Vault Remodeling

García-Mato¹,

Pascau²,

Caicoya³

2021

Spina Bifida and Craniosynostosis - New Perspectives and Clinical Applications

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Current approaches for the surgical correction of craniosynostosis are highly dependent on surgeon experience. Therefore, outcomes are often inadequate, causing suboptimal esthetic results. Novel methods for cranial shape analysis based on statistical shape models enable accurate and objective diagnosis from preoperative 3D photographs or computed tomography scans. Moreover, advanced algorithms are now available to calculate a reference cranial shape for each patient from a multi-atlas of healthy cases, and to determine the most optimal approach to restore normal calvarial shape. During surgery, multiple technologies are available to ensure accurate translation of the preoperative virtual plan into the operating room. Patient-specific cutting guides and templates can be designed and manufactured to assist during osteotomy and remodeling. Then, intraoperative navigation and augmented reality visualization can provide real-time guidance during the placement and fixation of the remodeled bone. Finally, 3D photography enables intraoperative surgical outcome evaluation and postoperative patient follow-up. This chapter summarizes recent literature on all these technologies, showing how their integration into the surgical workflow could increase reproducibility and reduce inter-surgeon variability in open cranial vault remodeling procedures.

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“…10,11 With recent advancements, several systems have been proposed for surgical planning that enable the surgeon to be engaged with both the graphic AR representation and the actual surgical field simultaneously. 7,9,10 Despite the importance of improving the technical skills, attitudes, and interpersonal abilities of those who perform surgical procedures, few studies have examined the use of AR technology in preoperative planning to determine the most favorable surgical approaches. 10 With the development of an AR-based training simulator, surgeons in training can experience realistic simulations of surgical operations comparable to those encountered in actual neurosurgery.…”

mentioning

confidence: 99%

Augmented reality and physical hybrid model simulation for preoperative planning of metopic craniosynostosis surgery

Coelho

Rabelo

Vieira

et al. 2020

Neurosurgical Focus

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OBJECTIVEThe main objective of neurosurgery is to establish safe and reliable surgical techniques. Medical technology has advanced during the 21st century, enabling the development of increasingly sophisticated tools for preoperative study that can be used by surgeons before performing surgery on an actual patient. Laser-printed models are a robust tool for improving surgical performance, planning an operative approach, and developing the skills and strategy to deal with uncommon and high-risk intraoperative difficulties. Practice with these models enhances the surgeon’s understanding of 3D anatomy but has some limitations with regard to tactile perception. In this study, the authors aimed to develop a preoperative planning method that combines a hybrid model with augmented reality (AR) to enhance preparation for and planning of a specific surgical procedure, correction of metopic craniosynostosis, also known as trigonocephaly.METHODSWith the use of imaging data of an actual case patient who underwent surgical correction of metopic craniosynostosis, a physical hybrid model (for hands-on applications) and an AR app for a mobile device were created. The hybrid customized model was developed by using analysis of diagnostic CT imaging of a case patient with metopic craniosynostosis. Created from many different types of silicone, the physical model simulates anatomical conditions, allowing a multidisciplinary team to deal with different situations and to precisely determine the appropriate surgical approach. A real-time AR interface with the physical model was developed by using an AR app that enhances the anatomic aspects of the patient’s skull. This method was used by 38 experienced surgeons (craniofacial plastic surgeons and neurosurgeons), who then responded to a questionnaire that evaluated the realism and utility of the hybrid AR simulation used in this method as a beneficial educational tool for teaching and preoperative planning in performing surgical metopic craniosynostosis correction.RESULTSThe authors developed a practice model for planning the surgical cranial remodeling used in the correction of metopic craniosynostosis. In the hybrid AR model, all aspects of the surgical procedure previously performed on the case patient were simulated: subcutaneous and subperiosteal dissection, skin incision, and skull remodeling with absorbable miniplates. The pre- and postoperative procedures were also carried out, which emphasizes the role of the AR app in the hybrid model. On the basis of the questionnaire, the hybrid AR tool was approved by the senior surgery team and considered adequate for educational purposes. Statistical analysis of the questionnaire responses also highlighted the potential for the use of the hybrid model in future applications.CONCLUSIONSThis new preoperative platform that combines physical and virtual models may represent an important method to improve multidisciplinary discussion in addition to being a powerful teaching tool. The hybrid model associated with the AR app provided an effective training environment, and it enhanced the teaching of surgical anatomy and operative strategies in a challenging neurosurgical procedure.

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A new method for cranial vault reconstruction: Augmented reality in synostotic plagiocephaly surgery

Cited by 30 publications

References 14 publications

Virtual and augmented reality for preoperative planning in plastic surgical procedures: A systematic review

Virtual and augmented reality for preoperative planning in plastic surgical procedures: A systematic review

New Technologies to Improve Surgical Outcome during Open-Cranial Vault Remodeling

Augmented reality and physical hybrid model simulation for preoperative planning of metopic craniosynostosis surgery

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