Virtual Reality and Augmented Reality in Plastic and Craniomaxillofacial Surgery: A Scoping Review

Abstract

Virtual reality (VR) and augmented reality (AR) have evolved since their introduction to medicine in the 1990s. More powerful software, the miniaturization of hardware, and greater accessibility and affordability enabled novel applications of such virtual tools in surgical practice. This scoping review aims to conduct a comprehensive analysis of the literature by including all articles between 2018 and 2021 pertaining to VR and AR and their use by plastic and craniofacial surgeons in a clinician-as-user, patient-specific manner. From the initial 1637 articles, 10 were eligible for final review. These discussed a variety of clinical applications: perforator flaps reconstruction, mastectomy reconstruction, lymphovenous anastomosis, metopic craniosynostosis, dermal filler injection, auricular reconstruction, facial vascularized composite allotransplantation, and facial artery mapping. More than half (60%) involved VR/AR use intraoperatively with the remainder (40%) examining preoperative use. The hardware used predominantly comprised HoloLens (40%) and smartphones (40%). In total, 9/10 Studies utilized an AR platform. This review found consensus that VR/AR in plastic and craniomaxillofacial surgery has been used to enhance surgeons’ knowledge of patient-specific anatomy and potentially facilitated decreased intraoperative time via preoperative planning. However, further outcome-focused research is required to better establish the usability of this technology in everyday practice.

Augmented reality in brachytherapy: A narrative review

“…HMDs, such as Microsoft HoloLens or Magic Leap, provide clinicians with a wearable, see-through display that overlays virtual information onto the real-world environment. These devices enable surgeons to visualize anatomical structures and treatment plans during procedures [ 30 ]. Tracking devices: To achieve precise registration of virtual objects with the patient anatomy, tracking devices are crucial.…”

3D Printing Applications for Craniomaxillofacial Reconstruction: A Sweeping Review

“…AR can be combined with 3D printing technology for resident training, preoperative planning, or intraoperatively to accurately position surgical guides and subsequent fixation devices. Thus, far, this technology has been successfully applied in cranio­synostosis, face transplantation, mandibular and auricular reconstruction, as well as for patient-specific facial artery mapping. ,− With adequate training, reported outcomes have included improved accuracy, minimization of operative injury, reduced costs, and shortened intraoperative time …”

“…AR allows the user to virtually visualize an overlay of critical patient anatomy (e.g., arterial supply, innervation, musculature) that may not be visible in reality. 225 The virtual, holographic projections are generated from patient CT/MRI data and registered in that specific surgical field. AR can be combined with 3D printing technology for resident training, preoperative planning, or intraoperatively to accurately position surgical guides and subsequent fixation devices.…”

“…214,225−229 With adequate training, reported outcomes have included improved accuracy, minimization of operative injury, reduced costs, and shortened intraoperative time. 225 8.3. In Situ Bioprinting.…”

“…With the latest advancements in augmented reality (AR) technology, commercial AR platforms have become available for surgical use. AR allows the user to virtually visualize an overlay of critical patient anatomy (e.g., arterial supply, innervation, musculature) that may not be visible in reality . The virtual, holographic projections are generated from patient CT/MRI data and registered in that specific surgical field.…”