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Application of holographic augmented reality for external approaches to the frontal sinus
Author(s) -
Neves Caio A.,
Vaisbuch Yona,
Leuze Christoph,
McNab Jennifer A.,
Daniel Bruce,
Blevins Nikolas H.,
Hwang Peter H.
Publication year - 2020
Publication title -
international forum of allergy and rhinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.503
H-Index - 46
eISSN - 2042-6984
pISSN - 2042-6976
DOI - 10.1002/alr.22546
Subject(s) - frontal sinus , medicine , cadaveric spasm , sinus (botany) , holography , radiology , computer vision , anatomy , computer science , physics , optics , botany , biology , genus
Background External approaches to the frontal sinus such as osteoplastic flaps are challenging because they require blind entry into the sinus, posing risks of injury to the brain or orbit. Intraoperative computed tomography (CT)‐based navigation is the current standard for planning the approach, but still necessitates blind entry into the sinus. The aim of this work was to describe a novel technique for external approaches to the frontal sinus using a holographic augmented reality (AR) application. Methods Our team developed an AR system to create a 3‐dimensional (3D) hologram of key anatomical structures, based on CT scans images. Using Magic Leap AR goggles for visualization, the frontal sinus hologram was aligned to the surface anatomy in 6 fresh cadaveric heads’ anatomic boundaries, and the boundaries of the frontal sinus were demarcated based on the margins of the fused image. Trephinations and osteoplastic flap approaches were performed. The specimens were re‐scanned to assess the accuracy of the osteotomy with respect to the actual frontal sinus perimeter. Results Registration and surgery were completed successfully in all specimens. Registration required an average of 2 minutes. The postprocedure CT showed a mean difference of 1.4 ± 4.1 mm between the contour of the osteotomy and the contour of the frontal sinus. One surgical complication (posterior table perforation) occurred (16%). Conclusion We describe proof of concept of a novel technique utilizing AR to enhance external approaches to the frontal sinus. Holographic AR‐enhanced surgical navigation holds promise for enhanced visualization of target structures during surgical approaches to the sinuses.