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Supporting fibula free flap harvest with augmented reality: A proof‐of‐concept study
Author(s) -
Pietruski Piotr,
Majak Marcin,
ŚwiątekNajwer Ewelina,
Żuk Magdalena,
Popek Michał,
Jaworowski Janusz,
Mazurek Maciej
Publication year - 2020
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.28090
Subject(s) - contouring , medicine , sagittal plane , fibula , augmented reality , osteotomy , orthodontics , absolute deviation , trajectory , nuclear medicine , surgery , computer science , computer vision , mathematics , radiology , tibia , statistics , physics , computer graphics (images) , astronomy
Objective To analyze a novel navigation system utilizing augmented reality (AR) as a supporting method for fibula free flap (FFF) harvest and fabrication. Methods A total of 126 simulated osteotomies supported with a cutting guide or one of two AR‐based intraoperative navigation modules—simple AR (sAR) or navigated AR (nAR)—were carried out on 18 identical models of the fibula (42 osteotomies per method). After fusing postoperative computed tomography scans of the operated fibulas with the virtual surgical plan based on preoperative images, the objective outcomes—angular deviations from the planned osteotomy trajectory ( o ) and deviations of control points marked on the trajectory (mm)—were determined. Results All analyzed methods provided similar accuracy of assisted osteotomies. The only significant difference referred to angular deviation in the sagittal plane, which was smaller after the cutting guide‐assisted procedures than after the application of sAR and nAR (4.1 ± 2.29 vs. 5.08 ± 3.64 degrees, P = 0.031 and 4.1 ± 2.29 vs. 4.97 ± 2.91, P = 0.002, respectively). Mean deviation of control points after the cutting guide‐assisted procedures was 2.76 ± 1.06 mm, as compared with 2.67 ± 1.09 mm for sAR and 2.95 ± 1.11 mm for nAR. Conclusion Our study demonstrated that both novel AR‐based methods provided similar accuracy of assisted harvesting and contouring of the FFF as the cutting guides. This fact, as well as the acceptability of the concept by clinicians, justify their further development and evaluation in preclinical settings. Level of Evidence NA Laryngoscope , 130:1173–1179, 2020