<< Back to the abstract archive
Combining Virtual Surgical Planning and Mixed-Reality for Verification of Bony Alignment in Orthognathic Surgery
Nicolás M Kass, Anjali Raghuram, Angel Dixon, Megan Pencek, Nikhil Sharma, Stephen Canton, Edward Andrews, Jesse Goldstein
UPMC
2024-01-15
Presenter: Nicolás Kass
Affidavit:
Vu Nguyen
Director Name: Vu Nguyen
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
ntroduction
Virtual surgical planning (VSP) gives a surgeon a roadmap of the operation prior to the start of the case and Mixed Reality (MR) allows for superimposed visualization and manipulation of patient imaging intraoperatively. We evaluated a workflow for incorporating VSP and MR to better understand complex patient anatomy in orthognathic surgery and compare intraoperative results with an idealized version.
Methods
VSP was done in mimics for Le Fort I osteotomy, BSSO, and genioplasty in a pediatric patient. Medivis SurgicalAR and Microsoft Hololens2 were used to visualize preoperative patient CT imaging during the start of the case and VSP to verify bony alignment. Deviation from real patient anatomy was assessed in multiple methods of registration and ease of workflow was assessed.
Results
Virtual surgical planning was carried out multiple weeks preoperatively. Initial registration on bilateral medial and lateral canthi lasted 8 minutes and 43 seconds and was significantly different than patient anatomy. Second registration with a fifth point over the frontal bone lasted 4 minutes and 47 seconds. Registration with a sixth point over the naision lasted 1 minute 30 seconds and was most accurate. The hologram was highly sensitive to manipulation of tracking fiducial array.
Discussion
We found that increasing the number of virtual fiducials in multiple axes increased registration accuracy and that superimposing VSP imaging is a viable method of verification of intraoperative efficacy. Although workflow was efficient, more work needs to be devoted to ensuring image registration is correctly aligned throughout the case.
