Augmented Reality Technology for the Positioning of the Auricle in the Treatment of Microtia

BACKGROUND: The positioning of the auricle is a key factor in successful ear reconstruction. However, the position of the ear is usually determined by transferring the auricle image of the nonaffected side to the affected side using a transparent film. Augmented reality (AR) is becoming useful in the surgical field allowing computer-generated images to be superimposed on patients. In this report, we would like to introduce an application of AR technology in ear reconstruction. METHODS: AR technology was used to determine the position of the reconstructed ear of a 10-year-old male with right microtia. Preoperative 3-dimensional photographs of the nonaffected side were taken using VECTRAH1. Then, the image was horizontally inverted and superimposed on the three-dimensional image of the affected side with reference to the anatomical landmarks of the patient’s face. These images were projected onto the patient in the operation room using Microsoft’s HoloLens. The design and positioning of the auricle was done with reference to the AR image. To confirm the accuracy of the AR technique, we compared it to the original transparent film technique. After the insertion of the cartilage framework into the skin pocket, the position and shape of the reconstructed ear was confirmed using the AR technology. RESULTS: The positioning of the reconstructed ear was successfully performed. The deviation between the 2 designated positions using the AR and the transparent film was within 2 mm. CONCLUSION: The AR technology is a promising option in the surgical treatment of microtia.