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Augmented Reality and Intraoperative Navigation in Sinonasal Malignancies: A Preclinical Study
OBJECTIVE: To report the first use of a novel projected augmented reality (AR) system in open sinonasal tumor resections in preclinical models and to compare the AR approach with an advanced intraoperative navigation (IN) system. METHODS: Four tumor models were created. Five head and neck surgeons p...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8591179/ https://www.ncbi.nlm.nih.gov/pubmed/34790568 http://dx.doi.org/10.3389/fonc.2021.723509 |
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author | Sahovaler, Axel Chan, Harley H. L. Gualtieri, Tommaso Daly, Michael Ferrari, Marco Vannelli, Claire Eu, Donovan Manojlovic-Kolarski, Mirko Orzell, Susannah Taboni, Stefano de Almeida, John R. Goldstein, David P. Deganello, Alberto Nicolai, Piero Gilbert, Ralph W. Irish, Jonathan C. |
author_facet | Sahovaler, Axel Chan, Harley H. L. Gualtieri, Tommaso Daly, Michael Ferrari, Marco Vannelli, Claire Eu, Donovan Manojlovic-Kolarski, Mirko Orzell, Susannah Taboni, Stefano de Almeida, John R. Goldstein, David P. Deganello, Alberto Nicolai, Piero Gilbert, Ralph W. Irish, Jonathan C. |
author_sort | Sahovaler, Axel |
collection | PubMed |
description | OBJECTIVE: To report the first use of a novel projected augmented reality (AR) system in open sinonasal tumor resections in preclinical models and to compare the AR approach with an advanced intraoperative navigation (IN) system. METHODS: Four tumor models were created. Five head and neck surgeons participated in the study performing virtual osteotomies. Unguided, AR, IN, and AR + IN simulations were performed. Statistical comparisons between approaches were obtained. Intratumoral cut rate was the main outcome. The groups were also compared in terms of percentage of intratumoral, close, adequate, and excessive distances from the tumor. Information on a wearable gaze tracker headset and NASA Task Load Index questionnaire results were analyzed as well. RESULTS: A total of 335 cuts were simulated. Intratumoral cuts were observed in 20.7%, 9.4%, 1.2,% and 0% of the unguided, AR, IN, and AR + IN simulations, respectively (p < 0.0001). The AR was superior than the unguided approach in univariate and multivariate models. The percentage of time looking at the screen during the procedures was 55.5% for the unguided approaches and 0%, 78.5%, and 61.8% in AR, IN, and AR + IN, respectively (p < 0.001). The combined approach significantly reduced the screen time compared with the IN procedure alone. CONCLUSION: We reported the use of a novel AR system for oncological resections in open sinonasal approaches, with improved margin delineation compared with unguided techniques. AR improved the gaze-toggling drawback of IN. Further refinements of the AR system are needed before translating our experience to clinical practice. |
format | Online Article Text |
id | pubmed-8591179 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-85911792021-11-16 Augmented Reality and Intraoperative Navigation in Sinonasal Malignancies: A Preclinical Study Sahovaler, Axel Chan, Harley H. L. Gualtieri, Tommaso Daly, Michael Ferrari, Marco Vannelli, Claire Eu, Donovan Manojlovic-Kolarski, Mirko Orzell, Susannah Taboni, Stefano de Almeida, John R. Goldstein, David P. Deganello, Alberto Nicolai, Piero Gilbert, Ralph W. Irish, Jonathan C. Front Oncol Oncology OBJECTIVE: To report the first use of a novel projected augmented reality (AR) system in open sinonasal tumor resections in preclinical models and to compare the AR approach with an advanced intraoperative navigation (IN) system. METHODS: Four tumor models were created. Five head and neck surgeons participated in the study performing virtual osteotomies. Unguided, AR, IN, and AR + IN simulations were performed. Statistical comparisons between approaches were obtained. Intratumoral cut rate was the main outcome. The groups were also compared in terms of percentage of intratumoral, close, adequate, and excessive distances from the tumor. Information on a wearable gaze tracker headset and NASA Task Load Index questionnaire results were analyzed as well. RESULTS: A total of 335 cuts were simulated. Intratumoral cuts were observed in 20.7%, 9.4%, 1.2,% and 0% of the unguided, AR, IN, and AR + IN simulations, respectively (p < 0.0001). The AR was superior than the unguided approach in univariate and multivariate models. The percentage of time looking at the screen during the procedures was 55.5% for the unguided approaches and 0%, 78.5%, and 61.8% in AR, IN, and AR + IN, respectively (p < 0.001). The combined approach significantly reduced the screen time compared with the IN procedure alone. CONCLUSION: We reported the use of a novel AR system for oncological resections in open sinonasal approaches, with improved margin delineation compared with unguided techniques. AR improved the gaze-toggling drawback of IN. Further refinements of the AR system are needed before translating our experience to clinical practice. Frontiers Media S.A. 2021-11-01 /pmc/articles/PMC8591179/ /pubmed/34790568 http://dx.doi.org/10.3389/fonc.2021.723509 Text en Copyright © 2021 Sahovaler, Chan, Gualtieri, Daly, Ferrari, Vannelli, Eu, Manojlovic-Kolarski, Orzell, Taboni, de Almeida, Goldstein, Deganello, Nicolai, Gilbert and Irish https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Oncology Sahovaler, Axel Chan, Harley H. L. Gualtieri, Tommaso Daly, Michael Ferrari, Marco Vannelli, Claire Eu, Donovan Manojlovic-Kolarski, Mirko Orzell, Susannah Taboni, Stefano de Almeida, John R. Goldstein, David P. Deganello, Alberto Nicolai, Piero Gilbert, Ralph W. Irish, Jonathan C. Augmented Reality and Intraoperative Navigation in Sinonasal Malignancies: A Preclinical Study |
title | Augmented Reality and Intraoperative Navigation in Sinonasal Malignancies: A Preclinical Study |
title_full | Augmented Reality and Intraoperative Navigation in Sinonasal Malignancies: A Preclinical Study |
title_fullStr | Augmented Reality and Intraoperative Navigation in Sinonasal Malignancies: A Preclinical Study |
title_full_unstemmed | Augmented Reality and Intraoperative Navigation in Sinonasal Malignancies: A Preclinical Study |
title_short | Augmented Reality and Intraoperative Navigation in Sinonasal Malignancies: A Preclinical Study |
title_sort | augmented reality and intraoperative navigation in sinonasal malignancies: a preclinical study |
topic | Oncology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8591179/ https://www.ncbi.nlm.nih.gov/pubmed/34790568 http://dx.doi.org/10.3389/fonc.2021.723509 |
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