• A portable mixed reality navig...

Treffer: A portable mixed reality navigation system for oral and maxillofacial surgery: Design and preliminary clinical evaluation.

Title:
A portable mixed reality navigation system for oral and maxillofacial surgery: Design and preliminary clinical evaluation.
Authors:
Shi Z; Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361003, China; National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, 361102, China. Electronic address: xmusw@foxmail.com., Li T; Department of Oral Maxillofacial Surgery, Affiliated Stomatological Hospital of Xuzhou Medical University, Xuzhou, 221002, China., Ke J; Department of Stomatology, The First Affiliated Hospital of Xiamen University, Xiamen, 361000, China., Li J; Department of Stomatology, The First Affiliated Hospital of Xiamen University, Xiamen, 361000, China., Gao X; Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361003, China; Xiamen Neurosurgical Quality Control Center, Xiamen, 361008, China., Zhang X; Department of Oral Maxillofacial Surgery, Affiliated Stomatological Hospital of Xuzhou Medical University, Xuzhou, 221002, China., Wang X; Department of Oral Maxillofacial Surgery, Affiliated Stomatological Hospital of Xuzhou Medical University, Xuzhou, 221002, China., Si Y; Department of Oral Maxillofacial Surgery, Affiliated Stomatological Hospital of Xuzhou Medical University, Xuzhou, 221002, China. Electronic address: 18905200972@189.cn., Wang Z; Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361003, China; National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, 361102, China; Xiamen Neurosurgical Quality Control Center, Xiamen, 361008, China. Electronic address: wangzx@xmu.edu.cn.
Source:
Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery [J Craniomaxillofac Surg] 2025 Dec; Vol. 53 (12), pp. 2230-2237. Date of Electronic Publication: 2025 Oct 16.
Publication Type:
Journal Article
Language:
English
Journal Info:
Publisher: Elsevier Country of Publication: Scotland NLM ID: 8704309 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1878-4119 (Electronic) Linking ISSN: 10105182 NLM ISO Abbreviation: J Craniomaxillofac Surg Subsets: MEDLINE
Imprint Name(s):
Publication: Edinburgh : Elsevier
Original Publication: Stuttgart ; New York : Thieme, [c1986-
MeSH Terms:
Surgery, Computer-Assisted*/instrumentation , Surgery, Computer-Assisted*/methods , Oral Surgical Procedures*/methods , Oral Surgical Procedures*/instrumentation , Surgical Navigation Systems* , Augmented Reality*, Humans ; Prospective Studies ; Male ; Female ; Adult ; Imaging, Three-Dimensional/methods ; Feasibility Studies ; Young Adult ; Equipment Design ; Middle Aged ; Adolescent
Contributed Indexing:
Keywords: 3D slicer; Mixed reality; Oral and maxillofacial surgery; Surgical positioning
Entry Date(s):
Date Created: 20251017 Date Completed: 20251211 Latest Revision: 20251211
Update Code:
20251211
DOI:
10.1016/j.jcms.2025.10.007
PMID:
41107072
Database:
MEDLINE

Weitere Informationen

Objective: To develop a novel mixed reality (MR)-based portable navigation system for oral and maxillofacial surgery (OMFS) and to evaluate its feasibility and spatial accuracy in clinical applications.
Methods: The MR-based system was developed using Microsoft HoloLens 2, leveraging its built-in near-infrared cameras for reflective marker tracking. A customized software module, developed on the 3D Slicer platform, enabled automatic registration and real-time 3D anatomical visualization through a spatial pose filtering algorithm. A non-invasive patient-specific dental bracket was fabricated using silicone rubber for fixation and registration. A prospective clinical trial involving 24 patients was conducted. Navigation performance was quantitatively assessed by comparing preoperative and intraoperative registration errors, and qualitatively evaluated based on lesion overlap observed through the MR headset.
Results: The proposed MR system successfully achieved real-time 3D visualization and immersive intraoperative navigation without the use of external tracking devices. The mean preoperative localization error was 1.64 ± 0.78 mm, and the intraoperative error was 1.65 ± 1.00 mm (p = 0.44), indicating no significant difference. Among the 24 cases, 83.3 % demonstrated high virtual-to-actual concordance, while 16.7 % showed moderate concordance. The average data processing time was 8.38 ± 0.83 min, with improved efficiency observed over repeated trials.
Conclusion: The MR-based navigation system demonstrated good feasibility, accuracy, and usability for OMFS procedures. Its low cost, non-invasive design, and flexibility make it a promising intelligent surgical guidance tool for routine clinical practice, particularly in primary healthcare settings.
(Copyright © 2025 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Conflict of interest The authors declare that they have no conflicts of interest in this work.