Augmented reality technology for auricular reconstruction in the treatment of microtia

Abstract

Facial defects and deformations occupy a significant place in the practice of maxillofacial and dental surgeons. Nevertheless, maxillofacial surgery is developing rapidly and requires improvement of existing treatment methods, and introduction of new approaches to reconstructive surgery. Augmented reality is a promising direction of computer technology development which is actively used in medicine and education. Modern computer technology allows to create a 3D model of a lost organ and use it for preoperative planning, as well as apply a virtual model for intraoperative navigation. Recently, the method of augmented reality has been actively developed, when a virtual image of the zone of the surgical area or a dedicated organ is used, which is compared with its real prototype in static mode, or in real-time using computer devices. The benefits of using augmented reality technologies in reconstructive surgery is associated with preoperative virtual planning, simplification of the surgical intervention itself, as well as with a reduction in the risks of intra- and postoperative complications. The aim of our work was to study the opportunity of using the augmented reality technology in reconstructive surgery for microtia correction based on pre-operative computer simulation. At the preoperative stage, a photometric analysis of the patient was carried out, then a computer simulation of the missing auricle was performed. Using a 3D printer, a virtual model of the reconstructed auricle was obtained. The image in three-dimensional format was loaded into augmented reality glasses, which made it possible to project the shape and position of the simulated auricle to the area of the defect of the auricle when preparing for surgery. During the surgery, a marker was installed near the surgical field, in order to display the three-dimensional model in a destined position. During surgical intervention, an autogenous costal cartilage was taken, from which the auricle was formed using augmented reality approach and three-dimensional modeling. Subsequently, the graft was introduced to the formed bed in the area of the right ear auricle. The obtained 3D model of the auricle before the operation enabled planning of the forthcoming operation and determine the amount of autograft needed for reconstruction. Using the augmented reality glasses, the exact shape of the auricle is reproduced during the operation, and its proper position is assessed in relation to the healthy side. No complications were observed over the postoperative period. Virtual modelling of a lost or absent organ based on a preoperative examination provides important information about its spatial structure. Preoperative virtual planning allows you to predict the individual features of the operation, its difficult stages, to anticipate possible complications. The use of augmented reality technology during reconstructive surgery is a promising method requiring further development and improvement.