Nuri Takashi, Mitsuno Daisuke, Otsuki Yuki, Ueda Koichi
Department of Plastic and Reconstructive Surgery, Osaka Medical College, 569-8686, 2-7, Daigaku-cho, Takatsuki, Osaka, Japan.
Plast Reconstr Surg Glob Open. 2020 Feb 6;8(2):e2626. doi: 10.1097/GOX.0000000000002626. eCollection 2020 Feb.
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.
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.
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.
The AR technology is a promising option in the surgical treatment of microtia.
耳廓的定位是成功进行耳再造的关键因素。然而，耳朵的位置通常是通过使用透明薄膜将未受影响侧的耳廓图像转移到受影响侧来确定的。增强现实（AR）在外科领域正变得越来越有用，它能使计算机生成的图像叠加在患者身上。在本报告中，我们想介绍AR技术在耳再造中的应用。
使用AR技术确定一名10岁右侧小耳畸形男性患者再造耳的位置。使用VECTRA H1拍摄未受影响侧的术前三维照片。然后，将图像水平翻转，并参照患者面部的解剖标志叠加在受影响侧的三维图像上。这些图像在手术室中使用微软的HoloLens投射到患者身上。耳廓的设计和定位参照AR图像进行。为了确认AR技术的准确性，我们将其与原始的透明薄膜技术进行了比较。在将软骨支架插入皮瓣后，使用AR技术确认再造耳的位置和形状。
成功完成了再造耳的定位。使用AR和透明薄膜确定的两个指定位置之间的偏差在2毫米以内。
AR技术在小耳畸形的手术治疗中是一个有前景的选择。
