Division of Plastic, Reconstructive & Aesthetic Surgery, National University Hospital, Singapore.
Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
J Plast Reconstr Aesthet Surg. 2024 Nov;98:100-102. doi: 10.1016/j.bjps.2024.08.078. Epub 2024 Sep 2.
This paper describes our experience with mixed reality (MR) intra-operative guides in patients with congenital craniofacial malformations. The first case was a patient with bilateral hemifacial microsomia. He underwent bilateral mandibular distraction osteogenesis. Pre-operative virtual planning determined the sites of osteotomy. Standard Tessellation Language (STL) files of mandibular 3D models with osteotomy sites were uploaded onto the HoloLens 2® MR glasses (Microsoft®, Washington, USA). The superimposed hologram denoted the osteotomy line. This was validated with a physical cutting guide. The second case was a patient with Crouzon's syndrome. A modified Lefort 2 advancement was performed to correct his midfacial deficiency. Pre-operative virtual planning was performed to determine the sites of osteotomies. Superimposed hologram using the Hololens 2® denoted the osteotomy sites. These were validated with a conventional intra-operative navigation system. The advantages of using MR include its immediate availability for use; saving time and costs. MR allows surgeons to maintain continuous line-of-sight within the operative field. A robust registration system is required to anchor the hologram onto the patient's skull without variations in hologram position from different angles of gaze. MR has the potential to function as an adjunct and possible replacement for conventional cutting guides and intra-operative navigation. LAY SUMMARY: We describe the use of mixed reality intra-operative guides in patients with congenital craniofacial malformations. Our experience shows the potential MR has as an adjunct and possible replacement for conventional cutting guides and intra-operative navigation.
这篇文章介绍了我们在先天性颅面畸形患者中使用混合现实（MR）术中引导的经验。第一个病例是一位双侧颜面裂畸形的患者。他接受了双侧下颌骨牵引成骨术。术前虚拟规划确定了截骨部位。将带有截骨部位的下颌骨三维模型的标准三角化语言（STL）文件上传到 HoloLens 2®MR 眼镜（美国华盛顿州微软公司）上。叠加的全息图表示了截骨线。这与物理切割导板进行了验证。第二个病例是一位 Crouzon 综合征患者。进行改良的 Le Fort 2 型前颅底切开术以矫正他的中面部不足。进行术前虚拟规划以确定截骨部位。使用 HoloLens 2®叠加的全息图表示了截骨部位。这些都与传统的术中导航系统进行了验证。使用 MR 的优点包括其可立即使用；节省时间和成本。MR 允许外科医生在手术区域内保持连续的视线。需要一个强大的配准系统来将全息图固定在患者的颅骨上，而不会因不同的注视角度导致全息图位置发生变化。MR 有可能作为传统切割导板和术中导航的辅助手段和可能的替代品。
我们描述了在先天性颅面畸形患者中使用混合现实术中引导的情况。我们的经验表明，MR 作为传统切割导板和术中导航的辅助手段和可能的替代品具有一定的潜力。
