Explore the World of Medical Extended Reality
Contributors throughout the academic ecosystem have helped forward the science and innovation within the world of Medical Extended Reality (MXR).
Since November of 2023, we have contributed:
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35 abstracts
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19 conference presentations
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3 published manuscripts (9 more in progress)
This collection of articles includes some of the most recent discussions of the field and science behind the clinical achievements.
Augmented Reality Navigation in Craniomaxillofacial/Head and Neck Surgery
E. Brandon Strong, MS1 , Anuj Patel, MD, MS1 , Alexander P. Marston, MD1 , Cameron Sadegh, MD, PhD2 , Jeffrey Potts, PhD3 , Darin Johnston, DMD4 , David Ahn, DMD4 , Shae Bryant, DMD4 , Michael Li, MD1 , Osama Raslan, MD5 , Steven A. Lucero, BS6 , Marc J. Fischer7 , Marike Zwienenberg, MD2 , Neha Sharma, MDS, DMD, PhD8,9 , Florian Thieringer, MD, DDS, MHBA8,9 , Christian El Amm, MD3 , Kiarash Shahlaie, MD, PhD2 , Marc Metzger, MD, DMD, PhD10 , and E. Bradley Strong, MD
Abstract: Objective. This study aims to (1) develop an augmented reality (AR) navigation platform for craniomaxillofacial (CMF) and head and neck surgery; (2) apply it to a range of surgical cases; and (3) evaluate the advantages, disadvantages, and clinical opportunities for AR navigation. Conclusion: While still a developing technology, AR navigation provides several advantages over traditional navigation for CMF and head and neck surgery, including heads up, interactive 3D visualization of the surgical plan, identification of critical anatomy, and real-time tracking... more
AR Surgical Navigation With Surface Tracing: Comparing In-Situ Visualization with Tool-Tracking Guidance for Neurosurgical Applications
Marc J. Fischer*1 , Jeffrey Potts2 , Gabriel Urreola1 , Dax Jones3 , Paolo Palmisciano1 , E. Bradley Strong1 , Branden Cord1 , Andrew D. Hernandez1 , Julia D. Sharma1 , and E. Brandon Strong†1 1University of California, Davis 2University of Oklahoma 3Xironetic
Abstract: Augmented Reality (AR) surgical navigation systems are emerging as the next generation of intraoperative surgical guidance, promising to overcome limitations of traditional navigation systems. However, known issues with AR depth perception due to vergenceaccommodation conflict and occlusion handling limitations of the currently commercially available display technology present acute challenges ...more
Clinical Application of Augmented Reality in TMJ Arthroscopy: A Case Series
David Ahn, DMD, Brandon Strong, MS, Shae Bryant, DMD, Darin Johnston, DMD
Abstract: Abstract This case series evaluates the clinical application of augmented reality (AR) in temporomandibular joint (TMJ) arthroscopy, with a focus on improving accuracy in initial and secondary portal placement. Five patients underwent AR-assisted arthroscopy using preoperative CT-based virtual planning and intraoperative holographic visualization with the Microsoft HoloLens 2 and Xironetic’s IntraOpVSP system. The AR interface enabled real-time alignment of surgical instruments with planned trajectories, resulting in successful joint access and completion of all intended procedures. The first portal was consistently placed with high precision, while the second portal benefited from AR-guided triangulation despite variability in preoperative joint space estimation. Although AR was not used during advanced intra-articular maneuvers due to current technical limitations, the system enhanced spatial orientation and procedural confidence. These findings support the feasibility of integrating AR into TMJ arthroscopy and highlight its potential to improve surgical accuracy, streamline workflow, and serve as a valuable adjunct in minimally invasive joint procedures...more
Augmented Reality Navigation in Craniomaxillofacial/Head and Neck
Surgery
E. Brandon Strong, MS1 , Anuj Patel, MD, MS1, Alexander P. Marston, MD1 , Cameron Sadegh, MD, PhD2, Jeffrey Potts, PhD3, Darin Johnston, DMD4, David Ahn, DMD4, Shae Bryant, DMD4, Michael Li, MD1, Osama Raslan, MD5 , Steven A. Lucero, BS6, Marc J. Fischer7, Marike Zwienenberg, MD2, Neha Sharma, MDS, DMD, PhD8,9 , Florian Thieringer, MD, DDS, MHBA8,9, Christian El Amm, MD3, Kiarash Shahlaie, MD, PhD2,
Marc Metzger, MD, DMD, PhD10 , and E. Bradley Strong, MD1
Objective. This study aims to (1) develop an augmented reality (AR) navigation platform for craniomaxillofacial (CMF) and head and neck surgery; (2) apply it to a range of surgical cases; and (3) evaluate the advantages, disadvantages, and clinical opportunities for AR navigation, Conclusion: While still a developing technology, AR navigation provides several advantages over traditional navigation for CMF and head and neck surgery, including heads up, interactive 3D visualization of the surgical
plan, identification of critical anatomy, and real-time tracking....more
Computer-assisted maxillofacial reconstruction
Tsung-yen Hsieh, MD, Edward Bradley Strong, MD
A comprehensive maxillofacial computer-assisted surgical workflow can be divided into three areas: 1) presurgical planning, 2) surgical execution, and 3) anatomic verification. Historically, presurgical planning has been a function of the surgeon’s spatial cognition abilities, surgical execution was heavily dependent on surgeon experience, and intraoperative verification tools to confirm the surgical reconstruction were nonexistent. Advances in computer-assisted surgery (CAS) have resulted in a paradigm shift in each of these areas...more
Assessment of the Learning Curve for Virtual Surgical Planning in Orbital Fractures
Tsung-yen Hsieh, MD, Mena Said, BS2, Raj D. Dedhia, MD, Mary Roz Timbang, MD, Toby O. Steele, MD, and Edward Bradley Strong, MD
Abstract: Virtual surgical planning (VSP) is becoming more widely used in maxillofacial reconstruction and can be surgeon-based or industry-based. Surgeon-based models require software training but allow surgeon autonomy. We evaluate the learning curve for VSP through a prospective cohort study in which planning times and accuracy of 7 otolaryngology residents with no prior VSP experience were compared to that of a proficient user after a single training protocol and 6 planning sessions ...more
3D Printing in Augmented Reality Navigation in Craniomaxillofacial/Head and Neck Surgery
E Brandon Strong 1, Anuj Patel 1, Alexander P Marston 1, Cameron Sadegh 2, Jeffrey Potts 3, Darin Johnston 4, David Ahn 4, Shae Bryant 4, Michael Li 1, Osama Raslan 5, Steven A Lucero 6, Marc J Fischer 7, Marike Zwienenberg 2, Neha Sharma 8 9, Florian Thieringer 8 9, Christian El Amm 3, Kiarash Shahlaie 2, Marc Metzger 10, E Bradley Strong 1
Objective: This study aims to (1) develop an augmented reality (AR) navigation platform for craniomaxillofacial (CMF) and head and neck surgery; (2) apply it to a range of surgical cases; and (3) evaluate the advantages, disadvantages, and clinical opportunities for AR navigation... more
Evaluating Mixed Reality as a Tool for Patient Education of Facial Fractures
Angela A Colback 1, Oscar Velazquez-Castro 1, Michael Agarrado 1, Renuka Reddy 2, E Brandon Strong 3, Machelle Wilson 4, E Bradley Strong 2 Affiliations Expand
Abstract: Background: Patients may be educated about facial fractures using two-dimensional computed tomography (2DCT); however, three-dimensional mixed reality (3DMR) goggles may improve patient education by delivering content in an immersive environment. Objective: To compare the effectiveness of 2DCT and 3DMR formats used for patient education on facial fractures, as measured by surveys. Methods: In this prospective, randomized, crossover study, video tutorials intended for facial fracture informed consent were created in 2DCT and 3DMR formats from a single CT data set of a zygomaticomaxillary complex (ZMC) fracture. more
Improving Patient Education of Facial Fractures Using 3-Dimensional Computed Tomography
Peter Wickwire 1, Sukhraj Kahlon 2, Soroush Kazemi 3, Travis Tollefson 1, Toby Steele 1, Jennifer Chang 2, Bradley Strong 1
Abstract: Objective: Advances in 3-dimensional modeling have revolutionized presurgical planning for maxillofacial reconstruction, yet little is known about how this technology may affect patient education. This study was designed to evaluate the efficacy of 2-dimensional computed tomography versus 3-dimensional computed tomography for patient education in maxillofacial reconstruction... more
3D Printing in Otolaryngology Surgery: Descriptive Review of Literature to Define the State of the Art
Federica Zoccali 1 , Andrea Colizza 1,* , Fabrizio Cialente 1 , Arianna Di Stadio 2 , Ignazio La Mantia 2 , Charlie Hanna 3,4, Antonio Minni 1 , Massimo Ralli 1 , Antonio Greco 1 and Marco de Vincentiis 1
Abstract: Background: Three-dimensional (3D) printing has allowed great progression in the medical field. In otolaryngology practice, 3D printing can be used for planning in case of malformation/complex surgery, for surgeon training, and for recreating missing tissues. This systematic review aimed to summarize the current benefits and the possible future application of 3D technologies in the otolaryngology field. Methods: A systematic review of articles that discuss the use of 3D printing in the otolaryngology field ... more