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CC BY 4.0 · J Neurol Surg Rep 2025; 86(02): e83-e88
DOI: 10.1055/a-2547-5400
Technical Report

Application of Augmented Reality Navigation in Craniofacial Surgery for Fibrous Dysplasia

Will C. Kaiser
1   Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
,
Sanaa Hameed
1   Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
,
Fauziyya Muhammad
1   Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
,
David Barkyoumb 
1   Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
,
Christian El Amm
2   Section of Plastic Surgery, Department of Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
,
Zachary A. Smith
1   Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
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Abstract

Introduction

Fibrous dysplasia of the craniofacial bones, or craniofacial dysplasia (CFD), involves the replacement of normal bone with fibrous osseous tissue, resulting in asymmetry and distortion of the overlying soft tissue and irregular bone deposition. Treatment primarily involves surgical resection, and achieving symmetry by matching the contralateral unaffected side is crucial. However, surgical correction is challenging due to the lack of visualization of the normal contralateral structures and the need to precisely control resection depth. Although the application of an augmented reality navigation (ARN) system for CFD surgery has been documented, to our knowledge its specific use in identifying key neurovascular structures has not been reported.

Methods

We present the application of an ARN system for the surgical management of an 18-year-old woman with CFD. The virtual plan was designed to visualize the extent of tumor, identify normal and abnormal vasculature, and guide the reconstruction of a normal anatomical contour.

Results

ARN was successfully integrated into the surgical workflow and optimized operative planning, identification of tumor margins, avoidance of neurovascular structures, reconstruction, and symmetric recontouring. The ability to visualize structures in real time proved to be especially beneficial for making intraoperative adjustments.

Conclusion

ARN has significant applications for CFD surgery by providing real-time, three-dimensional simulation, and precise overlay of patient-specific anatomy and pathology, facilitating safe resection, and providing a useful reconstruction guide. To our knowledge, this report presents the first detailed description of its utility in visualizing critical neurovascular structures, offering significant potential to enhance surgical safety and patient outcomes.

Keywords

augmented reality - craniofacial - fibrous dysplasia - surgical navigation


Publication History

Received: 27 December 2024

Accepted: 14 February 2025

Accepted Manuscript online:
28 February 2025

Article published online:
11 April 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

  • References

  • 1 Adetayo OA, Salcedo SE, Borad V, Richards SS, Workman AD, Ray AO. Fibrous dysplasia: an overview of disease process, indications for surgical management, and a case report. Eplasty 2015; 15: e6
    Search in Google Scholar
  • 2 Kim DY. Current concepts of craniofacial fibrous dysplasia: pathophysiology and treatment. Arch Craniofac Surg 2023; 24 (02) 41-51
    Search in Google Scholar
  • 3 Rahman AMA, Madge SN, Billing K. et al. Craniofacial fibrous dysplasia: clinical characteristics and long-term outcomes. Eye (Lond) 2009; 23 (12) 2175-2181
    Search in Google Scholar
  • 4 Menon S, Venkatswamy S, Ramu V, Banu K, Ehtaih S, Kashyap VM. Craniofacial fibrous dysplasia: surgery and literature review. Ann Maxillofac Surg 2013; 3 (01) 66-71
    Search in Google Scholar
  • 5 Lopez-Garibay LA, Guevara-Valmaña O, Telich-Tarriba JE. et al. Craniofacial fibrous dysplasia: surgical management and long-term outcomes at a referral center in Mexico City. Indian J Plast Surg 2023; 56 (02) 124-129
    Search in Google Scholar
  • 6 Ayoub A, Pulijala Y. The application of virtual reality and augmented reality in oral & maxillofacial surgery. BMC Oral Health 2019; 19 (01) 238
    Search in Google Scholar
  • 7 Lin L, Gao Y, Aung ZM. et al. Preliminary reports of augmented-reality assisted craniofacial bone fracture reduction. J Plast Reconstr Aesthet Surg 2022; 75 (11) e1-e8
    Search in Google Scholar
  • 8 Darwood A, Collier J, Joshi N. et al. Re-thinking 3D printing: a novel approach to guided facial contouring. J Craniomaxillofac Surg 2015; 43 (07) 1256-1260
    Search in Google Scholar
  • 9 Ruggiero F, Cercenelli L, Emiliani N. et al. Preclinical application of augmented reality in pediatric craniofacial surgery: an accuracy study. J Clin Med 2023; 12 (07) 2693
    Search in Google Scholar
  • 10 Gao Y, Liu K, Lin L, Wang X, Xie L. Use of augmented reality navigation to optimise the surgical management of craniofacial fibrous dysplasia. Br J Oral Maxillofac Surg 2022; 60 (02) 162-167
    Search in Google Scholar
  • 11 Liu K, Gao Y, Abdelrehem A. et al. Augmented reality navigation method for recontouring surgery of craniofacial fibrous dysplasia. Sci Rep 2021; 11 (01) 10043
    Search in Google Scholar
  • 12 Day KM, Kelley PK, Harshbarger RJ. et al. Advanced three-dimensional technologies in craniofacial reconstruction. Plast Reconstr Surg 2021; 148 (01) 94e-108e
    Search in Google Scholar
  • 13 Besharati Tabrizi L, Mahvash M. Augmented reality-guided neurosurgery: accuracy and intraoperative application of an image projection technique. J Neurosurg 2015; 123 (01) 206-211
    Search in Google Scholar
  • 14 Xiao SX, Wu WT, Yu TC, Chen IH, Yeh KT. Augmenting reality in spinal surgery: a narrative review of augmented reality applications in pedicle screw instrumentation. Medicina (Kaunas) 2024; 60 (09) 1485
    Search in Google Scholar
  • 15 Matthews JH, Shields JS. The clinical application of augmented reality in orthopaedics: where do we stand?. Curr Rev Musculoskelet Med 2021; 14 (05) 316-319
    Search in Google Scholar
  • 16 Skolnick GB, Murthy S, Patel KB. et al. Long-term characterization of cranial defects after surgical correction for single-suture craniosynostosis. Ann Plast Surg 2019; 82 (06) 679-685
    Search in Google Scholar