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Chen J, Wang J, Guo J, Wang X, Kang Y, Wang Y, Guo C. Prediction of jaw opening function after mandibular reconstruction using subject-specific musculoskeletal modelling. J Oral Rehabil 2024; 51:1050-1060. [PMID: 38544336 DOI: 10.1111/joor.13670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 02/09/2024] [Accepted: 02/16/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Mandibular reconstruction patients often suffer abnormalities in the mandibular kinematics. In silico simulations, such as musculoskeletal modelling, can be used to predict post-operative mandibular kinematics. It is important to validate the mandibular musculoskeletal model and analyse the factors influencing its accuracy. OBJECTIVES To investigate the jaw opening-closing movements after mandibular reconstruction, as predicted by the subject-specific musculoskeletal model, and the factors influencing its accuracy. METHODS Ten mandibular reconstruction patients were enrolled in this study. Cone-beam computed tomography images, mandibular movements, and surface electromyogram signals were recorded preoperatively. A subject-specific mandibular musculoskeletal model was established to predict surgical outcomes using patient-averaged muscle parameter changes as model inputs. Jaw bone geometry was replaced by surgical planning results, and the muscle insertion sites were registered based on the non-rigid iterative closest point method. The predicted jaw kinematic data were validated based on 6-month post-operative measurements. Correlations between the prediction accuracy and patient characteristics (age, pathology and surgical scope) were further analysed. RESULTS The root mean square error (RMSE) for lower incisor displacement was 31.4%, and the error for peak magnitude of jaw opening was 4.9 mm. Age, post-operative infection and radiotherapy influenced the prediction accuracy. The amount of masseter detachment showed little correlation with jaw opening. CONCLUSION The mandibular musculoskeletal model successfully predicted short-range jaw opening functions after mandibular reconstruction. It provides a novel surgical planning method to predict the risk of developing trismus.
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Affiliation(s)
- Junpeng Chen
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing, China
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Zhejiang University Medical College, Zhejiang, China
| | - Jing Wang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Jianqiao Guo
- MOE Key Laboratory of Dynamics and Control of Flight Vehicle, School of Aerospace Engineering, Beijing Institute of Technology, Beijing, China
| | - Xinyue Wang
- MOE Key Laboratory of Dynamics and Control of Flight Vehicle, School of Aerospace Engineering, Beijing Institute of Technology, Beijing, China
| | - Yanfeng Kang
- Department of Prosthodontics, Center for Oral Functional Diagnosis, Treatment and Research Peking University School of Stomatology, Beijing, China
| | - Yang Wang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Chuanbin Guo
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing, China
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Chou DW, Annadata V, Willson G, Gray M, Rosenberg J. Augmented and Virtual Reality Applications in Facial Plastic Surgery: A Scoping Review. Laryngoscope 2024; 134:2568-2577. [PMID: 37947302 DOI: 10.1002/lary.31178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 10/05/2023] [Accepted: 10/27/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVES Augmented reality (AR) and virtual reality (VR) are emerging technologies with wide potential applications in health care. We performed a scoping review of the current literature on the application of augmented and VR in the field of facial plastic and reconstructive surgery (FPRS). DATA SOURCES PubMed and Web of Science. REVIEW METHODS According to PRISMA guidelines, PubMed and Web of Science were used to perform a scoping review of literature regarding the utilization of AR and/or VR relevant to FPRS. RESULTS Fifty-eight articles spanning 1997-2023 met the criteria for review. Five overarching categories of AR and/or VR applications were identified across the articles: preoperative, intraoperative, training/education, feasibility, and technical. The following clinical areas were identified: burn, craniomaxillofacial surgery (CMF), face transplant, face lift, facial analysis, facial palsy, free flaps, head and neck surgery, injectables, locoregional flaps, mandible reconstruction, mandibuloplasty, microtia, skin cancer, oculoplastic surgery, rhinology, rhinoplasty, and trauma. CONCLUSION AR and VR have broad applications in FPRS. AR for surgical navigation may have the most emerging potential in CMF surgery and free flap harvest. VR is useful as distraction analgesia for patients and as an immersive training tool for surgeons. More data on these technologies' direct impact on objective clinical outcomes are still needed. LEVEL OF EVIDENCE N/A Laryngoscope, 134:2568-2577, 2024.
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Affiliation(s)
- David W Chou
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Vivek Annadata
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Gloria Willson
- Education and Research Services, Levy Library, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Mingyang Gray
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Joshua Rosenberg
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Gsaxner C, Li J, Pepe A, Jin Y, Kleesiek J, Schmalstieg D, Egger J. The HoloLens in medicine: A systematic review and taxonomy. Med Image Anal 2023; 85:102757. [PMID: 36706637 DOI: 10.1016/j.media.2023.102757] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 01/05/2023] [Accepted: 01/18/2023] [Indexed: 01/22/2023]
Abstract
The HoloLens (Microsoft Corp., Redmond, WA), a head-worn, optically see-through augmented reality (AR) display, is the main player in the recent boost in medical AR research. In this systematic review, we provide a comprehensive overview of the usage of the first-generation HoloLens within the medical domain, from its release in March 2016, until the year of 2021. We identified 217 relevant publications through a systematic search of the PubMed, Scopus, IEEE Xplore and SpringerLink databases. We propose a new taxonomy including use case, technical methodology for registration and tracking, data sources, visualization as well as validation and evaluation, and analyze the retrieved publications accordingly. We find that the bulk of research focuses on supporting physicians during interventions, where the HoloLens is promising for procedures usually performed without image guidance. However, the consensus is that accuracy and reliability are still too low to replace conventional guidance systems. Medical students are the second most common target group, where AR-enhanced medical simulators emerge as a promising technology. While concerns about human-computer interactions, usability and perception are frequently mentioned, hardly any concepts to overcome these issues have been proposed. Instead, registration and tracking lie at the core of most reviewed publications, nevertheless only few of them propose innovative concepts in this direction. Finally, we find that the validation of HoloLens applications suffers from a lack of standardized and rigorous evaluation protocols. We hope that this review can advance medical AR research by identifying gaps in the current literature, to pave the way for novel, innovative directions and translation into the medical routine.
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Affiliation(s)
- Christina Gsaxner
- Institute of Computer Graphics and Vision, Graz University of Technology, 8010 Graz, Austria; BioTechMed, 8010 Graz, Austria.
| | - Jianning Li
- Institute of AI in Medicine, University Medicine Essen, 45131 Essen, Germany; Cancer Research Center Cologne Essen, University Medicine Essen, 45147 Essen, Germany
| | - Antonio Pepe
- Institute of Computer Graphics and Vision, Graz University of Technology, 8010 Graz, Austria; BioTechMed, 8010 Graz, Austria
| | - Yuan Jin
- Institute of Computer Graphics and Vision, Graz University of Technology, 8010 Graz, Austria; Research Center for Connected Healthcare Big Data, Zhejiang Lab, Hangzhou, 311121 Zhejiang, China
| | - Jens Kleesiek
- Institute of AI in Medicine, University Medicine Essen, 45131 Essen, Germany; Cancer Research Center Cologne Essen, University Medicine Essen, 45147 Essen, Germany
| | - Dieter Schmalstieg
- Institute of Computer Graphics and Vision, Graz University of Technology, 8010 Graz, Austria; BioTechMed, 8010 Graz, Austria
| | - Jan Egger
- Institute of Computer Graphics and Vision, Graz University of Technology, 8010 Graz, Austria; Institute of AI in Medicine, University Medicine Essen, 45131 Essen, Germany; BioTechMed, 8010 Graz, Austria; Cancer Research Center Cologne Essen, University Medicine Essen, 45147 Essen, Germany
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Wan X, Shen L, Fang Z, Dong S, Zhang S, Lin C. A novel motionless calibration method for augmented reality surgery navigation system based on optical tracker. Heliyon 2022; 8:e12115. [PMID: 36590529 DOI: 10.1016/j.heliyon.2022.e12115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 09/25/2022] [Accepted: 11/28/2022] [Indexed: 12/13/2022] Open
Abstract
Augmented reality (AR) surgery navigation systems display the pre-operation planned virtual model at the accurate position in the real surgical scene to assist the operation. Accurate calibration of the mapping relationship between the virtual coordinate and the real world is the key to the virtual-real fusion effect. Former calibration methods require the doctor user to conduct complex manual procedures before usage. This paper introduces a novel motionless virtual-real calibration method. The method only requires to take a mixed reality image containing both virtual and real marker balls using the built-in forward camera of the AR glasses. The mapping relationship between the virtual and real spaces is calculated by using the camera coordinate system as a transformation medium. The composition and working process of the AR navigation system is introduced, and then the mathematical principle of the calibration is designed. The feasibility of the proposed calibration scheme is verified with a verification experiment, and the average registration accuracy of the scheme is around 5.80mm, which is of same level of formerly reported methods. The proposed method is convenient and rapid to implement, and the calibration accuracy is not dependent on the user experience. Further, it can potentially realize the real-time update of the registration transformation matrix, which can improve the AR fusion accuracy when the AR glasses moves. This motionless calibration method has great potential to be applied in future clinical navigation research.
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Zhao R, Zhu Z, Shao L, Meng F, Lei Z, Li X, Zhang T. Augmented reality guided in reconstruction of mandibular defect with fibular flap: A cadaver study. Journal of Stomatology, Oral and Maxillofacial Surgery 2022; 124:101318. [PMID: 36280109 DOI: 10.1016/j.jormas.2022.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 10/05/2022] [Accepted: 10/19/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Augmented reality (AR) navigation has been developed in recent years and can overcome some limitations of existing technologies. This study aimed to investigate a novel method of fibula free flap (FFF) osteotomy based on AR technology through a cadaver study. METHODS One mandible, seven fibulas, and seven lower limb specimens underwent computed tomography (CT) examination. We used the professional software Proplan CMF 3.0 to design a defective mandible model and created fourteen virtual reconstruction plans using the fibulas and lower limb specimens. The AR-based intraoperative guidance software prototype was developed using the Unity Real-Time Development Platform, and virtual plans were transferred into this software prototype. We used AR-based surgical navigation to guide the FFF osteotomy and used these fibular segments to reconstruct the defective mandible model. After reconstruction, all segments were scanned by CT. Osteotomy accuracy was evaluated by measuring the length and angular deviation between the virtual plan and the final result. The reconstruction precision was reflected by the volume overlap rate and average surface distance between the planned and obtained reconstruction. RESULTS The length difference, angular deviation, volume overlap rate and average surface distance of the in vitro group were 1.03±0.68 mm, 5.04±2.61°, 95.35±1.81%, and 1.02±0.27 mm, respectively. Those of the in vivo group were 1.18±0.84 mm, 5.45±1.47°, 95.31±2.09%, and 1.22±0.12 mm. CONCLUSIONS Due to the ideal result of cadaver experiments, an AR-based FFF osteotomy guided system may become a novel approach to assist FFF osteotomy for the reconstruction of defective mandibles.
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Pu JJ, Hakim SG, Melville JC, Su YX. Current Trends in the Reconstruction and Rehabilitation of Jaw following Ablative Surgery. Cancers (Basel) 2022; 14:cancers14143308. [PMID: 35884369 PMCID: PMC9320033 DOI: 10.3390/cancers14143308] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 06/18/2022] [Accepted: 06/21/2022] [Indexed: 12/04/2022] Open
Abstract
Simple Summary The Maxilla and mandible provide skeletal support for of the middle and lower third of our faces, allowing for the normal functioning of breathing, chewing, swallowing, and speech. The ablative surgery of jaws in the past often led to serious disfigurement and disruption in form and function. However, with recent strides made in computer-assisted surgery and patient-specific implants, the individual functional reconstruction of the jaw is evolving rapidly and the prompt rehabilitation of both the masticatory function and aesthetics after jaw resection has been made possible. In the present review, the recent advancements in jaw reconstruction technology and future perspectives will be discussed. Abstract The reconstruction and rehabilitation of jaws following ablative surgery have been transformed in recent years by the development of computer-assisted surgery and virtual surgical planning. In this narrative literature review, we aim to discuss the current state-of-the-art jaw reconstruction, and to preview the potential future developments. The application of patient-specific implants and the “jaw-in-a-day technique” have made the fast restoration of jaws’ function and aesthetics possible. The improved efficiency of primary reconstructive surgery allows for the rehabilitation of neurosensory function following ablative surgery. Currently, a great deal of research has been conducted on augmented/mixed reality, artificial intelligence, virtual surgical planning for soft tissue reconstruction, and the rehabilitation of the stomatognathic system. This will lead to an even more exciting future for the functional reconstruction and rehabilitation of the jaw following ablative surgery.
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Affiliation(s)
- Jane J. Pu
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong;
| | - Samer G. Hakim
- Department Oral and Maxillofacial Surgery, University Hospital of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany;
| | - James C. Melville
- Department of Oral and Maxillofacial Surgery, University of Texas Health Science Center at Houston, Houston, TX 77030, USA;
| | - Yu-Xiong Su
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong;
- Correspondence:
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