The application of augmented reality in craniofacial bone fracture reduction: study protocol for a randomized controlled trial

Advances in facial fracture care in patients with zygomaticomaxillary complex fractures

PURPOSE OF REVIEW

Zygomaticomaxillary complex (ZMC) fractures pose both functional and aesthetic challenges, requiring careful surgical planning to optimize outcomes while minimizing morbidity. Recent advancements in surgical planning, fixation strategies, and implant technology have refined the approach to ZMC fracture repair. This review highlights these developments and discusses their implications for surgical decision-making, emphasizing strategies that balance reduction accuracy with the least invasive intervention.

RECENT FINDINGS

Studies suggest that minimizing fixation points in properly selected ZMC fractures does not compromise patient satisfaction or postoperative symmetry. Intraoperative CT is increasingly utilized and has been shown to reduce unnecessary incisions and implants while improving reduction accuracy. Computer aided surgical planning has demonstrated improved surgical precision through preoperative planning, guiding plate placement, and enhancing anatomical symmetry. Additionally, patient specific implants (PSIs) have emerged as valuable tools in complex or revision cases, offering more precise reconstruction with reduced operative time. Augmented reality (AR) is a rapidly emerging technology that holds promise for surgical planning and navigation for ZMC fracture repair.

SUMMARY

Wider adoption of intraoperative CT has improved surgical assessment, while advances in computer aided surgical planning and patient specific implants continue to refine surgical workflows and outcomes. As technology evolves, future research should focus on optimizing cost-effectiveness and further integrating digital planning tools. AR, still in its preliminary stages, may represent a significant innovation in enhancing surgical precision and visualization during ZMC fracture repair.

Enhancing Surgical Vision: Augmented Reality in Otolaryngology-Head and Neck Surgery

Augmented reality (AR) technology has become widely established in otolaryngology-head and neck surgery. Over the past 20 years, numerous AR systems have been investigated and validated across the subspecialties, both in cadaveric and in live surgical studies. AR displays projected through head-mounted devices, microscopes, and endoscopes, most commonly, have demonstrated utility in preoperative planning, intraoperative guidance, and improvement of surgical decision-making. Specifically, they have demonstrated feasibility in guiding tumor margin resections, identifying critical structures intraoperatively, and displaying patient-specific virtual models derived from preoperative imaging, with millimetric accuracy. This review summarizes both established and emerging AR technologies, detailing how their systems work, what features they offer, and their clinical impact across otolaryngology subspecialties. As AR technology continues to advance, its integration holds promise for enhancing surgical precision, simulation training, and ultimately, improving patient outcomes.

Novel Use of Virtual Reality and Augmented Reality in Temporomandibular Total Joint Replacement Using Stock Prosthesis

This technical innovation demonstrates the use of ImmersiveTouch Virtual Reality (VR) and Augmented Reality (AR)-guided total temporomandibular joint replacement (TJR) using Biomet stock prosthesis in 2 patients with condylar degeneration. TJR VR planning includes condylar resection, prosthesis selection and positioning, and interference identification. AR provides real-time guidance for osteotomies, placement of prostheses and fixation screws, occlusion verification, and flexibility to modify the surgical course. Radiographic analysis demonstrated high correspondence between the preoperative plan and postoperative result. The average differences in the positioning of the condylar and fossa prosthesis are 1.252 ± 0.269 mm and 1.393 ± 0.335 mm, respectively. The main challenges include a steep learning curve, intraoperative technical difficulties, added surgical time, and additional costs. In conclusion, the case report demonstrates the advantages of implementing AR and VR technology in TJR's using stock prostheses as a pilot study. Further clinical trials are needed prior to this innovation becoming a mainstream practice.

Contemporary Surgical Management of Craniofacial Fibrous Dysplasia Using Computer-Assisted Surgery and Intraoperative Navigation

Craniofacial fibrous dysplasia (CFD) is a rare developmental disease of bone, which typically presents as a painless, expansile mass causing deformity of the craniofacial skeleton. In rare circumstances, compression of neurovascular structures may arise, causing symptoms such as pain, visual impairment, and hearing loss. Traditionally, CFD debulking has been performed with "freehand" techniques using preoperative imaging and anthropometric norms to determine the ideal amount of tissue removal. The advent of computer-assisted surgery, computer-aided design, and computer-aided manufacturing (CAD/CAM) has revolutionized the management of CFD. Surgeons can now fabricate patient-specific osteotomy/ostectomy guides, allowing for increased accuracy in bone removal and improved cosmetic outcomes. This series of 3 cases describe our institution's technique using patient-specific ostectomy "depth guides", which allow for maximum removal of fibro-osseous tissue while sparing deep and adjacent critical structures. These techniques can be widely applied to the craniofacial skeleton to assist in the surgical management of CFD.