A Novel Augmented Reality Navigation System for Endoscopic Sinus and Skull Base Surgery: A Feasibility Study

Area of Science:

• Neurosurgery
• Otolaryngology
• Medical Imaging
• Surgical Navigation

Background:

• Endoscopic sinus and skull base surgeries require high precision.
• Conventional navigation systems can be complex and increase surgeon workload.
• Augmented reality (AR) offers potential for enhanced visualization in surgery.

Purpose of the Study:

• To evaluate the reliability and clinical feasibility of a novel AR-based navigation system.
• To compare the performance of the AR system against conventional navigation methods.

Main Methods:

• Development of a custom AR navigation system with fused endoscopic and 3-D virtual images.
• Validation using head phantom and cadaver experiments.
• Comparison of target registration error (TRE), operation time, and NASA Task Load Index (NASA-TLX) scores with conventional systems.

Main Results:

• The AR navigation system achieved a TRE of 1.28 ± 0.45 mm, meeting surgical standards.
• The system demonstrated a novel display mode fusing endoscopic and 3-D virtual images.
• The AR system was more effective than conventional systems regarding operation time and surgeon mental workload, particularly for less experienced surgeons.

Conclusions:

• The developed AR navigation system shows significant advantages over conventional systems for endoscopic sinus and skull base surgery.
• It provides more intuitive and detailed imaging, reducing judgment time and mental workload.
• The system has the potential to enhance surgical quality and accelerate training for junior surgeons, acting as an adjunct to surgical expertise.