Integration of Augmented Reality in Temporal Bone and Skull Base Surgeries

Area of Science:

• Medical Technology
• Surgical Innovation
• Human-Computer Interaction

Background:

• Augmented reality (AR) offers transformative potential in surgery.
• Existing AR systems often require head-mounted displays, which can be cumbersome.
• Improving surgeon spatial orientation and reducing cognitive load are key challenges in complex procedures.

Purpose of the Study:

• To evaluate a novel AR system projecting 3D holographic images onto surgical footage.
• To assess the system's impact on surgeon performance and cognitive load without head-mounted displays.
• To compare the effectiveness of 2D versus 3D graphical surgical guides in specific otologic surgeries.

Main Methods:

• A novel AR system integrating exoscopic footage (ORBEYE) with 3D holographic displays on a single screen was developed.
• Thirteen surgeons and assistants performed simulated tasks using 2D and 3D guides.
• The NASA Task Load Index (NTLI) assessed task demands; video latency was measured.

Main Results:

• 3D guides significantly improved performance in cochlear implant surgeries, reducing mental, physical, temporal demands, and frustration.
• For Bonebridge implantation, the 2D guide yielded superior overall performance (p=0.045).
• The AR system exhibited imperceptible video latency (0.13 ± 0.01 s).

Conclusions:

• The developed AR system enhances surgical efficiency and precision, particularly for cochlear implantations, by improving spatial orientation and lowering cognitive load.
• The system's non-reliance on head-mounted displays offers a practical advantage.
• Procedure-specific optimization of 2D vs. 3D guidance is crucial for maximal benefit.