Clinical Application of Augmented Reality in TMJ Arthroscopy: A Case Series

This case series evaluates the clinical application of augmented reality (AR) in temporomandibular joint arthroscopy, with a focus on improving accuracy in initial and secondary portal placement. Five patients underwent AR-assisted arthroscopy using preoperative CT-based virtual planning and intraoperative holographic visualization with the Microsoft HoloLens 2 and Xironetic's IntraOpVSP system. The AR interface enabled real-time alignment of surgical instruments with planned trajectories, resulting in successful joint access and completion of all intended procedures. The first portal was consistently placed with high precision, while the second portal benefited from AR-guided triangulation despite variability in preoperative joint space estimation. Although AR was not used during advanced intra-articular maneuvers due to current technical limitations, the system enhanced spatial orientation and procedural confidence. These findings support the feasibility of integrating AR into temporomandibular joint arthroscopy and highlight its potential to improve surgical accuracy, streamline workflow, and serve as a valuable adjunct in minimally invasive joint procedures.