Extended Reality in Otolaryngology-Head & Neck Surgery: A State-of-the-Art Review

To review the current literature on the applications of extended reality (XR), including virtual reality (VR), augmented reality (AR), and mixed reality (MR), in otolaryngology-head and neck surgery (OHNS).

MEDLINE, Embase, Web of Science, and Scopus databases.

A comprehensive review of the literature on the applications of XR in OHNS was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. Eligible studies were synthesized into a narrative review.

In OHNS, XR technologies are increasingly being used across a wide range of clinical and educational contexts. The majority of studies focused on simulation for surgical education, particularly in otology, demonstrating improvements in learner engagement, anatomical understanding, and procedural skills. Other applications included preoperative planning, intraoperative guidance, distraction analgesia, vestibular and voice rehabilitation, and provider wellness. Despite these promising developments, the literature remains heavily concentrated in certain subspecialties, focused on education and surgical simulation, and largely limited to feasibility or proof-of-concept studies, with minimal integration into routine clinical practice. Unexplored XR applications in OHNS include at home self-monitoring, mental health conditions relevant to the specialty and telemedicine.

As XR technologies continue to evolve, they offer significant potential to enhance clinical care, improve patient education, and bridge gaps in surgical training. While early applications have focused largely on simulation, there is a growing interest in leveraging XR for perioperative and rehabilitative uses. Addressing current limitations, such as cost, access, standardization, and real-world validation, will be critical for broader adoption.