Augmented Reality Navigation in Perpendicular Plate of Ethmoid Bone Resection: A Teaching Practice

Area of Science:

• Otolaryngology
• Medical Education
• Surgical Simulation

Background:

• The perpendicular plate of the ethmoid bone (PPE) is a critical anatomical structure in endoscopic sinus surgery.
• Accurate anatomical localization and surgical navigation are essential for safe and effective PPE resection.
• Traditional training methods for PPE resection may have limitations in developing spatial awareness and surgical skills.

Purpose of the Study:

• To evaluate the application value of augmented reality (AR)-assisted surgical navigation in teaching perpendicular plate of ethmoid bone (PPE) resection.
• To assess AR's impact on medical trainees' mastery of PPE anatomical localization and surgical navigation.
• To provide a standardized training method for PPE resection using AR technology.

Main Methods:

• An AR navigation system using HoloLens 2 glasses was developed, superimposing virtual guidance onto the surgical field.
• Ten participants (five clinical, five non-clinical medical students) localized five anatomical points on PPE in cranial models.
• Localization accuracy and operation time were measured with and without AR guidance.

Main Results:

• AR-assisted navigation significantly improved the accuracy of PPE localization for safety harvesting area points in both groups.
• Clinical trainees showed higher accuracy than non-clinical trainees, irrespective of AR use.
• AR guidance increased annotation time, and Point E was identified as a critical landmark with the greatest deviation.

Conclusions:

• AR integration in simulated PPE resection training enhances trainees' spatial positioning accuracy and reduces experience-related variability.
• Despite limitations in projection alignment and system fidelity, AR is a feasible auxiliary educational tool for PPE resection.
• This preliminary study provides a technical foundation for mastering complex landmarks before clinical practice.