Augmented reality with HoloLens in parotid surgery: how to assess and to improve accuracy
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HEAD AND NECK
Augmented reality with HoloLens in parotid surgery: how to assess and to improve accuracy Claudia Scherl1 · Johanna Stratemeier2 · Celine Karle2 · Nicole Rotter1 · Jürgen Hesser2 · Lena Huber1 · Andre Dias1 · Oliver Hoffmann1 · Philipp Riffel3 · Stefan O. Schoenberg3 · Angela Schell1 · Anne Lammert1 · Annette Affolter1 · David Männle1 Received: 26 July 2020 / Accepted: 31 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Augmented reality improves planning and execution of surgical procedures. The aim of this study was to evaluate the feasibility of a 3D augmented reality hologram in live parotic surgery. Another goal was to develop an accuracy measuring instrument and to determine the accuracy of the system. Methods We created a software to build and manually align 2D and 3D augmented reality models generated from MRI data onto the patient during surgery using the H oloLens® 1 (Microsoft Corporation, Redmond, USA). To assess the accuracy of the system, we developed a specific measuring tool applying a standard electromagnetic navigation device (Fiagon GmbH, Hennigsdorf, Germany). Results The accuracy of our system was measured during real surgical procedures. Training of the experimenters and the use of fiducial markers significantly reduced the accuracy of holographic system (p = 0.0166 and p = 0.0132). Precision of the developed measuring system was very high with a mean error of the basic system of 1.3 mm. Feedback evaluation demonstrated 86% of participants agreed or strongly agreed that the HoloLens will play a role in surgical education. Furthermore, 80% of participants agreed or strongly agreed that the HoloLens is feasible to be introduced in clinical routine and will play a role within surgery in the future. Conclusion The use of fiducial markers and repeated training reduces the positional error between the hologram and the real structures. The developed measuring device under the use of the Fiagon navigation system is suitable to measure accuracies of holographic augmented reality images of the HoloLens. Keywords Augmented reality · HoloLens · Parotid surgery · Salivary glands · Accuracy augmented reality
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00405-020-06351-7) contains supplementary material, which is available to authorized users. * Claudia Scherl [email protected] 1
Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor‑Kutzer‑Ufer 1‑3, 68167 Mannheim, Germany
2
Institute of Experimental Radiation Oncology, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor‑Kutzer‑Ufer 1‑3, 68167 Mannheim, Germany
3
Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor‑Kutzer‑Ufer 1‑3, 68167 Mannheim, Germany
Introduction Surgery of the parotid g
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