The field of maxillofacial surgery specializes in the diagnosis and treatment of conditions affecting the face, jaws, and oral structures. It includes procedures to manage trauma, deformities, tumors, and functional disorders. Advances in augmented reality and AI are increasingly being integrated into both the planning and execution of these procedures to enhance surgical precision, which is crucial for achieving optimal functional and aesthetic outcomes.

Mandibular reconstruction

The mandible, or lower jawbone, forms the lower facial skeleton and supports the teeth, playing a key role in chewing and speech. Mandibular defects can significantly impact these functions, making precise reconstruction essential.

A recent study from Latin America described a case of a 26-year-old female patient with a large, destructive osteoblastoma of the left mandible, requiring wide resection and reconstruction. In the preoperative phase, DICOM data from CT scans were used to generate 3D holographic models with the Medicalholodeck software. In a virtual environment, the surgical team explored the patient’s anatomy, tested different resection margins, and planned the fibula free flap reconstruction with precise cutting guides.

During the procedure, the primary surgeon used a Meta Quest 3 AR headset to superimpose the hologram over the patient’s anatomy. This facilitated accurate determination of resection margins and improved visualization of critical vascular landmarks, enhancing surgical precision and safety.

The patient experienced an uncomplicated postoperative course. Follow-up evaluations demonstrated successful flap integration, preserved mandibular function, and return to normal daily activities, confirming the value of incorporating affordable VR and AR technologies into reconstructive surgery.

Maxillofacial oncologic surgery

Maxillofacial oncologic surgery involves the removal of benign or malignant tumors affecting the jaws, midface, and surrounding structures, often followed by complex reconstruction to restore function and appearance. These resections, such as partial or total maxillectomies, require precise osteotomy lines to achieve tumor-free margins while preserving as much healthy tissue as possible.

In another study, patient-specific 3D data were first obtained from preoperative CT scans. The models were used to create a virtual surgical plan with detailed osteotomy lines and resection margins.. Surgeons utilized AR technology in the operating room to overlay this plan directly onto the patient’s anatomy and trace osteotomy lines in real time without looking away from the surgical field.

The lines were verified and completed using custom cutting guides. The comparison showed close agreement, with discrepancies between AR-guided corticotomy lines and cutting guide–assisted osteotomy lines remaining under two millimeters.

MR-based intraoperative navigation

Mixed reality merges real and virtual environments, allowing for interactions between physical and digital elements. This capability enabled the development of an MR-based system for maxillofacial tumor surgery. It consisted of four modules:

• MR image processing and selection module, which turns preoperative imaging into 3D models
• Registration module, which aligns the virtual 3D models with the patient’s actual anatomy using landmark extraction, positioning frames, and navigator-based identification
• Control module, which allows the surgeon to operate the system and adjust the settings
• class="article-link-page" target area depth calculation module, which calculates the depth of the surgical instrument relative to the class="article-link-page" target and optimizes navigation accuracy

The system successfully assisted four procedures, during which surgeons could then perform tumor resections and reconstructions while visualizing the precise location of the tumor and surrounding critical structures in real time. The study demonstrated that MR guidance improved intraoperative spatial orientation and surgical precision, highlighting its potential as a navigation tool.

Immersive training environments

VR provides an immersive platform for surgical planning and training by allowing surgeons to interact with patient-specific 3D models. This enabled the development of a VR simulator for maxillofacial reconstruction, a surgery that requires a high level of precision due to restoring skeletal structures in areas such as the mouth, jaw, and face.

Surgeons could perform virtual osteotomies and manipulate the reconstructed segments in real time. Validation tests demonstrated that the simulator accurately represented anatomical structures and surgical steps. Such a training approach offers a safe environment for skill development and preoperative planning, potentially improving surgical outcomes and reducing intraoperative errors.

The immersive technologies address the need for high-level accuracy during maxillofacial procedures. Not only do VR, AR, and MR tools allow surgeons to perform accurate tumor resections and navigate critical anatomical structures in real time, but they also provide environments for skill development and preoperative rehearsal.

How to get started

Medicalholodeck integrates with secure hospital systems, offering PACS access, HIPAA-compliant data handling, and full patient security. It works on VR headsets, PCs, iPads, and iPhones for flexible use in hospitals, classrooms, and training centers.

Specialized features for surgical planning are exclusive to Medical Imaging XR PRO FDA. Currently, Medicalholodeck is available only for educational use. The platform is undergoing FDA and CE certification, and we expect Medical Imaging XR PRO to be available soon in the U.S. and EU markets.

For updates, regulatory news, availability, or questions contact info@medicalholodeck.com.