Exploring Deep Cervical Compartments in Head and Neck Surgical Oncology through Augmented Reality Vision: A Proof of Concept.
Alessandro Tel, Marco Zeppieri, Massimo Robiony, Salvatore Sembronio, Shankeeth Vinayahalingam, Antonio Pontoriero, Stefano Pergolizzi, Filippo Flavio Angileri, Leopoldo Spadea, Tamara Ius
Author Information
Alessandro Tel: Clinic of Maxillofacial Surgery, Head-Neck and NeuroScience Department, University Hospital of Udine, Piazzale S. Maria della Misericordia 15, 33100 Udine, Italy. ORCID
Marco Zeppieri: Department of Ophthalmology, University Hospital of Udine, Piazzale S. Maria della Misericordia 15, 33100 Udine, Italy. ORCID
Massimo Robiony: Clinic of Maxillofacial Surgery, Head-Neck and NeuroScience Department, University Hospital of Udine, Piazzale S. Maria della Misericordia 15, 33100 Udine, Italy.
Salvatore Sembronio: Clinic of Maxillofacial Surgery, Head-Neck and NeuroScience Department, University Hospital of Udine, Piazzale S. Maria della Misericordia 15, 33100 Udine, Italy.
Shankeeth Vinayahalingam: Department of Maxillofacial Surgery, Radboud Medical University, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands. ORCID
Antonio Pontoriero: Radiation Oncology Unit, Department of Biomedical, Dental Science and Morphological and Functional Images, University of Messina, 98125 Messina, Italy. ORCID
Stefano Pergolizzi: Radiation Oncology Unit, Department of Biomedical, Dental Science and Morphological and Functional Images, University of Messina, 98125 Messina, Italy.
Filippo Flavio Angileri: Neurosurgery Unit, Department of Biomedical, Dental Science and Morphological and Functional Images, 98125 Messina, Italy.
Leopoldo Spadea: Eye Clinic, Policlinico Umberto I, "Sapienza" University of Rome, 00142 Rome, Italy. ORCID
Tamara Ius: Neurosurgery Unit, Head-Neck and NeuroScience Department, University Hospital of Udine, Piazzale S. Maria della Misericordia 15, 33100 Udine, Italy. ORCID
BACKGROUND: Virtual surgical planning allows surgeons to meticulously define surgical procedures by creating a digital replica of patients' anatomy. This enables precise preoperative assessment, facilitating the selection of optimal surgical approaches and the customization of treatment plans. In neck surgery, virtual planning has been significantly underreported compared to craniofacial surgery, due to a multitude of factors, including the predominance of soft tissues, the unavailability of intraoperative navigation and the complexity of segmenting such areas. Augmented reality represents the most innovative approach to translate virtual planning for real patients, as it merges the digital world with the surgical field in real time. Surgeons can access patient-specific data directly within their field of view, through dedicated visors. In head and neck surgical oncology, augmented reality systems overlay critical anatomical information onto the surgeon's visual field. This aids in locating and preserving vital structures, such as nerves and blood vessels, during complex procedures. In this paper, the authors examine a series of patients undergoing complex neck surgical oncology procedures with prior virtual surgical planning analysis. For each patient, the surgical plan was imported in Hololens headset to allow for intraoperative augmented reality visualization. The authors discuss the results of this preliminary investigation, tracing the conceptual framework for an increasing AR implementation in complex head and neck surgical oncology procedures.
