All-in-One Augmented Reality Guided Head and Neck Tumor Resection
This addresses the issue of positive margins in head and neck tumor surgery for medical trainees and surgeons, representing an incremental improvement over existing methods.
The paper tackled the problem of imprecise intraoperative re-resection in head and neck squamous cell carcinoma due to verbal margin communication, and resulted in an augmented reality system that reduced localization error from a median of 14.2 mm to 3.2 mm, with all errors within 5 mm.
Positive margins are common in head and neck squamous cell carcinoma, yet intraoperative re-resection is often imprecise because margin locations are typically communicated verbally from pathology. We present an all-in-one augmented reality (AR) system that relocalizes positive margins from a resected specimen to the resection bed and visualizes them in situ using HoloLens 2 depth sensing and fully automated markerless surface registration. In a silicone phantom study with six medical trainees, markerless registration achieved target registration errors comparable to a marker-based baseline (median 1.8 mm vs. 1.7 mm; maximum < 4 mm). In a margin relocalization task, AR guidance reduced error from verbal guidance (median 14.2 mm) to a few millimeters (median 3.2 mm), with all AR localizations within 5 mm error. These results support the feasibility of markerless AR margin guidance for more precise intraoperative re-excision.