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

Aesthetic Plast Surg. 2026 Aug 10. doi: 10.1007/s00266-026-06211-5. Online ahead of print.

ABSTRACT

OBJECTIVE: This article aims to evaluate the application value of augmented reality (AR)-assisted surgical navigation in perpendicular plate of ethmoid bone (PPE) resection teaching, assessing the extent to which AR improves medical trainees’ mastery of PPE anatomical localization and surgical navigation, and providing a standardized training method.

METHODS: PPE osteotomy lines were designed and integrated into an AR navigation system that superimposes virtual guidance onto the surgical field using HoloLens 2 AR glasses. Ten participants (five clinical medical students and five non-clinical students) were instructed to localize five anatomical points on the PPE of eight cranial models, both manually and with AR guidance. Teaching effect was evaluated via statistical analysis of localization accuracy and operation time.

RESULTS: AR-assisted navigation significantly improved the accuracy of the safety harvesting area points of PPE localization in both groups. Clinical group trainees demonstrated higher accuracy than non-clinical group trainees, both when using AR and not using AR. However, AR guidance prolonged annotation time due to participants reassessing anatomical landmarks. Point E consistently exhibited the greatest deviation, suggesting that it is a critical anatomical landmark during PPE harvest.

CONCLUSION: Integrating AR technology into simulated PPE resection training may enhance trainees’ spatial positioning accuracy and reduce experience-related variability. While current limitations exist in projection alignment and system fidelity, AR serves as a feasible auxiliary educational tool for PPE resection. As a preliminary simulation study, it provides a technical foundation for trainees to master complex landmarks prior to clinical practice.

LEVEL OF EVIDENCE V: Experimental simulation study: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

PMID:42576063 | DOI:10.1007/s00266-026-06211-5

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