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Guidesvsaugmentedreality1237INTRODUCTIONOpencranialvaultreconstruction(OCVR)isthemostcommonlyusedmethodforthetreatmentofcraniosynostosispatientsolderthansixmonths1–6DuringOCVRthecranialvaultisdissectedandoptimallyreconstructedwithincreasedvolumeandanimprovedaestheticalshapeBeforetheactualoperationvirtualsurgicalplanning(VSP)canassistthesurgicalteambyvirtuallysimulatingthecompleteprocedureinathree-dimensional(3D)spaceWithVSP,theprojectedcranial volumecouldbecalculatedcranialshapeaestheticscanbereviewed fromdifferentperspectivesandcrucialoutcomeparameters(egorbitaldistance)canbemeasured78 This additionalinsight and theoption toevaluate differentsurgicalstrategiescouldavoidinadequateosteotomiesduringtheactualsurgery9–11However,transferringtheVSPtothepatientintheoperationtheatreremainsachallenge3Dprintingtechniquescanbeusedtogeneratepatient-specificguidestointraoperatively transfer theosteotomypatternsandreconstructionpositions Thiscanreduceoperationtimeaswellasperioperativebloodloss1012–14Neverthelesscostsupto1500eurosandthemanufacturingtimeofseveraldaysaresignificantdrawbacksofusing3Dprintedsurgicalguides121516Augmentedreality(AR)isanewandinnovativevisualisationtechniquethatcanbeusedtoenhancetherealworldwithvirtualobjectsBywearingARglassestheusercanseea3DrepresentationoftheVSPdirectlyprojectedonthepatient1718andtherebyovercomingthelimitationsofothertransfertechniquesYetlittleisknownonaccuracyandusabilityofARforthispurposeThegoalofthispilotstudywastodevelopanARapplicationtoprojecttheVSPdirectlytothepatientTheusabilityandaccuracyoftheARworkflowwascomparedtothesurgicalguidesbytransferringthe VSPon103D-printedmodelsofcraniosynostosispatients
