{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T09:06:21Z","timestamp":1779527181984,"version":"3.53.1"},"reference-count":54,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,1]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Augmented reality (AR) in cranial surgery allows direct projection of preregistered overlaid images in real time on the microscope surgical field. In this study, the authors aimed to compare the precision of AR-assisted navigation and standard pointer-based neuronavigation (NV) by using a 3D-printed skull in surgical conditions.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n A commercial standardized 3D-printed skull was scanned, fused, and referenced with an MR image and a CT scan of a patient with a 2 \u00d7 2\u2013mm right frontal sinus defect. The defect was identified, registered, and integrated into NV. The target was physically marked on the 3D-printed skull replicating the right frontal sinus defect. Twenty-six subjects participated, 25 of whom had no prior NV or AR experience and 1 with little AR experience. The subjects were briefly trained in how to use NV, AR, and AR recalibration tools. Participants were asked to do the following: 1) \u201ctarget the center of the defect in the 3D-printed skull with a navigation pointer, assisted only by NV orientation,\u201d and 2) \u201cuse the surgical microscope and AR to focus on the center of the projected object\u201d under conventional surgical conditions. For the AR task, the number of recalibrations was recorded. Confidence regarding NV and AR precision were assessed prior to and after the experiment by using a 9-level Likert scale.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n The median distance to target was statistically lower for AR than for NV (1 mm [Q1: 1 mm, Q3: 2 mm] vs 3 mm [Q1: 2 mm, Q3: 4 mm] [p < 0.001]). In the AR task, the median number of recalibrations was 4 (Q1: 4, Q3: 4.75). The number of recalibrations was significantly correlated with the precision (Spearman rho: \u22120.71, p < 0.05). The trust assessment after performing the experiment scored a median of 8 for AR and 5.5 for NV (p < 0.01).<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n This study shows for the first time the superiority of AR over NV in terms of precision. AR is easy to use. The number of recalibrations performed using reference structures increases the precision of the navigation. The confidence regarding precision increases with experience.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2020.10.focus20789","type":"journal-article","created":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T11:31:25Z","timestamp":1609500685000},"page":"E17","source":"Crossref","is-referenced-by-count":31,"title":["Evaluation of the precision of operative augmented reality compared to standard neuronavigation using a 3D-printed skull"],"prefix":"10.3171","volume":"50","author":[{"given":"Julien","family":"Haemmerli","sequence":"first","affiliation":[{"name":"Division of Neurosurgery, Department of Clinical Neurosciences, Geneva University Hospitals; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alioucha","family":"Davidovic","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torstein R.","family":"Meling","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Clinical Neurosciences, Geneva University Hospitals; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara","family":"Chavaz","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl","family":"Schaller","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Clinical Neurosciences, Geneva University Hospitals; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Bijlenga","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Clinical Neurosciences, Geneva University Hospitals; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"546","DOI":"10.1016\/j.wneu.2015.12.101","article-title":"Utility of neuronavigation in intracranial meningioma resection: a single-center retrospective study","volume":"90","author":"Bir SC","year":"2016","unstructured":"Bir SC, Konar SK, Maiti TK, Utility of neuronavigation in intracranial meningioma resection: a single-center retrospective study. 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