title: Clinical experience with interactive teleconsultation and teleassistance in craniomaxillofacial surgical procedures.
abstract: OBJECTIVE
  The objective of this study was to evaluate the clinical value and feasibility of surgical telenavigation and teleassistance technology in the field of craniomaxillofacial surgery.
  
  
  METHODS
  The technology is based on the principles of augmented reality environment technology and remote stereotactic visualization. A consultant surgeon in a remote location receives video, audio, and stereotactic navigation data from the operation site almost in real-time and, using a head-mounted display, is emerged in the surgical augmented reality environment. By telepresence or teleconsultation, the composite images and superimposed graphics (instruments, target structures, landmarks, contours) can be seen and discussed in connected clinics with the possibility of interactive manipulation and assistance.
  
  
  RESULTS
  Interactive teleassistance was used in 27 cases of various types craniomaxillofacial surgery. The principles of computer-aided telenavigation were applied successfully. Technical problems in 6 cases did not cause a breakdown of overall system performance.
  
  
  CONCLUSIONS
  Teleconsultation with remote experts is a useful tool, although some shortcomings exist. The financial and personal effort involved is considerable.
authors.affiliation: Clinic of Maxillofacial Surgery, Vienna Medical School, University of Vienna, Austria.
authors.forename: A
authors.initials: A
authors.lastname: Wagner
authors.forename: W
authors.initials: W
authors.lastname: Millesi
authors.forename: F
authors.initials: F
authors.lastname: Watzinger
authors.forename: M
authors.initials: M
authors.lastname: Truppe
authors.forename: M
authors.initials: M
authors.lastname: Rasse
authors.forename: G
authors.initials: G
authors.lastname: Enislidis
authors.forename: C
authors.initials: C
authors.lastname: Kermer
authors.forename: R
authors.initials: R
authors.lastname: Ewers
mesh_terms: D003196:Computer Graphics; D019465:Craniofacial Abnormalities / Q000601:surgery*; D003399:Craniotomy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008122:Local Area Networks; D008446:Maxillofacial Injuries / Q000601:surgery*; D008953:Models, Anatomic; D019114:Remote Consultation; D013238:Stereotaxic Techniques; D013690:Television; D013813:Therapy, Computer-Assisted / Q000379:methods*