Along with the benefit of training students on complicated otolaryngologic anatomy, she said VR and AR are also useful for training students on uncommon anatomy such as cranio-facial or congenital anomalies that require specific surgical planning. She noted that interest in AR is growing, as VR can result in motion sickness, which can affect up to 30% of users.
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May 2024Eric Gantwerker, MD, MSc, MS, a pediatric otolaryngologist at Northwell Health in New Hyde Park, N.Y., sees many benefits to using XR in otolaryngologic training, among them the ability for trainees to learn at their own pace on their own time and the opportunity to allow for remote training in real time.
We should think critically about the advantages of XR and where it is worth the cost for implementation. We should build to scale instead of having a ton of one-off pilots and proof of concepts that never go anywhere. — Eric Gantwerker, MD, MS
He is currently investigating the use of XR for telecollaboration, in which clinicians across long distances can collaborate via a real-time video and audio feed directly to the point of care. He listed several areas in which otolaryngologists are using XR for otolaryngologic surgical training, including anatomic virtual dissections, patient-specific surgical preparation, operative live surgical guidance, and procedural training with sinus task trainers and temporal bone drilling.
Dr. Gantwerker cautioned, however, that although the technology has tremendous potential, it still comes with many challenges. Among them are cost, technical problems with hardware and software, and inconsistent quality ranging from clunky and unrealistic software to poor educational implementation (using the technology for technology’s sake without realizing the value added with XR). “We should think critically about the advantages of XR and where it is worth the cost for implementation,” he said. “We should build to scale instead of having a ton of one-off pilots and proof of concepts that never go anywhere.”
Dr. Gantwerker noted that the research is still sparse on the effectiveness of XR in otolaryngology and otolaryngologic training, on patient-level outcomes, and in assessments of its return on investment. In a 2022 scoping review of the current state of XR use in otolaryngology, of which he is senior author, he and his colleagues highlighted the need for more studies that, for example, assess high-level learning outcomes with XR and deliberate testing of AR and MR applications in otolaryngology (the review found that all studies to date were limited to VR) (Laryngoscope. 2023;133:227-234). The authors also encouraged the development of a shared definition for XR technology.
David W. Chou, MD, assistant professor of facial plastic and reconstructive surgery in the department of otolaryngology–head and neck surgery at Atlanta’s Emory University, also pointed to accessibility and cost as the biggest hurdles to implementing XR in otolaryngologic practice, and underscored the need for a “critical eye” on how to use these technologies in a way that actually impacts outcomes and to recognize that “they are simply tools to aid us but never to solely rely on.”
I would like my peers to embrace new technologies like XR, as it is definitely exciting and has broad applications which are yet to be completely explored. —David W. Chou, MD