Mixed Reality Combined with Surgical Navigation versus Conventional Navigation for Resection of Oral and Maxillofacial Tumors: A Comparative Study

Objective To evaluate the feasibility and effectiveness of mixed reality combined with surgical navigation for resection of oral and maxillofacial tumors. Methods Patients with tumors involving maxilla and mandible in the oral and maxillofacial region who underwent surgical treatment at Peking University School and hospital of Stomatology between January 2020 and June 2023 were enrolled in this study. The experimental group underwent image data processing using mixed reality–surgical navigation technology, and tumor localization and resection were performed under its guidance. The control group received assistance from digital surgical technology for three-dimensional reconstruction and computer-aided design during image processing, with tumor resection also completed under navigation guidance. Basic patient characteristics were recorded for both groups. Using a normal vector-based osteotomy plane selection method, osteotomy planes were selected from both the preoperative virtual design and the postoperative CT reconstruction model via digital software for chromatographic analysis. The deviations in osteotomy planes between the experimental and control groups were compared. Statistical analyses were conducted using independent samples t-tests, with a significance level set at P  < 0.05. Results A total of 38 patients were included, with 19 assigned to the experimental group and 19 to the control group. The osteotomy deviation was significantly smaller in the experimental group than in the control group (1.84 mm vs. 3.07 mm, P  < 0.001). Chromatographic analysis revealed that the proportion of osteotomy points deviating by less than 3 mm was 74.84% in the experimental group and 64.81% in the control group. When analyzed by subcategory—maxillary versus mandibular and benign versus malignant tumors—the experimental group consistently exhibited smaller deviations than the control group. No significant differences in osteotomy accuracy were observed between maxillary and mandibular tumors, or between benign and malignant tumors, within either group ( P  > 0.05). During an average follow-up of 27 months in the experimental group, five patients experienced complications, including facial paralysis, skin numbness, and titanium mesh exposure; no tumor exposure or distant metastasis occurred. In the control group, with an average follow-up of 18.8 months, two patients developed complications such as infection and titanium mesh exposure, and three patients experienced tumor recurrence. Conclusion The clinical application of mixed reality combined with surgical navigation is feasible in the resection of oral and maxillofacial tumors. Compared to conventional navigation systems, this technology enables more precise localization of osteotomy planes and enhances the accuracy of tumor resection.