Exploration of temporal bone anatomy using mixed reality (HoloLens): development of a mixed reality anatomy teaching resource prototype.

Mixed reality (MR), a technology which supplements the real world with virtual objects, is increasingly becoming available as a teaching tool in medical education. The Microsoft HoloLens device allows operators to experience MR using a head-mounted device without interfering with their physical reality, stimulating a realistic learning experience using virtual objects. This project aimed to develop a MR anatomy teaching application with HoloLens for exploring the anatomy of the temporal bone. The educational application was developed from a multidisciplinary collaboration between undergraduate and postgraduate students across several academic disciplines with Medtronic, a medical technology company. 3D anatomical models were built using ZBrush and Blender, while the HoloLens1 application was developed using Windows 10, Visual Studio 2017, Unity and Mixed Reality Toolkit (MRTK). Modules developed within the application included a basic HoloLens tutorial, a virtual temporal bone with surgical anatomy landmarks and free drilling of the temporal bone. The basic tutorial allows the operator to adapt to the MR environment prior to exploring the anatomical landmarks of the 3D temporal bone. The free drilling of the temporal bone using vertex displacement and texture stretching replicates a real-time bone drilling experience and allows the operator to explore the anatomical relationship between different otological structures.