Randomized crossover study of immersive planning in craniomaxillofacial trauma comparing virtual reality and workstation workflows

Preoperative planning for cranio-maxillofacial (CMF) trauma requires precise understanding of complex anatomy. Planning in CMF trauma benefits from advanced visualization and segmentation techniques. While conventional workstation-based software is established, it is often time-consuming and less intuitive. Virtual reality (VR) platforms offer stereoscopic visualization and intuitive spatial interaction with volumetric data and have demonstrated potential advantages in efficiency and user acceptance in previous studies. The aim of this study was to compare workflow efficiency and usability of a VR-based platform with workstation-based software for CMF trauma segmentation. In a randomized crossover study, 15 participants segmented five CMF trauma CT datasets using both platforms. Each case was segmented twice (once per platform) in randomized order with a one-week washout period. Segmentation time was recorded, and user experience assessed using the System Usability Scale (SUS). Statistical analysis used paired t-tests and Wilcoxon signed-rank tests. The VR platform completed segmentation significantly faster, with an average time reduction of 23 min (24%, p = 0.008). The SUS scores were higher for the VR platform; the VR platform exceeded the good usability threshold (73.0) while the workstation-based software scored below average (58.17). Participants rated the VR platform as less complex, easier to learn, and more intuitive. Both platforms received equivalent ratings for anatomical structure recognition and physical fatigue. VR-based segmentation demonstrated significant efficiency gains and favorable usability while maintaining equivalent anatomical visualization. These results suggest that immersive systems offer valuable benefits for CMF trauma planning.