Faculty Practice · Mount Sinai Health System · Upper East Side, NYC
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Alfred Iloreta, MD Director · Endoscopic Skull Base Surgery
Research · Mixed reality

Surgery with X-ray vision.

Mixed reality headsets like HoloLens can project a patient's own imaging — carotid artery, cranial nerves, tumor margins — directly onto the surgical field. Dr. Iloreta's group is among the first to bring this into endoscopic sinus and skull base surgery, work that has been featured in national press.

Why it matters

Seeing what the endoscope can't show.

Endoscopic skull base surgery happens millimeters from the carotid artery, the optic nerve, and the brain. Conventional navigation displays that anatomy on a separate monitor — the surgeon glances away from the field to check position. Mixed reality changes the geometry of attention: a HoloLens headset overlays the navigation data onto the surgical view itself, so critical structures and tumor margins are visible exactly where they are.

The group's work spans pre-operative planning in virtual reality — rehearsing endoscopic corridors to the craniovertebral junction before the first incision — through intraoperative AR in lateral skull base procedures, and a field-defining scoping review mapping where AR/VR genuinely help in rhinology versus where the evidence is still thin.

Key publications

Selected papers.

  • Augmented and Virtual Reality Applications in Rhinology: A Scoping Review. The Laryngoscope, 2024. PubMed · DOI
  • The utility of augmented reality in lateral skull base surgery: A preliminary report. American Journal of Otolaryngology, 2021. PubMed
  • Virtual reality surgical planning for endoscopic endonasal approaches to the craniovertebral junction. American Journal of Otolaryngology, 2021. PubMed
In practice

From the lab to your operation.

This is not far-future speculation — AR-assisted visualization is part of how complex skull base cases are planned and performed at Mount Sinai today, layered on top of standard image-guided navigation in every case.

Questions about this research — or a case it could help? Reach out.

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