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Ultrasound is a widely available imaging modality that can be used to precisely localize subcutaneous osseointegrated implants, allowing for minimally invasive percutaneous placement of an abutment under local or general anesthesia. Augmented reality (AR) solely based on image features is achievable in operating room conditions and its precision is compatible with otological surgery. The objective of this work was to evaluate the performance of a vision-based AR system for middle ear surgery in the operating room conditions. Nine adult