Model-based prediction of mastication and swallowing outcomes for head and neck surgery

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Three-dimensional computer modeling of anatomical structures is an indispensable tool for surgical planning. An outstanding example is reconstruction of the jaws that is a complex geometric surgery. The microvascular fibular free flap is the workhorse for jaw reconstruction and is internationally pervasive for management of head/neck cancer, trauma and certain congenital defects. Geometric modeling methods have greatly improved the geometric (anatomical) predictability of these complex microvascular reconstructive procedures. They have also enabled the introduction of surgical innovations that reduce treatment time remarkably, from 2-4 years down to 12 weeks. The endpoint of these procedures is to improve functional outcomes of care. However, geometric modeling is static, and cannot predict functional outcomes such as how effectively a patient will chew or swallow. These outcomes enormously impact patient's quality of life, with swallowing deficits producing significant risk of morbidity and mortality due to aspiration. Thus, we propose creating dynamic, 3D, patient-specific computer models of oral and upper airway anatomy to predict functional mastication and swallowing outcomes for head and neck surgery. Our predictions will optimize functional outcomes through simulation and design of surgery, surgical guides, prostheses and implant installation. Our project will also provide the science and tools to enable dynamic biomechanical modeling used for other surgical procedures besides jaw reconstruction. We have assembled a world-class interdisciplinary team of investigators, collaborators and knowledge transfer users, with proven technical expertise, track record and ability to work together for this project.