PhotoThe first successful face transplant was carried out in 2008. In the future, doctors say this delicate surgery will be improved through the use of an innovative computer platform.

Researchers at Johns Hopkins and Walter Reed National Military Medical Center worked to build a computer system that provides real-time feedback before and during facial transplant surgery, with the goal of improving face-jaw-teeth alignment between donor and recipient.

Since the first surgery seven years ago, there have been nearly 30 more, during which the surgeons had to rely of visual judgment in the jaw alignment. While these operations have been pretty amazing in and of themselves, the current methods can leave patients with some undesired residual deformities and abnormalities in function.

More successful, less costly

With the assistance of a computer, doctors may be less likely to misalign the new set of bones, jaw, and teeth. Doctors believe the new system could make these operations more successful, less costly, and more accessible to a wider selection of patients who might benefit from them.

To date, the new platform has been tested in mock surgeries performed on plastic models and human cadavers. Called the computer-assisted planning and execution (CAPE) system, the platform is first used to help plan surgery once a donor has been identified for transplantation.

The surgeons use data from CT scans to match the donor’s anatomy to the recipient’s. It syncs up form and appearance, as well as more subtle functions, like chewing and breathing.

The execution portion of the system’s name refers to the technology used during the surgery that provides the surgeon with precise measurements and angles related to ideal jaw-teeth positions. The surgical team also gets instantaneous visual feedback in the operating room.

Unprecedented visual data

“Every time the donor’s jaw-teeth segment moves during facial transplant inset, the computer recalculates its movements in comparison to the face transplant recipient, meaning the surgical team can have unprecedented visual data in achieving ideal alignment of the face, jaw and teeth,” said Chad Gordon, assistant professor of plastic and reconstructive surgery at the Johns Hopkins University School of Medicine.

He says because the technology is so precise, a patient is much less likely to need to undergo additional corrective operations, which is the case now.

People with severe facial burns or trauma may be candidates for facial transplants, whereas in the past their only option was facial constructive surgery.

The first U.S. face transplant was done at the Cleveland Clinic in 2008, when surgeons completed a near-total face transplant for a woman with severe facial disfigurement from a gunshot wound.

According to the Clinic, the patient regained her ability to eat, smell, and open and close her eyes, as well as her ability to express emotion.

While doctors are excited about the new technology, its practical use may be years away, since it must go through a series of clinical trials. Meanwhile, the research team that developed it has applied for eight patents in connection with it.

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