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Research on Human Facial Transplantation Using Integrated 3-D Imaging

Researchers led by Darren M. Smith, a plastic surgery resident at the University of Pittsburgh Medical Center (UPMC), have presented a novel study on the transplantation of the human face at the annual meeting of the Radiological Society of North America (RSNA).

The study was made by combining the 3D modeling methods used in Hollywood blockbusters with conventional medical imaging technology. The defects and injuries of the face are reconstructed using donor’s facial tissue to retain important life-sustaining functions including chewing, speaking and breathing.

Vijay S. Gorantla, Reconstructive Transplantation Program’s administrative medical director at UPMC, stated that this transplantation is for patients, who have had devastating injuries to the face with loss in the ability to eat, smell and social engagement, for which traditional treatments are not possible.

It is very essential to clearly specify and understand the defects and deficits in complex tissue, which normally occur due to highly serious facial injuries such as blast wounds, electric burns and trauma due to the accident in order to obtain both technical success and conduct an objective evaluation of the restoration of key functions after face transplantation. The medical imaging technology plays a key role in the complete spectrum of the facial surgery methods, which includes patient selecting process, surgery planning for donor and recipient, and postoperative analysis of recovering motor and sensory functions. The preparation steps for facial surgery includes creation of plastic or plaster templates based on 3D angiographic or CT images, dissection of mock cadaver for surgery planning of donor and recipient and examination using MRI techniques to provide supplemental data. A sophisticated 3D computer template is created by integrating the data from 3D CT angiography, CT, high-definition tractography and MRI. An assessment of the contours, facial structures, the underlying nerves, muscles and vessels and also on the extent of damage caused is performed by the researchers using the computer model.

Drs. Smith and Gorantla and Joseph Losee created a 3D model of neck and head anatomy of the patient using the created 3D computer model. The researchers with the 3D computer model superimposed the 3D model with a generic human face’s polygon mesh and customized the model to the recipient’s anatomy.

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