In vivo nerve identification in head and neck surgery using diffuse reflectance spectroscopy

Area of Science:

• Surgical Innovation
• Biomedical Optics
• Medical Technology

Background:

• Nerve identification in head and neck surgery is crucial for preventing damage.
• Current methods rely on anatomy, appearance, and electromyography (EMG), with up to 50% nerve damage in difficult cases.
• Optical techniques offer a novel approach to enhance nerve identification.

Purpose of the Study:

• To evaluate the potential of diffuse reflectance spectroscopy (DRS) and fluorescence spectroscopy (FS) for intraoperative nerve identification.
• To assess the accuracy of optical techniques in distinguishing nerves from surrounding tissues.

Main Methods:

• Performed 212 intraoperative DRS/FS measurements on small nerve branches (1-3 mm) and adjacent tissues (adipose, muscle, fat) during 11 surgeries.
• Utilized quantified concentrations of optical absorbers and scattering parameters for tissue identification.

Main Results:

• Significant differences (<0.05) in optical parameters were observed between different tissues.
• A k-Nearest Neighbor classification model achieved 100% sensitivity and 83% specificity (91% accuracy) in identifying nerves.

Conclusions:

• DRS and FS show potential as effective intraoperative tools for distinguishing nerves from adjacent tissues.
• This optical approach could improve surgical safety and reduce nerve damage during head and neck procedures.