Quantifying Tumor and Vasculature Deformations during Laryngoscopy

Area of Science:

• Surgical Oncology
• Medical Imaging
• Anatomy

Background:

• Head and neck surgery relies on preoperative imaging for tumor resection planning.
• Surgical instruments like retractors and scopes can cause substantial tissue deformation.
• This deformation compromises the accuracy of preoperative imaging as a surgical roadmap.

Purpose of the Study:

• To quantify tumor and vasculature deformation during diagnostic laryngoscopy for head and neck cancer.
• To evaluate the impact of anatomical registration on deformation.
• To assess the implications for surgical planning and intraoperative guidance.

Main Methods:

• Quantitative analysis of pre- and intra-operative imaging data.
• Measurement of tumor and vasculature displacement in patients with laryngeal and pharyngeal tumors.
• Comparison of deformation with and without registration to the hyoid bone.

Main Results:

• Mean tumor displacement of 1.02 cm and vasculature displacement of 0.99 cm were observed.
• Registration to the hyoid bone reduced tumor displacement to 0.67 cm but increased overall vasculature displacement.
• Significant deviations in critical structures highlight limitations of relying solely on preoperative imaging.

Conclusions:

• Significant intraoperative tissue deformation occurs in head and neck surgery.
• Preoperative imaging alone is insufficient for precise surgical guidance due to these deformations.
• Intraoperative landmarks or real-time imaging are crucial for improving surgical accuracy and outcomes.