Diffuse optical imaging maps arteries to improve oral surgery outcomes

Purdue University (West Lafayette, IN) startup Starfish Engineering LLC has developed a method to map arteries in the roof of the mouth to help avoid complications and improve outcomes in oral surgery.

The method, known as diffuse optical imaging, injects light to image arteries and lesions through the tissue in the roof of the mouth, creating a 3D map. Surgeons working in the area of the mouth use the greater palatine artery as a landmark, and need to know where it is to avoid damaging it or its surrounding nerves. But studies have shown that there can be a discrepancy of up to 4 mm between where surgeons believe the artery is and where it actually is, a disparity that can cause a variety of surgical complications and injuries.

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A potential serious complication is hemorrhage. Significant bleeding can occur if the greater palatine artery is severed, especially if the artery retracts into the bony canal, making it difficult to access. Most surgeons, therefore, justifiably avoid involving the entire range of possible locations of the greater palatine artery and surrounding area in the surgical field. However, because of significant individual variation, landmarks only provide a rough estimate of the actual location in a given patient. At present, there is no available device to accurately identify the location of the foramen and artery in an individual patient in real time during surgery, and is therefore an unmet clinical need.

This phantom that simulates biological tissue was 3D-printed to develop, test, and calibrate the diffuse optical imaging method.

The process, developed by Brian Bentz, Starfish Engineering's CEO and Kevin Webb, a professor of electrical and computer engineering at Purdue University, along with Vaibhav Gaind and Timothy C. Wu, can be used in periodontal and oral surgeries, sinus and ridge augmentations, greater palatine nerve block, soft tissue biopsies, dental implants, and wisdom teeth removal.

"The greater palatine artery is filled with blood, so it will absorb more photons. You can use that contrast in absorption to determine the location of that artery," Bentz says. The specificity of lesions could be improved with topical fluorescence or absorption contrast agents, he adds.

The red lines in this graphic show the imaged location of arteries simulated in a 3D-printed mouth phantom.

The results of the complex shapes can be displayed on a mobile device or a computer. The information can be used to make printed surgical guides that can be placed on the roof of the mouth to help during surgery. The method also can be useful in identifying operative and postoperative bleeding.

Starfish Engineering, which is still developing the technology, is seeking funding to build a prototype so that it can pursue testing in humans.

For more information, please visit engineering.purdue.edu/ece.