Computational Modeling Shows Promise for Otolaryngology Use

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Key Points

• The hope is that CM will be able to guide surgeons to help prevent potential errors, increase patient safety, and predict outcomes in head and neck surgeries.
• CM could also be used to predict individual postoperative complication rates.
• Although promising, CM is still in the proof-of-concept stage, and studies have been prospective in nature and small in number.

Computer Modeling in Medical Research

Computational modeling (CM) is becoming an important part of medical research. This is especially true in the surgical specialties.

The NIBIB was established in December 2000 and focuses its work on integrating engineering with physical and life sciences. The institute funds more than 700 grants and the work of approximately 5,000 researchers around the country and internationally. “[The NIBIB is] working with researchers who are looking at computer models to not only systematically guide therapy, but also plan surgery and predict outcomes,” said Dr. Peng.

One of the areas under intensive research is the development and use of computer models for health research and clinical practice. “With modeling, you have the beauty of utilizing a platform where you can try an infinite number of scenarios that you can’t try in real life,” said Dr. Peng. “This helps you see what would be the optimal way to do the surgery or to have certain outcomes occur.”

Many of the models are still basic science, however. For example, recipients of one NIBIB grant are studying nasal surgery parameters. Currently, information is lacking on which biophysical variables best predict symptom changes, what ranges of objective values are normal, and how best to make a virtual surgery tool that can be used to develop the “correct” surgical plan for each patient. The investigators are hoping to better understand which indicators are important and meld them into a computer model that would help address these issues during pre-surgical planning.

Postoperative Applications

There is also developing evidence that CM will have an application in the postoperative world. A program could use patient-specific clinical information and in-surgery indicators to help develop risk measurements for postoperative complications.

With this information, the surgeon and the rest of the team might be able to better manage the patient, by taking certain precautions, and the healthcare resources, by deciding who is most likely to need an intensive care unit bed and planning accordingly. “Think of this as a medical equivalent of one of the tax programs you or your accountant uses,” said Dr. Peng. “You put in some numbers, [along with] additional information like your address and Social Security number. The model under the hood then asks the right questions and does the calculations for us.”—KU