Physicians and engineers at Johns Hopkins and Walter Reed National Military Medical Center have developed a computer platform that provides rapid, real-time feedback before and during facial transplant surgery. The achievement may someday improve face-jaw-teeth alignment between donor and recipient.

Called the computer-assisted planning and execution (CAPE) system, the platform is first used to plan surgery once a donor has been identified for transplantation. Using information from CT scans, the donor’s anatomy is matched to the recipient’s anatomy in an effort to optimize form, or appearance, and function, such as chewing and breathing.

The preciseness of the technology will likely reduce the need for patients to undergo revision surgery, according to Chad Gordon, D.O., an assistant professor of plastic and reconstructive surgery at the Johns Hopkins University School of Medicine and co-director of the Multidisciplinary Adult Cranioplasty Center at Johns Hopkins.

A novel feature, known as real-time cephalometry (RTC), provides the surgeon with objective measurements and angles related to ideal jaw-teeth positions. The system also offers real-time visual feedback; the computer recalculates its movements as the donor's jaw-teeth segment shift during facial transplant inset.

The team performed donor-to-recipient face-jaw-teeth transplantation on two plastic models and two human cadavers using the CAPE system.