Abstract
PURPOSE: Functional inoperability in advanced oral cancer is difficult to assess preoperatively. To assess functions of lips and tongue, biomechanical models are required. Apart from adjusting generic models to individual anatomy, muscle activation patterns (MAPs) driving patient-specific functional movements are necessary to predict remaining functional outcome. We aim to evaluate how volunteer-specific MAPs derived from surface electromyographic (sEMG) signals control a biomechanical face model. METHODS: Muscle activity of seven facial muscles in six volunteers was measured bilaterally with sEMG. A triple camera set-up recorded 3D lip movement. The generic face model in ArtiSynth was adapted to our needs. We controlled the model using the volunteer-specific MAPs. Three activation strategies were tested: activating all muscles [Formula: see text], selecting the three muscles showing highest muscle activity bilaterally [Formula: see text]-this was calculated by taking the mean of left and right muscles and then selecting the three with highest variance-and activating the muscles considered most relevant per instruction [Formula: see text], bilaterally. The model's lip movement was compared to the actual lip movement performed by the volunteers, using 3D correlation coefficients [Formula: see text]. RESULTS: The correlation coefficient between simulations and measurements with [Formula: see text] resulted in a median [Formula: see text] of 0.77. [Formula: see text] had a median [Formula: see text] of 0.78, whereas with [Formula: see text] the median [Formula: see text] decreased to 0.45. CONCLUSION: We demonstrated that MAPs derived from noninvasive sEMG measurements can control movement of the lips in a generic finite element face model with a median [Formula: see text] of 0.78. Ultimately, this is important to show the patient-specific residual movement using the patient's own MAPs. When the required treatment tools and personalisation techniques for geometry and anatomy become available, this may enable surgeons to test the functional results of wedge excisions for lip cancer in a virtual environment and to weigh surgery versus organ-sparing radiotherapy or photodynamic therapy.