Maxillofacial Diagnosis & AI

Robot assisted surgery has become more common, along with the question of whether a robot will ultimately replace the consultant.

Science fiction films have often shown patients being diagnosed and treated in a spaceship’s automated medical system. The issues neatly identified and curative surgery provided.

In the real world, advances are being made in diagnosis using AI. Analysis of skin cancer lesions via image recognition is a fair example and others will follow suit.

In March 2023, a team of researchers decided to apply the principle to maxillofacial fracture detection. Evaluating the ability of neural networks to identify hidden fractures.

A Dedicated Study

The researchers used a convolutional neural network, a type of artificial intelligence often applied to analyze imagery. In this case, the images were several thousand facial CT scans, with and without fractures.

Most were used to “train” the AI, a small sample compared to other medical areas. With the training dataset in place, around 150 CT scans were tried to validate the system’s ability to detect fractures.

Bearing in mind this had to cope with frontal, midface, or mandible fractures and had little experience, the outcome was not bad. Around a 70% success rate, depending on the exact set up of the neural network.

One downside was an inability to provide a precise location for the fractures, regardless of the type of injury being studied.

The Future – Or Not

The rate of facial fracture identification and inability to confirm location are clearly not appropriate to need, or as good as input from an experienced clinician.

There is an argument that the research has shown potential, when skin cancer identification was no better in the early stages. We should however remember that no medical AI analysis has yet matched consultant skills.

Even if this were possible in an identification sense, treatment involves more. Optimal management of maxillofacial fractures requires going beyond accurate diagnosis.

Deciding whether exploratory surgery, or immediate intervention are appropriate require experience. Whatever form of treatment is chosen comes from a subtle mix of learning and an ability to see outcome.

Maxillofacial fractures can arise from traffic accidents, falls from heights, work related accidents, blast damage. The facial injuries will not be alone, comprehensive medical understanding is needed.

As much as the idea of robot doctors seems fascinating, for a complex field such as maxillofacial care, this still seems decades away.

Where AI Can Help

Microsoft co-founder Bill Gates recently called AI the most important technological advance in decades. He believes the field will change health care, particularly “in countries where people never get to see a doctor.”

Whilst robot doctors in a literal sense may be for another lifetime, Bill Gates point is important. AI will be valuable for analysing health issues in underserved areas, often remotely.

A few years down the road, this can help people who would otherwise be left disfigured, or with loss of function, due to lack of treatment for facial trauma.

A reminder of how grateful we should be to live in a city with exceptional medical facilities and consultants. Not everyone is so fortunate.