Mathematical modelling of tongue deformation during swallow in patients with head and neck cancer

ABSTRACT

Cancer localized to the tongue is often characterized by increased stiffness in the affected region. This stiffness affects swallow in a manner that is difficult to quantify in patients. A biomechanical model was developed to simulate the spatio-temporal deformation of the tongue during the pharyngeal phase of swallow in patients with cancer of the tongue base. The model involves finite element analysis (FEA) of a three-dimensional (3D) model of the tongue reconstructed from magnetic resonance images (MRI). The tongue tissue is assumed to be hyper-elastic. In order to examine the effects of tissue change (increased stiffness) due to the presence of cancer localized to the tongue base, various sections of the 3D geometry are modified to exhibit different elastic properties. Three cases are considered, representing the normal tongue, a tongue with early-stage cancer, and tongue with late-stage cancer. Early- and late-stage cancers are differentiated by the degree of stiffness within the base of tongue tissue. Analysis of the model suggests that healthy tongue has a maximum deformation of 9.38 mm, whereas tongues having mild cancer and severe cancer have a maximum deformation of 8.65 and 6.17 mm, respectively. Biomechanical modelling is a useful tool to explain and estimate swallowing abnormalities associated with tongue cancer and post-treatment characteristics.