Buchaillard Stéphanie, Brix Muriel, Perrier Pascal, Payan Yohan
ICP/GIPSA-lab, UMR CNRS 5216, INP Grenoble, France.
Int J Med Robot. 2007 Sep;3(3):252-61. doi: 10.1002/rcs.142.
We studied the ability of a three-dimensional (3D) biomechanical model of the oral cavity to predict the consequences of tongue surgery on tongue movements, according to the size and location of the tissue loss and the nature of the flap used by the surgeon.
The core of our model consists of a 3D biomechanical model representing the tongue as a finite element structure with hexahedral elements and hyperelastic properties, in which muscles are represented by specific subsets of elements. This model is inserted in the oral cavity including jaw, palate and pharyngeal walls. Hemiglossectomy and large resection of the mouth floor are simulated by removing the elements corresponding to the tissue losses. Three kinds of reconstruction are modelled, assuming flaps with low, medium or high stiffness.
The consequences of these different surgical treatments during the activation of some of the main tongue muscles are shown. Differences in global 3D tongue shape and in velocity patterns are evaluated and interpreted in terms of their potential impact on speech articulation. These simulations have been shown to be efficient in accounting for some of the clinically observed consequences of tongue surgery.
Further improvements still need to be done before being able to generate patient-specific models easily and to decrease the computation time significantly. However, this approach should represent a significant improvement in planning tongue surgery systems and should be a very useful means of improving the understanding of muscle behaviour after partial resection.
我们研究了口腔三维（3D）生物力学模型根据组织缺损的大小和位置以及外科医生使用的皮瓣性质来预测舌手术对舌运动后果的能力。
我们模型的核心是一个3D生物力学模型，将舌表示为具有六面体单元和超弹性特性的有限元结构，其中肌肉由特定的单元子集表示。该模型被插入到包括颌骨、腭和咽壁的口腔中。通过去除与组织缺损相对应的单元来模拟半舌切除术和口底大切除术。假设皮瓣具有低、中或高刚度，对三种重建方式进行建模。
展示了在激活一些主要舌肌时这些不同手术治疗的后果。根据其对语音清晰度的潜在影响，评估并解释了整体3D舌形状和速度模式的差异。这些模拟已被证明在解释舌手术一些临床观察到的后果方面是有效的。
在能够轻松生成针对患者的模型并显著减少计算时间之前，仍需要进一步改进。然而，这种方法在舌手术规划系统中应代表着显著的进步，并且应该是增进对部分切除后肌肉行为理解的非常有用的手段。
