Gladilin Evgeny, Ivanov Alexander
German Cancer Research Centre, Heidelberg, Germany.
Comput Methods Biomech Biomed Engin. 2009 Jun;12(3):305-18. doi: 10.1080/10255840802529925.
Cranio-maxillofacial (CMF) surgery operations are associated with rearrangement of facial hard and soft tissues, leading to dramatic changes in facial geometry. Often, correction of the aesthetical patient's appearance is the primary objective of the surgical intervention. Due to the complexity of the facial anatomy and the biomechanical behaviour of soft tissues, the result of the surgical impact cannot always be predicted on the basis of surgeon's intuition and experience alone. Computational modelling of soft tissue outcome using individual tomographic data and consistent numerical simulation of soft tissue mechanics can provide valuable information for surgeons during the planning stage. In this article, we present a general framework for computer-assisted planning of CMF surgery interventions that is based on the reconstruction of patient's anatomy from 3D computer tomography images and finite element analysis of soft tissue deformations. Examples from our clinical case studies that deal with the solution of direct and inverse surgical problems (i.e. soft tissue prediction, inverse implant shape design) demonstrate that the developed approach provides a useful tool for accurate prediction and optimisation of aesthetic surgery outcome.
颅颌面（CMF）外科手术会导致面部软硬组织的重新排列，从而使面部几何形状发生显著变化。通常，改善患者的美观外观是手术干预的主要目标。由于面部解剖结构的复杂性以及软组织的生物力学行为，仅依靠外科医生的直觉和经验往往无法预测手术效果。利用个体断层扫描数据对软组织结果进行计算建模，并对软组织力学进行一致的数值模拟，可为外科医生在手术规划阶段提供有价值的信息。在本文中，我们提出了一个用于CMF手术干预计算机辅助规划的通用框架，该框架基于从3D计算机断层扫描图像重建患者解剖结构以及对软组织变形进行有限元分析。我们临床案例研究中处理直接和逆向手术问题（即软组织预测、逆向植入物形状设计）的示例表明，所开发的方法为准确预测和优化美容手术结果提供了一个有用的工具。
