Division of Plastic Surgery, The Ohio State University Medical Center, Columbus, OH 43210, USA.
Proc Natl Acad Sci U S A. 2010 Jul 27;107(30):13222-7. doi: 10.1073/pnas.1001208107. Epub 2010 Jul 13.
Restoring normal function and appearance after massive facial injuries with bone loss is an important unsolved problem in surgery. An important limitation of the current methods is heuristic ad hoc design of bone replacements by the operating surgeon at the time of surgery. This problem might be addressed by incorporating a computational method known as topological optimization into routine surgical planning. We tested the feasibility of using a multiresolution three-dimensional topological optimization to design replacements for massive midface injuries with bone loss. The final solution to meet functional requirements may be shaped differently than the natural human bone but be optimized for functional needs sufficient to support full restoration using a combination of soft tissue repair and synthetic prosthetics. Topological optimization for designing facial bone tissue replacements might improve current clinical methods and provide essential enabling technology to translate generic bone tissue engineering methods into specific solutions for individual patients.
在大量面部损伤伴骨缺失的情况下，恢复正常的功能和外观是外科领域一个尚未解决的重要问题。目前方法的一个重要局限性是手术时由外科医生凭经验临时设计骨替代物。通过将一种称为拓扑优化的计算方法纳入常规手术规划，可能会解决这个问题。我们测试了使用多分辨率三维拓扑优化来设计伴骨缺失的大面积面中部损伤的替代物的可行性。为满足功能要求的最终解决方案可能与天然人骨的形状不同，但经过优化，足以满足功能需求，可充分利用软组织修复和合成假体来实现完全修复。用于设计面骨组织替代物的拓扑优化可能会改进当前的临床方法，并为将通用骨组织工程方法转化为针对个体患者的特定解决方案提供必要的使能技术。
