Tse Kwong Ming, Tan Long Bin, Lee Shu Jin, Lim Siak Piang, Lee Heow Pueh
Department of Mechanical Engineering, National University of Singapore, 9 Engineering Drive 1, Singapore 117576.
Department of Mechanical Engineering, National University of Singapore, 9 Engineering Drive 1, Singapore 117576.
Accid Anal Prev. 2015 Jun;79:13-32. doi: 10.1016/j.aap.2015.03.012. Epub 2015 Mar 17.
In spite of anatomic proximity of the facial skeleton and cranium, there is lack of information in the literature regarding the relationship between facial and brain injuries. This study aims to correlate brain injuries with facial injuries using finite element method (FEM). Nine common impact scenarios of facial injuries are simulated with their individual stress wave propagation paths in the facial skeleton and the intracranial brain. Fractures of cranio-facial bones and intracranial injuries are evaluated based on the tolerance limits of the biomechanical parameters. General trend of maximum intracranial biomechanical parameters found in nasal bone and zygomaticomaxillary impacts indicates that severity of brain injury is highly associated with the proximity of location of impact to the brain. It is hypothesized that the midface is capable of absorbing considerable energy and protecting the brain from impact. The nasal cartilages dissipate the impact energy in the form of large scale deformation and fracture, with the vomer-ethmoid diverging stress to the "crumpling zone" of air-filled sphenoid and ethmoidal sinuses; in its most natural manner, the face protects the brain. This numerical study hopes to provide surgeons some insight in what possible brain injuries to be expected in various scenarios of facial trauma and to help in better diagnosis of unsuspected brain injury, thereby resulting in decreasing the morbidity and mortality associated with facial trauma.
尽管面部骨骼与颅骨在解剖位置上相近，但文献中缺乏关于面部损伤与脑损伤之间关系的信息。本研究旨在使用有限元方法（FEM）将脑损伤与面部损伤相关联。模拟了九种常见的面部损伤冲击场景及其在面部骨骼和颅内大脑中的各自应力波传播路径。基于生物力学参数的耐受极限评估颅面骨骨折和颅内损伤。在鼻骨和颧上颌冲击中发现的最大颅内生物力学参数的总体趋势表明，脑损伤的严重程度与冲击位置与大脑的接近程度高度相关。据推测，中面部能够吸收相当多的能量并保护大脑免受冲击。鼻软骨以大规模变形和骨折的形式消散冲击能量，犁骨 - 筛骨将应力分散到充满空气的蝶窦和筛窦的“褶皱区”；面部以其最自然的方式保护大脑。这项数值研究希望为外科医生提供一些见解，了解在各种面部创伤情况下可能预期的脑损伤情况，并有助于更好地诊断未被怀疑的脑损伤，从而降低与面部创伤相关的发病率和死亡率。
