State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
PLoS One. 2018 Jun 28;13(6):e0199964. doi: 10.1371/journal.pone.0199964. eCollection 2018.
For better outcomes of the primary correction of cleft lip nasal deformity, it is important to clarify the specific morphological and biomechanical consequences of major surgical maneuvers during cleft lip nose correction. In this study, a finite element model was established basing on the micro-MRI imaging of an infant specimen with unilateral complete cleft lip deformity. Alar base adduction was simulated as a medially-directed force on the lateral crus (F1); columella straightening was simulated as a laterally-directed force on the medial crus (F2); and nasal tip enhancement was simulated as an anteriorly-directed force on the intermediate crus (F3). The deformation and stress distribution consequent to each force vector or different force combinations were analyzed in details. Our biomechnical analyses suggested that W\when loaded alone, the three forces generated disparate morphological changes. The combination of different force loadings generated obviously different outcomes. F3 generated the most intensive stress when compared to F1 and F2. When F2 was loaded on top of F1-F3 combination, it further relieved nasal deviation without incurring significant increase in stress. Our simulation suggested that alar base adduction, columella straightening, and nasal tip elevation should all be included in a competent cleft lip nose correction.
为了获得更好的唇裂鼻畸形初次矫正效果，明确唇裂鼻矫正过程中主要手术操作的具体形态学和生物力学后果非常重要。本研究基于单侧完全性唇裂畸形婴儿标本的 micro-MRI 成像，建立了有限元模型。模拟鼻翼基底内收作为向外侧脚施加的内侧向力（F1）；鼻中隔挺直模拟为向内侧脚施加的外侧向力（F2）；鼻尖增强模拟为向中间脚施加的前向力（F3）。详细分析了每个力向量或不同力组合作用下的变形和应力分布。我们的生物力学分析表明，当单独加载时，三个力产生不同的形态变化。不同力加载的组合产生明显不同的结果。与 F1 和 F2 相比，F3 产生的应力最大。当 F2 加载在 F1-F3 组合之上时，它进一步减轻了鼻偏曲，而不会导致应力显著增加。我们的模拟表明，鼻翼基底内收、鼻中隔挺直和鼻尖抬高都应该包含在有能力的唇裂鼻矫正中。
