CNRS, Laboratoire Modélisation et Simulation Multi Echelle, MSME UMR 8208 CNRS, Créteil Cedex, France.
Service de Chirurgie Plastique, reconstructrice, esthétique et Maxillo-faciale du Centre Hospitalier Universitaire Henri Mondor, Créteil, France.
Proc Inst Mech Eng H. 2021 Jul;235(7):838-845. doi: 10.1177/09544119211011824. Epub 2021 Apr 23.
Osteotomies are common surgical procedures used for instance in rhinoplasty and usually performed using an osteotome impacted by a mallet. Visual control being difficult, osteotomies are often based on the surgeon proprioception to determine the number and energy of each impact. The aim of this study is to determine whether a hammer instrumented with a piezoelectric force sensor can be used to (i) follow the displacement of the osteotome and (ii) determine when the tip of the osteotome arrives in frontal bone, which corresponds to the end of the osteotomy pathway. Seven New Zealand White rabbit heads were collected, and two osteotomies were performed on their left and right nasal bones using the instrumented hammer to record the variation of the force as a function of time during each impact. The second peak time was derived from each signal while the displacement of the osteotome tip was determined using video motion tracking. The results showed a significant correlation between and ( = 0.74), allowing to estimate the displacement of the osteotome through the measurement of The values of measured in the frontal bone were significantly lower than in the nasal bone (<10), which allows to determine the transition between the nasal and frontal bones when becomes lower than 0.78 its initial averaged value. Although results should be validated clinically, this technology could be used by surgeons in the future as a decision support system to help assessing the osteotome environment.
骨切开术是一种常见的外科手术，例如在鼻整形术中使用，通常使用骨凿和锤子进行操作。由于视觉控制困难，骨切开术通常基于外科医生的本体感觉来确定每次冲击的次数和能量。本研究旨在确定是否可以使用配备压电力传感器的锤子：(i) 跟踪骨凿的位移；(ii) 确定骨凿尖端到达额骨的时间，这对应于骨切开术路径的终点。收集了 7 个新西兰白兔头颅，并在其左右鼻骨上使用仪器化锤子进行了两次骨切开术，以记录每次冲击过程中力随时间的变化。从每个信号中得出第二峰值时间 ，并使用视频运动跟踪确定骨凿尖端的位移 。结果表明 与 之间存在显著相关性（ = 0.74），允许通过测量 来估计骨凿的位移。在额骨中测量的 值明显低于在鼻骨中（<10），这允许在 低于其初始平均值的 0.78 时确定从鼻骨到额骨的过渡。尽管结果需要临床验证，但这项技术未来可能被外科医生用作决策支持系统，以帮助评估骨凿环境。
