Isazadeh Amir Reza, Seikaly Hadi, Westover Lindsey, Aalto Daniel
Department of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine, University of Alberta, 6-129 Clinical Sciences Building, 11304 - 83 Ave NW, Edmonton, AB, T6G 2G3, Canada.
Institute for Reconstructive Sciences in Medicine (iRSM), Misericordia Community Hospital, Edmonton, Canada.
Int J Comput Assist Radiol Surg. 2024 Apr;19(4):735-746. doi: 10.1007/s11548-024-03062-w. Epub 2024 Jan 18.
Despite the significance and complexity of tongue reconstruction surgery, a digital tool for flap design is currently lacking. This study investigates the effectiveness of employing inverse finite element method (IFEM) for meticulously designing the geometric characteristics of harvested tissue (free flap) for tongue reconstruction.
In the case of an artificially simulated hemiglossectomy, IFEM algorithm was applied for algorithmic flap design. The method's effectiveness was evaluated by assessing flap deformation in a simplified virtual reconstruction, focusing on parameters such as stress, strain, and thickness.
The IFEM algorithm successfully generated an optimal flap design for the intended surgical removal. Analysis of the flap's overall surface area, deformation characteristics, and safety margins demonstrated the feasibility of the deformation. Notably, the stress and thickness assessments suggested that the flap's tension post-surgery would not adversely affect the mobility of the reconstructed tongue, suggesting a positive outcome for functional recovery.
The IFEM demonstrates significant potential as a tool for precise free flap design in tongue reconstruction surgeries. Its application could lead to improved surgical accuracy and better quality of life for patients undergoing such procedures.
尽管舌重建手术具有重要性和复杂性，但目前缺乏用于皮瓣设计的数字工具。本研究探讨采用逆有限元法（IFEM）精心设计用于舌重建的采集组织（游离皮瓣）几何特征的有效性。
在人工模拟半舌切除术的情况下，应用IFEM算法进行皮瓣设计。通过在简化的虚拟重建中评估皮瓣变形来评估该方法的有效性，重点关注应力、应变和厚度等参数。
IFEM算法成功为预期的手术切除生成了最佳皮瓣设计。对皮瓣的总表面积、变形特征和安全 margins 的分析证明了变形的可行性。值得注意的是，应力和厚度评估表明，术后皮瓣的张力不会对重建舌的活动度产生不利影响，提示功能恢复良好。
IFEM作为舌重建手术中精确游离皮瓣设计的工具具有巨大潜力。其应用可提高手术准确性，改善接受此类手术患者的生活质量。
