Bas Dit Nugues Manon, Lamassoure Leo, Rosi Giuseppe, Flouzat-Lachaniette Charles Henri, Khonsari Roman Hossein, Haiat Guillaume
CNRS, Univ Paris Est Creteil, Univ Gustave Eiffel, UMR 8208, MSME, 61, Avenue du Général de Gaulle, 94010, Créteil Cedex, France.
APHP, Hôpital Henri-Mondor, Service de Chirurgie Orthopédique, 94010, Créteil, France.
Ann Biomed Eng. 2025 Jan;53(1):59-70. doi: 10.1007/s10439-024-03596-9. Epub 2024 Aug 22.
Craniofacial osteotomies involving pterygomaxillary disjunction are common procedures in maxillofacial surgery. Surgeons still rely on their proprioception to determine when to stop impacting the osteotome, which is important to avoid complications such as dental damage and bleeding. Our group has developed a technique consisting in using an instrumented hammer that can provide information on the mechanical properties of the tissue located around the osteotome tip. The aim of this study is to determine whether a mallet instrumented with a force sensor can be used to predict the crossing of the osteotome through the pterygoid plates.
31 osteotomies were carried out in 16 lamb skulls. For each impact, the force signal obtained was analysed using a dedicated signal processing technique. A prediction algorithm based on an SVM classifier and a cost matrix was applied to the database.
We showed that the device could always detect the crossing of the osteotome, sometimes before its occurrence. The prediction accuracy of the device was 94.7%. The method seemed to be sensitive to the thickness of the plate and to crack apparition and propagation.
These results pave the way for the development of a per-operative decision support system in maxillofacial surgery.
涉及翼上颌离断的颅面截骨术是颌面外科常见的手术。外科医生仍依赖本体感觉来确定何时停止敲击骨凿，这对于避免诸如牙齿损伤和出血等并发症很重要。我们团队开发了一种技术，即使用一种装有仪器的锤子，它可以提供骨凿尖端周围组织力学特性的信息。本研究的目的是确定配备力传感器的槌是否可用于预测骨凿穿过翼突板的情况。
在16个羊颅骨上进行了31次截骨术。对于每次敲击，使用专用信号处理技术分析获得的力信号。将基于支持向量机分类器和代价矩阵的预测算法应用于数据库。
我们表明该装置总能检测到骨凿的穿过，有时甚至在其发生之前。该装置的预测准确率为94.7%。该方法似乎对板的厚度以及裂纹的出现和扩展敏感。
这些结果为颌面外科术中决策支持系统的开发铺平了道路。
