Abstract
Osteodistraction, a technique for new bone formation by the gradual separation of bony fragments, is a possible treatment for dysplasia of the maxillofacial skeleton. However, preoperative assessment of the optimal distraction direction, of the osteotomy trajectory, and of the influence of this procedure on the outlook of a patient, is difficult to assess preoperatively.
We report on an 3D image-based planning system for osteodistraction. Basically we adhere to a scene-based approach in which image derived visualizations and additional 3D structures are co-presented and manipulated. Osteotomy simulation with user-defined cutting trajectories, virtual distraction employing biomechanical models specific to the distraction type and evaluation tools based on a cephalometric reference frame, are available in our planning environment. According to the surgeon’s findings, different choices can be redone in order to optimize the therapy. To account for soft tissue implications, skin tissue deformations are calculated using a finite element elastic model based on tetrahedral elements.
We report on results in the field of unilateral mandibular distraction. A detailed overview of the planning procedure is given by a case study.
Chapter PDF
Similar content being viewed by others
References
Tavakoli, K., Steward, K.J., Poole, M.D.: Distraction Osteogenesis in Craniofacial Surgery: A Review. Annals of Plastic Surgery 40(Nr.1), 88–99 (1990)
McCarthy, J.G., Schreiber, J., Karp, N.: Lengthening of the human mandible by gradual distraction. Plast. Reconstr. Surg. 89, 1–8 (1992)
Lehman, J.A., Haas, A.J.: Surgical-orthodontic correction of transverse maxillary deficiency. Clinical Plastic Surgery 16, 749–775 (1989)
Stromberg, C., Holm, J.: Surgically assisted, rapid maxillary expansion in adults: a retrospective long-term follow-up study. Journal of Craniomaxillofacial Surgery 23, 222–227 (1995)
Polley, J.W., Figueroa, A.: Rigid External Distraction: Its Application in Cleft Maxillary Deformities. Plastic and Reconstructive Surgery 102(Nr. 5), 1360–1374 (1998)
Losken, H.W., Patterson, G.T., Lazarou, S.A., Whitney, T.: Planning Mandibular Distraction: a priliminary report. Cleft Palate-Craniofacial Journal 32(1), 71–76 (1995)
Cutting, C., Bookstein, F.L., Grayson, B., Fellingham, L., McCarthy, J.G.: Three-dimensional Computer-assisted Design of Craniofacial Surgical Procedures: Optimization and Interaction with Cephalometric and CT-based Models. Plastic and Reconstructive Surgery 77(6), 877–885 (1986)
Cutting, C., Grayson, B., McCarthy, J.G., Thorne, C., Khorramabadi, D., Haddad, B., Taylor, R.: A Virtual Reality System for Bone Fragment Positioning in Multisegment Craniofacial Surgical Procedures. Plastic and Reconstructive Surgery 102(7), 2436–2443 (1998)
Santler, G., Karcher, H., Gaggl, A., Schultes, G., Mossböck, R.: Advantage of Three-Dimensional Models in Intraoral Callus Distraction. Computer Aided Surgery 3(3), 99–107 (1998)
Fung, Y.C.: Biomechanics: Mechanical properties of Living Tissues, 2nd edn., ch. 7, pp. 242–320. Springer, Heidelberg (1993)
Teschner, M., Girod, S., Girod, B.: Optimization Approaches for Soft-Tissue Prediction in Craniofacial Surgery Simulation. In: Taylor, C., Colchester, A. (eds.) MICCAI 1999. LNCS, vol. 1679, pp. 1183–1190. Springer, Heidelberg (1999)
Koch, R.M., Gross, M.H., Carls, F.R., von Büren, D.F., Fankhauser, G., Parish, Y.: Simulating Facial Surgery Using Finite Element Methods. In: SIGGRAPH 19 96 Conference Proceedings, pp. 421–428 (1996)
Waters, K.: A physical model of facial tissue and muscle articulation derived from computertomography data. SPIE, vol. 1808. Visualization in Biomedical Computing, vol. 21, pp. 574–583 (1992)
Schutyser, F., Van Cleynenbreugel, J., Schoenaers, J., Marchal, G., Suetens, P.: A Simulation Environment for Maxillofacial Surgery Including Soft Tissue Implications. In: Taylor, C., Colchester, A. (eds.) MICCAI 1999. LNCS, vol. 1679, pp. 1210–1217. Springer, Heidelberg (1999)
ShapeSnatcher, http://www.eyetronics.com
Ferrant, M., Warfield, S.K., Guttmann, C.R.G., Mulkren, R.V., Jolesz, F.A., Kikinis, R.: 3D Image Matching Using a Finite Element Based Elastic Deformation Model. In: Taylor, C., Colchester, A. (eds.) MICCAI 1999. LNCS, vol. 1679, pp. 202–209. Springer, Heidelberg (1999)
Schutyser, F., Van Cleynenbreugel, J., Nadjmi, N., Schoenaers, J., Suetens, P.: 3D image-based planning for unilateral mandibular distraction. In: Proceedings 14th international congress and exhibition on computer assisted radiology and surgery (CARS 2000), San Francisco, USA, June 28 -July 1, pp. 899–904 (2000)
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2000 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Schutyser, F., Van Cleynenbreugel, J., Ferrant, M., Schoenaers, J., Suetens, P. (2000). Image-Based 3D Planning of Maxillofacial Distraction Procedures Including Soft Tissue Implications. In: Delp, S.L., DiGoia, A.M., Jaramaz, B. (eds) Medical Image Computing and Computer-Assisted Intervention – MICCAI 2000. MICCAI 2000. Lecture Notes in Computer Science, vol 1935. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-40899-4_104
Download citation
DOI: https://doi.org/10.1007/978-3-540-40899-4_104
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-41189-5
Online ISBN: 978-3-540-40899-4
eBook Packages: Springer Book Archive