3D surgical planning method for lower jaw osteotomies applied to facial feminization surgery - 18/07/24
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Highlights |
• | It is crucial to accurately predict the desired aesthetic outcome in facial feminization surgery to avoid asymmetries affecting the patient's self-perception. |
• | A slimmer lower jaw facial contour is one of the most used techniques in facial feminization surgery, and the underlying skeletal bone structure primarily influences this feature. |
• | The design of osteotomies itself is a field that deserves investigation and can represent a potential tool in 3D surgical planning, especially for this type of surgery. |
• | Non-linear regression curves can be used to model individual anatomy and generate desired osteotomy curves. |
Abstract |
Our proposed method uses a three-dimensional (3D) measurement approach that focuses mainly on the lower jaw from basal, lateral, and frontal views applied to the volumetric skull model derived from a computed tomography (CT) of the head. Likewise, we discuss the geometrical features and clinical considerations involved in the 3D biomodeling of the surgical osteotomy. The workflow that allowed this virtual planning to be developed was composed of medical imaging processing software, data extraction software from images, and statistical software that allows the creation and generation of curve-fitting (nonlinear regression) graphs from data. Thirty-two (32) anatomical points were positioned, sixteen (16) measurements were taken, and two-dimensional (2D) sketches in three views (frontal, lateral, and inferior) were generated to overlap in a 3D environment, which informed the cutting of the desired bone segments. Implementing a nonlinear regression curve-fitting on the contours of the original jaws allowed optimal planning of the osteotomy. Desired cutting shapes were extrapolated for the front view by third-order equations, while for the side and bottom views, log-normal distribution curves and second-order polynomial curves were used, respectively. The reduction in the mandibular volume was between 6.55 and 10.27 %, with two of the most important measurements related to vertical reduction in the lateral views and the difference to determine gonion reduction.
Le texte complet de cet article est disponible en PDF.Keywords : Facial feminization surgery, Osteotomies, 3D biomodeling, Virtual surgical planning, Lower jaw, Contouring
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Vol 15
Article 100164- août 2024 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.