IMPROVING TREATMENT OUTCOMES FOR PATIENTS WITH FACIAL DEFORMITY USING 3D IMAGING

使用 3D 成像改善面部畸形患者的治疗效果

• 批准号: 7470738
• 负责人: Lucia H Cevidanes
• 金额: $ 12.67万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-08-01 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7470738
• 关键词: 3-Dimensional; Affect; Agreement; Area; Cephalic; Class; Clinical Research; Clinical assessments; Complex; Computer Assisted; Databases; Deformity; Development; Diagnosis; Dose; Equipment; Face; Feedback; Goals; Gold; Growth; Head; Human; Image; Image Analysis; Individual; Intake; Jaw; Left; Location; Mandible; Measures; Methods; Modality; Modeling; Movement; Observational Study; Operative Surgical Procedures; Outcome; Patient Care; Patients; Procedures; Radiation; Range; Research; Research Design; Research Personnel; Rotation; Side; Simulate; Skeletal system; Spiral Computed Tomography; Standards of Weights and Measures; Structure; Surface; Surgeon; Techniques; Three-Dimensional Image; Three-Dimensional Imaging; Time; Training; Treatment outcome; Validation; Work; cone-beam computed tomography; cost; craniofacial; dentofacial; digital imaging; improved; maxillofacial; multidisciplinary; orthognathic; parent grant; patient oriented; programs; prospective; response; simulation; skull base; soft tissue; three-dimensional modeling; tool; treatment planning; two-dimensional

DESCRIPTION (provided by applicant): Surgical correction of a craniofacial anomaly or dentofacial deformity is a complex procedure, particularly in patients with asymmetries. Even with the focus on post-surgical assessments of hard and soft tissue over the past decades, there are critical areas, such as maxillomandibular rotations and condylar/ramus resorbtion, that can not be evaluated with two-dimensional methods. The objectives of this prospective observational study that incorporates three-dimensional imaging (3-D) techniques are to characterize asymmetries more precisely prior to surgery, quantify areas of instability following facial surgical procedures, and improve pre-operative surgical planning. Since asymmetries are particularly difficult to ascertain and treatment plan, the agreement between clinical assessment of asymmetry location and its 3D characterization will be evaluated. In the 3D characterization, the surface distances between the 3-D models of the "affected" side of the mandible and the reflected mirror image of the "unaffected" side will be used to anatomically locate and estimate the asymmetry with two different mirroring techniques. An ancillary question is whether providing this information to surgeons alters the approach to the surgical correction. Surgeons will be trained in the use of 3D surgical simulation and the actual surgical outcome compared to the surgical simulation as one aspect of the validation of this method. In addition, this project will quantitatively assess 3D displacement and rotations of the jaws following orthognathic surgery for correction of asymmetry and Class III skeletal deformities. Voxel-wise rigid registration of the 3D cranial base surfaces will be used to avoid observer-dependent superimposition. The proposed work is multidisciplinary - incorporating treatment of craniofacial and dentofacial deformities, clinical research design and computer imaging. The combination of better planning of surgical treatment and identification of factors that contribute to the most successful treatment has great potential to improve treatment for some of the most difficult facial problems and dysmorphisms in the cranio-maxillofacial region. Involvement in these studies will enhance the candidate's prior training in cranio-maxillofacial problems and 3D imaging, while equipping her with tools to perform meaningful studies centered around patient oriented clinical research.

描述（由申请人提供）：颅面异常或牙面畸形的手术矫正是一个复杂的过程，特别是对于不对称的患者。尽管过去几十年来重点关注硬组织和软组织的术后评估，但仍有一些关键区域，例如上颌旋转和髁突/升支吸收，无法使用二维方法进行评估。这项结合了三维成像 (3-D) 技术的前瞻性观察研究的目的是在手术前更精确地表征不对称性，量化面部手术后不稳定的区域，并改进术前手术计划。由于不对称性特别难以确定和制定治疗计划，因此将评估不对称性位置的临床评估与其 3D 表征之间的一致性。在 3D 表征中，下颌骨“受影响”侧的 3-D 模型与“未受影响”侧的反射镜像之间的表面距离将用于通过两种不同的镜像技术在解剖学上定位和估计不对称性。一个附带问题是，向外科医生提供这些信息是否会改变手术矫正的方法。外科医生将接受使用 3D 手术模拟以及与手术模拟进行比较的实际手术结果的培训，作为验证该方法的一方面。此外，该项目还将定量评估正颌手术后颌骨的 3D 位移和旋转，以矫正不对称和 III 类骨骼畸形。 3D 颅底表面的体素刚性配准将用于避免依赖于观察者的叠加。拟议的工作是多学科的——包括颅面和牙面畸形的治疗、临床研究设计和计算机成像。更好地规划手术治疗和识别有助于最成功治疗的因素相结合，对于改善颅颌面部区域一些最困难的面部问题和畸形的治疗具有巨大的潜力。参与这些研究将增强候选人在颅颌面问题和 3D 成像方面的先前培训，同时为她提供以患者为中心的临床研究开展有意义的研究的工具。