Virtual tool to address facial appearance transfer in face transplantation

解决面部移植中面部外观转移的虚拟工具

• 批准号: 8239711
• 负责人: Bohdan Pomahac
• 金额: $ 36.18万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-06-01 至 2013-12-01
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8239711
• 关键词: Address; Adult; Affect; Age; Anxiety; Appearance; Archives; Blood Vessels; Clinical; Computer Simulation; Computers; Data; Decision Making; Deformity; Ethical Issues; Ethics; Face; Family; Female; Future; Gender; Head; Hospitals; Informed Consent; Injury; Lip structure; Modeling; Muscle; Nerve; Nose; Operative Surgical Procedures; Outcome; Patients; Persons; Procedures; Process; Research; Resolution; Scalp structure; Simulate; Skeleton; Skin; Structure; Testing; Tissue Donations; Tissues; Tooth structure; Transplantation; Transplanted tissue; Virtual Tool; Woman; base; bone; craniofacial; expectation; experience; facial transplantation; improved; male; prospective; soft tissue; three-dimensional modeling; tomography; tool; two-dimensional; virtual

DESCRIPTION (provided by applicant): Face transplantation is a promising experimental surgery for patients with severe facial disfigurement. In face transplantation, a severely disfigured Recipient receives a transplant of healthy facial tissues from a Donor. The transplanted tissues may include nose, lips, teeth, skin, bone, blood vessels, muscles and nerves, among others. A major ethical concern in face transplantation is the lack of understanding on how much of the facial appearance of the Donor is transferred to the Recipient (undesirable), and how much the Recipient looks after the surgery like he/she did before the disfigurement (desirable). These outcomes are defined as "appearance transfer" and "appearance persistence", respectively. Addressing these concerns is crucial for the future of face transplantation, because the prospect of appearance transfer may discourage Donor families to donate the facial tissues, and generate worry and anxiety in the Recipients. Unfortunately, these concerns cannot be addressed [with statistical significance] in real face transplantation Donors and Recipients, because there are so few in the world, and because [their identities are confidential]. This study proposes to perform virtual face transplantation (VFT) to test the hypothesis that appearance transfer from Donor to Recipient in face transplantation is low. 3D computer models of real human adult heads will be created from existing computer tomography data in the clinical archives of Brigham and Women's Hospital. 100 VFTs will be performed across these 3D models, and 20 independent Reviewers will evaluate the resemblance of post-transplant faces to Donors and Recipients. The Specific Aims are: 1. To estimate appearance transfer after VFT. Reviewers will assess whether each post-transplant face: (a) looks a lot like the Donor, (b) looks a little like the Donor, (c) does not look like the Donor, or (d) not sure. Large numbers of (a), (b), (c) or (d) answers respectively indicate: significant, moderate, low or inconclusive appearance transfer. 2. To estimate appearance persistence after VFT. Reviewers will assess whether each Post- transplant face: (a) looks a lot like the Recipient, (b) looks a little like the Recipient, (c) does not look like the Recipient, or (d) not sure. Large numbers of (a), (b), (c) or (d) answers respectively indicate: significant, low, moderate or inconclusive appearance persistence. 3. To determine if age and/or gender of the Recipient of VFT affect appearance transfer and/or persistence. VFTs will be performed in Recipients grouped by gender (male or female) and age (20- 29, 30-39, 40-49, 50-59 and 60-69 years old), and it will be determined whether appearance transfer and persistence depend on the age and/or gender of the Recipient. PUBLIC HEALTH RELEVANCE: Face transplantation has emerged as a powerful approach to treat the most severe cases of facial deformity. However, a major ethical issue in face transplantation research is the transfer of facial appearance from the Donor to the Recipient, which heavily influences the informed consent process of the Donor's family, may negatively affect facial tissue donation and generates worry and anxiety in the Recipient. [Addressing this ethical issue is critical for the future of face transplantation].

描述(申请人提供)：面部移植是一种很有前途的实验性手术，适用于严重面部毁容的患者。在面部移植中，严重毁容的接受者会从捐赠者那里接受健康的面部组织移植。移植的组织可能包括鼻子、嘴唇、牙齿、皮肤、骨骼、血管、肌肉和神经等。面部移植的一个主要伦理问题是缺乏对捐赠者面部外观有多少转移到接受者身上的理解(不受欢迎)，以及接受者在手术后看起来像他/她毁容前的样子(受赠者是可取的)。这些结果分别被定义为“外貌转移”和“外貌持久性”。解决这些问题对面部移植的未来至关重要，因为外表转移的前景可能会阻止捐赠者家庭捐赠面部组织，并在接受者中引发担忧和焦虑。不幸的是，在真实的面部移植捐赠者和接受者中，这些担忧无法[以统计学意义]得到解决，因为世界上很少有人，而且因为[他们的身份是保密的]。本研究提出进行虚拟人脸移植(VFT)，以验证面部移植中供者与受者之间的容貌传递率较低的假设。根据布里格姆妇女医院临床档案中现有的计算机断层扫描数据，将创建真实成人头部的3D计算机模型。将在这些3D模型上进行100次VFT，20名独立审查者将评估移植后面部与捐赠者和接受者的相似性。具体目的是：1.评估VFT后的外貌迁移。评价者将评估移植后的每一张脸：(A)看起来很像捐赠者，(B)看起来有点像捐赠者，(C)看起来不像捐赠者，或者(D)不确定。大量的(A)、(B)、(C)或(D)答案分别表示：显著、中等、较低或不确定的外表迁移。2.评估VFT后的外观持续性。评价者将评估移植后的每一张脸：(A)看起来很像接受者，(B)看起来有点像接受者，(C)看起来不像接受者，或者(D)不确定。大量的(A)、(B)、(C)或(D)答案分别表明：显著的、低的、中等的或不确定的外表坚持。3.确定VFT接受者的年龄和/或性别是否影响外表转移和/或持久性。VFTS将按性别(男性或女性)和年龄(20-29岁、30-39岁、40-49岁、50-59岁和60-69岁)分组进行，并将确定容貌转移和持久性是否取决于接受者的年龄和/或性别。 公共卫生相关性：面部移植已经成为治疗最严重的面部畸形病例的一种强有力的方法。然而，面部移植研究中的一个主要伦理问题是面部外观从捐赠者转移到接受者身上，这严重影响了捐赠者家人的知情同意过程，可能会对面部组织捐赠产生负面影响，并在接受者中产生担忧和焦虑。[解决这一伦理问题对脸部移植的未来至关重要]。

项目成果

Facial appearance transfer and persistence after three-dimensional virtual face transplantation.

• DOI: 10.1097/prs.0b013e3182a0143b
• 发表时间: 2013-10
• 期刊: Plastic and reconstructive surgery
• 影响因子: 3.6
• 作者: Chandawarkar AA;Diaz-Siso JR;Bueno EM;Jania CK;Hevelone ND;Lipsitz SR;Caterson EJ;Mukundan S Jr;Pomahac B
• 通讯作者: Pomahac B