单侧完全性唇腭裂的三维有限元模型及口腔表面力学分析  

 The threedimensional finite element model of unilateral complete cleft lip and palate and mechanical analysis of the oral surfaces  

Authors: Qingqian Wei, Hao Liang, Jingyi Wang, Fei Chen, Yinyue Chen, Yiwei Liu, Haidong Li  

 摘要:

背景：腭裂是一种常见的口腔颌面部畸形，需要复杂的手术干预。在腭裂修复中，管理皮瓣张力对于避免并发症如皮瓣破裂和愈合障碍至关重要。此外，过度的皮瓣移动可能影响血液供应，进而影响术后效果。全面了解这些生物力学因素对手术成功至关重要。方法：利用CT扫描数据开发三维有限元模型，模拟手术条件下腭裂的生物力学行为。模型使用ANSYS Workbench及相关软件构建和分析，纳入骨、黏膜和肌肉的材料特性。计算应力和变形分布以评估手术切口点和皮瓣移动。结果：模型识别了手术切口上高张力和移动的关键区域，观察到的最大变形为3.9885 mm，应力集中在缝合线和皮瓣边缘。结果突出了易受机械应力影响的特定区域，这对优化手术策略至关重要。结论：本研究展示了三维有限元模型在预测腭裂手术修复过程中机械响应的潜力。研究结果为外科医生提供了宝贵的见解，以改进切口位置、皮瓣设计和缝合技术，从而减少张力并促进愈合。这种个性化方法可显著改善腭裂修复的手术效果并减少术后并发症。  

Abstract:

Background Cleft palate is a prevalent oral and maxillofacial malformation that requires complex surgical interventions. In cleft palate repair, managing flap tension is critical to avoid complications such as flap rupture and impaired healing. Additionally, excessive flap movement can compromise blood supply, affecting postoperative outcomes. A thorough understanding of these biomechanical factors is crucial for surgical success. Methods A threedimensional finite element model was developed using CT scan data to simulate the biomechanical behavior of the cleft palate under surgical conditions. The model was constructed and analyzed using ANSYS Workbench and related software, incorporating material properties of bone, mucosa, and muscle. Stress and deformation distributions were calculated to evaluate surgical incision points and flap movement. Results The model identified critical areas of high tension and movement along the surgical incisions on both oral and nasal surfaces. The maximum deformation observed was 3.9885 mm, with stress concentration points along the suture lines and flap edges. The results highlighted specific regions prone to mechanical stress, which are crucial for optimizing surgical strategies. Conclusion This study demonstrates the potential of a 3D finite element model in predicting mechanical responses of the cleft palate during surgical repair. The findings provide surgeons with valuable insights for improving incision placement, flap design, and suturing techniques to minimize tension and enhance healing. This personalized approach could significantly improve surgical outcomes and reduce postoperative complications in cleft palate repair.