arXiv subjects

Yohan Payan

Publications and source records attributed to Yohan Payan.

105 records · Page 6Linked to original sources

arXiv2006

Rigid Registration of Freehand 3D Ultrasound and CT-Scan Kidney Images

This paper presents a method to register a preoperative CT volume to a sparse set of intraoperative US slices. In the context of percutaneous renal puncture, the aim is to transfer a planning information to an intraoperative coordinate system. The spatial position of the US slices is measured by localizing a calibrated probe. Our method consists in optimizing a rigid 6 degree of freedom (DOF) transform by evaluating at each step the similarity between the set of US images and the CT volume. The images have been preprocessed in order to increase the relationship between CT and US pixels. Correlation Ratio turned out to be the most accurate and appropriate similarity measure to be used in a Powell-Brent minimization scheme. Results are compared to a standard rigid point-to-point registration involving segmentation, and discussed.

physics.med-ph↗

arXiv2006

A finite element study of the influence of the osteotomy surface on the backward displacement during exophthalmia reduction

Exophthalmia is characterized by a protrusion of the eyeball. The most frequent surgery consists in an osteotomy of the orbit walls to increase the orbital volume and to retrieve a normal eye position. Only a few clinical obser-vations have estimated the relationship between the eyeball backward dis-placement and the decompressed fat tissue volume. This paper presents a method to determine the relationship between the eyeball backward displace-ment and the osteotomy surface made by the surgeon, in order to improve ex-ophthalmia reduction planning. A poroelastic finite element model involving morphology, material properties of orbital components, and surgical gesture is proposed to perform this study on 12 patients. As a result, the osteotomy sur-face seems to have a non-linear influence on the backward displacement. More-over, the FE model permits to give a first estimation of an average law linking those two parameters. This law may be helpful in a surgical planning frame-work.

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arXiv2006

Comparison of linear and non-linear soft tissue models with post-operative CT scan in maxillofacial surgery

A Finite Element model of the face soft tissue is proposed to simulate the morphological outcomes of maxillofacial surgery. Three modelling options are implemented: a linear elastic model with small and large deformation hypothesis, and an hyperelastic Mooney-Rivlin model. An evaluation procedure based on a qualitative and quantitative comparison of the simulations with a post-operative CT scan is detailed. It is then applied to one clinical case to evaluate the differences between the three models, and with the actual patient morphology. First results shows in particular that for a "simple" clinical procedure where stress is less than 20%, a linear model seams sufficient for a correct modelling.

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arXiv2006

Physical modelling of the airflow-walls interactions to understand the sleep apnea syndrome

Sleep Apnea Syndrome (SAS) is defined as a partial or total closure of the patient upper airways during sleep. The term "collapsus" (or collapse) is used to describe this closure. From a fluid mechanical point of view, this collapse can be understood as a spectacular example of fluid-walls interaction. Indeed, the upper airways are delimited in their largest part by soft tissues having different geometrical and mechanical properties: velum, tongue and pharyngeal walls. Airway closure during SAS comes from the interaction between these soft tissues and the inspiratory flow. The aim of this work is to understand the physical phenomena at the origin of the collapsus and the metamorphosis in inspiratory flow pattern that has been reported during SAS. Indeed, a full comprehension of the physical conditions allowing this phenomenon is a prerequisite to be able to help in the planning of the surgical gesture that can be prescribed for the patients. The work presented here focuses on a simple model of fluid-walls interactions. The equations governing the airflow inside a constriction are coupled with a Finite Element (FE) biomechanical model of the velum. The geometries of this model is extracted from a single midsagittal radiography of a patient. The velar deformations induced by airflow interactions are computed, presented, discussed and compared to measurements collected onto an experimental setup.

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arXiv2006

Models for Planning and Simulation in Computer Assisted Orthognatic Surgery

Two aspects required to establish a planning in orthognatic surgery are addressed in this paper. First, a 3D cephalometric analysis, which is clini-cally essential for the therapeutic decision. Then, an original method to build a biomechanical model of patient face soft tissue, which provides evaluation of the aesthetic outcomes of an intervention. Both points are developed within a clinical application context for computer aided maxillofacial surgery.

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arXiv2006

Simulation of the Exophthalmia Reduction using a Finite Element Model of the Orbital Soft Tissues

This paper proposes a computer-assisted system for the surgical treatment of exophthalmia. This treatment is classically characterized by a de-compression of the orbit, by the mean of an orbital walls osteotomy. The plan-ning of this osteotomy consists in defining the size and the location of the de-compression hole. A biomechanical model of the orbital soft tissues and its in-teractions with the walls are provided here, in order to help surgeons in the definition of the osteotomy planning. The model is defined by a generic Finite Element poro-elastic mesh of the orbit. This generic model is automatically adapted to the morphologies of four patients, extracted from TDM exams. Four different FE models are then generated and used to simulate osteotomies in the maxillary or ethmoid sinuses regions. Heterogeneous results are observed, with different backwards movements of the ocular globe according to the size and/or the location of the hole.

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arXiv2006

A 3D Finite Element model of the face for simulation in plastic and maxillo-facial surgery

This paper introduces a new Finite Element biomechanical model of the human face, which has been developed to be integrated into a simulator for plastic and maxillo-facial surgery. The idea is to be able to predict, from an aesthetic and functional point of view, the deformations of a patient face, resulting from repositioning of the maxillary and mandibular bone structures. This work will complete the simulator for bone-repositioning diagnosis that has been developed by the laboratory. After a description of our research project context, each step of the modeling is precisely described: the continuous and elastic structure of the skin tissues, the orthotropic muscular fibers and their insertions points, and the functional model of force generation. First results of face deformations due to muscles activations are presented. They are qualitatively compared to the functional studies provided by the literature on face muscles roles and actions.

physics.med-ph↗

arXiv2006

Orbital and Maxillofacial Computer Aided Surgery: Patient-Specific Finite Element Models To Predict Surgical Outcomes

This paper addresses an important issue raised for the clinical relevance of Computer-Assisted Surgical applications, namely the methodology used to automatically build patient-specific Finite Element (FE) models of anatomical structures. From this perspective, a method is proposed, based on a technique called the Mesh-Matching method, followed by a process that corrects mesh irregularities. The Mesh-Matching algorithm generates patient-specific volume meshes from an existing generic model. The mesh regularization process is based on the Jacobian matrix transform related to the FE reference element and the current element. This method for generating patient-specific FE models is first applied to Computer-Assisted maxillofacial surgery, and more precisely to the FE elastic modelling of patient facial soft tissues. For each patient, the planned bone osteotomies (mandible, maxilla, chin) are used as boundary conditions to deform the FE face model, in order to predict the aesthetic outcome of the surgery. Seven FE patient-specific models were successfully generated by our method. For one patient, the prediction of the FE model is qualitatively compared with the patient's post-operative appearance, measured from a Computer Tomography scan. Then, our methodology is applied to Computer-Assisted orbital surgery. It is, therefore, evaluated for the generation of eleven patient-specific FE poroelastic models of the orbital soft tissues. These models are used to predict the consequences of the surgical decompression of the orbit. More precisely, an average law is extrapolated from the simulations carried out for each patient model. This law links the size of the osteotomy (i.e. the surgical gesture) and the backward displacement of the eyeball (the consequence of the surgical gesture).

physics.med-ph↗

arXiv2006

Prediction of tissue decompression in orbital surgery

Objective: A method to predict the relationships between decompressed volume of orbital soft tissues, backward displacement of globe after osteotomy, and force exerted by the surgeon, was proposed to improve surgery planning in exophthalmia reduction. Design: A geometric model and a poroelastic finite element model were developed, based on Computed Tomography scan data. Background: The exophthalmia is characterised by a protrusion of the eyeball. Surgery consists in an osteotomy of the orbit walls to decompress the orbital content. A few clinical observations ruling on an almost linear relationship between globe backward displacement and tissue decompressed volume are described in the literature. Methods: Fast prediction of decompressed volume is derived from the geometric model: a sphere in interaction with a cone. Besides, a poroelastic Finite Element model involving morphology, material properties of orbital components and surgical gesture was implemented. Results: The geometric model provided a better decompression volume estimation than the Finite Element model. Besides, the Finite Element model permitted to quantify the backward displacement, the surgical gesture and the stiffness of the orbital content. Conclusions: The preliminary results obtained for one patient, in accordance with the clinical literature, were relatively satisfying. An efficient aid for location and size of osteotomies was derived and seemed to be able to help in the surgery planning. Relevance: To our knowledge, this paper concerns the first biomechanical study of exophthalmia reduction. The approach permitted to improve the treatment of orbitopathy and can be used in a clinical setting.

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arXiv2006

Biomechanical models to simulate consequences of maxillofacial surgery

This paper presents the biomechanical finite element models that have been developed in the framework of the computer-assisted maxillofacial surgery. After a brief overview of the continuous elastic modelling method, two models are introduced and their use for computer-assisted applications discussed. The first model deals with orthognathic surgery and aims at predicting the facial consequences of maxillary and mandibular osteotomies. For this, a generic three-dimensional model of the face is automatically adapted to the morphology of the patient by the mean of elastic registration. Qualitative simulations of the consequences of an osteotomy of the mandible can thus be provided. The second model addresses the Sleep Apnoea Syndrome. Its aim is to develop a complete modelling of the interaction between airflow and upper airways walls during respiration. Dynamical simulations of the interaction during a respiratory cycle are computed and compared with observed phenomena.

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arXiv2006

Computer-aided hepatic tumour ablation : requirements and preliminary results

Surgical resection of hepatic tumours is not always possible, since it depends on different factors, among which their location inside the liver functional segments. Alternative techniques consist in local use of chemical or physical agents to destroy the tumour. Radio frequency and cryosurgical ablations are examples of such alternative techniques that may be performed percutaneously. This requires a precise localisation of the tumour placement during ablation. Computer-assisted surgery tools may be used in conjunction with these new ablation techniques to improve the therapeutic efficiency, whilst they benefit from minimal invasiveness. This paper introduces the principles of a system for computer-assisted hepatic tumour ablation and describes preliminary experiments focusing on data registration evaluation. To keep close to conventional protocols, we consider registration of pre-operative CT or MRI data to intra-operative echographic data.

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arXiv2006

A 3D dynamical biomechanical tongue model to study speech motor control

A 3D biomechanical dynamical model of human tongue is presented, that is elaborated in the aim to test hypotheses about speech motor control. Tissue elastic properties are accounted for in Finite Element Modeling (FEM). The FEM mesh was designed in order to facilitate the implementation of muscle arrangement within the tongue. Therefore, its structure was determined on the basis of accurate anatomical data about the tongue. Mechanically, the hypothesis of hyperelasticity was adopted with the Mooney-Rivlin formulation of the strain energy function. Muscles are modeled as general force generators that act on anatomically specified sets of nodes of the FEM structure. The 8 muscles that are known to be largely involved in the production of basic speech movements are modeled. The model and the solving of the Lagrangian equations of movement are implemented using the ANSYSTM software. Simulations of the influence of muscle activations onto the tongue shape are presented and analyzed.

physics.med-ph↗

arXiv2006

A simulator for maxillo-facial surgery integrating cephalometry and orthodontia

Objectives : This paper presents a new simulator for maxillo-facial surgery, that gathers the dental and the maxillo-facial analyses together into a single computer-assisted procedure. The idea is first to propose a repositioning of the maxilla, via the introduction of a 3D cephalometry, applied to a 3D virtual model of the patient's skull. Then, orthodontic data are integrated into this model, thanks to optical measurements of teeth plaster casts. Materials and Methods : The feasibility of the maxillo-facial demonstrator was first evaluated on a dry skull. To simulate malformations (and thus to simulate a "real" patient), the skull was modified and manually cut by the surgeon, in order to generate a given maxillo-facial malformation (with asymmetries in the sagittal, frontal and axial planes). Results : The validation of our simulator consisted in evaluating its ability to propose a bone repositioning diagnosis that will put the skull as it was in its original configuration. A first qualitative validation is provided in this paper, with a 1.5-mm error in the repositioning diagnosis. Conclusions : These results mainly validate the concept of a maxillo-facial numerical simulator that integrates 3D cephalometry and guarantees a correct dental occlusion.

physics.med-ph↗

arXiv2006

Influences of tongue biomechanics on speech movements during the production of velar stop consonants: a modeling study

This study explores the following hypothesis: forward looping movements of the tongue that are observed in VCV sequences are due partly to the anatomical arrangement of the tongue muscles and how they are used to produce a velar closure. The study uses an anatomically based 2D biomechanical tongue model. Tissue elastic properties are accounted for in finite-element modeling, and movement is controlled by constant-rate control parameter shifts. Tongue raising and lowering movements are produced by the model with the combined actions of the genioglossus, styloglossus and hyoglossus. Simulations of V1CV2 movements were made, where C is a velar consonant and V is [a], [i] or [u]. If V1 is one of the vowels [a] and [u], the resulting trajectories describe movements that begin to loop forward before consonant closure and continue to slide along the palate during the closure. This prediction is in agreement with classical data published in the literature. If V1 is vowel [i], we observe a small backward movement. This is also in agreement with some measurements on human speakers, but it is also in contradiction with the original data published by Houde (1967). These observations support the idea that the biomechanical properties of the tongue could be the main factor responsible for the forward loops when V1 is a back vowel. In the left [i] context, it seems that additional factors have to be taken into considerations, in order to explain the observations made on some speakers

physics.med-ph↗

arXiv2006

Computer assisted planning and orbital surgery: patient-related prediction of osteotomy size in proptosis reduction

BACKGROUND: Proptosis is characterized by a protrusion of the eyeball due to an increase of the orbital tissue volume. To recover a normal eyeball positioning, the most frequent surgical technique consists in the osteotomy of orbital walls combined with the manual loading on the eyeball. Only a rough clinical rule is currently available for the surgeons but it is useless for this technique. The first biomechanical model dealing with proptosis reduction, validated in one patient, has been previously proposed by the authors. METHODS: This paper proposes a rule improving the pre-operative planning of the osteotomy size in proptosis reduction. Patient-related poroelastic FE models combined with sensitivity studies were used to propose two clinical rules to improve the pre-operative planning of proptosis reduction. This poroelastic model was run on 12 patients. Sensitivity studies permitted to establish relationships between the osteotoemy size, the patient-related orbital volume, the decompressed tissue volume and the eyeball backward displacement. FINDINGS: The eyeball displacement and the osteotomy size were non-linearly related: an exponential rule has been proposed. The patient-related orbital volume showed a significant influence: a bi-quadratic analytical equation liking the osteotomy size, the orbital volume and the targeted eyeball protrusion has been established. INTERPRETATION: Two process rules derived from patient-related biomechanical FE models have been proposed for the proptosis reduction planning. The implementation of the process rules into a clinical setting is easy since only a sagittal radiography is required. The osteotomy size can be monitored using optical guided instruments.

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