1
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Al-Zanoon N, Cummine J, Jeffery CC, Westover L, Aalto D. The effect of simulated radiation induced fibrosis on tongue protrusion. Biomech Model Mechanobiol 2024:10.1007/s10237-024-01860-4. [PMID: 38869655 DOI: 10.1007/s10237-024-01860-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 05/14/2024] [Indexed: 06/14/2024]
Abstract
Radiation therapy (RT) is an important adjuvant and primary treatment modality for head and neck cancers. A severe side effect of RT is fibrosis or scarring of muscle tissues of the oral cavity including the tongue. Previous studies have demonstrated that increased radiation doses to the oral cavity structures have led to decrements in function, hypothesized to result from changes in muscle tissue properties that affect the tongue's function. To understand the complex relationship between tongue muscle fibrosis and tongue function, the current study used a virtual biomechanical model of the tongue. Fibrosis parameters including density (high, low), area (large, small) and location (946 node centres) were systematically varied in the model to test its impact on a target tongue tip motion (protrusion). The impact of fibrosis lesion parameters on three directional components of the tip (anterior-inferior, lateral-medial, and superior-inferior) were analyzed using multi linear regression models. Increases in density and area of fibrosis significantly predicted tongue protrusion movements compared to baseline. In the anterior-posterior direction, reductions in the tongue protrusion were observed. In the inferior-superior direction, the tongue height remained above baseline for the majority of cases. In the lateral-medial direction, ipsilateral deviations were observed. The location of fibrosis modulated these three main effects by either amplifying the observed effect or minimizing it. The findings support the hypothesis that changes in muscle tissue properties because of fibrosis impact tongue function. Increases in density and area of fibrosis impact key muscles in the target motion. The range of modulating effects of the lesion location (i.e., either amplifying or minimizing certain impact patterns) highlights the intricacy of tongue anatomy/soft tissue biomechanics and may suggest that lesions in any location will compromise the tongue's movement.
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Affiliation(s)
- Noor Al-Zanoon
- Department of Communication Sciences and Disorders, University of Alberta, Rehabilitation Medicine, Edmonton, AB, Canada.
| | - Jacqueline Cummine
- Department of Communication Sciences and Disorders, University of Alberta, Rehabilitation Medicine, Edmonton, AB, Canada
| | - Caroline C Jeffery
- Department of Communication Sciences and Disorders, University of Alberta, Rehabilitation Medicine, Edmonton, AB, Canada
- Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Lindsey Westover
- Department of Biomedical Engineering, Faculty of Engineering, University of Alberta, Edmonton, AB, Canada
- Department of Mechanical Engineering, Faculty of Engineering, University of Alberta, Edmonton, AB, Canada
| | - Daniel Aalto
- Department of Communication Sciences and Disorders, University of Alberta, Rehabilitation Medicine, Edmonton, AB, Canada
- Institute for Reconstructive Sciences in Medicine (iRSM), Misericordia Community Hospital, Edmonton, AB, Canada
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2
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Isazadeh AR, Seikaly H, Westover L, Aalto D. Algorithmically designed flaps in tongue reconstruction: a feasibility analysis. Int J Comput Assist Radiol Surg 2024:10.1007/s11548-024-03062-w. [PMID: 38236478 DOI: 10.1007/s11548-024-03062-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 01/05/2024] [Indexed: 01/19/2024]
Abstract
PURPOSE Despite the significance and complexity of tongue reconstruction surgery, a digital tool for flap design is currently lacking. This study investigates the effectiveness of employing inverse finite element method (IFEM) for meticulously designing the geometric characteristics of harvested tissue (free flap) for tongue reconstruction. METHODS In the case of an artificially simulated hemiglossectomy, IFEM algorithm was applied for algorithmic flap design. The method's effectiveness was evaluated by assessing flap deformation in a simplified virtual reconstruction, focusing on parameters such as stress, strain, and thickness. RESULTS The IFEM algorithm successfully generated an optimal flap design for the intended surgical removal. Analysis of the flap's overall surface area, deformation characteristics, and safety margins demonstrated the feasibility of the deformation. Notably, the stress and thickness assessments suggested that the flap's tension post-surgery would not adversely affect the mobility of the reconstructed tongue, suggesting a positive outcome for functional recovery. CONCLUSION The IFEM demonstrates significant potential as a tool for precise free flap design in tongue reconstruction surgeries. Its application could lead to improved surgical accuracy and better quality of life for patients undergoing such procedures.
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Affiliation(s)
- Amir Reza Isazadeh
- Department of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine, University of Alberta, 6-129 Clinical Sciences Building, 11304 - 83 Ave NW, Edmonton, AB, T6G 2G3, Canada
| | - Hadi Seikaly
- Institute for Reconstructive Sciences in Medicine (iRSM), Misericordia Community Hospital, Edmonton, Canada
- Division of Otolaryngology, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Lindsey Westover
- Department of Mechanical Engineering, Faculty of Engineering, University of Alberta, Edmonton, Canada
| | - Daniel Aalto
- Department of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine, University of Alberta, 6-129 Clinical Sciences Building, 11304 - 83 Ave NW, Edmonton, AB, T6G 2G3, Canada.
- Institute for Reconstructive Sciences in Medicine (iRSM), Misericordia Community Hospital, Edmonton, Canada.
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3
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Alvarez P, El Mouss M, Calka M, Belme A, Berillon G, Brige P, Payan Y, Perrier P, Vialet A. Predicting primate tongue morphology based on geometrical skull matching. A first step towards an application on fossil hominins. PLoS Comput Biol 2024; 20:e1011808. [PMID: 38252664 PMCID: PMC10833839 DOI: 10.1371/journal.pcbi.1011808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 02/01/2024] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
As part of a long-term research project aiming at generating a biomechanical model of a fossil human tongue from a carefully designed 3D Finite Element mesh of a living human tongue, we present a computer-based method that optimally registers 3D CT images of the head and neck of the living human into similar images of another primate. We quantitatively evaluate the method on a baboon. The method generates a geometric deformation field which is used to build up a 3D Finite Element mesh of the baboon tongue. In order to assess the method's ability to generate a realistic tongue from bony structure information alone, as would be the case for fossil humans, its performance is evaluated and compared under two conditions in which different anatomical information is available: (1) combined information from soft-tissue and bony structures; (2) information from bony structures alone. An Uncertainty Quantification method is used to evaluate the sensitivity of the transformation to two crucial parameters, namely the resolution of the transformation grid and the weight of a smoothness constraint applied to the transformation, and to determine the best possible meshes. In both conditions the baboon tongue morphology is realistically predicted, evidencing that bony structures alone provide enough relevant information to generate soft tissue.
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Affiliation(s)
- Pablo Alvarez
- Sorbonne Université, Institut des Sciences du Calcul et des Données, Paris, France
- Univ. Grenoble Alpes, CNRS, Grenoble INP, TIMC, Grenoble, France
| | - Marouane El Mouss
- Sorbonne Université, Institut des Sciences du Calcul et des Données, Paris, France
| | - Maxime Calka
- Sorbonne Université, Institut des Sciences du Calcul et des Données, Paris, France
| | - Anca Belme
- Sorbonne Université, Institut des Sciences du Calcul et des Données, Paris, France
- Sorbonne Université, Institute Jean Le Rond d’Alembert, UMR 7190, Paris, France
| | - Gilles Berillon
- Muséum national d’Histoire naturelle, UMR 7194 - Histoire naturelle de l’Homme préhistorique, Paris, France
| | - Pauline Brige
- Laboratoire d’Imagerie Interventionnelle Expérimentale, CERIMED, Marseille, France
| | - Yohan Payan
- Univ. Grenoble Alpes, CNRS, Grenoble INP, TIMC, Grenoble, France
| | - Pascal Perrier
- Univ. Grenoble Alpes, CNRS, Grenoble INP, GIPSA-lab, Grenoble, France
| | - Amélie Vialet
- Sorbonne Université, Institut des Sciences du Calcul et des Données, Paris, France
- Muséum national d’Histoire naturelle, UMR 7194 - Histoire naturelle de l’Homme préhistorique, Paris, France
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4
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Singh G, Chanda A. Mechanical properties of whole-body soft human tissues: a review. Biomed Mater 2021; 16. [PMID: 34587593 DOI: 10.1088/1748-605x/ac2b7a] [Citation(s) in RCA: 78] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 09/29/2021] [Indexed: 11/11/2022]
Abstract
The mechanical properties of soft tissues play a key role in studying human injuries and their mitigation strategies. While such properties are indispensable for computational modelling of biological systems, they serve as important references in loading and failure experiments, and also for the development of tissue simulants. To date, experimental studies have measured the mechanical properties of peripheral tissues (e.g. skin)in-vivoand limited internal tissuesex-vivoin cadavers (e.g. brain and the heart). The lack of knowledge on a majority of human tissues inhibit their study for applications ranging from surgical planning, ballistic testing, implantable medical device development, and the assessment of traumatic injuries. The purpose of this work is to overcome such challenges through an extensive review of the literature reporting the mechanical properties of whole-body soft tissues from head to toe. Specifically, the available linear mechanical properties of all human tissues were compiled. Non-linear biomechanical models were also introduced, and the soft human tissues characterized using such models were summarized. The literature gaps identified from this work will help future biomechanical studies on soft human tissue characterization and the development of accurate medical models for the study and mitigation of injuries.
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Affiliation(s)
- Gurpreet Singh
- Centre for Biomedical Engineering, Indian Institute of Technology (IIT), Delhi, India
| | - Arnab Chanda
- Centre for Biomedical Engineering, Indian Institute of Technology (IIT), Delhi, India.,Department of Biomedical Engineering, All India Institute of Medical Sciences (AIIMS), Delhi, India
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5
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Kappert KDR, Voskuilen L, Smeele LE, Balm AJM, Jasperse B, Nederveen AJ, van der Heijden F. Personalized biomechanical tongue models based on diffusion-weighted MRI and validated using optical tracking of range of motion. Biomech Model Mechanobiol 2021; 20:1101-1113. [PMID: 33682028 PMCID: PMC8154835 DOI: 10.1007/s10237-021-01435-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 02/11/2021] [Indexed: 12/13/2022]
Abstract
For advanced tongue cancer, the choice between surgery and organ-sparing treatment is often dependent on the expected loss of tongue functionality after treatment. Biomechanical models might assist in this choice by simulating the post-treatment function loss. However, this function loss varies between patients and should, therefore, be predicted for each patient individually. In the present study, the goal was to better predict the postoperative range of motion (ROM) of the tongue by personalizing biomechanical models using diffusion-weighted MRI and constrained spherical deconvolution reconstructions of tongue muscle architecture. Diffusion-weighted MRI scans of ten healthy volunteers were obtained to reconstruct their tongue musculature, which were subsequently registered to a previously described population average or atlas. Using the displacement fields obtained from the registration, the segmented muscle fiber tracks from the atlas were morphed back to create personalized muscle fiber tracks. Finite element models were created from the fiber tracks of the atlas and those of the individual tongues. Via inverse simulation of a protruding, downward, left and right movement, the ROM of the tongue was predicted. This prediction was compared to the ROM measured with a 3D camera. It was demonstrated that biomechanical models with personalized muscles bundles are better in approaching the measured ROM than a generic model. However, to achieve this result a correction factor was needed to compensate for the small magnitude of motion of the model. Future versions of these models may have the potential to improve the estimation of function loss after treatment for advanced tongue cancer.
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Affiliation(s)
- K D R Kappert
- Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands. .,Department of Robotics and Mechatronics, Faculty of EEMCS, Technical Medical Centre, University of Twente, Enschede, The Netherlands.
| | - L Voskuilen
- Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Department of Oral and Maxillofacial Surgery, Academic Centre for Dentistry Amsterdam and Amsterdam UMC, University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | - L E Smeele
- Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.,Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - A J M Balm
- Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.,Department of Robotics and Mechatronics, Faculty of EEMCS, Technical Medical Centre, University of Twente, Enschede, The Netherlands.,Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - B Jasperse
- Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - A J Nederveen
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - F van der Heijden
- Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.,Department of Robotics and Mechatronics, Faculty of EEMCS, Technical Medical Centre, University of Twente, Enschede, The Netherlands
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6
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Kappert KDR, Connesson N, Elahi SA, Boonstra S, Balm AJM, van der Heijden F, Payan Y. In-vivo tongue stiffness measured by aspiration: Resting vs general anesthesia. J Biomech 2020; 114:110147. [PMID: 33276256 DOI: 10.1016/j.jbiomech.2020.110147] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 11/16/2020] [Accepted: 11/21/2020] [Indexed: 11/29/2022]
Abstract
Tongue cancer treatment often results in impaired speech, swallowing, or mastication. Simulating the effect of treatments can help the patient and the treating physician to understand the effects and impact of the intervention. To simulate deformations of the tongue, identifying accurate mechanical properties of tissue is essential. However, not many succeeded in characterizing in-vivo tongue stiffness. Those who did, measured the tongue At Rest (AR), in which muscle tone subsides even if muscles are not willingly activated. We expected to find an absolute rest state in participants 'under General Anesthesia' (GA). We elaborated on previous work by measuring the mechanical behavior of the in-vivo tongue under aspiration using an improved volume-based method. Using this technique, 5 to 7 measurements were performed on 10 participants both AR and under GA. The obtained Pressure-Shape curves were first analyzed using the initial slope and its variations. Hereafter, an inverse Finite Element Analysis (FEA) was applied to identify the mechanical parameters using the Yeoh, Gent, and Ogden hyperelastic models. The measurements AR provided a mean Young's Modulus of 1638 Pa (min 1035 - max 2019) using the Yeoh constitutive model, which is in line with previous ex-vivo measurements. However, while hoping to find a rest state under GA, the tongue unexpectedly appeared to be approximately 2 to 2.5 times stiffer under GA than AR. Explanations for this were sought by examining drugs administered during GA, blood flow, perfusion, and upper airway reflexes, but neither of these explanations could be confirmed.
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Affiliation(s)
- K D R Kappert
- Head & Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands; Robotics and Mechatronics, Technical Medical Centre, University of Twente, Enschede, The Netherlands.
| | - N Connesson
- TIMC-IMAG Laboratory, University Grenoble Alpes & CNRS, Grenoble, France
| | - S A Elahi
- Human Movement Science Department, Mechanical Engineering Department, KU Leuven, Leuven, Belgium
| | - S Boonstra
- Head & Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands; Robotics and Mechatronics, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - A J M Balm
- Head & Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands; Robotics and Mechatronics, Technical Medical Centre, University of Twente, Enschede, The Netherlands; Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - F van der Heijden
- Head & Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands; Robotics and Mechatronics, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Y Payan
- TIMC-IMAG Laboratory, University Grenoble Alpes & CNRS, Grenoble, France
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7
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Calka M, Perrier P, Ohayon J, Grivot Boichon C, Rochette M, Payan Y. Real-time simulations of human tongue movements with a reduced order model of a non-linear dynamic biomechanical model. Comput Methods Biomech Biomed Engin 2020. [DOI: 10.1080/10255842.2020.1812158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- M. Calka
- Univ. Grenoble Alpes, CNRS, Grenoble INP, TIMC-IMAG, Grenoble, France
- Univ. Grenoble Alpes, CNRS, Grenoble INP, GIPSA-lab, Grenoble, France
- ANSYS, Villeurbanne, France
| | - P. Perrier
- Univ. Grenoble Alpes, CNRS, Grenoble INP, GIPSA-lab, Grenoble, France
| | - J. Ohayon
- Univ. Grenoble Alpes, CNRS, Grenoble INP, TIMC-IMAG, Grenoble, France
- Polytech Annecy-Chambéry, Savoie Mont-Blanc University, Le Bourget du Lac, France
| | | | | | - Y. Payan
- Univ. Grenoble Alpes, CNRS, Grenoble INP, TIMC-IMAG, Grenoble, France
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8
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Łukaszewski K, Wichniarek R, Górski F. Determination of the Elasticity Modulus of Additively Manufactured Wrist Hand Orthoses. MATERIALS 2020; 13:ma13194379. [PMID: 33019613 PMCID: PMC7579548 DOI: 10.3390/ma13194379] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/19/2020] [Accepted: 09/24/2020] [Indexed: 11/16/2022]
Abstract
The article describes the experimental and simulation research on the material properties of the individualized wrist orthoses produced in the additive manufacturing (AM) process by the fused filament fabrication (FFF) method. The authors produced a series of standard (normalized) samples for three-point bending from acrylonitrile butadiene styrene (ABS) filament on a low-budget 3D printer and a series of samples in the shape of a fragment of the orthosis and the entire orthosis. All types of samples were subjected to experimental tests on a universal testing machine, which allowed us to determine the modulus of elasticity of the produced materials by comparing it with finite element method (FEM) simulation models in the ABAQUS environment. The adopted research methodology allowed us to compare the material properties of the material of the entire product-wrist hand orthosis (WHO)-with the material properties of standard bending samples. The obtained values of Young's modulus are characterized by a large discrepancy between the standard samples and the entire orthosis. On the other hand, the samples with the shape of the middle part of the orthosis were similar in the value of Young's modulus to the results obtained during the examination of the complete orthosis.
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Affiliation(s)
| | | | - Filip Górski
- Correspondence: (K.Ł.); (F.G.); Tel.: +48-61-665-2708 (F.G.)
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9
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Kappert KDR, van Alphen MJA, Smeele LE, Balm AJM, van der Heijden F. Quantification of tongue mobility impairment using optical tracking in patients after receiving primary surgery or chemoradiation. PLoS One 2019; 14:e0221593. [PMID: 31454385 PMCID: PMC6711543 DOI: 10.1371/journal.pone.0221593] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 08/10/2019] [Indexed: 11/18/2022] Open
Abstract
PURPOSE Tongue mobility has shown to be a clinically interesting parameter on functional results after tongue cancer treatment which can be objectified by measuring the Range Of Motion (ROM). Reliable measurements of ROM would enable us to quantify the severity of functional impairments and use these for shared decision making in treatment choices, rehabilitation of speech and swallowing disturbances after treatment. METHOD Nineteen healthy participants, eighteen post-chemotherapy patients and seventeen post-surgery patients were asked to perform standardized tongue maneuvers in front of a 3D camera system, which were subsequently tracked and corrected for head and jaw motion. Indicators, such as the left-right tongue range and the deflection angle with the horizontal axis were extracted from the tongue trajectory to serve as a quantitative measure for the impaired tongue mobility. RESULTS The range and deflection angle showed an excellent intra- and interrater reliability (ICC 0.9) The repeatability experiment showed an average standard deviation of 2.5 mm to 3.5 mm for every movement, except the upward movement. The post-surgery patient group showed a smaller tongue range and higher deflection angle overall than the healthy participants. Post-chemoradiation patients showed less difference in tongue ROM compared with healthy participants. Only a few patients showed asymmetrical movement after treatment, which could not always be explained by T-stage or the side of treatment alone. CONCLUSION We introduced a reliable and reproducible method for measuring the ROM and to quantify for motion impairments, that was able to show differences in tongue ROM between healthy subjects and patients after chemoradiation or surgery. Future research should focus on measuring patients with oral cancer pre- and post-treatment in combination with the collection of detailed information about the individual tongue anatomy, so that the full ROM trajectory can be used to identify changes over time and to quantify functional impairment.
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Affiliation(s)
- K. D. R. Kappert
- Head & Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Robotics and Mechatronics, University of Twente, Enschede, The Netherlands
- * E-mail:
| | - M. J. A. van Alphen
- Head & Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - L. E. Smeele
- Head & Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - A. J. M. Balm
- Head & Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Robotics and Mechatronics, University of Twente, Enschede, The Netherlands
- Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - F. van der Heijden
- Head & Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Robotics and Mechatronics, University of Twente, Enschede, The Netherlands
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10
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Kappert KDR, van Alphen MJA, van Dijk S, Smeele LE, Balm AJM, van der Heijden F. An interactive surgical simulation tool to assess the consequences of a partial glossectomy on a biomechanical model of the tongue. Comput Methods Biomech Biomed Engin 2019; 22:827-839. [PMID: 30963800 DOI: 10.1080/10255842.2019.1599362] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Oral cancer surgery has a negative influence on the quality of life (QOL). As a result of the complex physiology involved in oral functions, estimation of surgical effects on functionality remains difficult. We present a user-friendly biomechanical simulation of tongue surgery, including closure with suturing and scar formation, followed by an automated adaptation of a finite element (FE) model to the shape of the tongue. Different configurations of our FE model were evaluated and compared to a well-established FE model. We showed that the post-operative impairment as predicted by our model was qualitatively comparable to a patient case for five different tongue maneuvers.
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Affiliation(s)
- K D R Kappert
- a Department of Head and Neck Oncology and Surgery , Netherlands Cancer Institute , Amsterdam , The Netherlands.,b Robotics and Mechatronics , University of Twente , Enschede , The Netherlands
| | - M J A van Alphen
- a Department of Head and Neck Oncology and Surgery , Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - S van Dijk
- a Department of Head and Neck Oncology and Surgery , Netherlands Cancer Institute , Amsterdam , The Netherlands.,c Department of Oral and Maxillofacial Surgery , Amsterdam UMC, University of Amsterdam , Amsterdam , The Netherlands
| | - L E Smeele
- a Department of Head and Neck Oncology and Surgery , Netherlands Cancer Institute , Amsterdam , The Netherlands.,c Department of Oral and Maxillofacial Surgery , Amsterdam UMC, University of Amsterdam , Amsterdam , The Netherlands
| | - A J M Balm
- a Department of Head and Neck Oncology and Surgery , Netherlands Cancer Institute , Amsterdam , The Netherlands.,c Department of Oral and Maxillofacial Surgery , Amsterdam UMC, University of Amsterdam , Amsterdam , The Netherlands
| | - F van der Heijden
- a Department of Head and Neck Oncology and Surgery , Netherlands Cancer Institute , Amsterdam , The Netherlands.,b Robotics and Mechatronics , University of Twente , Enschede , The Netherlands
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11
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Kwan BCH, Jugé L, Gandevia SC, Bilston LE. Sagittal Measurement of Tongue Movement During Respiration: Comparison Between Ultrasonography and Magnetic Resonance Imaging. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:921-934. [PMID: 30691918 DOI: 10.1016/j.ultrasmedbio.2018.12.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Revised: 12/06/2018] [Accepted: 12/08/2018] [Indexed: 06/09/2023]
Abstract
The tongue makes up the anterior pharyngeal wall and is critical for airway patency. Magnetic resonance imaging (MRI) is commonly used to study pharyngeal muscle function in pharyngeal disorders such as obstructive sleep apnoea. Tagged MRI and ultrasound studies have separately revealed ∼1 mm of anterior tongue movement during inspiration in healthy patients, but these modalities have not been directly compared. In the study described here, agreement between ultrasound and MRI in measuring regional tongue displacement in 21 healthy patients and 21 patients with obstructive sleep apnoea was evaluated. We found good consistency and agreement between the two techniques, with an intra-class correlation coefficient of 0.79 (95% confidence interval: 0.75-0.82) for anteroposterior tongue motion during inspiration. Ultrasound measurements of posterior tongue displacement were 0.24 ± 0.64 mm greater than MRI measurements (95% limits of agreement: 1.03 to -1.49). This may reflect the higher spatial and temporal resolution of the ultrasound technique. This study confirms that ultrasound is a suitable method for quantifying inspiratory tongue movement.
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Affiliation(s)
- Benjamin C H Kwan
- Neuroscience Research Australia, Sydney, New South Wales, Australia; Prince of Wales Hospital Clinical School, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.
| | - Lauriane Jugé
- Neuroscience Research Australia, Sydney, New South Wales, Australia; School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Simon C Gandevia
- Neuroscience Research Australia, Sydney, New South Wales, Australia; Prince of Wales Hospital Clinical School, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Lynne E Bilston
- Neuroscience Research Australia, Sydney, New South Wales, Australia; Prince of Wales Hospital Clinical School, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
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12
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Hewer A, Wuhrer S, Steiner I, Richmond K. A multilinear tongue model derived from speech related MRI data of the human vocal tract. COMPUT SPEECH LANG 2018. [DOI: 10.1016/j.csl.2018.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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13
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Eskes M, Balm AJM, van Alphen MJA, Smeele LE, Stavness I, van der Heijden F. sEMG-assisted inverse modelling of 3D lip movement: a feasibility study towards person-specific modelling. Sci Rep 2017; 7:17729. [PMID: 29255198 PMCID: PMC5735193 DOI: 10.1038/s41598-017-17790-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 11/30/2017] [Indexed: 11/17/2022] Open
Abstract
We propose a surface-electromyographic (sEMG) assisted inverse-modelling (IM) approach for a biomechanical model of the face to obtain realistic person-specific muscle activations (MA) by tracking movements as well as innervation trajectories. We obtained sEMG data of facial muscles and 3D positions of lip markers in six volunteers and, using a generic finite element (FE) face model in ArtiSynth, performed inverse static optimisation with and without sEMG tracking on both simulation data and experimental data. IM with simulated data and experimental data without sEMG data showed good correlations of tracked positions (0.93 and 0.67) and poor correlations of MA (0.27 and 0.20). When utilising the sEMG-assisted IM approach, MA correlations increased drastically (0.83 and 0.59) without sacrificing performance in position correlations (0.92 and 0.70). RMS errors show similar trends with an error of 0.15 in MA and of 1.10 mm in position. Therefore, we conclude that we were able to demonstrate the feasibility of an sEMG-assisted inverse modelling algorithm for the perioral region. This approach may help to solve the ambiguity problem in inverse modelling and may be useful, for instance, in future applications for preoperatively predicting treatment-related function loss.
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Affiliation(s)
- Merijn Eskes
- Dept of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands. .,MIRA Institute of Biomedical Engineering and Technical Medicine, University of Twente, Drienerlolaan 5, 7522 NB, Enschede, The Netherlands.
| | - Alfons J M Balm
- Dept of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.,MIRA Institute of Biomedical Engineering and Technical Medicine, University of Twente, Drienerlolaan 5, 7522 NB, Enschede, The Netherlands.,Dept of Oral and Maxillofacial Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Maarten J A van Alphen
- Dept of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Ludi E Smeele
- Dept of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.,Dept of Oral and Maxillofacial Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.,ACTA Academic Centre for Dentistry Amsterdam, Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands
| | - Ian Stavness
- Dept of Computer Science, University of Saskatchewan, 176 Thorvaldson Building, 110 Science Place, Saskatoon, SK S7N 5C9, Canada
| | - Ferdinand van der Heijden
- Dept of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.,MIRA Institute of Biomedical Engineering and Technical Medicine, University of Twente, Drienerlolaan 5, 7522 NB, Enschede, The Netherlands
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Eskes M, Balm AJM, van Alphen MJA, Smeele LE, Stavness I, van der Heijden F. Simulation of facial expressions using person-specific sEMG signals controlling a biomechanical face model. Int J Comput Assist Radiol Surg 2017; 13:47-59. [PMID: 28861702 PMCID: PMC5754395 DOI: 10.1007/s11548-017-1659-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 08/11/2017] [Indexed: 11/01/2022]
Abstract
PURPOSE Functional inoperability in advanced oral cancer is difficult to assess preoperatively. To assess functions of lips and tongue, biomechanical models are required. Apart from adjusting generic models to individual anatomy, muscle activation patterns (MAPs) driving patient-specific functional movements are necessary to predict remaining functional outcome. We aim to evaluate how volunteer-specific MAPs derived from surface electromyographic (sEMG) signals control a biomechanical face model. METHODS Muscle activity of seven facial muscles in six volunteers was measured bilaterally with sEMG. A triple camera set-up recorded 3D lip movement. The generic face model in ArtiSynth was adapted to our needs. We controlled the model using the volunteer-specific MAPs. Three activation strategies were tested: activating all muscles [Formula: see text], selecting the three muscles showing highest muscle activity bilaterally [Formula: see text]-this was calculated by taking the mean of left and right muscles and then selecting the three with highest variance-and activating the muscles considered most relevant per instruction [Formula: see text], bilaterally. The model's lip movement was compared to the actual lip movement performed by the volunteers, using 3D correlation coefficients [Formula: see text]. RESULTS The correlation coefficient between simulations and measurements with [Formula: see text] resulted in a median [Formula: see text] of 0.77. [Formula: see text] had a median [Formula: see text] of 0.78, whereas with [Formula: see text] the median [Formula: see text] decreased to 0.45. CONCLUSION We demonstrated that MAPs derived from noninvasive sEMG measurements can control movement of the lips in a generic finite element face model with a median [Formula: see text] of 0.78. Ultimately, this is important to show the patient-specific residual movement using the patient's own MAPs. When the required treatment tools and personalisation techniques for geometry and anatomy become available, this may enable surgeons to test the functional results of wedge excisions for lip cancer in a virtual environment and to weigh surgery versus organ-sparing radiotherapy or photodynamic therapy.
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Affiliation(s)
- Merijn Eskes
- Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
- MIRA Institute of Biomedical Engineering and Technical Medicine, University of Twente, Drienerlolaan 5, 7522 NB, Enschede, The Netherlands.
- , P.O. Box 90203, 1006 BE, Amsterdam, The Netherlands.
| | - Alfons J M Balm
- Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
- MIRA Institute of Biomedical Engineering and Technical Medicine, University of Twente, Drienerlolaan 5, 7522 NB, Enschede, The Netherlands
- Department of Oral and Maxillofacial Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Maarten J A van Alphen
- Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Ludi E Smeele
- Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
- Department of Oral and Maxillofacial Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Ian Stavness
- Department of Computer Science, University of Saskatchewan, 176 Thorvaldson Building, 110 Science Place, Saskatoon, SK, S7N 5C9, Canada
| | - Ferdinand van der Heijden
- Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
- MIRA Institute of Biomedical Engineering and Technical Medicine, University of Twente, Drienerlolaan 5, 7522 NB, Enschede, The Netherlands
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Amatoury J, Cheng S, Kairaitis K, Wheatley JR, Amis TC, Bilston LE. Development and validation of a computational finite element model of the rabbit upper airway: simulations of mandibular advancement and tracheal displacement. J Appl Physiol (1985) 2016; 120:743-57. [DOI: 10.1152/japplphysiol.00820.2015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 01/12/2016] [Indexed: 11/22/2022] Open
Abstract
The mechanisms leading to upper airway (UA) collapse during sleep are complex and poorly understood. We previously developed an anesthetized rabbit model for studying UA physiology. On the basis of this body of physiological data, we aimed to develop and validate a two-dimensional (2D) computational finite element model (FEM) of the passive rabbit UA and peripharyngeal tissues. Model geometry was reconstructed from a midsagittal computed tomographic image of a representative New Zealand White rabbit, which included major soft (tongue, soft palate, constrictor muscles), cartilaginous (epiglottis, thyroid cartilage), and bony pharyngeal tissues (mandible, hard palate, hyoid bone). Other UA muscles were modeled as linear elastic connections. Initial boundary and contact definitions were defined from anatomy and material properties derived from the literature. Model parameters were optimized to physiological data sets associated with mandibular advancement (MA) and caudal tracheal displacement (TD), including hyoid displacement, which featured with both applied loads. The model was then validated against independent data sets involving combined MA and TD. Model outputs included UA lumen geometry, peripharyngeal tissue displacement, and stress and strain distributions. Simulated MA and TD resulted in UA enlargement and nonuniform increases in tissue displacement, and stress and strain. Model predictions closely agreed with experimental data for individually applied MA, TD, and their combination. We have developed and validated an FEM of the rabbit UA that predicts UA geometry and peripharyngeal tissue mechanical changes associated with interventions known to improve UA patency. The model has the potential to advance our understanding of UA physiology and peripharyngeal tissue mechanics.
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Affiliation(s)
- Jason Amatoury
- Neuroscience Research Australia (NeuRA), Sydney, New South Wales, Australia
- School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
- Ludwig Engel Centre for Respiratory Research, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia
- University of Sydney at Westmead Hospital, Sydney, New South Wales, Australia; and
| | - Shaokoon Cheng
- Neuroscience Research Australia (NeuRA), Sydney, New South Wales, Australia
- School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
- Department of Engineering, Macquarie University, Sydney, New South Wales, Australia
| | - Kristina Kairaitis
- Ludwig Engel Centre for Respiratory Research, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia
- University of Sydney at Westmead Hospital, Sydney, New South Wales, Australia; and
| | - John R. Wheatley
- Ludwig Engel Centre for Respiratory Research, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia
- University of Sydney at Westmead Hospital, Sydney, New South Wales, Australia; and
| | - Terence C. Amis
- Ludwig Engel Centre for Respiratory Research, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia
- University of Sydney at Westmead Hospital, Sydney, New South Wales, Australia; and
| | - Lynne E. Bilston
- Neuroscience Research Australia (NeuRA), Sydney, New South Wales, Australia
- Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia
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Bijar A, Rohan PY, Perrier P, Payan Y. Atlas-Based Automatic Generation of Subject-Specific Finite Element Tongue Meshes. Ann Biomed Eng 2015; 44:16-34. [PMID: 26577253 DOI: 10.1007/s10439-015-1497-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 10/27/2015] [Indexed: 10/22/2022]
Abstract
Generation of subject-specific 3D finite element (FE) models requires the processing of numerous medical images in order to precisely extract geometrical information about subject-specific anatomy. This processing remains extremely challenging. To overcome this difficulty, we present an automatic atlas-based method that generates subject-specific FE meshes via a 3D registration guided by Magnetic Resonance images. The method extracts a 3D transformation by registering the atlas' volume image to the subject's one, and establishes a one-to-one correspondence between the two volumes. The 3D transformation field deforms the atlas' mesh to generate the subject-specific FE mesh. To preserve the quality of the subject-specific mesh, a diffeomorphic non-rigid registration based on B-spline free-form deformations is used, which guarantees a non-folding and one-to-one transformation. Two evaluations of the method are provided. First, a publicly available CT-database is used to assess the capability to accurately capture the complexity of each subject-specific Lung's geometry. Second, FE tongue meshes are generated for two healthy volunteers and two patients suffering from tongue cancer using MR images. It is shown that the method generates an appropriate representation of the subject-specific geometry while preserving the quality of the FE meshes for subsequent FE analysis. To demonstrate the importance of our method in a clinical context, a subject-specific mesh is used to simulate tongue's biomechanical response to the activation of an important tongue muscle, before and after cancer surgery.
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Affiliation(s)
- Ahmad Bijar
- Univ. Grenoble Alpes, TIMC-IMAG, 38000, Grenoble, France. .,CNRS, TIMC-IMAG, 38000, Grenoble, France. .,Univ. Grenoble Alpes, Gipsa-lab, 38000, Grenoble, France. .,CNRS, Gipsa-lab, 38000, Grenoble, France.
| | - Pierre-Yves Rohan
- LBM/Institut de Biomécanique Humaine Georges Charpak, 151 Boulevard de l'Hôpital, 75013, Paris, France.
| | - Pascal Perrier
- Univ. Grenoble Alpes, Gipsa-lab, 38000, Grenoble, France. .,CNRS, Gipsa-lab, 38000, Grenoble, France.
| | - Yohan Payan
- Univ. Grenoble Alpes, TIMC-IMAG, 38000, Grenoble, France. .,CNRS, TIMC-IMAG, 38000, Grenoble, France.
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Acher A, Perrier P, Savariaux C, Fougeron C. Speech production after glossectomy: methodological aspects. CLINICAL LINGUISTICS & PHONETICS 2014; 28:241-256. [PMID: 23837408 DOI: 10.3109/02699206.2013.802015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This article focuses on methodological issues related to quantitative assessments of speech quality after glossectomy. Acoustic and articulatory data were collected for 8 consonants from two patients. The acoustic analysis is based on spectral moments and the Klatt VOT. Lingual movements are recorded with ultrasound without calibration. The variations of acoustic and articulatory parameters across pre- and post-surgery conditions are analyzed in the light of perceptual evaluations of the stimuli. A parameter is considered to be relevant if its variation is congruent with perceptual ratings. The most relevant acoustic parameters are the skewness and the Center of Gravity. The Klatt VOT explains differences that could not be explained by spectral parameters. The SNTS ultrasound parameter provides information to describe impairments not accounted for by acoustical parameters. These results suggest that the combination of articulatory, perceptual and acoustic data provides comprehensive complementary information for a quantitative assessment of speech after glossectomy.
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Affiliation(s)
- Audrey Acher
- GIPSA-Lab, UMR 5216 CNRS/ Université Grenoble-Alpes , Saint Martin d'Hères , France and
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Reaungamornrat S, Liu WP, Wang AS, Otake Y, Nithiananthan S, Uneri A, Schafer S, Tryggestad E, Richmon J, Sorger JM, Siewerdsen JH, Taylor RH. Deformable image registration for cone-beam CT guided transoral robotic base-of-tongue surgery. Phys Med Biol 2013; 58:4951-79. [PMID: 23807549 PMCID: PMC3990286 DOI: 10.1088/0031-9155/58/14/4951] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Transoral robotic surgery (TORS) offers a minimally invasive approach to resection of base-of-tongue tumors. However, precise localization of the surgical target and adjacent critical structures can be challenged by the highly deformed intraoperative setup. We propose a deformable registration method using intraoperative cone-beam computed tomography (CBCT) to accurately align preoperative CT or MR images with the intraoperative scene. The registration method combines a Gaussian mixture (GM) model followed by a variation of the Demons algorithm. First, following segmentation of the volume of interest (i.e. volume of the tongue extending to the hyoid), a GM model is applied to surface point clouds for rigid initialization (GM rigid) followed by nonrigid deformation (GM nonrigid). Second, the registration is refined using the Demons algorithm applied to distance map transforms of the (GM-registered) preoperative image and intraoperative CBCT. Performance was evaluated in repeat cadaver studies (25 image pairs) in terms of target registration error (TRE), entropy correlation coefficient (ECC) and normalized pointwise mutual information (NPMI). Retraction of the tongue in the TORS operative setup induced gross deformation >30 mm. The mean TRE following the GM rigid, GM nonrigid and Demons steps was 4.6, 2.1 and 1.7 mm, respectively. The respective ECC was 0.57, 0.70 and 0.73, and NPMI was 0.46, 0.57 and 0.60. Registration accuracy was best across the superior aspect of the tongue and in proximity to the hyoid (by virtue of GM registration of surface points on these structures). The Demons step refined registration primarily in deeper portions of the tongue further from the surface and hyoid bone. Since the method does not use image intensities directly, it is suitable to multi-modality registration of preoperative CT or MR with intraoperative CBCT. Extending the 3D image registration to the fusion of image and planning data in stereo-endoscopic video is anticipated to support safer, high-precision base-of-tongue robotic surgery.
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Affiliation(s)
- S Reaungamornrat
- Department of Computer Science, Johns Hopkins University, Baltimore, MD 21218, USA
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Payan Y. Biomechanics for computer-assisted surgery. Comput Methods Biomech Biomed Engin 2012; 15 Suppl 1:8-9. [PMID: 23009402 DOI: 10.1080/10255842.2012.713595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Yohan Payan
- UJF-Grenoble 1/CNRS/TIMC-IMAG UMR 5525, Grenoble, F-38041, France.
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Schuster M, Stelzle F. Outcome measurements after oral cancer treatment: speech and speech-related aspects--an overview. Oral Maxillofac Surg 2012; 16:291-8. [PMID: 22864645 DOI: 10.1007/s10006-012-0340-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Accepted: 07/16/2012] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Oral cancer and its surgical treatment impair speech quality by an alteration of the vocal tract. Local size and stage of the tumour as well as surgical and adjuvant treatment modalities have an impact on the functional outcome of patients' speech rehabilitation. It was the aim of this overview to specifiy speech and speech-related aspects as well as to delineate measurement methods of speech outcome in patients with oral cancer by a review of the literature. METHODS The review is based on a Medline Search on "speech", "cancer", "oral cancer", "malignoma mouth", "intelligibility", "formant", "ultrasound". DISCUSSION In particular, speech intelligibility is inevitable for the social interaction of patients which is highly correlated with the patient's quality of life. However, speech outcome measurement shows a variety of methods without an international standardisation. Additionally, several co-aspects of speech production have to be considered: tongue mobility, voice production, velopharyngeal closure and neural coordination are important influencing factors. Speech assessment is traditionally performed by perceptual methods on a subjective or semi-subjective base. More objective, technical-based methods of speech evaluation are in development and under research. PURPOSE It was the aim of this overview to specify speech and speech-related aspects as well as to delineate measurement methods of speech outcome in patients with oral cancer by a review of the current literature.
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Affiliation(s)
- M Schuster
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Munich, Marchioninistr. 15, 81377, Munich, Germany.
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ArtiSynth: A Fast Interactive Biomechanical Modeling Toolkit Combining Multibody and Finite Element Simulation. STUDIES IN MECHANOBIOLOGY, TISSUE ENGINEERING AND BIOMATERIALS 2012. [DOI: 10.1007/8415_2012_126] [Citation(s) in RCA: 90] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
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Cheng S, Gandevia S, Green M, Sinkus R, Bilston L. Viscoelastic properties of the tongue and soft palate using MR elastography. J Biomech 2011; 44:450-4. [DOI: 10.1016/j.jbiomech.2010.09.027] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2010] [Revised: 09/20/2010] [Accepted: 09/27/2010] [Indexed: 01/22/2023]
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Hannam AG. Current computational modelling trends in craniomandibular biomechanics and their clinical implications. J Oral Rehabil 2010; 38:217-34. [PMID: 20819138 DOI: 10.1111/j.1365-2842.2010.02149.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Computational models of interactions in the craniomandibular apparatus are used with increasing frequency to study biomechanics in normal and abnormal masticatory systems. Methods and assumptions in these models can be difficult to assess by those unfamiliar with current practices in this field; health professionals are often faced with evaluating the appropriateness, validity and significance of models which are perhaps more familiar to the engineering community. This selective review offers a foundation for assessing the strength and implications of a craniomandibular modelling study. It explores different models used in general science and engineering and focuses on current best practices in biomechanics. The problem of validation is considered at some length, because this is not always fully realisable in living subjects. Rigid-body, finite element and combined approaches are discussed, with examples of their application to basic and clinically relevant problems. Some advanced software platforms currently available for modelling craniomandibular systems are mentioned. Recent studies of the face, masticatory muscles, tongue, craniomandibular skeleton, temporomandibular joint, dentition and dental implants are reviewed, and the significance of non-linear and non-isotropic material properties is emphasised. The unique challenges in clinical application are discussed, and the review concludes by posing some questions which one might reasonably expect to find answered in plausible modelling studies of the masticatory apparatus.
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Affiliation(s)
- A G Hannam
- Faculty of Dentistry, Department of Oral Health Sciences, The University of British Columbia, Vancouver, BC, Canada.
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Buchaillard S, Perrier P, Payan Y. A biomechanical model of cardinal vowel production: muscle activations and the impact of gravity on tongue positioning. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2009; 126:2033-2051. [PMID: 19813813 DOI: 10.1121/1.3204306] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
A three-dimensional (3D) biomechanical model of the tongue and the oral cavity, controlled by a functional model of muscle force generation (lambda-model of the equilibrium point hypothesis) and coupled with an acoustic model, was exploited to study the activation of the tongue and mouth floor muscles during the production of French cardinal vowels. The selection of the motor commands to control the tongue and the mouth floor muscles was based on literature data, such as electromyographic, electropalatographic, and cineradiographic data. The tongue shapes were also compared to data obtained from the speaker used to build the model. 3D modeling offered the opportunity to investigate the role of the transversalis, in particular, its involvement in the production of high front vowels. It was found, with this model, to be indirect via reflex mechanisms due to the activation of surrounding muscles, not voluntary. For vowel /i/, local motor command variations for the main tongue muscles revealed a non-negligible modification of the alveolar groove in contradiction to the saturation effect hypothesis, due to the role of the anterior genioglossus. Finally, the impact of subject position (supine or upright) on the production of French cardinal vowels was explored and found to be negligible.
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Savoldelli C, Tillier Y, Bouchard PO, Odin G. Apport de la méthode des éléments finis en chirurgie maxillofaciale. ACTA ACUST UNITED AC 2009; 110:27-33. [DOI: 10.1016/j.stomax.2008.10.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2008] [Accepted: 10/20/2008] [Indexed: 10/21/2022]
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Abstract
Advances in computer power, novel diagnostic and therapeutic medical technologies, and an increasing knowledge of pathophysiology from gene to organ systems make it increasingly feasible to apply multiscale patient-specific modeling based on proven disease mechanisms. Such models may guide and predict the response to therapy in many areas of medicine. This is an exciting and relatively new approach, for which efficient methods and computational tools are of the utmost importance. Investigators have designed patient-specific models in almost all areas of human physiology. Not only will these models be useful in clinical settings to predict and optimize the outcome from surgery and non-interventional therapy, but they will also provide pathophysiologic insights from the cellular level to the organ system level. Models, therefore, will provide insight as to why specific interventions succeed or fail.
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Schiavone P, Boudou T, Promayon E, Perrier P, Payan Y. A light sterilizable pipette device for the in vivo estimation of human soft tissues constitutive laws. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2008; 2008:4298-4301. [PMID: 19163663 DOI: 10.1109/iembs.2008.4650160] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
This paper introduces a new light device for the in vivo estimation of human soft tissues constitutive laws. It consists of an aspiration pipette able to meet the very severe sterilization and handling issues imposed during surgery. The simplicity of the device, free of any electronic circuitry, allows using it as an ancillary instrument. The deformation of the aspired tissue is imaged via a mirror using an external camera. The paper describes the experimental setup as well as the protocol that should be used during surgery. First feasibility measurements are shown for human tongue and forearm skin.
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Affiliation(s)
- P Schiavone
- TIMC-IMAG Laboratory, UMR UJF CNRS, 5525, Faculté de Médecine de Grenoble, Pavillon Taillefer, F38706 La Tronche Cédex, France
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