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Van Den Berg C, El Ghoul K, O'Sullivan E, Guntaka P, Resnick C, Pullens B, Khonsari R, Dunaway D, Wolvius E, Van de Lande L, Koudstaal M. Hyoid bone morphology in patients with isolated robin sequence - A case-control study utilizing 3D morphable models. Bone Rep 2024; 20:101738. [PMID: 38292932 PMCID: PMC10827493 DOI: 10.1016/j.bonr.2024.101738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 01/09/2024] [Accepted: 01/11/2024] [Indexed: 02/01/2024] Open
Abstract
Background Abnormalities of the hyoid bone are associated with impairment of oropharyngeal functions including feeding, swallowing, and breathing. Few studies have characterized anatomic abnormalities of the hyoid in patients with Robin sequence (RS), e.g. a less mineralized and voluminous hyoid. The purpose of this study was to compare normal hyoid bone morphology and hyoid bone morphology in children with isolated RS. Methods Three-dimensional (3D) reconstructions of the hyoid bone were obtained from CT-imaging of children with RS and unaffected controls. A 3D morphable model was constructed using Principal Component Analysis (PCA). Partial least squares - Discriminant Analysis (PLS-DA) and multivariate analysis of variance (MANOVA) were used to characterize and compare hyoid shape differences between patients with RS and an age-matched control group. Results The study included 23 subjects with RS (mean age 9.8 ± 10.3 months) and 46 age-matched control samples. A less voluminous hyoid was observed for the RS group with a larger lateral divergence of the greater horns compared to controls (MANOVA, p-value<0.001). The first shape variable from the PLS-DA model showed a significant correlation for the observed variance between the two groups (Spearman R = -0.56, p-value<0.001). The control samples and 151 CT-scans of subjects up to age 4 years were used to create a 3D morphable model of normal hyoid shape variation (n = 197, mean age 22.1 ± 13.1 months). For the normal 3D morphable model, a high degree of allometric shape variation was observed along the first principal component. Conclusions The 3D morphable models provide a comprehensive and quantitative description of variation in normal hyoid bone morphology, and allow detection of distinct differences between patients with isolated RS and controls.
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Affiliation(s)
- C.P.O.M. Van Den Berg
- Department of Oral and Maxillofacial Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - K. El Ghoul
- Department of Oral and Maxillofacial Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - E. O'Sullivan
- Department of Computing, Imperial College London, London, United Kingdom
| | - P.K. Guntaka
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, United States of America
| | - C.M. Resnick
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, United States of America
| | - B. Pullens
- Department of Otorhinolaryngology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - R.H. Khonsari
- Service de Chirurgie Maxillofaciale et Chirurgie Plastique, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Faculté de Médecine, Université Paris Cité, Paris, France
| | - D.J. Dunaway
- Craniofacial Unit, University College London, Great Ormond Street Hospital, London, United Kingdom
| | - E.B. Wolvius
- Department of Oral and Maxillofacial Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - L.S. Van de Lande
- Department of Oral and Maxillofacial Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands
- Service de Chirurgie Maxillofaciale et Chirurgie Plastique, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Faculté de Médecine, Université Paris Cité, Paris, France
- Craniofacial Unit, University College London, Great Ormond Street Hospital, London, United Kingdom
| | - M.J. Koudstaal
- Department of Oral and Maxillofacial Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, United States of America
- Craniofacial Unit, University College London, Great Ormond Street Hospital, London, United Kingdom
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Zhu J, Hu J, Zhu K, Ma X, Wang Y, Xu E, Huang Z, Zhu Y, Zhang C. Design of 3D-printed prostheses for reconstruction of periacetabular bone tumors using topology optimization. Front Bioeng Biotechnol 2023; 11:1289363. [PMID: 38116196 PMCID: PMC10728281 DOI: 10.3389/fbioe.2023.1289363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 11/22/2023] [Indexed: 12/21/2023] Open
Abstract
Background: Prostheses for the reconstruction of periacetabular bone tumors are prone to instigate stress shielding. The purpose of this study is to design 3D-printed prostheses with topology optimization (TO) for the reconstruction of periacetabular bone tumors and to add porous structures to reduce stress shielding and facilitate integration between prostheses and host bone. Methods: Utilizing patient CT data, we constructed a finite element analysis (FEA) model. Subsequent phases encompassed carrying out TO on the designated area, utilizing the solid isotropic material penalization model (SIMP), and this optimized removal area was replaced with a porous structure. Further analyses included preoperative FEA simulations to comparatively evaluate parameters, including maximum stress, stress distribution, strain energy density (SED), and the relative micromotion of prostheses before and after TO. Furthermore, FEA based on patients' postoperative CT data was conducted again to assess the potential risk of stress shielding subsequent to implantation. Ultimately, preliminary follow-up findings from two patients were documented. Results: In both prostheses, the SED before and after TO increased by 143.61% (from 0.10322 to 0.25145 mJ/mm3) and 35.050% (from 0.30964 to 0.41817 mJ/mm3) respectively, showing significant differences (p < 0.001). The peak stress in the Type II prosthesis decreased by 10.494% (from 77.227 to 69.123 MPa), while there was no significant change in peak stress for the Type I prosthesis. There were no significant changes in stress distribution or the proportion of regions with micromotion less than 28 μm before and after TO for either prosthesis. Postoperative FEA verified results showed that the stress in the pelvis and prostheses remained at relatively low levels. The results of follow-up showed that the patients had successful osseointegration and their MSTS scores at the 12th month after surgery were both 100%. Conclusion: These two types of 3D-printed porous prostheses using TO for periacetabular bone tumor reconstruction offer advantages over traditional prostheses by reducing stress shielding and promoting osseointegration, while maintaining the original stiffness of the prosthesis. Furthermore, in vivo experiments show that these prostheses meet the requirements for daily activities of patients. This study provides a valuable reference for the design of future periacetabular bone tumor reconstruction prostheses.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Chunlin Zhang
- Department of Orthopedic Surgery, Institute of Bone Tumor, Shanghai 10th People’s Hospital Affiliated to Tongji University, Tongji University School of Medicine, Shanghai, China
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Kurbanova A, Aksoy S, Nalça Andrieu M, Öz U, Orhan K. Evaluation of the influence of hyoid bone position, volume, and types on pharyngeal airway volume and cephalometric measurements. Oral Radiol 2023; 39:731-742. [PMID: 37330936 DOI: 10.1007/s11282-023-00691-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 06/09/2023] [Indexed: 06/20/2023]
Abstract
OBJECTIVES We aimed to explore the position, morphological, and morphometric properties of the hyoid bone (HB) and to investigate the effect of HB on the pharyngeal airway (PA) volume and cephalometric measurements. METHODS A total of 305 patients with CT images were included in the study. DICOM images were transferred to the InVivoDental three-dimensional imaging software. The position of the HB was determined based on the cervical vertebra level and in volume render tab, the bone was classified into six types after all structures around the HB were removed. Also, final bone volume was recorded. In the same tab, the pharyngeal airway volume was divided and measured in three groups (nasopharynx-oropharynx-hypopharynx). The linear and angular measurements were performed on the 3D cephalometric analysis tab. RESULTS HB was most commonly located in C3 vertebra level (80.3%). While B-type was found to be the most frequent (34%), V-type was the least frequent (8%). The volume of the HB was found to be significantly higher in male (3205 mm3) than female (2606 mm3) patients. Also, it was significantly higher in the C4 vertebra group. The vertical height of the face was positively correlated with the HB volume, C4 level position, and increased oro-nasopharyngeal airway volume. CONCLUSION The volume of the HB is found to differ significantly between genders and can potentially serve as a valuable diagnostic tool for understanding respiratory disorders. Its morphometric features are associated with increased face height and airway volume; however, are not related with the skeletal malocclusion classes.
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Affiliation(s)
- Aida Kurbanova
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Near East University, Nicosia, Cyprus.
| | - Seçil Aksoy
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Near East University, Nicosia, Cyprus
| | - Meltem Nalça Andrieu
- Department of Radiation Oncology, Faculty of Medicine, Near East University, Nicosia, Cyprus
| | - Ulaş Öz
- Department of Orthodontics, Faculty of Dentistry, Final International University, Nicosia, Cyprus
| | - Kaan Orhan
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
- Medical Design Application and Research Center (MEDITAM), Ankara University, Ankara, Turkey
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Changes in Hyoid Bone Position before and after Distraction Osteogenesis in Infants with Robin Sequence. J Craniofac Surg 2021; 33:1051-1056. [PMID: 34775445 DOI: 10.1097/scs.0000000000008377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To study the changes of hyoid position in infants with Robin sequence before and after mandibular distraction osteogenesis, and to explore the related factors. MATERIAL AND METHODS Twenty-six infants with Robin sequence underwent bilateral mandibular distraction osteogenesis from May 2016 to April 2020. Three-dimensional computed tomography data of patients before and after surgery were analyzed with Materialise Mimics 17.0. Changes in the three-dimensional position of the hyoid bone were studied. RESULTS The angle between the long axis of the tongue body and hard palate plane, and the angle between the long axis of the tongue body and mandibular plane were significantly decreased after surgery than before surgery. The hyoid bone-cranial base vertical distance, hyoid bone-mental point distance, and hyoid bone-epiglottis distance were significantly increased after surgery. The differences in the above-mentioned data were statistically significant (P < 0.05). Changes in the angle between the long axis of the tongue body and the hyoid bone-mental point line correlated with changes in the position of the hyoid bone relative to the cervical spine (P = 0.006). Postoperatively, the hyoid bone moved forward and the increase in the hyoid bone-mental point osseous distance interval (41.28%) was significantly greater than the increase in the hyoid bone-epiglottis distance (18.73%). Differences in the total mandibular length and the hyoid bone-cranial base vertical distance are related to the age at the operation (P < 0.05). The younger the age at the time of surgical intervention, the greater the difference before and after surgery for the same follow-up interval. CONCLUSIONS The three-dimensional direction of the hyoid bone changes after the distraction osteogenesis of the mandible, and the hyoid bone moves downward and forward. Because the mandibular length and airway changed, the relative positions of the long axis of the tongue body on the sagittal plane rotated clockwise.
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Makoshi LA, Buchanan EP, Tran HD, Lambert EM. A Case Report of Aplasia of the epiglottis and the hyoid bone in a Pierre Robin Sequence Patient, an underreported association? OTOLARYNGOLOGY CASE REPORTS 2021. [DOI: 10.1016/j.xocr.2021.100373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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