Finite element modelling of maxillofacial surgery and facial expressions - a preliminary study

Background Recent advances in diagnostic imaging and associated software have enabled the transformation of anatomical structures into finite element (FE) models facilitating computerized facial modelling. The work presented employs personalized imaging data of facial anatomical structures for use in planning and predicting the outcome of maxillofacial surgery. The current process relies on either freehand planning and/or commercial two-dimensional (2D) and three-dimensional (3D) surgical planning software packages, but the validity of these software packages has been questioned. In this paper, the finite element technique was used to predict the outcome of maxillofacial surgery. Methods A finite element facial model was created, based on patient specific bone and skin image data, combined with generic muscle data. The model was used for two distinct purposes: simulation of the maxillofacial surgery and simulation of facial expressions pre- and post-surgery. This combination allowed for an improved prediction of surgery outcome. Commercial software was used for creating the FE facial model from the original image data, and LS-DYNA (R) was the analysis code used for the purpose of the FE simulation. Results The results from the simulation of maxillofacial surgery showed an overall agreement of 85% with the patient data at 6 months post-surgery and the error was generally contained within a +/- 2 mm threshold. Conclusions The results show that the approach of using commercial FE software tools to create a detailed and anatomically accurate patient specific model for simulation of maxillofacial surgery, as well as facial expressions, can be applied in facial surgery planning. As the study was based on data collected from one patient, further work is needed in which additional subjects can be assessed. Copyright (C) 2010 John Wiley & Sons, Ltd.