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研究生:許秉文
研究生(外文):Ping-WenHsu
論文名稱:使用腓骨於下顎骨重建手術規劃之模擬系統
論文名稱(外文):Development of An Automatic Pre-Surgical Planning for Mandibular Reconstruction Simulation using Fibula Flap
指導教授:蔡明俊蔡明俊引用關係
指導教授(外文):Ming-June Tsai
學位類別:碩士
校院名稱:國立成功大學
系所名稱:機械工程學系碩博士班
學門:工程學門
學類:機械工程學類
論文種類:學術論文
論文出版年:2012
畢業學年度:100
語文別:英文
論文頁數:68
中文關鍵詞:下顎骨重建參數化腓骨術前規劃
外文關鍵詞:mandibular reconstructionparameterizationfibulapre-surgical planning
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利用腓骨膜瓣進行的下顎骨重建手術中,為讓病患術後復原擁有較佳的外觀,現今有許多術前規劃的相關研究可幫助醫師掌握手術情況,其中利用電腦輔助技術在近年來逐漸被廣泛使用。大多數的術前規劃方式皆是觀察下顎骨及病變部位的外型特徵來安排腓骨的切塊數量、長度及角度,然而此步驟需仰賴人工量測尺寸或模具製作。
為簡化上述程序,本研究目的為針對“使用腓骨進行之下顎骨重建手術”開發一套自動化重建規劃系統。研究共分為參數化及重建規劃兩大部份,在參數化中,下顎骨的三角網格模型及腓骨的三維掃描點將會根據其自然特徵轉換成具有特徵定義的結構點之組成,並利用結構點重建出新的三角網格模型;而在重建規劃中,我們利用下顎骨及腓骨的結構參數來定義下顎骨的病變區域及腓骨皮瓣位置,由決定好的腓骨擺放方位來計算最佳的切塊數量及長度,最後於虛擬實境中模擬切骨手術及下顎骨重建完成後的結果。

Using fibular flap for mandibular reconstrcution is a common method. In order to achieve a better functional and aesthetic reconstruction result, many studies for pre-surgical planning are employed to assist surgeons in the surgery, especially for computer-aided system that is widely used in recently. Most of methods for pre-surgical planning are performed by observing the geometry features of mandible defect portion, and then the number of fibular segment required to shape the original contour can be determined. However, this relies on vision measurement and model production.
In order to simplify this process, this study aims to develop an automatic surgical planning system for mandibular reconstrcution using fibular flap. The study insists of two major parts, which are parameterization and reconstruction planning. In the parameterization, a mandible Stereo Lithograph (STL) model and fibula scan data will be parameterized into feature-defined structure points according to their geometry characteristics. A New STL model can be generated using structure points. For reconstruction planning, the structure parameters are used to determine the mandible defect and the orientation of fibula to reconstruct, and then to calculate for the optimal reconstruction solution. Finally, the simulation of osteotomy and reconstruction are performed in the virtual reality.

摘要.....................................................I
Abstract................................................II
謝誌.....................................................IV
Chapter 1 Introduction................................1
1.1 Motivation and Background.......................1
1.2 Literature Review...............................3
1.2.1 Mandibular Reconstruction...................3
1.2.2 Development of Computer-Aided System........6
1.3 Paper Outline...................................7
Chapter 2 Mandible Parameterization...................9
2.1 Introduction....................................9
2.2 Reference Line Construction.....................10
2.2.1 The Best Symmetrical Plane..................11
2.2.2 Two-dimensional Medial-axis.................17
2.2.3 Reference Line..............................19
2.3 Parameterization................................21
2.3.1 Parameterization of Reference Line..........21
2.4 Non-Dimensionalized Nodes.......................29
2.4.1 Structure points............................31
Chapter 3 Fibula Parameterization.....................35
3.1 Introduction....................................35
3.2 Noise Filtering.................................35
3.3 Parameterization................................38
3.3.1 Sectional Contour of Fibula.................38
3.3.2 Structure Definition........................40
3.3.3 STL Model Reconstruction....................41
Chapter 4 Osteotomy Planning..........................42
4.1 Introduction....................................42
4.2 Mandible Resection..............................42
4.3 Optimal Cutting Planning Algorithm..............43
4.3.1 Optimal Cutting Position Algorithm..........44
4.3.2 Optimization Algorithm......................47
4.4 Reconstruction Path Estimation..................50
4.4.1 Local Coordinate System.....................51
4.4.2 Reconstruction Reference Line...............52
4.5 Osteotomy Guide Planes..........................54
Chapter 5 Result and Discussion.......................58
5.1 Simulation Result...............................58
5.2 Discussion......................................59
Chapter 6 Conclusions and Future Works................62
Reference...............................................65

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