Stress Distribution Patterns within Viscero- and Neurocranium during Nasoalveolar Molding: a Finite Element Analysis.

Ritschl, Lucas M; Heinrich, Veronika; Grill, Florian D; Roth, Maximilian; Hedderich, Dennis M; Rau, Andrea; Wolff, Klaus-Dietrich; Bauer, Franz X; Loeffelbein, Denys J

doi:10.1097/GOX.0000000000001832

2018

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Dokumenttyp:: Journal Article
Autor(en):: Ritschl, Lucas M; Heinrich, Veronika; Grill, Florian D; Roth, Maximilian; Hedderich, Dennis M; Rau, Andrea; Wolff, Klaus-Dietrich; Bauer, Franz X; Loeffelbein, Denys J
Titel:: Stress Distribution Patterns within Viscero- and Neurocranium during Nasoalveolar Molding: a Finite Element Analysis.
Abstract:: Background: The purpose of this study was to evaluate the stress distribution patterns within the viscero- and neurocranium of neonates during nasoalveolar molding. Methods: Finite element models of 3 different healthy neonates at different times of life (date of birth, 4 weeks, and 3.5 months) were generated on the basis of computed tomography scans. A validated workflow, including segmentation, meshing, setting of boundary conditions, and implementation of a bone density-dependent material model, was carried out for each model. A small and a large unilateral alveolar and hard palatal cleft were virtually cut in each model. The stress distribution pattern in each model was then analyzed by using Ansys APDL. Results: Convergence analysis validated the results. The virtual experiments at the date of birth showed a stress pattern above a previously defined threshold value of 30,000 Pa in the ipsilateral naso-orbital-complex, frontal sinus, and the anterior fossa of the base of the skull, with von Mises values > 35,000 Pa. Stress patterns at the age of 4 weeks and 3.5 months showed reduced von Mises values at < 15,000 Pa. Conclusions: Nasoalveolar molding therapy is a safe presurgical treatment modality without significant influence on the viscero- and neurocranium of neonates. Treatment, considering the stress distribution at the naso-orbital-complex and anterior fossa of the base of the skull, should begin in the second week of life, and treatment initiation of preterm infants should be adapted respectively.
Zeitschriftentitel:: PRS-GLOB. OPEN
Jahr:: 2018
Band / Volume:: 6
Heft / Issue:: 7
Volltext / DOI:: doi:10.1097/GOX.0000000000001832
PubMed:: http://view.ncbi.nlm.nih.gov/pubmed/30175012
TUM Einrichtung:: Fachgebiet Neuroradiologie (Prof. Zimmer); Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie
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