Computational modeling of the mature unilateral cleft lip nasal deformity for objective assessment of patient nasal function and treatment outcomes

成熟单侧唇裂鼻畸形的计算模型，用于客观评估患者鼻功能和治疗结果

基本信息

批准号：
10369059
负责人：
Dennis Onyeka Frank-Ito
金额：
$ 37.1万
依托单位：
DUKE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-04-01 至 2025-03-31
项目状态：
未结题

项目摘要

PROJECT SUMMARY / ABSTRACT In the Western world where the long surgical history of cleft lip repair dates back to 17th century, restoring form and function in the unilateral cleft lip nasal deformity (uCLND) is acknowledged as among the most difficult remaining surgical challenges. Further, compared to the aesthetic aspects of the mature uCLND deformity, the functional implications of uCLND have received limited attention. Although cleft-lip- and/or palate-induced nasal obstruction was first described over 86 years ago, almost no progress has been made to improve treatment outcomes associated with nasal breathing. An estimated 70% of cleft individuals have impaired functional nasal breathing and upwards of 80% “mouth-breathe”. Structural abnormalities in uCLND create multiple sites of airway obstruction; the inability to accurately identify the most relevant obstructive sites for correction to yield optimal patient outcome is arguably the biggest diagnostic dilemma hindering functional advancement in treating uCLND. Our long-term goal is to restore nasal breathing function to normative levels in post-surgical cleft patients by developing a computational modeling platform to aid surgeons to optimize treatment outcomes. The rationale underlying our application is that once it is known to what extent and severity each of the different sites of airway obstructive deformities impede nasal breathing, post-surgical improvement in nasal function to a normative baseline will be attainable in uCLND patients. Based on the strength of our preliminary data, the following Specific Aims are proposed: [1] Determine effectiveness of current nasal surgical procedure(s) for skeletally mature uCLND patients in restoring nasal function to healthy normative ranges; and [2] Optimize treatment options for uCLND via identification and digital correction of greatest obstructive sites. The culmination of this research will provide a scientific basis for successful treatment of cleft-induced nasal breathing dysfunction because, significantly, our contributions will provide [1] objective evidence for why current interventions may not completely restore nasal function to normative levels, and [2] treatment options with the potential to optimize patient outcomes using computational methods.

项目摘要 /摘要在西方世界，较长的唇裂修复的手术历史可以追溯到17世纪，恢复形式并在单侧裂口鼻畸形（UCLND）中的功能被认为是最困难的剩下的手术挑战。此外，与成熟UCLND畸形的美学方面相比 UCLND的功能含义受到了有限的关注。虽然唇裂 - 和/或pa诱导鼻反应最初是在86年前描述的，几乎没有进步来改进与鼻呼吸有关的治疗结果。估计有70％的裂缝受损功能性鼻呼吸，高达80％的“口气”。 UCLND创建的结构异常气道异议的多个地点；无法准确识别最相关的阻塞站点纠正以产生最佳患者结果可以说是最大的诊断困境阻碍功能进步治疗UCLND。我们的长期目标是将鼻呼吸功能恢复到正常水平在手术后裂口患者中，通过开发一个计算建模平台来帮助外科医生优化治疗结果。我们申请的基本原理是，一旦知道了何种程度和严重程度的每个不同地点的气道阻塞性畸形会阻碍鼻呼吸，后手术后在UCLND患者中，可以实现鼻腔功能对正常基线的改善。基于我们初步数据的强度，提出了以下特定目的：[1]确定有效性当前用于骨骼成熟UCLND患者的鼻腔外科手术恢复健康的鼻功能正常范围； [2]通过识别和数字校正优化UCLND的治疗选择最大的阻塞地点。这项研究的高潮将为成功提供科学基础裂口诱导的鼻呼吸功能障碍的治疗，因为我们的贡献将提供[1] 客观证明为什么当前干预措施可能不会将鼻功能完全恢复到正常水平， [2]治疗方案有可能使用计算方法优化患者的结果。