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

• 批准号: 10132302
• 负责人: Dennis Onyeka Frank-Ito
• 金额: $ 37.22万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-01 至 2023-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10132302
• 关键词: Address; Affect; Air Conditioning; Air Movements; Anatomy; Appearance; Attention; Awareness; Back; Breathing; Caring; Chronic; Cleft Lip; Cleft lip with or without cleft palate; Computer Models; Computing Methodologies; Data; Deformity; Depressed mood; Diagnosis; Diagnostic; Economics; Esthetics; Face; Functional disorder; Goals; Hearing; In Vitro; Individual; Intervention; Life Experience; Liquid substance; Measurement; Mission; Modality; Modeling; Nasal cavity; Nose; Obstruction; Operative Surgical Procedures; Oral cavity; Outcome; Patient-Focused Outcomes; Patients; Personal Satisfaction; Procedures; Public Health; Publications; Quality of life; Recording of previous events; Recurrence; Reporting; Research; Residual state; Resistance; Respiration Disorders; Severities; Site; Societal Factors; Speech Intelligibility; Structural defect; Surgeon; Symptoms; Treatment outcome; United States National Institutes of Health; Western World; airway obstruction; base; digital; drinking; effectiveness evaluation; experimental study; functional disability; functional outcomes; functional restoration; hazard; improved; insight; nasal obstruction; psychosocial; public health relevance; repaired; simulation; skeletal; social; social stigma; surgery outcome; treatment optimization; virtual surgery

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.

项目概要/摘要 在西方世界，唇裂修复手术的悠久历史可以追溯到 17 世纪 单侧唇裂鼻畸形 (uCLND) 的功能和功能被认为是最困难的手术之一 此外，与成熟的 uCLND 畸形的美学方面相比，仍然存在手术挑战。 尽管唇裂和/或腭裂引起的，但 uCLND 的功能影响受到的关注有限。 86年前首次描述鼻塞，但改善方面几乎没有任何进展 估计 70% 的唇腭裂患者的治疗效果受到影响。 uCLND 中出现功能性鼻呼吸和 80% 以上的“口呼吸”结构异常。 气道阻塞的多个部位；无法准确识别最相关的阻塞部位 纠正以产生最佳的患者结果可以说是阻碍功能的最大诊断困境 我们的长期目标是将鼻呼吸功能恢复到正常水平。 通过开发计算建模平台来帮助外科医生优化术后唇裂患者 我们应用的基本原理是，一旦知道治疗结果的程度和程度。 不同部位气道阻塞性畸形的严重程度阻碍鼻呼吸，术后 uCLND 患者的鼻功能将可改善至正常基线。 根据我们初步数据的强度，提出以下具体目标： [1] 确定 目前针对骨骼成熟的 uCLND 患者的鼻外科手术可将鼻功能恢复到健康状态 规范范围；以及 [2] 通过识别和数字校正优化 uCLND 的治疗方案 这项研究的成果将为成功提供科学基础。 治疗裂口引起的鼻呼吸功能障碍，因为我们的贡献将显着提供 [1] 客观证据说明为什么当前的干预措施可能无法将鼻功能完全恢复到正常水平， [2] 有可能使用计算方法优化患者结果的治疗方案。