Abstract
A FEA-based methodology was developed in order to predict the wear status of an osteotome (surgical instrument) during its use in a lateral nasal bone osteotomy considering its fatigue strength. The latter parameter was determined by appropriate FEM-evaluation of the perpendicular impact test results. For the simulation of the surgical procedure, two scenarios were examined: (i) when utilizing a brand new osteotome and (ii) when utilizing an already used osteotome characterized by decreased fatigue strength. The actual nasal bone geometry used in the FEA model was obtained from a high-resolution, maxillofacial, computed tomography (CT) scan of a single patient. In both cases examined, depiction of fracture patterns for the osteotome and the nasal bone were obtained. The wear of a new osteotome and an already used osteotome was also calculated and compared. The developed von Mises stresses in both the osteotome and nasal bone were depicted. The proposed methodology allowed an accurate prediction of the critical number of impacts that the osteotome can receive during the lateral nasal osteotomy which is followed in all rhinoplasties. Based on the developed methodology, a preventive replacement of the osteotome before its extensive fracture can be determined, thereby minimizing the risk of postoperative complications.
Highlights
Modern rhinoplasty involves restoring both the external appearance of the nose and the functionality
Huang et al [1,2] had simulated the surgical correction of cleft lip nasal deformity and the cleft lip rhinoplasty procedure in terms of stresses developed on several parts of the nose
As the osteotome penetrates deeper into the nasal bone, the developed stresses fatigue stress determined by the instrument Wohler diagram, the failure criterion is met and the related are increased
Summary
Modern rhinoplasty involves restoring both the external appearance of the nose and the functionality. Both procedures are important and for this, all functional abnormalities of the nose should be corrected in the same surgical procedure. To elucidate critical information for the biomechanics of the nose several researchers resort to FEM (Finite Element Method) analysis as a powerful modeling tool. Huang et al [1,2] had simulated the surgical correction of cleft lip nasal deformity and the cleft lip rhinoplasty procedure in terms of stresses developed on several parts of the nose. FEM was employed for modelling of the nasal septum with a view to facilitating the proper septal realignment and reconstruction [3]. FE analyses (FEA) of certain deformities of nose such as the inverted-V and the support of the nasal tip [4,5,6] were reported
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