Simulations of the consequences of tongue surgery on tongue mobility: implications for speech production in post-surgery conditions.
BACKGROUND
We studied the ability of a three-dimensional (3D) biomechanical model of the oral cavity to predict the consequences of tongue surgery on tongue movements, according to the size and location of the tissue loss and the nature of the flap used by the surgeon.


METHODS
The core of our model consists of a 3D biomechanical model representing the tongue as a finite element structure with hexahedral elements and hyperelastic properties, in which muscles are represented by specific subsets of elements. This model is inserted in the oral cavity including jaw, palate and pharyngeal walls. Hemiglossectomy and large resection of the mouth floor are simulated by removing the elements corresponding to the tissue losses. Three kinds of reconstruction are modelled, assuming flaps with low, medium or high stiffness.


RESULTS
The consequences of these different surgical treatments during the activation of some of the main tongue muscles are shown. Differences in global 3D tongue shape and in velocity patterns are evaluated and interpreted in terms of their potential impact on speech articulation. These simulations have been shown to be efficient in accounting for some of the clinically observed consequences of tongue surgery.


CONCLUSIONS
Further improvements still need to be done before being able to generate patient-specific models easily and to decrease the computation time significantly. However, this approach should represent a significant improvement in planning tongue surgery systems and should be a very useful means of improving the understanding of muscle behaviour after partial resection.
Buchaillard
Stéphanie
S
ICP/GIPSA-lab, UMR CNRS 5216, INP Grenoble, France.
Brix
Muriel
M
Perrier
Pascal
P
Payan
Yohan
Y
D003198:Computer Simulation; D006801:Humans; D008954:Models, Biological; D009068:Movement; D019647:Oral Surgical Procedures / Q000009:adverse effects* / Q000379:methods*; D013060:Speech; D013064:Speech Disorders / Q000209:etiology / Q000503:physiopathology* / Q000517:prevention & control; D013068:Speech Production Measurement; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014059:Tongue / Q000503:physiopathology* / Q000601:surgery*; D016896:Treatment Outcome