title: Simultaneous cutting of coupled tetrahedral and triangulated meshes and its application in orbital reconstruction.
abstract: BACKGROUND
  Recently, advances in imaging techniques for diagnostics and associated technologies have led to an improved preoperative planning for craniomaxillofacial surgeons. In particular, the application of navigation-aided procedures for orbital reconstruction has proved to be essential. Preforming orbital implants for orbital floor reconstruction and determining overcorrection with regard to the orbital floor reconstruction could be achieved using preoperative planning. It has turned out that the computation of soft tissue cuts is an essential prerequisite for the realistic placement of implants.
  
  
  METHODS
  We propose a simulation framework that allows for the static and dynamic cutting of soft and hard tissue representations. The framework comprises components to model tissue deformation, cutting of tissue and interaction between the physical bodies. Furthermore, volume and surface representations are decoupled which allows for an independent scaling in the complexity of the representations and, therefore, in the simulation and visualisation performance. In contrast to many other cutting approaches, our algorithm handles both representations simultaneously.
  
  
  CONCLUSIONS
  The framework is used to simulate the realistic insertion of a preformed orbital implant model through the soft tissue cut and the prediction of the postoperative eye bulb position. Experiments show that the framework can be used to determine overcorrection and to preform orbital implants.
authors.affiliation: Department of Craniomaxillofacial Surgery, University Hospital Freiburg, Freiburg, Germany.
authors.forename: Marc Christian
authors.initials: MC
authors.lastname: Metzger
authors.forename: Marc
authors.initials: M
authors.lastname: Gissler
authors.forename: Matthias
authors.initials: M
authors.lastname: Asal
authors.forename: Matthias
authors.initials: M
authors.lastname: Teschner
mesh_terms: D000465:Algorithms; D006801:Humans; D008954:Models, Biological; D009915:Orbit / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D020273:Orbital Implants; D019651:Plastic Surgery Procedures / Q000379:methods*; D015203:Reproducibility of Results; D025321:Surgery, Computer-Assisted; D013526:Surgical Mesh; D014057:Tomography, X-Ray Computed