Soft-tissue Driven Craniomaxillofacial Surgical Planning

In CMF surgery, the planning of bony movement to achieve a desired facial outcome is a challenging task. Current bone driven approaches focus on normalizing the bone with the expectation that the facial appearance will be corrected accordingly. However, due to the complex non-linear relationship between bony structure and facial soft-tissue, such bone-driven methods are insufficient to correct facial deformities. Despite efforts to simulate facial changes resulting from bony movement, surgical planning still relies on iterative revisions and educated guesses. To address these issues, we propose a soft-tissue driven framework that can automatically create and verify surgical plans. Our framework consists of a bony planner network that estimates the bony movements required to achieve the desired facial outcome and a facial simulator network that can simulate the possible facial changes resulting from the estimated bony movement plans. By combining these two models, we can verify and determine the final bony movement required for planning. The proposed framework was evaluated using a clinical dataset, and our experimental results demonstrate that the soft-tissue driven approach greatly improves the accuracy and efficacy of surgical planning when compared to the conventional bone-driven approach.

Deep Learning-based Facial Appearance Simulation Driven by Surgically Planned Craniomaxillofacial Bony Movement

Simulating facial appearance change following bony movement is a critical step in orthognathic surgical planning for patients with jaw deformities. Conventional biomechanics-based methods such as the finite-element method (FEM) are labor intensive and computationally inefficient. Deep learning-based approaches can be promising alternatives due to their high computational efficiency and strong modeling capability. However, the existing deep learning-based method ignores the physical correspondence between facial soft tissue and bony segments and thus is significantly less accurate compared to FEM. In this work, we propose an Attentive Correspondence assisted Movement Transformation network (ACMT-Net) to estimate the facial appearance by transforming the bony movement to facial soft tissue through a point-to-point attentive correspondence matrix. Experimental results on patients with jaw deformity show that our proposed method can achieve comparable facial change prediction accuracy compared with the state-of-the-art FEM-based approach with significantly improved computational efficiency.