An Instrumented Hammer to Detect the Rupture of the Pterygoid Plates

Overview

Journal Ann Biomed Eng

Specialty Biomedical Engineering

Date 2024 Aug 22

PMID 39174762

Authors

Manon Bas Dit Nugues

Leo Lamassoure

Giuseppe Rosi

Charles Henri Flouzat-Lachaniette

Roman Hossein Khonsari

Guillaume Haiat

Affiliations

Soon will be listed here.

Abstract

Purpose: Craniofacial osteotomies involving pterygomaxillary disjunction are common procedures in maxillofacial surgery. Surgeons still rely on their proprioception to determine when to stop impacting the osteotome, which is important to avoid complications such as dental damage and bleeding. Our group has developed a technique consisting in using an instrumented hammer that can provide information on the mechanical properties of the tissue located around the osteotome tip. The aim of this study is to determine whether a mallet instrumented with a force sensor can be used to predict the crossing of the osteotome through the pterygoid plates.

Methods: 31 osteotomies were carried out in 16 lamb skulls. For each impact, the force signal obtained was analysed using a dedicated signal processing technique. A prediction algorithm based on an SVM classifier and a cost matrix was applied to the database.

Results: We showed that the device could always detect the crossing of the osteotome, sometimes before its occurrence. The prediction accuracy of the device was 94.7%. The method seemed to be sensitive to the thickness of the plate and to crack apparition and propagation.

Conclusion: These results pave the way for the development of a per-operative decision support system in maxillofacial surgery.

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