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                <term xml:lang="en">Finite Element method.</term>
                <term xml:lang="en">poroelasticity</term>
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                <term xml:lang="en">exophthalmia</term>
                <term xml:lang="en">orbital surgery</term>
                <term xml:lang="fr">méthode des Eléments Finis</term>
                <term xml:lang="fr">chirurgie orbitaire</term>
                <term xml:lang="fr">exophtalmie</term>
                <term xml:lang="fr">planning assisté par ordinateur</term>
                <term xml:lang="fr">modèles biomécaniques</term>
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              <p>Cette thèse propose une étude du comportement des tissus mous intra-orbitaires dans le cadre du traitement des exophtalmies, caractérisées par une protrusion du globe oculaire. La partie chirurgicale de ce traitement consiste en une décompression de l'orbite par le biais d'une ostéotomie des parois orbitaires pour réduire la protrusion du globe. Nos travaux visent à prédire les relations entre le volume des tissus décompressés, la surface d'ostéotomie et le recul oculaire résultant pour apporter une aide au planning chirurgical. Pour cela, deux modèles ont été développés. Le premier est un modèle analytique simple de l'orbite assimilant les parois orbitaires à un cône et le globe à une sphère. Il permet de déterminer de façon satisfaisante le volume décompressé en fonction du recul souhaité. Le deuxième est un modèle biomécanique des tissus mous intra-orbitaires et de leurs interactions avec les parois osseuses et le globe. Il s'agit d'un maillage Eléments Finis utilisant un matériau poroélastique et prenant en compte la morphologie de l'orbite du patient, les propriétés mécaniques des tissus mous. Il permet de quantifier le recul oculaire et le volume de tissus décompressés en fonction de l'effort (ou du déplacement) imposé par le chirurgien et de l'ostéotomie (surface et position). Ses résultats sont relativement intéressants et permettent d'évaluer le comportement des tissus intra-orbitaires. La méthode de génération automatique de maillage éléments finis, développée dans cette thèse, a permis d'effectuer différentes simulations d'ostéotomies et de conclure que la morphologie de l'orbite patient a un impact sur le recul et le volume décompressé et que l'influence de la surface d'ostéotomie est modérée. Une analyse rhéologique des tissus mous orbitaires a été effectuée. Les tests in vitro ont permis de poser les bases de futures mesures. Les tests in vivo, réalisés avec un capteur ad hoc, ont déterminé la raideur des tissus mous. Bien que les modèles présentés dans cette thèse ne soient pas encore utilisables dans le cadre d'un planning chirurgical, ils fournissent des résultats satisfaisants et une bonne estimation des phénomènes observés lors d'une décompression orbitaire.</p>
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