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Günay MM, Saylam G, Fırat İH, Akyıldız İ, Bayır Ö, Mutlu M, Korkmaz MH. Novel clinical screening method to identify patients at risk of obstructive sleep apnea. Cranio 2024; 42:190-198. [PMID: 34053418 DOI: 10.1080/08869634.2021.1933308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To investigate whether the distance between the two retromolar trigones (RMTs) with the distance between the two posterior plicas (PPs) affects obstructive sleep apnea syndrome (OSAS) and to determine a physical examination method that can be used in the selection of patients to be referred to polysomnography (PSG). METHODS The study included 86 OSAS patients and 29 healthy controls. RMTs and PPs were measured using a caliper-like device. The values obtained from these measurements were evaluated in both groups. RESULTS The PPs were narrower, and the RMTs-PPs, RMTs-PPs/RMTs, and RMTs/PPs values were greater in the OSAS group (p < .05) compared to the control group. The cut-off values were 0.612 for RMTs-PPs/RMTs and 2.589 for RMTs/PPs. The specificity of these values for OSAS was 97%, and sensitivity was 57% and 58%, respectively. CONCLUSION The presented method may play a role in preventing unnecessary PSG among patients with suspected OSAS.
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Affiliation(s)
- Mehmet Murat Günay
- Department of Otorhinolaryngology Head and Neck Surgery, Adiyaman Kahta State Hospital, Adiyaman, Turkey
| | - Güleser Saylam
- Department of Otorhinolaryngology Head and Neck Surgery, University of Health Sciences, Ankara Diskapi Training and Research Hospital, Ankara, Turkey
| | - İbrahim Hikmet Fırat
- Department of Chest Diseases, University of Health Sciences, Ankara Diskapi Training and Research Hospital, Ankara, Turkey
| | - İlker Akyıldız
- Department of Otorhinolaryngology Head and Neck Surgery, University of Health Sciences, Ankara Diskapi Training and Research Hospital, Ankara, Turkey
| | - Ömer Bayır
- Department of Otorhinolaryngology Head and Neck Surgery, University of Health Sciences, Ankara Diskapi Training and Research Hospital, Ankara, Turkey
| | - Murad Mutlu
- Department of Otorhinolaryngology Head and Neck Surgery, Adiyaman Kahta State Hospital, Adiyaman, Turkey
| | - Mehmet Hakan Korkmaz
- Department of Otorhinolaryngology Head and Neck Surgery, Ankara Yildirim Beyazit University Faculty of Medicine, Ankara, Turkey
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Pham TD, Holmes SB, Patel M, Coulthard P. Features and networks of the mandible on computed tomography. ROYAL SOCIETY OPEN SCIENCE 2024; 11:231166. [PMID: 38234434 PMCID: PMC10791540 DOI: 10.1098/rsos.231166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 12/19/2023] [Indexed: 01/19/2024]
Abstract
The mandible or lower jaw is the largest and hardest bone in the human facial skeleton. Fractures of the mandible are reported to be a common facial trauma in emergency medicine and gaining insights into mandibular morphology in different facial types can be helpful for trauma treatment. Furthermore, features of the mandible play an important role in forensics and anthropology for identifying gender and individuals. Thus, discovering hidden information of the mandible can benefit interdisciplinary research. Here, for the first time, a method of artificial intelligence-based nonlinear dynamics and network analysis are used for discovering dissimilar and similar radiographic features of mandibles between male and female subjects. Using a public dataset of 10 computed tomography scans of mandibles, the results suggest a difference in the distribution of spatial autocorrelation between genders, uniqueness in network topologies among individuals and shared values in recurrence quantification.
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Affiliation(s)
- Tuan D. Pham
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Turner Street, London E1 2AD, UK
| | - Simon B. Holmes
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Turner Street, London E1 2AD, UK
| | - Mangala Patel
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Turner Street, London E1 2AD, UK
| | - Paul Coulthard
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Turner Street, London E1 2AD, UK
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Liao FC, Zhang T, Huang XP, Sangwatanakul J, Li HY, Zhou N. Correlation analysis of upper airway morphology in patients with obstructive sleep apnea and anatomically small retruded mandibles. Cranio 2023; 41:416-422. [PMID: 33355036 DOI: 10.1080/08869634.2020.1864165] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To investigate the relationship between upper airway morphology and the severity of obstructive sleep apnea (OSA) in patients with anatomically small retruded mandibles. METHODS Fifty-two patients with small retruded mandibles underwent polysomnography and airway computed tomography. The airway morphology parameters and sleep assessment were compared between the patients with or without OSA. RESULTS Twenty-eight patients diagnosed with OSA, according to polysomnography, had a higher distance between the hyoid bone and mandibular plane (HMP), lateral dimension (LAT)/anteroposterior dimension (AP), but lower minimum cross-sectional area (mCSA), AP, surface area, volume, avgCSA, and airway uniformity (U). The apnea-hypopnea index had negative correlations with mCSA, AP, surface area, volume, avgCSA, and U, and had a positive correlation with HMP and LAT/AP. CONCLUSION OSA is common among patients with small retruded mandibles and is associated with a more compressed upper airway shape and longer HMP.
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Affiliation(s)
- Feng-Chun Liao
- Department of Oral and Maxillofacial Surgery, College of Stomatology, Guangxi Medical University, Nanning, People's Republic of China
- Guangxi Clinical Research Center for Craniofacial Deformity, Nanning, People's Republic of China
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Nanning, People's Republic of China
- Guangxi Key Laboratory of Oral and Maxillofacial Surgery Disease Treatment, Nanning, People's Republic of China
| | - Tao Zhang
- Department of Oral and Maxillofacial Surgery, College of Stomatology, Guangxi Medical University, Nanning, People's Republic of China
- Guangxi Clinical Research Center for Craniofacial Deformity, Nanning, People's Republic of China
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Nanning, People's Republic of China
- Guangxi Key Laboratory of Oral and Maxillofacial Surgery Disease Treatment, Nanning, People's Republic of China
| | - Xuan-Ping Huang
- Department of Oral and Maxillofacial Surgery, College of Stomatology, Guangxi Medical University, Nanning, People's Republic of China
- Guangxi Clinical Research Center for Craniofacial Deformity, Nanning, People's Republic of China
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Nanning, People's Republic of China
- Guangxi Key Laboratory of Oral and Maxillofacial Surgery Disease Treatment, Nanning, People's Republic of China
| | - Jirayus Sangwatanakul
- Department of Oral and Maxillofacial Surgery, College of Stomatology, Guangxi Medical University, Nanning, People's Republic of China
- Guangxi Clinical Research Center for Craniofacial Deformity, Nanning, People's Republic of China
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Nanning, People's Republic of China
- Guangxi Key Laboratory of Oral and Maxillofacial Surgery Disease Treatment, Nanning, People's Republic of China
| | - Hong-Yi Li
- Department of Oral and Maxillofacial Surgery, College of Stomatology, Guangxi Medical University, Nanning, People's Republic of China
- Guangxi Clinical Research Center for Craniofacial Deformity, Nanning, People's Republic of China
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Nanning, People's Republic of China
- Guangxi Key Laboratory of Oral and Maxillofacial Surgery Disease Treatment, Nanning, People's Republic of China
| | - Nuo Zhou
- Department of Oral and Maxillofacial Surgery, College of Stomatology, Guangxi Medical University, Nanning, People's Republic of China
- Guangxi Clinical Research Center for Craniofacial Deformity, Nanning, People's Republic of China
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Nanning, People's Republic of China
- Guangxi Key Laboratory of Oral and Maxillofacial Surgery Disease Treatment, Nanning, People's Republic of China
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Ohmura K, Suzuki M, Soma M, Yamazaki S, Uchida Y, Komiyama K, Shirahata T, Miyashita T, Nagata M, Nakamura H. Predicting the presence and severity of obstructive sleep apnea based on mandibular measurements using quantitative analysis of facial profiles via three-dimensional photogrammetry. Respir Investig 2021; 60:300-308. [PMID: 34810147 DOI: 10.1016/j.resinv.2021.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 10/13/2021] [Accepted: 10/21/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND In obstructive sleep apnea (OSA), the upper airway is obstructed during sleep due to obesity and/or posterior collapse of the tongue root. Maxillofacial morphological abnormalities increase the risk of OSA in the Asian population. This study sought to elucidate whether three-dimensional (3D) photogrammetry measurements correlate with the severity of OSA irrespective of sex and degree of obesity. METHODS A prospective pilot study was performed, in which 37 consecutive adult patients (M/F = 28/9) underwent polysomnography and 3D photogrammetry in the supine position for the diagnosis of OSA. Measurements obtained from 3D photogrammetry included mandibular width (Mw), mandibular length (Ml), mandibular depth (Md), mandibular width-length angle (Mwla), and mandibular area (Ma). The effects of sex and body mass index (BMI) on the measurements and their association with the apnea-hypopnea index (AHI) were statistically analyzed. The inter-rater reliability of the measurements was evaluated using intraclass correlation coefficients (ICC). RESULTS Mwla (R = 0.73, p < 0.01), Mw (R = 0.39, p < 0.05), and Md (R = -0.34, p < 0.05) were significantly correlated with the severity of OSA. On multivariate analysis, Mwla (p < 0.01) and Md (p < 0.05) remained independent factors for AHI after adjusting for sex, age, BMI, and neck circumference. In addition, diagnosability analysis revealed that Mwla was useful for identifying the presence of OSA (AHI ≥5) (cutoff: 78.6°, sensitivity: 0.938, specificity: 0.800, area under the curve: 0.931). The ICC was >0.9, showing high reliability. CONCLUSIONS This study suggests that Mwla measured using 3D photogrammetry can predict the presence of OSA and correlates with the severity of OSA, independent of obesity and sex.
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Affiliation(s)
- Kazuyuki Ohmura
- School of Medical Technology, Faculty of Health and Medical Care, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1241, Japan; Department of Respiratory Medicine, Saitama Medical University Hospital, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0400, Japan.
| | - Masahiko Suzuki
- School of Medical Technology, Faculty of Health and Medical Care, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1241, Japan
| | - Machika Soma
- Department of Respiratory Medicine, Saitama Medical University Hospital, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0400, Japan
| | - Susumu Yamazaki
- Department of Respiratory Medicine, Saitama Medical University Hospital, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0400, Japan
| | - Yoshitaka Uchida
- Department of Respiratory Medicine, Saitama Medical University Hospital, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0400, Japan
| | - Kenichiro Komiyama
- Department of Respiratory Medicine, Saitama Medical University Hospital, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0400, Japan
| | - Toru Shirahata
- Department of Respiratory Medicine, Saitama Medical University Hospital, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0400, Japan
| | - Tatsuyuki Miyashita
- Department of Respiratory Medicine, Saitama Medical University Hospital, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0400, Japan
| | - Makoto Nagata
- Department of Respiratory Medicine, Saitama Medical University Hospital, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0400, Japan
| | - Hidetoshi Nakamura
- Department of Respiratory Medicine, Saitama Medical University Hospital, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0400, Japan
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Three-Dimensional Measurement of Oropharynx and Laryngopharynx in Children With Hemifacial Microsomia. J Craniofac Surg 2021; 32:1331-1333. [PMID: 33710054 DOI: 10.1097/scs.0000000000007361] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE This study focused on evaluating different parts of the airway in patients with hemifacial microsomia classified by the Pruzansky-Kaban classification system. METHODS Volumetric and morphologic airway parameters of 66 children with hemifacial microsomia were measured on 3D models. Using the Pruzansky-Kaban system, the patient cohort was composed of seven I-type, 14 IIa type, 27 IIb type, and 18 III type patients. RESULTS The total airway volume was not statistically different among groups. In the 3D oropharynx models, volume and surface area of the oropharynx decreased from the type I group to the type IIb group. However, no statistically significant difference was found for length (P = 0.965) or minimum cross-sectional area (mini-CSA, P = 0.550) of the oropharynx in the type III group compared to the other groups. In the 3D laryngopharynx models, the mean-CSA (P = 0.413) and mini-CSA (P = 0.378) were not statistically different among groups. In contrast, volume (P = 0.014), length (P = 0.005), and surface area (P = 0.032) of the laryngopharynx were reduced from type I to type III. Kruskal-Wallis analysis indicated statistically significant differences of volume (P = 0.004), length (P = 0.017), and surface area (P = 0.010) of the laryngopharynx among groups I, IIa, and IIb. The mean-CSA (P = 0.247) and mini-CSA (P = 0.206) of the laryngopharynx were not correlated with the different clinical types. CONCLUSION The mean-CSA varied significantly from type I to IIb at the level of oropharynx. In addition, the volume of the laryngopharynx decreased from type I to type III. However, type III was unique in this study with nonseverely airway measurement results.
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