Language：English  

Clinical application of a swallowing function evaluation system that is minimally invasive and enables an objective evaluation is necessary. We constructed a system that can synchronise and analyse lip motion with a three-dimensional (3D) camera and swallowing dynamics with videofluoroscopy (VF) and clarified the relationship between lip movement and swallowing dynamics. A compact 3D camera was adapted to Microsoft XBox One Kinect Sensor® . We examined Kinect's accuracy and repeatability and analysed the highest measurement accuracy and repeatability of the distance between anguli oris muscles. The constructed system simultaneously measured, synchronised and analysed lip motion by Kinect and swallowing dynamics by VF. Fourteen elderly men without dysphagia were included. Barium turbid solution (5, 10, 15 and 20 mL) was used for swallowing. Measurement parameters were the 3D distance between angulus oris displacement (TDDD), swallowing quantity (SQ), oral transit time (OTT), stage transit duration (STD), pharyngeal transit time (PTT) and total swallowing duration (TSD). Statistical analyses were performed. The measurement accuracy and reproducibility were optimum within a 10° horizontal imaging angle at a 120-cm measurement distance. SQ, TDDD, OTT, STD, PTT and TSD showed significant differences, and correlation was found between TDDD and OTT. SQ affected TDDD, OTT, STD, PTT and TSD; OTT could be predicted from TDDD. Improvement in the system and analysis method was considered to enable prediction of swallowing dynamics from body surface movement of the head and neck, including realisation of measurement conditions with higher precision and reproducibility, and from lip motion.

DOI： 10.1111/joor.12916

Scopus

PubMed

Language：Japanese   Publisher：鹿児島県小児保健協会  

症例は2歳10ヵ月男児で、食事に時間がかかることを主訴とした。全身所見として低緊張、低身長・低体重、アヒル様歩行を認め、口腔内所見として下顎左側乳中切歯の早期脱落、下顎右側乳中切歯の動揺、エックス線写真にて歯槽骨吸収像を認めた。また血液データにてアルカリホスファターゼ(ALP)値85U/Lと低値を認め、遺伝子検査の結果、ALP遺伝子のヘテロ変異を認め、低フォスホターゼ症(HPP)歯限局型と診断された。患児の兄および父に同様の遺伝子変異を認めたが、HPPを疑う症状は認めなかった。歯科的対応として動揺歯の固定と口腔衛生管理を行い、今後は小児義歯作製なども検討している。

Language：Japanese   Publisher：(一社)日本摂食嚥下リハビリテーション学会  

【目的】小型3Dカメラによる口唇動作の測定と嚥下造影検査(VF)による嚥下動態の撮影を同時に行い、同期・解析し、嚥下時における口角間距離、嚥下時間ならびに嚥下量の関連性を明らかにする。【方法】小型3Dカメラとして、Microsoft XBox One Kinect Sensor(Kinect)を用いた。Microsoft社から提供された開発ソフトウェアを利用して、対象の顔面形状を自動認識し両側口角部の3次元座標を取得することで、口角間距離を記録できるプログラムを作成した。Kinectによりマネキンの口角間距離を一定の条件下における測定精度と再現性を検証し、被験者を対象とした測定に最も適した条件を検討した。検証結果を基に、試料嚥下時のKinectによる口唇動作とVFによる嚥下動態を同時測定し、ビデオ音声同期ソフトELANにより得られた情報を同期・解析した。対象は、摂食嚥下機能に異常のない成人男性12名(平均年齢27.8±1.2歳)とし、試料は硫酸バリウム混濁液5mL、10mL、15mL、20mLの4種類とした。試料嚥下時における口角間距離の変位量(変位量)と嚥下量、嚥下時間と嚥下量に関して一元配置分散分析、Pearsonの積率相関係数を算出し検討した。試料を口腔内に保持する位置(保持位置)、口唇動作ならびに嚥下量に関してFriedman検定にて検討した。【結果】最適条件(距離120cm/回転角度10°)でのKinectによる測定において、口角間距離は標準偏差±0.52mm、実測値と測定値の差は0.47mmで最も高い精度であった。成人男性での嚥下量と変位量には有意差ならびに相関を認め(p<0.01、r=0.56)、嚥下量と保持位置には有意差を認めた(p<0.01)。しかし、その他の項目に関して、有意差を認められなかった。【結論】本研究により、Kinectによる口角間距離の測定精度と再現性を明らかにした。口唇動作の測定と嚥下動態の撮影を同時に行い、同期・解析が可能となるシステムを構築した。嚥下量と変位量には有意差ならびに相関関係を認め、嚥下量と保持位置には有意差を認めた。一方で、他の項目において有意差は認められなかった。(著者抄録)

Language：English  

OBJECTIVES: Rapid maxillary expansion (RME) improves nasal airway ventilation in non-cleft palate children. Children with unilateral cleft lip and palate (UCLP) may have nasal obstruction and experience an increased risk of obstructive sleep apnoea. The effect of RME in UCLP children is unclear. This retrospective study evaluated RME-induced changes in ventilation parameters in children with UCLP using computational fluid dynamics. SETTING AND SAMPLE POPULATION: Nineteen patients (10 boys, mean age 10.7 years) who required RME had cone-beam computed tomography images taken before and after RME. Twenty control participants (11 boys, mean age 11.1 years) received regular orthodontic treatment. METHODS: Nasal airway ventilation parameters (air pressure, air velocity and airflow rate) were analysed via computational fluid dynamics, and nasal cross-sectional area (CSA) was measured. RESULTS: Maximum pressure, velocity and nasal resistance were significantly reduced by RME in the UCLP group. Air flow rate and CSA on the cleft side significantly were increased by RME in the UCLP group. CONCLUSIONS: In children with UCLP, increasing the quantity of airflow and CSA on the cleft side by RME substantially improved nasal ventilation.

DOI： 10.1111/ocr.12311

Scopus

PubMed

Language：English  

INTRODUCTION: Children with unilateral cleft lip and palate (UCLP) exhibit snoring and mouth breathing. They are also reported to show obstructive sleep apnea syndrome. However, their upper airway ventilation condition is not clearly understood. Therefore, this study was performed to evaluate upper airway ventilation condition in children with UCLP with the use of computational fluid dynamics. METHODS: Twenty-one children (12 boys, 9 girls; mean age 9.1 years) with UCLP and 25 children (13 boys, 12 girls; mean age 9.2 years) without UCLP who required orthodontic treatment underwent cone-beam computed tomography (CBCT). Nasal resistance and upper airway ventilation condition were evaluated with the use of computational fluid dynamics from CBCT data. The groups were compared with the use of Mann-Whitney U tests and Student t tests. RESULTS: Nasal resistance of the UCLP group (0.97 Pa/cm3/s) was significantly higher than that of the control group (0.26 Pa/cm3/s; P < 0.001). Maximal pressure of the upper airway (335.02 Pa) was significantly higher in the UCLP group than in the control group (67.57 Pa; P < 0.001). Pharyngeal airway (from choanae to base of epiglottis) pressure in the UCLP group (140.46 Pa) was significantly higher than in the control group (15.92 Pa; P < 0.02). CONCLUSIONS: Upper airway obstruction in children with UCLP resulted from both nasal and pharyngeal airway effects.

DOI： 10.1016/j.ajodo.2018.09.013

Scopus

PubMed

Language：Japanese   Publisher：鹿児島県小児保健協会  

Language：Japanese   Publisher：(公社)日本小児歯科学会  

Language：Japanese   Publisher：(NPO)日本睡眠歯科学会  

Language：Japanese   Publisher：(一社)日本障害者歯科学会  

Language：Japanese   Publisher：鹿児島県小児保健協会  

Language：Japanese  

Language：Japanese  

Language：Japanese  

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Language：Japanese