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Two-dimensional exciton-polaritons in monolayer transition metal dichalcogenides (TMDs) exhibit practical advantages in valley coherence, optical nonlinearities, and even bosonic condensation owing to their light-emission capability. To achieve robust exciton-polariton emission, strong photon-exciton couplings are required at the TMD monolayer, which is challenging due to its atomic thickness. High-quality (Q) factor optical cavities with narrowband resonances are an effective approach but typically limited to a specific excitonic state of a certain TMD material. Herein, we achieve on-demand exciton-polariton emission from a wide range of TMDs at room temperature by hybridizing excitons with broadband Mie resonances spanning the whole visible spectrum. By confining broadband light at the TMD monolayer, our one type of Mie resonator on different TMDs enables enhanced light-matter interactions with multiple excitonic states simultaneously. We demonstrate multi-Rabi splittings and robust polaritonic photoluminescence in monolayer WSe2, WS2, and MoS2. The hybrid system also shows the potential to approach the ultrastrong coupling regime.
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Children with cleft lip/palate are usually faced with upper airway problems after surgical repair. The severity of upper airway obstruction is more likely associated with the age and preoperative diagnosis of obstructive sleep apnea (OSA). This study aimed to investigate the severity of OSA in toddlers before palatoplasty from the perspective of polysomnography. In this retrospective cohort study, 97 children with unrepaired cleft palate and habitual prone sleeping were identified with a mean age of 1.6 years (SD 0.6) and divided into 2 age groups (1.5 year or younger and older than 1.5 year). Detailed information was collected including demographics, sleep parameters, and respiratory disturbances. Polysomnography results showed these children were at high risks of OSA with averagely moderate severity at night during their early childhood [apnea-hypopnea index 7.2±3.2 events/hour; obstructive apnea index (OAI) 6.5±2.8 events/hour]. Positional OAI was greatly lower in prone than that in laterals or in supine. Far more sleep time was spent in prone than in supine (42.9%±42.2% versus 8.5%±15.7%), which were consistent with parental reporting of prone sleeping habits. There were no significant differences found between the 2 age groups in respiratory disturbances such as apnea-hypopnea index, OAI, mean oxygen saturation, and nadir oxygen saturation ( P =0.097-0.988). Thus, prone sleeping with a history of snoring might be indicators for early screening for OSA in the cleft population. Adequate attention should be paid to their upper airway and, if available, overnight polysomnography should be performed to ascertain their potential respiratory problems before repair surgery.
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Fenda Labial , Fissura Palatina , Síndromes da Apneia do Sono , Apneia Obstrutiva do Sono , Humanos , Pré-Escolar , Lactente , Fissura Palatina/cirurgia , Fenda Labial/complicações , Estudos Retrospectivos , SonoRESUMO
Subwavelength nanostructures with tunable compositions and geometries show favorable optical functionalities for the implementation of nanophotonic systems. Precise and versatile control of structural configurations on solid substrates is essential for their applications in on-chip devices. Here, we report all-solid-phase reconfigurable chiral nanostructures with silicon nanoparticles and nanowires as the building blocks in which the configuration and chiroptical response can be tailored on-demand by dynamic manipulation of the silicon nanoparticle. We reveal that the optical chirality originates from the handedness-dependent coupling between optical resonances of the silicon nanoparticle and the silicon nanowire via numerical simulations and coupled-mode theory analysis. Furthermore, the coexisting electric and magnetic resonances support strong enhancement of optical near-field chirality, which enables label-free enantiodiscrimination of biomolecules in single nanostructures. Our results not only provide insight into the design of functional high-index materials but also bring new strategies to develop adaptive devices for photonic and electronic applications.
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Nanopartículas , Nanoestruturas , Óptica e Fotônica , Fótons , SilícioRESUMO
We present a theoretical study of directional light emission by dipole emitters near a spherical nanoparticle. Our analysis is extended from an exact electrodynamical approach for solving the coupling between a dipole and a sphere, providing a full picture of the directional emission for a complete set of combinations of variable emitters, particles, and their orientations. In particular, we show that the Mie resonances of a dielectric sphere are strongly influenced by the coupled dipole emitter, leading to the scattering properties that are different from the prediction by the standard Mie theory. Moreover, we demonstrate that the dielectric spheres have opposite effects on the emission direction and a decay rate of electric and magnetic dipoles. Our approach enriches the analytical toolbox for designing optical antennas and understanding dipole-sphere coupling.
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Circularly polarized light (CPL) carrying spin angular momentum is crucial to many applications, such as quantum computing, optical communication, novel displays, and biosensing. Nonetheless, the emission from chiral molecules contains comparable CPL components with opposite handedness, resulting in low levels of CPL overall with a small dissymmetry factor and fixed handedness consistent with the handedness of the molecules. Nanoantennas have proved to be useful tools for controlling the emission properties of quantum emitters. In particular, dielectric resonators support electric and magnetic modes, which implies unparalleled opportunities to interact with chiral molecules whose emission originates from both electric and magnetic dipole transitions. In this work, we theoretically study the effects of a spherical dielectric nanoantenna on the directionality and polarization of emission from a chiral molecule. With exact analytical solutions based on generalized Mie theory, we show that directional chiral light emission and nontrivial polarization modulation, such as handedness reversal or chirality enhancement, can be achieved simultaneously for a chiral dipole tangentially coupled with a silicon nanosphere. The influence of the relative strength and orientation between the electric and magnetic dipole moments is also discussed. Our results suggest a new approach to controlling chiral dipolar emission and could benefit the development of chiral light sources.
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Longitudinal surface plasmon resonance (LSPR)-based optical signals possess unique advantages in biomolecular sensing and detection which can be attributed to their ultrahigh sensitivity and signal-to-noise ratio. However, the lack of effective strategies for morphological control of gold nanorods (GNRs) complicates the precise tuning of their LSPR property. Herein, a "peptide-encoded" strategy was first developed to precisely control the morphologies of GNRs via overgrowth of GNR seeds in the presence of thiol-containing peptides. Significantly, the "peptide-encoded" GNRs exhibit a tunable LSPR peak ranging from 685 to 877 nm by altering the amount of peptide. A few obvious colorimetric changes were accompanied from pink to purple and even to blue. Other parameters, e.g., pH, temperature, and Ag+ concentration, could also be utilized to regulate the morphologies of the "peptide-encoded" GNRs. The ultrasensitive detection of tumor-related protease activities based on LSPR peak shifts was further successfully performed without the need for labeling or instrumental aid, achieving a limit of detection of 60 fM. It is much lower than traditional absorption-based analysis (1 nM) and enzyme-linked immunosorbent assay (ELISA) method (1 pM), indicating the great potential of this peptide-encoded strategy in the application of ultrasensitive biomarker assay and clinical diagnosis.
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Ouro/química , Nanotubos/química , Peptídeo Hidrolases/análise , Ressonância de Plasmônio de Superfície , Técnicas Biossensoriais , Ouro/metabolismo , Humanos , Peptídeo Hidrolases/metabolismo , Peptídeos/químicaRESUMO
A strong and dynamically controlled circular dichroism (CD) effect has aroused great attention due to its desirable applications in modern chemistry and life sciences. In this Letter, we propose a graphene-metal hybrid chiral metamaterial to generate mid-infrared CD with an intensity of more than 10%, which can be actively controlled over a wide wavelength range. In addition to the strong tunability, the CD signal intensity of our nanostructure is drastically larger than that of the purely graphene-based chiroptical nanostructures. Our design offers a new strategy for developing tunable chiral metadevices, which could be used in various applications, such as biochemical detection and information processing.
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Dicroísmo Circular/métodos , Grafite/química , Manufaturas , Metais , Nanoestruturas/química , Estereoisomerismo , Ressonância de Plasmônio de SuperfícieRESUMO
PURPOSE: Maxillomandibular advancement (MMA) is an effective alternative for treating severe obstructive sleep apnea (OSA). However, the promotion of MMA in China is limited by many Chinese patients having a convex facial profile. To achieve maximal upper airway enlargement without an esthetic disaster, we added counterclockwise rotation of the maxillomandibular complex (MMC) in the routine MMA. In this paper, we have evaluated the objective and subjective outcomes of this technology. METHODS: In total, 33 severe OSA patients who accepted counterclockwise maxillomandibular advancement (CMMA) were investigated in this study. Genioplasty, uvulopalatopharyngoplasty (UPPP), and turbinate reduction were also performed on selected patients. Polysomnography (PSG) and Epworth sleepiness scale (ESS) were chosen to evaluate the effectiveness of this technology in treating OSA. Patients' facial appearances were evaluated by cephalometric analysis and 5-point Likert scales. RESULTS: After CMMA, the apnea-hypopnea index (AHI) decreased from 59.3 ± 14.6 to 10.2 ± 6.7 (P < 0.001), minimum SpO2 (pulse oxygen saturation, %) increased from 74.0 ± 11.7 to 88.8 ± 4.4 (P < 0.001), and ESS decreased from 12.5 ± 2.3 to 7.3 ± 2.1. It is encouraging that soft-tissue cephalometric measurements such as facial convexity angle, nasolabial angle, and labiomental fold were not worsening after surgery. The Likert scales revealed that 28 patients (85%) were satisfied or very satisfied with their facial changes. In addition, no patient complained about dental function after surgery. CONCLUSIONS: These findings indicate that CMMA is an effective way to achieve a balance between airway enlargement and facial appearance for Chinese patients with severe OSA.
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Povo Asiático , Mandíbula , Avanço Mandibular/métodos , Maxila , Apneia Obstrutiva do Sono/fisiopatologia , Apneia Obstrutiva do Sono/terapia , Adolescente , Adulto , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Adulto JovemRESUMO
OBJECTIVE: To verify the short-time remolding of upper airway in patients diagnosed with obstructive sleep disordered breathing after Uvulopalatopharyngoplasty (UPPP). METHODS: Twenty-one male adult patients aged 27 to 52 years followed up ranged from preoperation to 6 months after the operation. Lateral cephalometric radiographs (conventional and when pronouncing "i") were obtained 2 weeks preoperatively, 3 days postoperatively, and 1, 2, 3, 6 months after the surgery. The anterolateral diameters of different levels of upper airway and parameters of hyoid position of the patients were then measured. SAS 8.02 was used to analyze the differences by time. RESULTS: The study illustrated that the UPPP major affected the velopharyngeal and glossopharyngeal areas: parameters wane (Pâ<0.05). On the other hand, UPPP leaded to the decline and retreat of hyoid. Most of the parameters remained metabolic. The nasopharynx kept statical (Pâ>0.05) while the velopharyngeal parameters were increasing (Pâ<0.05). The glossopharyngeal parameters increased in the first month after UPPP (Pâ<0.05), while hypopharyngeal parameters underwent decline since 2 months after UPPP (Pâ<0.05). The hyoid obtained decline and retreat (Pâ<0.05) overall, while it endured a short-time climb in the first month after UPPP (Pâ<0.05). CONCLUSION: Short-time upper airway remolding after UPPP existed.
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Remodelação das Vias Aéreas/fisiologia , Palato Mole/cirurgia , Faringe/cirurgia , Apneia Obstrutiva do Sono/cirurgia , Úvula/cirurgia , Adulto , Cefalometria , Seguimentos , Humanos , Osso Hioide/cirurgia , Masculino , Pessoa de Meia-Idade , Nasofaringe/fisiopatologia , Nasofaringe/cirurgia , Período Pós-Operatório , Apneia Obstrutiva do Sono/fisiopatologiaRESUMO
Swift electrons moving closely parallel to a periodic grating produce far-field radiation of light, which is known as the Smith-Purcell effect. In this letter, we demonstrate that designer Babinet metasurfaces composed of C-aperture resonators offer a powerful control over the polarization state of the Smith-Purcell emission, which can hardly be achieved via traditional gratings. By coupling the intrinsically nonradiative energy bound at the source current sheet to the out-of-plane electric dipole and in-plane magnetic dipole of the C-aperture resonator, we are able to excite cross-polarized light thanks to the bianisotropic nature of the metasurface. The polarization direction of the emitted light is aligned with the orientation of the C-aperture resonator. Furthermore, the efficiency of the Smith-Purcell emission from Babinet metasurfaces is significantly increased by 84%, in comparison with the case of conventional gratings. These findings not only open up a new way to manipulate the electron-beam-induced emission in the near-field region but also promise compact, tunable, and efficient light sources and particle detectors.
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PURPOSE: Pediatric patients with Crouzon syndrome have great possibilities of suffering from obstructive sleep apnea (OSA), which is mainly due to midfacial hypoplasia and facial deformities. For most patients, a multidisciplinary and sequential treatment plan is necessary to make for Crouzon syndrome often has different phenotypes of different severity in OSA and facial deformities. Typical patients were selected in this paper to illustrate the necessity of individualized therapy for treating OSA. METHODS: In this paper, we have introduced four Crouzon syndrome children of different severity in suffering from OSA and maxillofacial deformities. Detailed information was given including clinical manifestations, radiological findings, and polysomnography detections. Based on the above findings, different but effective treatment options for these children's OSA problems were adopted, either by surgeries including distraction osteogenesis and craniomaxillofacial surgeries with or without tonsillectomy or by noninvasive continuous positive airway pressure (CPAP) therapy. RESULTS: Follow-up studies for more than 1 year showed problems of OSA and nocturnal hypoxia of those four patients were all alleviated greatly, as well as maxillofacial deformities. Combined with pre-operative and post-operative orthodontics, one patient also got optimal results in better facial profile and dental occlusion. CONCLUSION: Thus, based on adequate clinical evaluations and patients' conditions including age, disease severity, and esthetic considerations, individualized therapy should be made and performed carefully to obtain optimized results in treating OSA for pediatric Crouzon syndrome patients.
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Pressão Positiva Contínua nas Vias Aéreas , Disostose Craniofacial/complicações , Disostose Craniofacial/terapia , Comunicação Interdisciplinar , Colaboração Intersetorial , Medicina de Precisão/métodos , Apneia Obstrutiva do Sono/etiologia , Apneia Obstrutiva do Sono/terapia , Cirurgia Bucal , Adolescente , Criança , China , Terapia Combinada , Feminino , Seguimentos , Humanos , Masculino , Ortodontia Corretiva , Polissonografia , Apneia Obstrutiva do Sono/diagnósticoRESUMO
We demonstrate a semiconductor based broadband near-field superlens in the mid-infrared regime. Here, the Drude response of a highly doped n-GaAs layer induces a resonant enhancement of evanescent waves accompanied by a significantly improved spatial resolution at radiation wavelengths around λ = 20 µm, adjustable by changing the doping concentration. In our experiments, gold stripes below the GaAs superlens are imaged with a λ/6 subwavelength resolution by an apertureless near-field optical microscope utilizing infrared radiation from a free-electron laser. The resonant behavior of the observed superlensing effect is in excellent agreement with simulations based on the Drude-Lorentz model. Our results demonstrate a rather simple superlens implementation for infrared nanospectroscopy.
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Far-field imaging beyond the diffraction limit is a long sought-after goal in various imaging applications, which requires usually mechanical scanning or an array of antennas. Here, we propose to solve this challenging problem using a single sensor in combination with a spatio-temporal resonant aperture antenna. We theoretically and numerically demonstrate that such resonant aperture antenna is capable of converting part evanescent waves into propagating waves and delivering them to far fields. The proposed imaging concept provides the unique ability to achieve super resolution for real-time data when illuminated by broadband electromagnetic waves, without the harsh requirements such as near- field scanning, mechanical scanning, or antenna arrays. We expect the imaging methodology to make breakthroughs in super-resolution imaging in microwave, terahertz, optical, and ultrasound regimes.
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Liquid-liquid interfaces hold the potential to serve as versatile platforms for dynamic processes, due to their inherent fluidity and capacity to accommodate surface-active materials. This study explores laser-driven actuation of liquid-liquid interfaces with and without loading of gold nanoparticles and further exploits the laser-actuated interfaces with nanoparticles for tunable photonics. Upon laser exposure, gold nanoparticles were rearranged along the interface, enabling the reconfigurable, small-aperture modulation of light transmission and the tunable lensing effect. Adapting the principles of optical and optothermal tweezers, we interpreted the underlying mechanisms of actuation and modulation as a synergy of optomechanical and optothermal effects. Our findings provide an analytical framework for understanding microscopic interfacial behaviors, contributing to potential applications in tunable photonics and interfacial material engineering.
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STUDY OBJECTIVES: This study aimed to evaluate the safety and short-term effect of contemporaneous surgeries (bariatric surgery plus uvulopalatopharyngoplasty [UPPP]) in the treatment of morbid obesity comorbid with severe obstructive sleep apnea (OSA). METHODS: A retrospective cohort study was performed to identify patients with obesity and severe OSA who underwent laparoscopic sleeve gastrectomy (LSG) with or without UPPP surgeries between December 2019 and December 2021 in our center. Patients were divided into 2 groups according to different surgical methods (contemporaneous group [LSG with UPPP] vs LSG-only group). Data about surgical safety, OSA remission, and effectiveness of weight loss were collected and analyzed between the 2 groups before and 12 months after surgery. RESULTS: A total of 101 patients were included in this study (contemporaneous group [LSG with UPPP], n = 42 vs LSG only group, n = 59). There was no significant difference in surgical safety between the 2 groups, and both OSA and obesity were significantly improved at 12.5 ± 2.1 months postoperative follow-up. The apnea-hypopnea index decreased from 68.7 ± 30.4 events/h to 10.2 ± 7.0 events/h in the contemporaneous group (P < .001) and from 64.7 ± 26.2 events/h to 18.9 ± 9.8 events/h in the LSG group (P < .001). Moreover, the apnea-hypopnea index decreased to below 5 events/h in 50% of patients (21/42) in the contemporaneous group but only in 13.5% of patients in the LSG group (P < .001). In the LSG group 20 (34%) patients achieved a reduction in apnea-hypopnea index < 15 events/h and resolution of daytime sleepiness. CONCLUSIONS: Contemporaneous surgery (concurrent bariatric and UPPP surgeries) is feasible and an effective option for patients with obesity and severe OSA. However, our finding suggests that approximately a third of patients undergoing LSG with UPPP may not derive significant benefit from the UPPP portion of the contemporaneous surgical approach. CITATION: Yang C, Yu W, Yao K, et al. Concurrent laparoscopic sleeve gastrectomy with uvulopalatopharyngoplasty in the treatment of morbid obesity comorbid with severe obstructive sleep apnea: a retrospective cohort study. J Clin Sleep Med. 2024;20(4):555-564.
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Laparoscopia , Obesidade Mórbida , Apneia Obstrutiva do Sono , Humanos , Obesidade Mórbida/complicações , Obesidade Mórbida/cirurgia , Estudos Retrospectivos , Resultado do Tratamento , Apneia Obstrutiva do Sono/complicações , Apneia Obstrutiva do Sono/epidemiologia , Apneia Obstrutiva do Sono/cirurgia , Gastrectomia/métodos , Laparoscopia/métodosRESUMO
Optically resonant particles are key building blocks of many nanophotonic devices such as optical antennas and metasurfaces. Because the functionalities of such devices are largely determined by the optical properties of individual resonators, extending the attainable responses from a given particle is highly desirable. Practically, this is usually achieved by introducing an asymmetric dielectric environment. However, commonly used simple substrates have limited influences on the optical properties of the particles atop. Here, we show that the multipolar scattering of silicon microspheres can be effectively modified by placing the particles on a dielectric-covered mirror, which tunes the coupling between the Mie resonances of microspheres and the standing waves and waveguide modes in the dielectric spacer. This tunability allows selective excitation, enhancement, suppression, and even elimination of the multipolar resonances and enables scattering at extended wavelengths, providing transformative opportunities in controlling light-matter interactions for various applications. We further demonstrate with experiments the detection of molecular fingerprints by single-particle mid-infrared spectroscopy and with simulations strong optical repulsive forces that could elevate the particles from a substrate.
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Rational manipulation and assembly of discrete colloidal particles into architected superstructures have enabled several applications in materials science and nanotechnology. Optical manipulation techniques, typically operated in fluid media, facilitate the precise arrangement of colloidal particles into superstructures by using focused laser beams. However, as the optical energy is turned off, the inherent Brownian motion of the particles in fluid media impedes the retention and reconfiguration of such superstructures. Overcoming this fundamental limitation, we present on-demand, three-dimensional (3D) optical manipulation of colloidal particles in a phase-change solid medium made of surfactant bilayers. Unlike liquid crystal media, the lack of fluid flow within the bilayer media enables the assembly and retention of colloids for diverse spatial configurations. By utilizing the optically controlled temperature-dependent interactions between the particles and their surrounding media, we experimentally exhibit the holonomic microscale control of diverse particles for repeatable, reconfigurable, and controlled colloidal arrangements in 3D. Finally, we demonstrate tunable light-matter interactions between the particles and 2D materials by successfully manipulating and retaining these particles at fixed distances from the 2D material layers. Our experimental results demonstrate that the particles can be retained for over 120 days without any change in their relative positions or degradation in the bilayers. With the capability of arranging particles in 3D configurations with long-term stability, our platform pushes the frontiers of optical manipulation for distinct applications such as metamaterial fabrication, information storage, and security.
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OBJECTIVE: To compare the age-specific detection rates of colorectal neoplasms by colonoscopic screening among high-risk population in rural area and to provide evidence for determining the initial age in the colorectal cancer screening. METHODS: The age-specific detection rates of colorectal cancers and adenomas, and the proportion of detected cases in each age group after screening by the optimized sequential colorectal cancer screening program in Jiashan County, Zhejiang Province, were analyzed. RESULTS: Mass screening with the optimized sequential colorectal cancer screening program in Jiashan was conducted and 8867 colonoscopic examinations were performed. A total of 1811 individuals with at least one colorectal neoplastic lesion were found. Among them, there were 92 (1.04%) colorectal cancer patients, 1164 (13.13%) patients with at least one adenoma and 377 (4.25%) patients with at least one advanced adenoma. The detection rate of colorectal neoplastic lesions for the age group 40 - 44 was considerably lower than that in the age group 45 - 49. Hypothetically, to increase the initial age to 45-years for the optimized sequential colorectal cancer screening program would yield a 7.84% increase in the detection rate of total colorectal neoplastic lesions, 13.46% increase in the detection rate of colorectal cancer, 8.76% increase in the detection rate of adenoma, 12.24% increase in the detection rate of advanced adenoma and 19.64% lower in the cost of initial screening, 13.30% lower in the cost of colonoscopic screening. CONCLUSIONS: Among the high-risk population aged 40 to 74, the detection rates of colorectal cancer and adenoma are increasing with the increase of age, the detection rates of colorectal cancer and adenoma as well as proportion of detected cases in the 40 - 44 age group are considerably lower. To increase the initial age to 45 for colorectal cancer screening in rural area of China is reasonable.
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Adenoma/diagnóstico , Carcinoma/diagnóstico , Neoplasias Colorretais/diagnóstico , Adenoma/epidemiologia , Adenoma/patologia , Adulto , Distribuição por Idade , Idoso , Carcinoma/epidemiologia , Carcinoma/patologia , China/epidemiologia , Colite Ulcerativa/diagnóstico , Colite Ulcerativa/epidemiologia , Colite Ulcerativa/patologia , Pólipos do Colo/diagnóstico , Pólipos do Colo/epidemiologia , Pólipos do Colo/patologia , Colonoscopia , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/patologia , Feminino , Humanos , Incidência , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Risco , População Rural , Inquéritos e QuestionáriosRESUMO
The aim of the study was to describe an approach where condylar resection with condylar neck preservation was combined with Le Fort I osteotomy and unilateral mandibular sagittal split ramus osteotomy (SSRO). Patients with a unilateral condylar osteochondroma combined with dentofacial deformity and facial asymmetry who underwent surgery between January 2020 and December 2020 were enrolled. The operation included condylar resection, Le Fort I osteotomy and contralateral mandibular sagittal split ramus osteotomy (SSRO). Simplant Pro 11.04 software was used to reconstruct and measure the preoperative and postoperative craniomaxillofacial CT images. The deviation and rotation of the mandible, change in the occlusal plane, position of the "new condyle" and facial symmetry were compared and evaluated during follow-up. Three patients were included in the present study. The patients were followed up for 9.6 months on average (range, 8-12). Immediate postoperative CT images showed that the mandible deviation and rotation and occlusion plane canting decreased significantly postoperatively; facial symmetry was improved but still compromised. During the follow-up, the mandible gradually rotated to the affected side, the position of the "new condyle" moved further inside toward the fossa, and both the mandible rotation and facial symmetry were more significantly improved. Within the limitations of the study it seems that for some patients a combination of condylectomy with condylar neck preservation and unilateral mandibular SSRO can be effective in achieving facial symmetry.
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Osteocondroma , Osteotomia Sagital do Ramo Mandibular , Humanos , Osteotomia Sagital do Ramo Mandibular/métodos , Côndilo Mandibular/diagnóstico por imagem , Côndilo Mandibular/cirurgia , Estudos Retrospectivos , Osteotomia Maxilar , Mandíbula/diagnóstico por imagem , Mandíbula/cirurgia , Osteocondroma/complicações , Osteocondroma/diagnóstico por imagem , Osteocondroma/cirurgiaRESUMO
Cephalometric analysis is a standard diagnostic tool in orthodontics and craniofacial surgery. Today, as conventional 2D cephalometry is limited and susceptible to analysis bias, a more reliable and user-friendly three-dimensional system that includes hard tissue, soft tissue, and airways is demanded in clinical practice. We launched our study to develop such a system based on CT data and landmarks. This study aims to determine whether the data labeled through our process is highly qualified and whether the soft tissue and airway data derived from CT scans are reliable. We enrolled 15 patients (seven males, eight females, 26.47 ± 3.44 years old) diagnosed with either non-syndromic dento-maxillofacial deformities or OSDB in this study to evaluate the intra- and inter-examiner reliability of our system. A total of 126 landmarks were adopted and divided into five sets by region: 28 cranial points, 25 mandibular points, 20 teeth points, 48 soft tissue points, and 6 airway points. All the landmarks were labeled by two experienced clinical practitioners, either of whom had labeled all the data twice at least one month apart. Furthermore, 78 parameters of three sets were calculated in this study: 42 skeletal parameters (23 angular and 19 linear), 27 soft tissue parameters (9 angular and 18 linear), and 9 upper airway parameters (2 linear, 4 areal, and 3 voluminal). Intraclass correlation coefficient (ICC) was used to evaluate the inter-examiner and intra-examiner reliability of landmark coordinate values and measurement parameters. The overwhelming majority of the landmarks showed excellent intra- and inter-examiner reliability. For skeletal parameters, angular parameters indicated better reliability, while linear parameters performed better for soft tissue parameters. The intra- and inter-examiner ICCs of airway parameters referred to excellent reliability. In summary, the data labeled through our process are qualified, and the soft tissue and airway data derived from CT scans are reliable. Landmarks that are not commonly used in clinical practice may require additional attention while labeling as they are prone to poor reliability. Measurement parameters with values close to 0 tend to have low reliability. We believe this three-dimensional cephalometric system would reach clinical application.