JP5319031B1 - Obstructive sleep apnea syndrome risk determination index calculation method, obstructive sleep apnea syndrome risk determination method, program, and computer - Google Patents

Abstract

An obstructive sleep apnea that can easily calculate an obstructive sleep apnea syndrome risk determination index, which is an objective material for determining the risk of developing the obstructive sleep apnea syndrome. A method for calculating a syndrome risk determination index and a program thereof are provided.
A distance between S and A (SA), a distance between S and B (SB), and a distance between Go and B measured by X-ray imaging of a subject's head. P = ((S−B) + (Go−B) + (Cd−Go)) / (S−A) using the distance (Go−B) and the distance between Cd and Go (Cd−Go). ) To calculate the obstructive sleep apnea syndrome risk assessment index. The risk of developing obstructive sleep apnea syndrome is determined based on this obstructive sleep apnea syndrome risk determination index.
[Selection] Figure 1

Description

  TECHNICAL FIELD The present invention relates to a method for calculating an obstructive sleep apnea syndrome risk determination index, an obstructive sleep apnea syndrome risk determination method, a program, and a computer, and determines a risk that a subject develops obstructive sleep apnea syndrome. It is suitable for use.

Obstructive sleep apnea syndrome (OSAS) is a disease in which the patient's upper respiratory tract is blocked during sleep and breathing stops. Obstructive sleep apnea syndrome can lead to worsening of life prognosis through increased blood pressure, combined arrhythmia and acceleration of arteriosclerosis due to a significant decrease in arterial oxygen saturation (SaO ₂ ). It has become clear. In addition, obstructive sleep apnea syndrome causes sleeplessness and excessive daytime sleepiness (EDS) due to an awakening response associated with apnea, while attention, cognition, memory, etc. are impaired and work efficiency decreases. Not only does it cause traffic accidents and occupational accidents. For this reason, obstructive sleep apnea syndrome has become a major social problem.

Conventionally, the diagnosis of obstructive sleep apnea syndrome is performed, for example, as follows (see, for example, Non-Patent Document 1). That is, if a patient who visited a medical institution has found two or more of EDS, suffocation and gasping during sleep, repeated awakening, lack of refreshment when waking up, daytime fatigue, lack of concentration, Polysomnography (PSG) is performed. As a result, if apnea hypopnea index (AHI) ≧ 5 and the majority is obstructive apnea, the diagnosis of obstructive sleep apnea syndrome is established. Follow-up is performed if AHI <5. On the other hand, if you do not recognize two or more of EDS, suffocation and gasping during sleep, repeated awakening, lack of refreshment when waking up, fatigue during the day, and lack of concentration, check with a simple diagnostic device. Do. The simple diagnostic device is an inspection system that simultaneously records nasal airflow, respiratory movement of the chest or abdomen, tracheal sound, SaO _{2 and the} like and automatically analyzes them later. If AHI ≧ 5 as a result of the test by the simple diagnostic device, a multiple sleep latency test (MSLT) is performed. As a result, PSG is performed when sleep disorder is found, and follow-up is performed when sleep disorder is not found. If AHI <5 as a result of the inspection by the simple diagnostic apparatus, follow-up is performed.

  On the other hand, obstructive sleep apnea syndrome often involves morphological abnormalities of the upper airway. Therefore, for diagnosis of obstructive sleep apnea syndrome, it is said that observation of the upper respiratory tract by visual inspection or upper airway endoscope is indispensable, and cephalometry (cephalometry: cephalometric X-ray photographic analysis) is performed. If performed, it is considered that a more objective morphological evaluation of the upper respiratory tract is possible (for example, see Non-Patent Document 1). Specifically, in Non-Patent Document 1, as a characteristic of patients with obstructive sleep apnea syndrome, an extension of the distance (hyoid height) between the lower mandibular plane and the hyoid bone (lower hyoid bone), The extension of the length of the soft palate, the reduction of the degree of protrusion of the lower alveolar base, and the like are described.

Edited by the Society for Sleep and Breathing Disorders, “Guidelines for Diagnosis and Treatment of Sleep Apnea Syndrome in Adults”, pages 15-16, page 25 (Medical Review Inc., issued in July 2005)

  However, PSG needs to be admitted to a hospital and examined overnight, and it is not only time consuming for diagnosis, but also has a drawback that the mental and physical burden on the patient is great. In addition, accurate diagnosis is difficult with a simple diagnostic device. Furthermore, the effectiveness of morphological evaluation of the upper respiratory tract by cephalometry is unknown. On the other hand, if the risk of the subject to develop obstructive sleep apnea syndrome is easily known, measures can be taken to reduce the risk, so it is possible to suppress the onset of obstructive sleep apnea syndrome, So far, no effective risk determination method has been proposed.

  Therefore, the problem to be solved by the present invention is to simply calculate a risk determination index for obstructive sleep apnea syndrome, which is an objective material for determining the risk that the subject will develop obstructive sleep apnea syndrome. To provide a method for calculating an obstructive sleep apnea syndrome risk determination index, a program thereof, and a computer having the program.

  Another problem to be solved by the present invention is to use an obstructive sleep apnea syndrome risk determination index that is an objective material for determining the risk that a subject will develop obstructive sleep apnea syndrome. Risk assessment of obstructive sleep apnea syndrome that makes it possible for doctors to objectively determine the risk of developing obstructive sleep apnea syndrome in a short time by combining the results of the test method as appropriate It is to provide a method, a program thereof and a computer having the program.

  In the course of conducting intensive research to solve the above-mentioned problems, the present inventor identified a patient diagnosed with obstructive sleep apnea syndrome and a subject without breathing disorder in a cephalometric radiogram. It was found that the distribution of numerical values obtained by measuring the distance between the measurement points and calculating based on a specific calculation formula using these distances is clearly different between the two. As a result of intensive studies based on the knowledge thus obtained, the present invention has been devised.

That is, in order to solve the above problems, the present invention provides:
The distance between S and A (SA), the distance between S and B (SB), and the distance between Go and A (Go) measured by X-ray imaging of the subject's head. -A), selected from the group consisting of the distance between Go and B (Go-B), the distance between Go and Me (Go-Me), and the distance between Cd and Go (Cd-Go) Using the distance
It is the calculation method of the obstruction | occlusion type sleep apnea syndrome risk determination parameter | index which calculates P by at least 1 type | formula in the following formula | equation (1)-(6).
P = ((SB) + (Go−B) + (Cd−Go)) / (SA) (1)
P = ((SB) + (Go-Me) + (Cd-Go)) / (SA) (2)
P = ((SB) + (Go-Me)) / (SA) (3)
P = (Go-A)-(Go-B) (4)
P = ((Go−A) − (Go−B)) / (Go−A) (5)
P = ((Go−A) − (Go−B)) / (Go−B) (6)

Here, S, A, B, Go, Me, and Cd are measurement points obtained by cephalometric radiography. The position of each measurement point is shown in FIG. S is an abbreviation for Sella, and is the center point of the saddle-shaped shadow image of the sphenoid turkey. A is an abbreviation for point A, ANS (the anterior nasal spine, which is the tip of the anterior nasal spine, the tip of the joint bone with the people under the nose) and the maxillary central incisor This is the deepest point on the mid-sagittal plane between the foremost tip of the interproximal alveolar protrusion. B is an abbreviation for point B, and is the deepest point between Infradentale and pogonion (the most protruding point of the mandibular genital ridge with respect to the Frankfort plane). Go is an abbreviation for Gonion, and the bisector of the angle between the line connecting the posterior margin plane of the temporomandibular joint and the posterior edge of the mandibular angle and the mandibular plane intersects the mandibular angle. Is a point. Me is an abbreviation for menton, and is the lowest point of the midline cross-sectional image of the chin. Cd is the uppermost point (condylion) of the mandibular head. Although details will be described later, the expression (3) is more generally expressed as S and X _i (i is an integer of 1 to 4, X ₁ = B, X ₂ = Pog, X ₃ = Gn, X ₄ = the distance (S-X _i) and Go and X _j (j between Me) in 1 to 4 integer, j = i or distance between the j ≠ i) (Go-X j ) Can be expressed as P = ((S−X _i ) + (Go−X _j )) / (S−A).

The present inventor measured distances (SA), (SB), (Go-B), and (Cd-Go) in cephalometric radiographs of patients with many obstructive sleep apnea syndromes. As a result of calculating the equation (1), at least the majority of P in patients with obstructive sleep apnea syndrome is in the range of 2.800 ≦ P <3.200. The same applies when the distances (SA), (SB), (Go-Me), and (Cd-Go) are measured and the equation (2) is calculated. In this case, P itself may be used as a risk determination index for obstructive sleep apnea syndrome, but it is easy to understand when represented by an integer. Therefore, typically, after calculating P, for example, further round down the fourth decimal place of P / 4,
Q = (P / 4) × 1000
Calculate As an example, if P = 2.924, then Q = (P / 4) × 1000 = (2.924 / 4) × 1000 = 0.721 × 1000 = 731.

On the other hand, the present inventor measures distances (SA), (SB), and (Go-Me) in cephalometric radiograms of patients with many obstructive sleep apnea syndromes, and formula ( As a result of calculating 3), in patients with obstructive sleep apnea syndrome,
P = ((SB) + (Go-Me)) / (SA) = 2. XYZ
(X, Y and Z are integers from 0 to 9)
I found out that In other words, the P of the majority of patients is in the range of 2.000 ≦ P <3.000, especially 2.000 ≦ P ≦ 2.500. However, for very few patients, P <2.000. In this case as well, P itself may be used as a risk determination index for obstructive sleep apnea syndrome. For this reason, in the case of 2.000 ≦ P <3.000, typically, after calculating P, after rounding down the fourth decimal place of P, Q = (P− [P] ) × 1000. Since [P] means that the decimal part of P is rounded down, P- [P] means that the decimal part of P is extracted. Q = (P− [P]) × 1000 means that the fractional part thus extracted is multiplied by 1000. in this case,
P- [P] = 2. XYZ- [2. XYZ] = 2. XYZ-2 = 0. XYZ
It becomes. Therefore, Q = (P− [P]) × 1000 = XYZ, which is an integer of 0 to 999. As an example, when P = 2.212, Q = (P− [P]) × 1000 = (2.212− [2.212]) × 1000 = (2.212-2) × 1000 = 0.212 X1000 = 212. P- [P] or a numerical value XYZ obtained by multiplying it by 1000 can be considered as a numerical value for evaluating the ratio of the size of the mandible to the maxilla in the profile of the head.

  When calculating P according to equation (4), since P has a unit of length, this length P can be used directly as an obstructive sleep apnea syndrome risk determination index.

When calculating P by the formula (5) or (6), for example, further round down the fourth decimal place of P,
Q = P × 1000
Calculate

  The method of calculating the obstructive sleep apnea syndrome risk determination index can be easily executed by a computer having a predetermined program including the above-described calculation formulas for P and Q. The type of the computer is not particularly limited, and any of various types of mobile terminals such as a desktop type, a notebook type, and a tablet terminal may be used. This program can be stored in various computer-readable recording media such as a CD-ROM, or can be provided through an electric communication line such as the Internet. In the computer, as data necessary for the calculation, for example, distance (SA), (SB), (Go-A), (Go-B), (Go-Me) in a cephalometric radiogram And the distance used for calculation among the distances selected from the group consisting of (Cd-Go). Alternatively, image data obtained by cephalometric radiography is taken into a computer, and the coordinates of S, A, B, Go, Cd, and Me are measured from the image data, and the distance (SA) is calculated from the coordinates thus measured. ), (SB), (Go-A), (Go-B), (Go-Me) and (Cd-Go) are obtained by calculation, and these distances are used to calculate P, Q by the above formula. May be calculated. Typically, for example, a lateral cephalometric radiograph of a subject is performed using an X-ray diagnostic system including a computer having this program, and an obstructive sleep apnea syndrome risk determination index is determined based on the result. Execute the calculation method. The computer and the X-ray diagnosis system may be connected by wire or wirelessly.

In addition, this invention
The distance between S and A (SA), the distance between S and B (SB), and the distance between Go and A (Go) measured by X-ray imaging of the subject's head. -A), selected from the group consisting of the distance between Go and B (Go-B), the distance between Go and Me (Go-Me), and the distance between Cd and Go (Cd-Go) Using the distance
P is calculated by at least one of the formulas (1) to (6),
Or
When calculating P by the formula (1) or (2), further round down the fourth decimal place of P / 4,
Q = (P / 4) × 1000
Calculate
When calculating P by equation (3), further round off the fourth decimal place of P,
Q = (P− [P]) × 1000 ([] is a Gaussian symbol) (however, 2.000 ≦ P <3.000)
Or Q = (P − ([P] +1)) × 1000 ([] is a Gaussian symbol) (where P <2.000)
Calculate
When calculating P according to equation (5) or (6), further round off the fourth decimal place of P,
Q = P × 1000 is calculated,
It is an obstructive sleep apnea syndrome risk determination method for determining the risk of obstructive sleep apnea syndrome of a subject by comparing the calculated P or Q with a predetermined value.

  The obstructive sleep apnea syndrome risk determination method can be easily executed by a computer having a predetermined program including the above-described P and Q calculation formulas or P and Q determination formulas. The type of the computer is not particularly limited, and any of various types of mobile terminals such as a desktop type, a notebook type, and a tablet terminal may be used. This program can be stored in various computer-readable recording media such as a CD-ROM, or can be provided through an electric communication line such as the Internet. Data necessary for the calculation can be acquired in the same manner as the calculation method of the obstructive sleep apnea syndrome determination index.

  Except for the above-described obstructive sleep apnea syndrome risk determination method, what has been described in relation to the above-described calculation method of the obstructive sleep apnea syndrome determination index is valid as long as it does not contradict its nature.

  According to the present invention, it is possible to easily calculate an obstructive sleep apnea syndrome risk determination index, which is an objective material for determining the risk of the subject developing the obstructive sleep apnea syndrome. In addition, by using the obstruction-type sleep apnea syndrome risk determination index as an objective material for determining the risk that the subject will develop obstruction-type sleep apnea syndrome, the results of other test methods are used in combination as appropriate. The doctor can objectively and quickly determine the risk that the subject will develop obstructive sleep apnea syndrome.

It is a basic diagram for demonstrating the measurement point in a head X-ray standard photograph. It is a flowchart which shows the calculation method of the obstruction | occlusion type sleep apnea syndrome risk determination parameter | index by 1st Embodiment of this invention. 2 is a transcribing diagram created based on a cephalometric radiogram of patient 1. FIG. FIG. 5 is a transmission diagram created based on a cephalometric radiogram of patient 2. FIG. 4 is a transmission diagram created based on a cephalometric radiogram of patient 3. FIG. 6 is a transmission diagram created based on a cephalometric radiogram of patient 4. FIG. 6 is a transmission diagram created based on a cephalometric radiogram of a patient 5. FIG. 6 is a transmission diagram created based on a cephalometric radiogram of a patient 6. FIG. 5 is a transmission diagram created based on a cephalometric radiogram of a patient 7. FIG. 6 is a transmission diagram created based on a cephalometric radiogram of a patient 8. FIG. 6 is a transmission diagram created based on a cephalometric radiogram of a patient 9. FIG. 3 is a transmission diagram created based on a cephalometric radiogram of a patient 10. FIG. 3 is a transmission diagram created based on a cephalometric radiogram of a patient 11. FIG. 5 is a transmission diagram created based on a cephalometric radiogram of a patient 12. FIG. 6 is a transmission diagram created based on a cephalometric radiogram of a patient 13. FIG. 5 is a transmission diagram created based on a cephalometric radiogram of a patient 14. FIG. 6 is a transmission diagram created based on a cephalometric radiogram of a patient 15. FIG. 6 is a transmission diagram created based on a cephalometric radiogram of a patient 16. FIG. 6 is a transmission diagram created based on a cephalometric radiogram of a patient 17. FIG. 3 is a transmission diagram created based on a cephalometric radiogram of a patient 18. FIG. 6 is a transmission diagram created based on a cephalometric radiogram of a patient 19. FIG. 3 is a transmission diagram created based on a cephalometric radiogram of a patient 20. FIG. 4 is a transmission diagram created based on a cephalometric radiogram of a patient 21. FIG. 6 is a transmission diagram created based on a cephalometric radiogram of a patient 22 FIG. 6 is a transmission diagram created based on a cephalometric radiogram of a patient 23. FIG. 5 is a transmission diagram created based on a cephalometric radiogram of a subject 24. FIG. 5 is a transmission diagram created based on a cephalometric radiogram of a subject 25. FIG. 4 is a transmission diagram created based on a cephalometric radiogram of a subject 26. FIG. 4 is a transmission diagram created based on a cephalometric radiogram of a subject 27. FIG. 3 is a transmission diagram created based on a cephalometric radiogram of a subject 28. FIG. 6 is a transmission diagram created based on a cephalometric radiogram of a subject 29. FIG. 3 is a transmission diagram created based on a cephalometric radiogram of a subject 30. FIG. 3 is a transmission diagram created based on a cephalometric radiogram of a subject 31. FIG. 5 is a transmission diagram created based on a cephalometric radiogram of a subject 32. FIG. 6 is a transmission diagram created based on a cephalometric radiogram of a subject 33. FIG. 6 is a transmission diagram created based on a cephalometric radiogram of a subject 34. FIG. 6 is a transmission diagram created based on a cephalometric radiogram of a subject 35. It is a basic diagram which shows the calculation result of the OSAS index | exponent P of the patients 1-23 and the test subjects 24-35 in 1st Embodiment of this invention. It is a flowchart which shows the obstruction | occlusion type sleep apnea syndrome risk determination method by 2nd Embodiment of this invention. It is a flowchart which shows the calculation method of the obstruction | occlusion type sleep apnea syndrome risk determination parameter | index by 3rd Embodiment of this invention. It is a basic diagram which shows the calculation result of OSAS index | exponent Q of the patients 1-23 in the 3rd Embodiment of this invention, and the test subjects 24-35. It is a flowchart which shows the obstruction type sleep apnea syndrome risk determination method by 4th Embodiment of this invention. It is a flowchart which shows the calculation method of the obstruction | occlusion type sleep apnea syndrome risk determination parameter | index by 5th Embodiment of this invention. It is a basic diagram which shows the calculation result of the OSAS index | exponent Q of the patients 1-23 in the 5th Embodiment of this invention, and the test subjects 24-35. It is a flowchart which shows the obstruction type sleep apnea syndrome risk determination method by 6th Embodiment of this invention. It is a flowchart which shows the calculation method of the obstruction | occlusion type sleep apnea syndrome risk determination parameter | index by 7th Embodiment of this invention. It is a basic diagram which shows the calculation result of the OSAS index | exponent Q of the patients 1-23 in the 7th Embodiment of this invention, and the test subjects 24-35. It is a flowchart which shows the obstruction type sleep apnea syndrome risk determination method by 8th Embodiment of this invention. It is a flowchart which shows the calculation method of the obstruction | occlusion type sleep apnea syndrome risk determination parameter | index by 9th Embodiment of this invention. It is a basic diagram which shows the calculation result of the OSAS index | exponent Q of the patients 1-23 in the 9th Embodiment of this invention, and the test subjects 24-35. It is a flowchart which shows the obstruction | occlusion type sleep apnea syndrome risk determination method by 10th Embodiment of this invention. It is a flowchart which shows the calculation method of the obstruction | occlusion type sleep apnea syndrome risk determination parameter | index by 11th Embodiment of this invention. It is a basic diagram which shows the calculation result of OSAS index | exponent Q of the patients 1-23 in the 11th Embodiment of this invention, and the test subjects 24-35. It is a flowchart which shows the obstruction type sleep apnea syndrome risk determination method by 12th Embodiment of this invention. It is a basic diagram for demonstrating the measurement point in the head X-ray standard photograph used in the calculation method of the obstruction | occlusion type sleep apnea syndrome risk determination parameter | index by 13th Embodiment of this invention. It is a flowchart which shows the calculation method of the obstruction | occlusion type sleep apnea syndrome risk determination parameter | index by 13th Embodiment of this invention. It is a flowchart which shows the obstruction type sleep apnea syndrome risk determination method by 14th Embodiment of this invention. It is a basic diagram which shows the data processor used for the calculation method of the obstruction type sleep apnea syndrome risk determination index | exponent or the obstruction type sleep apnea syndrome risk determination method by 1st-14th embodiment of this invention. is there. It is a basic diagram for demonstrating the measurement point and the 1st triangle and 2nd triangle in the picked-up image of a lateral head and neck X-ray imaging. It is a left view of a skull. It is the perspective view which shows a hyoid bone, a top view, and sectional drawing. It is a flowchart which shows the obstruction type sleep apnea syndrome risk determination method by 15th Embodiment of this invention. An approximate line for explaining an example of a method for inputting a body part of a hyoid bone on a captured image of lateral head and neck X-ray imaging in the risk determination method for obstructive sleep apnea syndrome according to the fifteenth embodiment of the present invention FIG. It is a basic diagram which shows an example of the shape of the hyoid bone observed on the picked-up image of a lateral head and neck X-ray imaging in the obstruction type sleep apnea syndrome risk determination method by 15th Embodiment of this invention. It is a flowchart which shows the obstruction type sleep apnea syndrome risk determination method by 16th Embodiment of this invention. It is a flowchart which shows the obstruction type sleep apnea syndrome risk determination method by 17th Embodiment of this invention. FIG. 6 is a transmission diagram created based on a lateral head and neck X-ray standard photograph of a patient 41. It is a transmission drawing created based on the lateral head and neck X-ray standard photograph of patient 42. It is a transmission drawing created based on the lateral head and neck X-ray standard photograph of patient 43. It is the transcribing figure created based on the lateral head and neck X-ray standard photograph of the patient 44. FIG. It is a transmission drawing created based on a lateral head and neck X-ray standard photograph of a patient 45. FIG. 6 is a transmission diagram created based on a lateral head and neck X-ray standard photograph of a patient 46. FIG. 6 is a transmission diagram created based on a lateral head and neck X-ray standard photograph of a patient 47. FIG. 5 is a transmission diagram created based on a lateral head and neck X-ray standard photograph of a patient 48. FIG. 5 is a transmission diagram created based on a lateral head and neck X-ray standard photograph of a patient 49. FIG. 5 is a transmission diagram created based on a lateral head and neck X-ray standard photograph of a patient 50. FIG. 5 is a transmission diagram created based on a lateral head and neck X-ray standard photograph of a patient 51. FIG. 6 is a transmission diagram created based on a lateral head and neck X-ray standard photograph of a patient 52. FIG. 6 is a transmission diagram created based on a lateral head and neck X-ray standard photograph of a patient 53. FIG. 6 is a transmission diagram created based on a lateral head and neck X-ray standard photograph of a patient 54. FIG. 6 is a transmission diagram created based on a lateral head and neck X-ray standard photograph of a patient 55. It is a transmission drawing created based on the lateral head and neck X-ray standard photograph of patient 56. FIG. 6 is a transmission diagram created based on a lateral head and neck X-ray standard photograph of a subject 57. FIG. 5 is a transmission diagram created based on a lateral head and neck X-ray standard photograph of a subject 58; FIG. 6 is a transmission diagram created based on a lateral head and neck X-ray standard photograph of a subject 59. FIG. 6 is a transmission diagram created based on a lateral head and neck X-ray standard photograph of a subject 60. It is a transmission drawing created based on a lateral head and neck X-ray standard photograph of the subject 61. It is a flowchart which shows the obstruction type sleep apnea syndrome risk determination method by 18th Embodiment of this invention. FIG. 6 is a transmission diagram created based on a lateral head and neck X-ray standard photograph of a subject 62. 10 is a drawing-substituting photograph showing a posterior-front head and neck X-ray standard photograph of a subject 62; The first to eighteenth embodiments of the present invention are suitable for use in lateral head X-ray imaging, lateral head and neck X-ray imaging, posterior anterior head and neck X-ray imaging, and anteroposterior head and neck X-ray imaging. It is the basic diagram which looked at the cephalo X-ray imaging apparatus by 20th Embodiment from the perpendicular direction with respect to the horizontal direction and center X-rays. FIG. 92 is a schematic diagram illustrating an arm of the cephalo X-ray imaging apparatus illustrated in FIG. 91 and a head tilt setting device installed in the arm. It is a top view which shows the horizontal board provided in the lower end of the head inclination setting apparatus of the cephalo X-ray imaging apparatus shown in FIG. FIG. 92 is a schematic diagram for explaining a method of taking a lateral head and neck X-ray standard photograph using the cephalo X-ray imaging apparatus shown in FIG. 91. FIG. 92 is a schematic diagram for explaining a method of taking a lateral head and neck X-ray standard photograph using the cephalo X-ray imaging apparatus shown in FIG. 91. FIG. 92 is a schematic diagram for explaining a method of taking a lateral head and neck X-ray standard photograph using the cephalo X-ray imaging apparatus shown in FIG. 91. FIG. 92 is a schematic diagram for explaining a method of taking a lateral head and neck X-ray standard photograph at a high face level with the head inclined 10 ° in the front-rear direction using the cephalo X-ray imaging apparatus shown in FIG. 91; FIG. 92 is a schematic diagram for explaining a method of taking a posterior anterior head and neck X-ray standard photograph using the cephalo X-ray imaging apparatus shown in FIG. 91. FIG. 92 is a schematic diagram for explaining a method of taking a posterior anterior head and neck X-ray standard photograph using the cephalo X-ray imaging apparatus shown in FIG. 91. FIG. 92 is a drawing-substituting photograph showing a lateral head and neck X-ray standard photograph of a subject 63 photographed using the Cephalo X-ray photographing apparatus shown in FIG. 91. FIG. 92 is a drawing-substituting photograph showing a posterior front head-and-neck X-ray standard photograph of a subject 63 photographed using the Cephalo X-ray photographing apparatus shown in FIG. 91. FIG. 92 is a drawing-substituting photograph showing a lateral head and neck X-ray standard photograph of a subject 64 photographed using the Cephalo X-ray photographing apparatus shown in FIG. 91. FIG. 92 is a drawing-substituting photograph showing a posterior frontal head X-ray standard photograph of the subject 64 photographed using the cephalo X-ray photographing apparatus shown in FIG. 91.

Hereinafter, modes for carrying out the invention (hereinafter referred to as embodiments) will be described.
<1. First Embodiment>
In the first embodiment, P = (Go−A) − (Go−B) is used as an obstructive sleep apnea syndrome risk determination index (hereinafter also referred to as OSAS index), and calculation of the OSAS index P is performed. A method will be described.

  FIG. 2 shows a flowchart of this calculation method. A program according to this flowchart is created and executed by a computer.

  Before performing this calculation, a cephalometric radiograph of a subject to determine the risk of developing obstructive sleep apnea syndrome (hereinafter also referred to as OSAS) is performed, and the distance between Go and A (Go-A ) And the distance between Go and B (Go-B). These distances can be measured by inputting coordinate data of A, B and Go measurement points on a cephalometric radiogram using, for example, a pen tablet or digitizer, or connected to a computer, for example. When a captured image is displayed on the display, the mouse is moved on the display using the mouse to click on S, Go, and Me, or when a touch panel display is used, a finger on the display is displayed. By touching S, Go, and Me with a touch pen or the like, the detection can be easily performed using S, Go, and Me thus detected. Alternatively, image data obtained by cephalometric radiography is taken into a computer, and the coordinates of A, B, and Go are measured from the image data, and the distance (Go-A) and (Go-B) are determined from the coordinates thus measured. ) May be obtained by calculation.

  As shown in FIG. 2, in step S1, distances (Go-A) and (Go-B) measured as described above are input.

In step S2, from the inputted (Go-A) and (Go-B), P = (Go-A)-(Go-B)
Calculate P according to

  In step S3, the OSAS index P calculated as described above is output to a display, for example.

Thus if the calculated OSAS index P is a predetermined value C ₁ or more can be determined in terms of skeletal jawbone, and a high risk of developing OSAS. C ₁ can be determined as necessary, but can be set to 7 mm, for example.

If OSAS index P is less than C _1, from the viewpoint of skeletal jawbone it can be determined to be low risk of developing OSAS.

  In general, in addition to the OSAS index P, the doctor can finally determine the risk of developing OSAS by using the results of other tests conventionally used for OSAS tests.

[Example 1]
OSAS was examined by PSG and cephalometric radiographs of 23 patients diagnosed as severe, moderate or mild were taken. Photographing was performed at a central occlusal position or a position corresponding thereto (the same applies hereinafter). Based on this cephalometric radiogram, a translucent map was created, distances (Go-A) and (Go-B) were measured, and P = (Go-A)-(Go-B) was calculated.

Transflection diagrams of patients 1 to 23 are shown in FIGS. Distances measured from FIGS. 3 to 25 (Go-A), (Go-B), P = (Go-A)-(Go-B), AHI (patient position) of patients 1 to 23 obtained by PSG ) And SaO ₂ (minimum value) are as follows. However, the patient 3 showed SpO ₂ (minimum value) instead of SaO ₂ (minimum value).

Patient (Go-A) (Go-B) P AHI SaO ₂
(Mm) (mm) (mm) (%)
1 79 66 13 70.4 87
2 86 71 15 71.2 71
3 77 65 12 41.1 68 (SpO ₂ )
4 80 66 14 53.5 71
5 82 75 7 58.4 78
6 78 67 11 36.8 87
7 72 64 8 30.2 83
8 82 74 8 36.4 90
9 87 67 20 35.5 80
10 78 70 8 23.2 73
11 96 85 11 43.1 70
12 80 65 15 25.7 79
13 84 71 13 24.8 92
14 83 68 15 9.6 90
15 81 68 13 66.0 76
16 85 70 15 6.2 90
17 72 60 12 37.9 78
18 82 70 12 62.9 73
19 82 72 10 112.5 85
20 77 67 10 29.1 87
21 86 78 8 11.9 93
22 83 73 10 59.7 80
23 87 76 11 43.9 85

  As a control group, 12 subjects 24-35 in which no respiratory disturbance was observed during sleep were employed. A cephalometric radiograph was taken for these subjects 24-35, and distances (Go-A) and (Go-B) were measured based on a transmission diagram created based on the cephalometric radiograph. P = (Go−A) − (Go−B) was calculated.

  The transmission drawings of the subjects 24-35 are shown in FIGS. The distance (Go−A), distance (Go−B), and P = (Go−A) − (Go−B) measured from FIGS. 26 to 37 are as follows.

Subject (Go-A) (Go-B) P
(Mm) (mm) (mm)
24 77 78 -1
25 78 80 -2
26 85 80 5
27 78 76 2
28 74 73 1
29 79 80 -1
30 86 73 13
31 79 80 -1
32 81 74 7
33 83 72 11
34 78 69 9
35 87 70 17

  FIG. 38 shows the results of plotting the AHI and P values of patients 1 to 23. In FIG. 38, the values of P for subjects 24 to 35 are plotted on a straight line with AHI = 0. From FIG. 38, P of subjects 24 to 35 is distributed over a wide range of −2 mm to 17 mm, whereas P of patients 1 to 23 is concentrated and distributed over a range of 7 mm to 20 mm. It can be seen that the distribution is very different. Therefore, the risk of OSAS can be determined by the value of P using the difference in distribution.

  As described above, according to the calculation method for the obstructive sleep apnea syndrome risk determination index according to the first embodiment, the distance (Go-A) and (Go-B) measured by cephalometric radiography. ) Can be used to calculate the OSAS index P. Based on the OSAS index P, the risk of developing OSAS can be determined objectively and in a short time with a certain degree of accuracy without depending on the experience of the doctor.

<2. Second Embodiment>
In the second embodiment, an obstructive sleep apnea syndrome risk determination method will be described.

  FIG. 39 shows a flowchart of this obstructive sleep apnea syndrome risk determination method. A program according to this flowchart is created and executed by a computer. In this sense, this obstructive sleep apnea syndrome risk determination method can be rephrased as an operation method of the obstructive sleep apnea syndrome risk determination apparatus having this program.

  Similarly to the first embodiment, the distances (Go-A) and (Go-B) are measured before executing this obstructive sleep apnea syndrome risk determination method.

  As shown in FIG. 39, in step S11, the distances (Go-A) and (Go-B) measured as described above are input.

In step S12, P = (Go-A)-(Go-B) from the input distances (Go-A) and (Go-B).
Calculate P according to

In step S13, the P obtained by calculation as described above, determines whether the P ≧ C _1.

In step S14, if it is P ≧ C ₁ determines that the high risk of developing OSAS. For example, when P ≧ 7 mm, it is determined that the risk of developing OSAS is high. In this case, for example, if P ≧ 10 mm, it may be determined that the risk of developing OSAS is particularly high.

  In step S15, the determination result that the risk of developing OSAS is high is output to a display, for example.

In step S13, not P ≧ C _1, when it is determined that the other words P <C _1, in step S16, determines that the risk of developing OSAS is low.

  In step S17, a determination result that the risk of developing OSAS is low is output to, for example, a display.

  According to the obstructive sleep apnea syndrome risk determination method according to the second embodiment, based on the distance (Go-A) and (Go-B) measured by cephalometric radiography, the experience of the doctor The risk of developing OSAS can be determined objectively, in a short time, and with a certain degree of accuracy, without being influenced by the above.

<3. Third Embodiment>
In the third embodiment, Q = P × 1000 calculated from P = ((Go−A) − (Go−B)) / (Go−A) is used as the OSAS index. A calculation method will be described.

  FIG. 40 shows a flowchart of this calculation method. A program according to this flowchart is created and executed by a computer.

  Before performing this calculation, a cephalometric radiograph of the subject to determine the risk of developing OSAS is performed and the distance between Go and A (Go-A) and the distance between Go and B (Go- B) is measured. These distances can be measured in the same manner as in the first embodiment.

  As shown in FIG. 40, in step S21, the distances (Go-A) and (Go-B) measured as described above are input.

In step S22, from the inputted (Go-A) and (Go-B), P = ((Go-A)-(Go-B)) / (Go-A)
Calculate P according to

In step S23, the fourth decimal place of P calculated as described above is rounded down,
Q = P × 1000
Calculate

  In step S24, the OSAS index Q calculated as described above is output to a display, for example.

Thus if the calculated OSAS index Q is a predetermined value C ₂ or higher can be determined in terms of skeletal jawbone, and a high risk of developing OSAS. C ₂ can be determined as necessary, and is, for example, 90.

When the OSAS index Q is less than C _2, it can be determined that the risk of developing OSAS is low from the viewpoint of the skeletal nature of the jawbone.

  In general, in addition to the OSAS index Q, the doctor finally determines the risk of developing OSAS by using the results of other tests conventionally used for OSAS tests.

[Example 2]
The distances (Go-A) and (Go-B) are measured from FIGS. 3 to 25 which are transmission drawings created based on cephalometric radiographs of patients 1 to 23, and P = ((Go− A) − (Go−B)) / (Go−A) was calculated, and Q = P × 1000 was calculated.

The distance (Go-A), distance (Go-B), and Q measured from FIGS. 3 to 25 are as follows. AHI and SaO ₂ or SpO ₂ of patients 1 to 23 obtained by PSG are the same as in Example 1.

Patient (Go-A) (Go-B) Q
(Mm) (mm)
1 79 66 164
2 86 71 174
3 77 65 155
4 80 66 175
5 82 75 85
6 78 67 141
7 72 64 111
8 82 74 98
9 87 67 229
10 78 70 102
11 96 85 114
12 80 65 187
13 84 71 154
14 83 68 180
15 81 68 160
16 85 70 176
17 72 60 166
18 82 70 146
19 82 72 121
20 77 67 129
21 86 78 93
22 83 73 120
23 87 76 126

  Subjects 24 to 35 were employed as a control group. The distances (Go-A) and (Go-B) are measured from FIGS. 26 to 37, which are transmission drawings created based on cephalometric radiographs of these subjects 24-35, and P = (( Go-A)-(Go-B)) / (Go-A) and Q = P * 1000 was calculated.

  The distance (Go-A), distance (Go-B), and Q measured from FIGS. 26 to 37 are as follows.

Subject (Go-A) (Go-B) Q
(Mm) (mm)
24 77 78 -12
25 78 80 -25
26 85 80 58
27 78 76 25
28 74 73 13
29 79 80 -12
30 86 73 151
31 79 80 -12
32 81 74 86
33 83 72 132
34 78 69 115
35 87 70 195

  FIG. 41 shows the results of plotting the AHI and Q values of patients 1 to 23. In FIG. 41, Q values of subjects 24-35 are plotted on a straight line with AHI = 0. 41, Q of subjects 24-35 are distributed over a wide range of -25 to 195, whereas Q of patients 1 to 23 are concentrated in the range of 85 to 229. Can be seen to be very different. Therefore, using this difference in distribution, the risk of OSAS can be determined by the value of Q.

  According to the calculation method of the obstructive sleep apnea syndrome risk determination index according to the third embodiment, the OSAS is calculated using the distances (Go-A) and (Go-B) measured by cephalometric radiography. The index Q can be calculated. Based on the OSAS index Q, the risk of developing OSAS can be determined objectively and in a short time with a certain degree of accuracy without depending on the experience of the doctor.

<4. Fourth Embodiment>
In the fourth embodiment, an obstructive sleep apnea syndrome risk determination method will be described.

  FIG. 42 shows a flowchart of this obstructive sleep apnea syndrome risk determination method. A program according to this flowchart is created and executed by a computer.

  Similarly to the first embodiment, the distances (Go-A) and (Go-B) are measured before executing this obstructive sleep apnea syndrome risk determination method.

  As shown in FIG. 42, in step S31, the distances (Go-A) and (Go-B) measured as described above are input.

In step S32, P = ((Go-A)-(Go-B)) / (Go-A) from the input distances (Go-A) and (Go-B).
Calculate P according to

In step S33, the fourth decimal place of P calculated as described above is rounded down,
Q = P × 1000
Calculate

In step S34, it is determined whether or not Q ≧ C ₂ from Q obtained by calculation as described above.

In step S35, when it is Q ≧ C ₂ determines that there is a high risk of developing OSAS. For example, when Q ≧ 85, it is determined that the risk of developing OSAS is high. In this case, for example, when Q ≧ 110, it may be determined that the risk of developing OSAS is particularly high.

  In step S36, a determination result that the risk of developing OSAS is high is output to, for example, a display.

In step S34, not Q ≧ C _2, when it is determined that the other words Q <C _2, at step S37, determines that the risk of developing OSAS is low.

  In step S38, a determination result that the risk of developing OSAS is low is output to, for example, a display.

  According to the obstructive sleep apnea syndrome risk determination method according to the fourth embodiment, based on the distances (Go-A) and (Go-B) measured by cephalometric radiography, the experience of the doctor The risk of developing OSAS can be determined objectively, in a short time, and with a certain degree of accuracy, without being influenced by the above.

<5. Fifth Embodiment>
In the fifth embodiment, Q = P × 1000 calculated from P = ((Go−A) − (Go−B)) / (Go−B) is used as the OSAS index. A calculation method will be described.

  FIG. 43 shows a flowchart of this calculation method. A program according to this flowchart is created and executed by a computer.

  Before performing this calculation, a cephalometric radiograph of the subject to determine the risk of developing OSAS is performed and the distance between Go and A (Go-A) and the distance between Go and B (Go- B) is measured. These distances can be measured in the same manner as in the first embodiment.

  As shown in FIG. 43, in step S41, the distances (Go-A) and (Go-B) measured as described above are input.

In step S42, from the inputted (Go-A) and (Go-B), P = ((Go-A)-(Go-B)) / (Go-B)
Calculate P according to

In step S43, the fourth decimal place of P calculated as described above is rounded down,
Q = P × 1000
Calculate

  In step S44, the OSAS index Q calculated as described above is output to a display, for example.

When the OSAS index Q calculated in this way is equal to or greater than the predetermined value C ₃ , it can be determined that the risk of developing OSAS is high from the viewpoint of the skeletal nature of the jawbone. C ₃ can be determined as necessary, and is 93, for example.

When the OSAS index Q is less than C _3, it can be determined that the risk of developing OSAS is low from the viewpoint of the skeletal nature of the jawbone.

  In general, in addition to the OSAS index Q, the doctor finally determines the risk of developing OSAS by using the results of other tests conventionally used for OSAS tests.

[Example 3]
The distances (Go-A) and (Go-B) are measured from FIGS. 3 to 25 which are transmission drawings created based on cephalometric radiographs of patients 1 to 23, and P = ((Go− A) − (Go−B)) / (Go−B) was calculated and Q = P × 1000 was calculated.

The distance (Go-A), distance (Go-B), and Q measured from FIGS. 3 to 25 are as follows. AHI and SaO ₂ or SpO ₂ of patients 1 to 23 obtained by PSG are the same as in Example 1.

Patient (Go-A) (Go-B) Q
(Mm) (mm)
1 79 66 196
2 86 71 211
3 77 65 184
4 80 66 212
5 82 75 93
6 78 67 164
7 72 64 125
8 82 74 108
9 87 67 298
10 78 70 114
11 96 85 129
12 80 65 230
13 84 71 183
14 83 68 220
15 81 68 191
16 85 70 214
17 72 60 200
18 82 70 171
19 82 72 138
20 77 67 149
21 86 78 102
22 83 73 136
23 87 76 144

  Subjects 24 to 35 were employed as a control group. The distances (Go-A) and (Go-B) are measured from FIGS. 26 to 37, which are transmission drawings created based on cephalometric radiographs of these subjects 24-35, and P = (( Go-A)-(Go-B)) / (Go-B) was calculated and Q = P * 1000 was calculated.

  The distance (Go-A), distance (Go-B), and Q measured from FIGS. 26 to 37 are as follows.

Subject (Go-A) (Go-B) Q
(Mm) (mm)
24 77 78 -12
25 78 80 -25
26 85 80 62
27 78 76 26
28 74 73 13
29 79 80 -12
30 86 73 178
31 79 80 -12
32 81 74 94
33 83 72 152
34 78 69 130
35 87 70 242

  FIG. 44 shows the results of plotting the AHI and Q values of patients 1 to 23. In FIG. 44, the Q values of subjects 24-35 are plotted on a straight line with AHI = 0. From FIG. 44, Q of subjects 24-35 are distributed over a wide range of -25 to 195, whereas Q of patients 1 to 23 are concentrated in the range of 93 to 298. Can be seen to be very different. Therefore, using this difference in distribution, the risk of OSAS can be determined by the value of Q.

  According to the calculation method of the obstructive sleep apnea syndrome risk determination index according to the fifth embodiment, the OSAS is calculated using the distances (Go-A) and (Go-B) measured by cephalometric radiography. The index Q can be calculated. Based on the OSAS index Q, the risk of developing OSAS can be determined objectively and in a short time with a certain degree of accuracy without depending on the experience of the doctor.

<6. Sixth Embodiment>
In the sixth embodiment, an obstructive sleep apnea syndrome risk determination method will be described.

  FIG. 45 shows a flowchart of this obstructive sleep apnea syndrome risk determination method. A program according to this flowchart is created and executed by a computer.

  Similarly to the first embodiment, the distances (Go-A) and (Go-B) are measured before executing this obstructive sleep apnea syndrome risk determination method.

  As shown in FIG. 45, in step S51, the distances (Go-A) and (Go-B) measured as described above are input.

In step S52, P = ((Go-A)-(Go-B)) / (Go-B) from the input distances (Go-A) and (Go-B).
Calculate P according to

In step S53, the fourth decimal place of P calculated as described above is rounded down,
Q = P × 1000
Calculate

In step S54, it is determined whether or not Q ≧ C ₃ from P obtained by calculation as described above.

In step S55, when Q ≧ C _3, it is determined that the risk of developing OSAS is high. For example, when Q ≧ 93, it is determined that the risk of developing OSAS is high. In this case, for example, when Q ≧ 110, it may be determined that the risk of developing OSAS is particularly high.

  In step S56, the determination result that the risk of developing OSAS is high is output to, for example, a display.

In step S54, the non-Q ≧ C _3, when it is determined that the other words Q <C _3, at step S57, the determined risk of developing OSAS is low.

  In step S58, the determination result that the risk of developing OSAS is low is output to, for example, a display.

  According to the obstructive sleep apnea syndrome risk determination method according to the sixth embodiment, based on the distances (Go-A) and (Go-B) measured by cephalometric radiography, the doctor's experience The risk of developing OSAS can be determined objectively, in a short time, and with a certain degree of accuracy, without being influenced by the above.

<7. Seventh Embodiment>
In the seventh embodiment, Q = (P / 4) × 1000 calculated from P = ((S−B) + (Go−B) + (Cd−Go)) / (SA). A method for calculating the OSAS index Q using the OSAS index will be described.

  FIG. 46 shows a flowchart of this calculation method. A program according to this flowchart is created and executed by a computer.

  Before performing this calculation, a cephalometric radiograph of the subject to determine the risk of developing OSAS is performed, and the distance between S and A (SA), the distance between S and B (S- B) The distance between Go and B (Go-B) and the distance between Cd and Go (Cd-Go) are measured. These distances can be measured in the same manner as in the first embodiment.

  As shown in FIG. 46, in step S61, the distances (SA), (SB), (Go-B), and (Cd-Go) measured as described above are input.

In step S62, P = ((S−B) + (Go−B) + (Cd−) from the inputted (S−A), (S−B), (Go−B) and (Cd−Go)). Go)) / (SA)
Calculate P according to

In step S63, P / 4 is calculated from P calculated as described above, and the fourth decimal place is rounded down.
Q = (P / 4) × 1000
Calculate

  In step S64, the OSAS index Q calculated as described above is output to a display, for example.

When the OSAS index Q calculated in this way is equal to or greater than the predetermined value C ₄ , it can be determined that the risk of developing OSAS is high from the viewpoint of the skeletal nature of the jawbone. C ₄ can be determined as necessary, and is, for example, 693.

When the OSAS index Q is less than C _4, it can be determined that the risk of developing OSAS is low from the viewpoint of the skeletal nature of the jawbone.

  In general, in addition to the OSAS index Q, the doctor finally determines the risk of developing OSAS by using the results of other tests conventionally used for OSAS tests.

[Example 4]
Distances (SA), (SB), (Go-B) and (Cd-) from FIGS. 3 to 25, which are transmission drawings created based on cephalometric radiographs of patients 1 to 23. Go) was measured, P = ((SB) + (Go−B) + (Cd−Go)) / (SA) was calculated, and Q = (P / 4) × 1000 was calculated.

The distances (SA), (SB), (Go-B), (Cd-Go), and Q measured from FIGS. 3 to 25 are as follows. AHI and SaO ₂ or SpO ₂ of patients 1 to 23 obtained by PSG are the same as in Example 1.

Patient (SA) (SB) (Go-B) (Cd-Go) Q
(Mm) (mm) (mm) (mm)
1 75 106 66 68 800
2 83 111 71 67 750
3 77 104 65 63 753
4 79 103 66 60 724
5 84 117 75 64 761
6 78 108 67 60 753
7 79 102 64 60 715
8 89 121 74 71 747
9 83 111 67 68 740
10 80 111 70 59 750
11 88 115 85 65 752
12 80 105 65 68 743
13 83 109 71 64 734
14 83 111 68 60 719
15 79 103 68 66 750
16 84 108 70 61 711
17 70 108 60 61 760
18 70 97 70 56 717
19 85 115 72 59 756
20 77 101 67 60 693
21 80 107 78 48 747
22 85 113 73 63 731
23 83 111 76 59 773

  Subjects 24 to 35 were employed as a control group. Distances (SA), (SB), (Go-B) and (GO) from FIGS. 26 to 37, which are transmission drawings created based on cephalometric radiographs of these subjects 24-35. Cd−Go) is measured, P = ((S−B) + (Go−B) + (Cd−Go)) / (S−A)) is calculated, and Q = (P / 4) × 1000 is calculated. Calculated.

  The distances (SA), (SB), (Go-B), (Cd-Go), and Q measured from FIGS. 26 to 37 are as follows.

Subject (SA) (SB) (Go-B) (Cd-Go) Q
(Mm) (mm) (mm) (mm)
24 78 123 78 60 836
25 83 123 80 68 816
26 88 126 80 66 772
27 85 119 76 67 770
28 75 109 73 59 803
29 87 128 80 68 793
30 86 111 73 57 700
31 90 127 80 65 755
32 79 105 74 50 724
33 81 103 72 64 737
34 81 108 69 63 740
35 91 115 70 70 670

  FIG. 47 shows the results of plotting the AHI and Q values of patients 1 to 23. In FIG. 47, Q values of subjects 24-35 are plotted on a straight line with AHI = 0. From FIG. 47, Q of subjects 24-35 are distributed over a wide range of 670 to 836, whereas Q of patients 1 to 23 are concentrated in a range of 693 to 800, and the distribution of both is It turns out that it is very different. Therefore, using this difference in distribution, the risk of OSAS can be determined by the value of Q.

  According to the calculation method of the obstructive sleep apnea syndrome risk determination index according to the seventh embodiment, the distances (SA), (SB), (Go-) measured by cephalometric radiography. The OSAS index Q can be calculated using B) and (Cd-Go). Based on the OSAS index Q, the risk of developing OSAS can be determined objectively and in a short time with a certain degree of accuracy without depending on the experience of the doctor.

<8. Eighth Embodiment>
In the eighth embodiment, an obstructive sleep apnea syndrome risk determination method will be described.

  FIG. 48 shows a flowchart of this obstructive sleep apnea syndrome risk determination method. A program according to this flowchart is created and executed by a computer.

  Similar to the first embodiment, before executing the obstructive sleep apnea syndrome risk determination method, the distances (SA), (SB), (Go-B), and (Cd-Go) are determined. ).

  As shown in FIG. 48, in step S71, the distances (SA), (SB), (Go-B), and (Cd-Go) measured as described above are input.

In step S72, P = ((S−B) + (Go−B) + (Cd) from the inputted distances (S−A), (S−B), (Go−B) and (Cd−Go)). -Go)) / (SA)
Calculate P according to

In step S73, P / 4 is calculated from P calculated as described above, and the fourth decimal place is rounded down.
Q = (P / 4) × 1000
Calculate

In step S74, it is determined whether or not Q ≧ C ₄ from the Q obtained by calculation as described above.

In step S75, the in the case of Q ≧ C ₄ determines that there is a high risk of developing OSAS. For example, when Q ≧ 693, it is determined that the risk of developing OSAS is high. In this case, for example, when Q ≧ 720, it may be determined that the risk of developing OSAS is particularly high.

  In step S76, a determination result that the risk of developing OSAS is high is output to, for example, a display.

In step S74, the non-Q ≧ C _4, if it is determined in other words Q <as a C _4, at step S77, the determined risk of developing OSAS is low.

  In step S78, a determination result that the risk of developing OSAS is low is output to, for example, a display.

  According to the obstructive sleep apnea syndrome risk determination method according to the eighth embodiment, the distances (SA), (SB), (Go-B) and Based on (Cd-Go), the risk of developing OSAS can be determined with a certain degree of accuracy regardless of the experience of the doctor.

<9. Ninth Embodiment>
In the ninth embodiment, Q = (P / 4) × 1000 calculated from P = ((SB) + (Go−Me) + (Cd−Go)) / (SA). A method for calculating the OSAS index Q using the OSAS index will be described.

  FIG. 49 shows a flowchart of this calculation method. A program according to this flowchart is created and executed by a computer.

  Before performing this calculation, a cephalometric radiograph of the subject to determine the risk of developing OSAS is performed, and the distance between S and A (SA), the distance between S and B (S- B) The distance between Go and Me (Go-Me) and the distance between Cd and Go (Cd-Go) are measured. These distances can be measured in the same manner as in the first embodiment.

  As shown in FIG. 49, in step S81, the distances (SA), (SB), (Go-Me), and (Cd-Go) measured as described above are input.

In step S82, P = ((S−B) + (Go−Me) + (Cd−) from the input (S−A), (S−B), (Go−Me) and (Cd−Go)). Go)) / (SA)
Calculate P according to

In step S83, P / 4 is calculated from P calculated as described above, and the fourth decimal place is rounded down.
Q = (P / 4) × 1000
Calculate

  In step S84, the OSAS index Q calculated as described above is output to a display, for example.

When the OSAS index Q calculated in this way is a predetermined value C ₅ or more, it can be determined that the risk of developing OSAS is high from the viewpoint of the skeletal nature of the jawbone. C ₅ can be determined as necessary, and is 703, for example.

When the OSAS index Q is less than C _5, it can be determined that the risk of developing OSAS is low from the viewpoint of the skeletal nature of the jawbone.

  In general, in addition to the OSAS index Q, the doctor finally determines the risk of developing OSAS by using the results of other tests conventionally used for OSAS tests.

[Example 5]
Distances (SA), (SB), (Go-Me), and (Cd-) from FIG. 3 to FIG. 25, which are transmission drawings created based on cephalometric radiographs of patients 1 to 23. Go) was measured, P = ((SB) + (Go−Me) + (Cd−Go)) / (SA) was calculated, and Q = (P / 4) × 1000 was calculated.

The distances (SA), (SB), (Go-Me), (Cd-Go), and Q measured from FIGS. 3 to 25 are as follows. AHI and SaO ₂ or SpO ₂ of patients 1 to 23 obtained by PSG are the same as in Example 1.

Patient (SA) (SB) (Go-Me) (Cd-Go) Q
(Mm) (mm) (mm) (mm)
1 75 106 65 68 796
2 83 111 67 67 737
3 77 104 68 63 762
4 79 103 65 60 721
5 84 117 76 64 764
6 78 108 70 60 762
7 79 102 69 60 731
8 89 121 75 71 750
9 83 111 65 68 734
10 80 111 70 59 750
11 88 115 81 65 741
12 80 105 60 68 728
13 83 109 67 64 722
14 83 111 65 60 710
15 79 103 65 66 740
16 84 108 70 61 711
17 70 108 61 61 764
18 70 97 70 56 717
19 85 115 70 59 750
20 77 101 70 60 703
21 80 107 77 48 744
22 85 113 73 63 731
23 83 111 73 59 764

  Subjects 24 to 35 were employed as a control group. The distances (SA), (SB), (Go-Me) and (Go-Me) from (FIG. 26 to FIG. 37) which are transmission drawings created based on the cephalometric radiographs of these subjects 24-35. Cd−Go) is measured, P = ((SB) + (Go−Me) + (Cd−Go)) / (SA) is calculated, and Q = (P / 4) × 1000 is calculated. did.

  The distances (SA), (SB), (Go-Me), (Cd-Go), and Q measured from FIGS. 26 to 37 are as follows.

Subject (SA) (SB) (Go-Me) (Cd-Go) Q
(Mm) (mm) (mm) (mm)
24 78 123 78 60 836
25 83 123 81 68 819
26 88 126 78 66 66 767
27 85 119 77 67 773
28 75 109 70 59 793
29 87 128 80 68 793
30 86 111 69 57 688
31 90 127 80 65 755
32 79 105 73 50 721
33 81 103 70 64 731
34 81 108 68 63 737
35 91 115 65 70 656

  FIG. 50 shows the results of plotting the AHI and P values of patients 1 to 23. In FIG. 50, Q values of subjects 24-35 are plotted on a straight line with AHI = 0. From FIG. 50, Qs of subjects 24-35 are distributed over a wide range of 656 to 836, whereas Qs of patients 1 to 23 are concentrated and distributed over a range of 710 to 796. It turns out that it is very different. Therefore, using this difference in distribution, the risk of OSAS can be determined by the value of Q.

  According to the calculation method of the risk determination index for obstructive sleep apnea syndrome according to the ninth embodiment, the distances (SA), (SB), (Go-) measured by cephalometric radiography. The OSAS index Q can be calculated using Me) and (Cd-Go). Based on the OSAS index Q, the risk of developing OSAS can be determined objectively and in a short time with a certain degree of accuracy without depending on the experience of the doctor.

<10. Tenth Embodiment>
In the tenth embodiment, an obstructive sleep apnea syndrome risk determination method will be described.

  FIG. 51 shows a flowchart of this obstructive sleep apnea syndrome risk determination method. A program according to this flowchart is created and executed by a computer.

  Similar to the first embodiment, before executing this obstructive sleep apnea syndrome risk determination method, the distances (SA), (SB), (Go-Me), and (Cd-Go) are determined. ).

  As shown in FIG. 51, in step S91, distances (SA), (SB), (Go-Me), and (Cd-Go) measured as described above are input.

In step S92, P = ((S−B) + (Go−Me) + (Cd) from the inputted distances (S−A), (S−B), (Go−Me) and (Cd−Go)). -Go)) / (SA)
Calculate P according to

In step S93, P / 4 is calculated from P calculated as described above, and the fourth decimal place is rounded down.
Q = (P / 4) × 1000
Calculate

In step S94, it is determined whether or not Q ≧ C ₅ from Q obtained by calculation as described above.

In step S95, when it is Q ≧ C ₅ determines that there is a high risk of developing OSAS. For example, when Q ≧ 703, it is determined that the risk of developing OSAS is high. In this case, for example, when Q ≧ 720, it may be determined that the risk of developing OSAS is particularly high.

  In step S96, the determination result that the risk of developing OSAS is high is output to a display, for example.

In step S94, not Q ≧ C _5, if it is determined in other words Q <as the C _5, at step S97, determines that the risk of developing OSAS is low.

  In step S98, a determination result that the risk of developing OSAS is low is output to, for example, a display.

  According to the obstructive sleep apnea syndrome risk determination method according to the tenth embodiment, the distances (SA), (SB), (Go-Me), and the distance measured by cephalometric radiography and Based on (Cd-Go), the risk of developing OSAS can be determined with a certain degree of accuracy regardless of the experience of the doctor.

<11. Eleventh Embodiment>
In the eleventh embodiment, Q = (P− [P]) × 1000 or Q = (P calculated from P = ((SB) + (Go−Me)) / (SA) Using − ([P] +1)) × 1000 as the OSAS index, a method for calculating the OSAS index Q will be described.

  FIG. 52 shows a flowchart of this calculation method. A program according to this flowchart is created and executed by a computer.

  Before performing this calculation, a cephalometric radiograph of the subject to determine the risk of developing OSAS is performed, and the distance between S and A (SA), the distance between S and B (S- B) and the distance (Go-Me) between Go and Me. These distances can be measured in the same manner as in the first embodiment.

  As shown in FIG. 52, in step S101, the distances (SA), (SB), and (Go-Me) measured as described above are input.

In step S102, P = ((SB) + (Go-Me)) / (SA) from the inputted (SA), (SB) and (Go-Me).
Calculate P according to

In step S103, the fourth decimal place of P calculated as described above is rounded down,
Q = (P− [P]) × 1000 (however, 2.000 ≦ P <3.000)
Or Q = (P − ([P] +1)) × 1000 (where P <2.000)
Calculate

  In step S104, the OSAS index Q calculated as described above is output to a display, for example.

Thus if the calculated OSAS factor Q is equal to or higher than the predetermined value C ₆ it can be determined in terms of skeletal jawbone, and a high risk of developing OSAS. C ₆ can be determined as necessary, and is 62, for example.

When the OSAS index Q is less than C _6, it can be determined that the risk of developing OSAS is low from the viewpoint of the skeletal nature of the jawbone.

  In general, in addition to the OSAS index Q, the doctor finally determines the risk of developing OSAS by using the results of other tests conventionally used for OSAS tests.

[Example 6]
Measure distances (SA), (SB), and (Go-Me) from FIGS. 3 to 25, which are transmission drawings created based on cephalometric radiographs of patients 1 to 23, P = ((S−B) + (Go−Me)) / (S−A) is calculated and Q = (P− [P]) × 1000 or Q = (P − ([P] +1)) × 1000 was calculated.

The distances (SA), (SB), (Go-Me), and Q measured from FIGS. 3 to 25 are as follows. AHI and SaO ₂ or SpO ₂ of patients 1 to 23 obtained by PSG are the same as in Example 1.

Patient (SA) (SB) (Go-Me) Q
(Mm) (mm) (mm)
1 75 106 65 280
2 83 111 67 144
3 77 104 68 233
4 79 103 65 126
5 84 117 76 297
6 78 108 70 282
7 79 102 69 164
8 89 121 75 202
9 83 111 65 120
10 80 111 70 262
11 88 115 81 227
12 80 105 60 62
13 83 109 67 120
14 83 111 65 120
15 79 103 65 126
16 84 108 70 119
17 70 108 61 257
18 70 97 70 176
19 85 115 70 220
20 77 101 70 212
21 80 107 77 235
22 85 113 73 216
23 83 111 73 211

  Subjects 24 to 35 were employed as a control group. Distances (SA), (SB), and (Go-Me) are measured from FIGS. 26 to 37, which are transmission drawings created based on cephalometric radiographs of these subjects 24-35. P = ((SB) + (Go−Me)) / (SA)), and Q = (P− [P]) × 1000 or Q = (P − ([P] +1) )) X 1000 was calculated.

  The distances (SA), (SB), (Go-Me), and Q measured from FIGS. 26 to 37 are as follows.

Subject (SA) (SB) (Go-Me) Q
(Mm) (mm) (mm)
24 78 123 78 576
25 83 123 81 457
26 88 126 78 318
27 85 119 77 305
28 75 109 70 386
29 87 128 80 390
30 86 111 69 93
31 90 127 80 300
32 79 105 73 253
33 81 103 70 135
34 81 108 68 172
35 91 115 65 -22

  FIG. 53 shows the results of plotting the AHI and Q values of patients 1 to 23. In FIG. 53, Q values of subjects 24-35 are plotted on a straight line with AHI = 0. From FIG. 53, Q of subjects 24 to 35 are distributed over a wide range of −22 to 576, whereas Q of patients 1 to 23 are concentrated and distributed over a range of 62 to 297. Can be seen to be very different. Therefore, using this difference in distribution, the risk of OSAS can be determined by the value of Q.

  Here, Q can be used as an index for judging the maxilla and jawbone incongruity, and the degree of the maxilla and mandible incongruity can be classified by the magnitude of Q. For example, Q is 0 or less (Category 1), 1-150 (Category 2), 151-250 (Category 3), 251-300 (Category 4), 301-350 (Category 5), 351-400 (Category 6) , 401 or higher (Category 7). Category 1 is severe upper and lower jaw bone incongruity and falls under jaw deformity. Category 2 is moderate to mild upper and lower jawbone discord. Category 3 is a range in which the discord of the maxilla and mandible is not recognized and the skeletal is normal. Category 4 is mild upper and lower jawbone discord. Category 5 is mild to moderate maxillary jawbone incongruity. Category 6 is moderate or higher jawbone incongruity. Class 7 is severe upper and lower jaw bone incongruity and falls under jaw deformity. As for the above patients 1 to 23, the classification 2 is 8, the classification 3 is 10, the classification 4 is 5, and the classifications 1 and 5 to 7 are 0. On the other hand, the above-mentioned subjects 24-35 have one classification 1, two classification 2, one classification 3, one classification 4, two classification 5, two classification 6, two classification 7 A person. It is noteworthy that Q of subjects 24-35 are distributed almost evenly in categories 1-7, whereas Q of patients 1-23 are concentrated in categories 2-4.

  According to the calculation method of the obstructive sleep apnea syndrome risk determination index according to the eleventh embodiment, distances (SA), (SB), and (Go-) measured by cephalometric radiography. The OSAS index Q can be calculated using Me). Based on the OSAS index Q, the risk of developing OSAS can be determined objectively and in a short time with a certain degree of accuracy without depending on the experience of the doctor.

<12. Twelfth Embodiment>
In the twelfth embodiment, an obstructive sleep apnea syndrome risk determination method will be described.

  FIG. 54 shows a flowchart of this obstructive sleep apnea syndrome risk determination method. A program according to this flowchart is created and executed by a computer.

  Similar to the first embodiment, the distances (SA), (SB), and (Go-Me) are measured before the obstructive sleep apnea syndrome risk determination method is executed.

  As shown in FIG. 54, in step S111, the distances (SA), (SB), and (Go-Me) measured as described above are input.

In step S112, P = ((SB) + (Go-Me)) / (SA) from the inputted distances (SA), (SB) and (Go-Me).
Calculate P according to

In step S113, the fourth decimal place of P calculated as described above is rounded down,
Q = (P− [P]) × 1000 (however, 2.000 ≦ P <3.000)
Or Q = (P − ([P] +1)) × 1000 (where P <2.000)
Calculate

In step S114, it is determined whether or not Q ≧ C ₆ from the Q obtained by calculation as described above.

In step S115, when it is Q ≧ C ₆ judges that there is a high risk of developing OSAS. For example, when Q ≧ 62, it is determined that the risk of developing OSAS is high. In this case, for example, when Q ≧ 120, it may be determined that the risk of developing OSAS is particularly high.

  In step S116, a determination result that the risk of developing OSAS is high is output to, for example, a display.

In step S114, non-Q ≧ C _6, if it is determined in other words Q <as a C _6, at step S117, determines that the risk of developing OSAS is low.

  In step S118, a determination result that the risk of developing OSAS is low is output to, for example, a display.

  According to the obstructive sleep apnea syndrome risk determination method according to the twelfth embodiment, distances (SA), (SB), and (Go-Me) measured by cephalometric radiography. Based on this, the risk of developing OSAS can be determined with a certain degree of accuracy without depending on the experience of the doctor.

<13. Thirteenth Embodiment>
In the thirteenth embodiment, the distance between S and A (SA), S and X _i (i is an integer from 1 to 4) measured by X-ray imaging of the subject's head. X ₁ = B, X ₂ = Pog, X ₃ = Gn, X ₄ = Me) and the distance (S−X _i ) between Go and X _j (j is an integer between 1 and 4, j = i or distance (a Go-X _j) using, P = ((S-X i) between the j ≠ i) + (Go- X j)) / (S-a) ( provided that, X _i = B and Q = (P− [P]) × 1000 or Q = (P − ([P] +1)) × 1000 calculated from (except when X _j = Me) is used as the OSAS index. A calculation method will be described. This calculation method by P = ((S−X _i ) + (Go−X _j )) / (S−A) is expressed as P = ((S−B) + (Go−Me)) / (S−A). It is as effective as the calculation method by.

  Here, S, A, B, Go, Pog, Gn, and Me are measurement points obtained by cephalometric radiography. The position of each measurement point is shown in FIG. Pog is an abbreviation for Pogonion, and is the most protruding point of the mandibular bulge relative to the Frankfurt plane. Gn is an abbreviation for Gnathion, which is the second of the angle between the face plane (N (Nasion, the foremost point of nasal frontal suture) and Pog) and the lower mandibular plane. This is the point where the line intersects with the raised ridge image.

  FIG. 56 shows a flowchart of this calculation method. A program according to this flowchart is created and executed by a computer.

Before performing this calculation, a cephalometric radiograph of the subject to determine the risk of developing OSAS is performed, and the distance between S and A (SA), the distance between S and X _i (S measuring the distance (Go-X _j) between the -X _i) and Go and X _j. These distances can be measured in the same manner as in the first embodiment.

As shown in FIG. 56, in step S121, distance measured in the manner described above (S-A), and inputs the (S-X _i) and (Go-X _j).

In step S122, P = ((S−X _i ) + (Go−X _j )) / (S−A) from the inputted (S−A), (S−X _i ) and (Go−X _j ). )
Calculate P according to

In step S123, the fourth decimal place of P calculated as described above is rounded down,
Q = (P− [P]) × 1000 (however, 2.000 ≦ P <3.000)
Or Q = (P − ([P] +1)) × 1000 (where P <2.000)
Calculate

  In step S124, the OSAS index Q calculated as described above is output to a display, for example.

Thus if the calculated OSAS factor Q is equal to or higher than the predetermined value C ₆ it can be determined in terms of skeletal jawbone, and a high risk of developing OSAS. C ₆ can be determined as necessary, and is 62, for example.

When the OSAS index Q is less than C _6, it can be determined that the risk of developing OSAS is low from the viewpoint of the skeletal nature of the jawbone.

  In general, in addition to the OSAS index Q, the doctor finally determines the risk of developing OSAS by using the results of other tests conventionally used for OSAS tests.

According to the calculation method of the obstructive sleep apnea syndrome risk determination index according to the thirteenth embodiment, the distances (SA), (SX- _i ) and (Go) measured by cephalometric radiography. -X _j ) can be used to calculate the OSAS index Q. Based on the OSAS index Q, the risk of developing OSAS can be determined objectively and in a short time with a certain degree of accuracy without depending on the experience of the doctor.

<14. Fourteenth Embodiment>
In the fourteenth embodiment, an obstructive sleep apnea syndrome risk determination method will be described.

  FIG. 57 shows a flowchart of this obstructive sleep apnea syndrome risk determination method. A program according to this flowchart is created and executed by a computer.

Like the first embodiment, before performing the apnea risk judging method when the obstructive sleep distance (S-A), to measure the (S-X _i) and (Go-X _j) .

As shown in FIG. 57, in step S131, the distances (SA), (SX- _i ), and (Go- _Xj ) measured as described above are input.

In step S132, P = ((S−X _i ) + (Go−X _j )) / (S−) from the inputted distances (S−A), (S−X _i ) and (Go−X _j ). A)
Calculate P according to

In step S133, the fourth decimal place of P calculated as described above is rounded down,
Q = (P− [P]) × 1000 (however, 2.000 ≦ P <3.000)
Or Q = (P − ([P] +1)) × 1000 (where P <2.000)
Calculate

In step S134, it is determined whether or not Q ≧ C ₆ from the Q obtained by calculation as described above.

In step S135, when it is Q ≧ C ₆ judges that there is a high risk of developing OSAS. For example, when Q ≧ 62, it is determined that the risk of developing OSAS is high. In this case, for example, when Q ≧ 120, it may be determined that the risk of developing OSAS is particularly high.

  In step S136, the determination result that the risk of developing OSAS is high is output to a display, for example.

In step S134, non-Q ≧ C _6, if it is determined in other words Q <as a C _6, at step S137, determines that the risk of developing OSAS is low.

  In step S138, a determination result that the risk of developing OSAS is low is output to, for example, a display.

According to the obstructive sleep apnea syndrome risk determination method according to the fourteenth embodiment, the distances (SA), (SX- _i ), and (Go- _Xj ) measured by cephalometric radiography. ), The risk of developing OSAS can be determined with a certain degree of accuracy without depending on the experience of the doctor.

  Here, the calculation method of the obstructive sleep apnea syndrome risk determination index and the data processing apparatus used to implement the obstructive sleep apnea syndrome risk determination method according to the first to fourteenth embodiments will be described.

  FIG. 58 shows an example of the data processing apparatus 10. As shown in FIG. 58, the data processing device 10 includes an auxiliary storage device 11, a memory 12, a CPU (Central Processing Unit) 13 as a processing unit, an input unit 14, an output unit 15, and an input / output interface 16.

  The auxiliary storage device 11 stores various kinds of information, and includes, for example, a hard disk, a ROM (Read Only Memory), and the like. The auxiliary storage device 11 stores a program 111, a compiler 112, and an execution module 113.

  The program 111 is on the flowchart shown in FIGS. 2, 39, 40, 42, 43, 45, 46, 48, 49, 51, 52, 54, 56, and 57. A program (source program) in which processing is described. The compiler 112 compiles and links the program 111. The execution module 113 is a module compiled and linked by the compiler 112.

  The memory 12 is temporary storage means for storing various types of information, and is configured by, for example, a RAM (Random Access Memory). The CPU 13 performs various arithmetic processes such as addition, subtraction, multiplication, and division, and plays a role of executing the execution module 13 through the memory 12 and the input / output interface 16. The input unit 14 is an input device for inputting various execution commands and the like. The output unit 15 is an output device that outputs various execution results. The input / output interface 16 mediates input / output between each component of the data processing apparatus 10.

  Next, the operation of the data processing apparatus 10 configured as described above will be described. First, a compile command input from the input unit 14 by the operator is stored in the memory 12 via the input / output interface 16. In the memory 12, the program 111 of the auxiliary storage device 11 is compiled and linked by the compiler 112, and an execution module 113 that is a machine language code is generated.

  Next, when an execution command is input from the input unit 14 by the operator, the CPU 13 loads the execution module 113 into the memory 12. When the execution module 113 is loaded into the memory 12, the CPU 13 causes the CPU 13 to perform FIGS. 2, 39, 40, 42, 43, 45, 46, 48, 49, 51, 52, 54. Each process on the flowchart shown in FIG. 56 or 57 is sequentially called from the memory 12 to the CPU 13, and after each process is executed, the execution result is stored in the memory 12. The execution result stored in the memory 12 is output by the CPU 13 to the output unit 15 via the input / output interface 16.

  For example, when the OSAS index Q is calculated by executing the processing on the flowchart shown in FIG. First, the execution module 113 for realizing step S1 of the input process is called from the memory 12 to the CPU 13. In step S101, data (distance (SA), (SB) and (Go-Me)) input from the input unit 14 by the operator is loaded into the memory 12. When the input process of step S101 ends, an execution module 113 for realizing step S102 of the calculation process is called from the memory 12 to the CPU 13. In step S102, P is calculated from the input data. When the calculation process in step S102 ends, an execution module 113 for realizing step S103 is called from the memory 12 to the CPU 13. In step S103, the OSAS index Q is calculated according to the size of P. When the calculation process in step S103 is completed, the execution module 113 for realizing step S104 is called from the memory 12 to the CPU 13. In step S104, the value of Q is output to the output unit 15 as a calculation result.

  The case where the processing on the flowchart shown in FIG. 2, 39, 40, 42, 43, 45, 46, 48, 49, 51, 54, 56, or 57 is executed is also described above. It is the same.

<15. Fifteenth Embodiment>
The obstructive sleep apnea syndrome risk determination method according to the second, fourth, sixth, eighth, tenth, twelfth or fourteenth embodiment is a risk of developing OSAS from the viewpoint of the skeletal nature of the jawbone. This method is more effective when combined with an obstructive sleep apnea syndrome risk determination method for determining the risk of developing OSAS from the viewpoint of the position of the hyoid bone. Then, next, the obstructive sleep apnea syndrome risk determination method for determining the risk of developing OSAS from the viewpoint of the position of the hyoid bone will be described.

  That is, the present inventor, in the course of conducting intensive research, accidentally observed the tongue in a lateral head and neck X-ray standard photograph taken for a patient diagnosed with obstructive sleep apnea syndrome and a subject without breathing disorder. As a result of analyzing the position of the bone, and especially the position of the body part of the hyoid bone, it was found that the position of the center of the hyoid bone part was clearly different between the two. Furthermore, when a posterior anterior head and neck X-ray standard photograph or an anteroposterior head and neck X-ray standard photograph of a patient diagnosed with obstructive sleep apnea syndrome was taken, subjects with no respiratory disorder overlapped with the mandible etc. Based on the fact that the hyoid bone that is not observed is clearly observed, the hyoid bone is observed in the photographed image when a posterior anterior head and neck X-ray standard photograph or a anteroposterior head and neck X-ray standard photograph is taken based on this. It was found that the risk of obstructive sleep apnea syndrome of a patient can be easily determined depending on whether or not. Here, the posterior-anterior (posteroanterior) head and neck X-ray imaging is an imaging in which X-rays are transmitted from the back to the front of the subject, and the anteroposterior (posteroanterior) head and neck X-ray imaging is X-rays from the front to the back of the subject This is a transparent shooting. If the hyoid bone is not detected in the image obtained by posterior anterior head and neck X-ray or anteroposterior head and neck X-ray, there is no risk of obstructive sleep apnea syndrome and posterior anterior head and neck X-ray or When a hyoid bone is detected in a captured image obtained by front-rear head and neck X-ray imaging, it can be determined that there is a risk of obstructive sleep apnea syndrome. If the hyoid bone is not detected in the image obtained by anteroposterior head-and-neck X-ray imaging or anteroposterior head-and-neck X-ray imaging, the hyoid bone is hidden by the mandible, in other words, the mandible and hyoid bone Corresponds to being unable to distinguish. In addition, when the hyoid bone is detected in a captured image obtained by anteroposterior head and neck X-ray imaging or anteroposterior head and neck X-ray imaging, the hyoid bone is hidden by the mandible as a result of the low position of the hyoid bone Corresponds to the ability to distinguish between the mandible and the hyoid bone.

  This obstructive sleep apnea syndrome risk determination method is specifically the obstructive sleep apnea syndrome according to the second, fourth, sixth, eighth, tenth, twelfth or fourteenth embodiment. Risk determination is performed based on the risk determination method, and at least the hyoid bone, S, Go, and Me detected by lateral head and neck radiography of the subject are used, and the center of the body part of the detected hyoid bone is detected. Is included in the region above the perpendicular line extending from Me to the extended line of the line segment S-Go. Typically, the obstructive sleep apnea syndrome risk determination method includes a first step of detecting at least hyoid bone, S, Go and Me by lateral head and neck radiography of the subject, A second step of determining whether or not the center of the hyoid bone body part is included in a region above a perpendicular line extending from Me to an extension of the line segment S-Go. In this obstructive sleep apnea syndrome risk determination method, if the center of the hyoid bone is included in the region above the perpendicular line extending from Me to the extension of the line segment S-Go, there is no obstructive sleep apnea. There is no risk of respiratory syndrome, it is not included in this area, in other words, it is determined that there is a risk of obstructive sleep apnea syndrome if it is included in the area under the vertical line extending from Me to the extended line of S-Go can do. Preferably, in the second step, the center of the detected body part of the hyoid bone is an extension line of the line segment S-Go and a perpendicular line and a line segment Go− drawn from the Me to the extension line of the line segment S-Go. It is determined whether or not it is included in the first triangle formed by Me. In this case, when the center of the hyoid bone is contained within the first triangle, there is no risk of obstructive sleep apnea syndrome, and when the center of the hyoid bone is located in a region below the first triangle, It can be determined that there is a risk of apnea syndrome. In the obstructive sleep apnea syndrome risk determination method, if necessary, in the first step, the chondrion Cd is further detected by lateral X-ray imaging of the subject, and is detected in the second step. The center of the body of the hyoid bone is the interior of the first triangle, the extension of the line segment Cd-Go and the perpendicular line from Me to the extension line of the line segment Cd-Go and the extension of the line segment S-Go from Me It is determined which region is included in the region inside the second triangle formed by the perpendicular line drawn down to the line and the region below the second triangle. In this case, if the center of the hyoid bone is contained within the first triangle, there is no risk of obstructive sleep apnea syndrome, and the center of the hyoid bone is within the second triangle or the second triangle. It can be determined that there is a risk of obstructive sleep apnea syndrome when located in a region below the triangle. Further, in general, the center of the hyoid bone body part is located in the region below the second triangle compared to the case where the center of the hyoid bone body part is located inside the second triangle. It can be determined that the risk of obstructive sleep apnea syndrome is higher. The detection of the center of the hyoid bone, S, Go, Me, and Cd in the first step can typically be performed by image processing using a computer, for example. FIG. 59 shows the first triangle and the second triangle.

  As shown in FIG. 60, the hyoid bone is a mobile single bone released from the bones of other skeletal skeletal systems, generally considered to be at the same level as the third cervical vertebra of the anterior neck. It is. The hyoid bone is connected to the mandible, styloid process, thyroid cartilage, sternum and scapula by muscles and ligaments. As shown in FIG. 61A (right front outer surface) and FIG. 61B (front upper surface), the hyoid bone is composed of a body part (hyoid bone body), a large angle, and a small angle, and has a U-shape as a whole. The body part is in the central part of the hyoid bone and faces forward. The large angle is the body part and both ends of the hyoid bone following the body part. The small angle is a small protrusion that protrudes from above near the joint between the large angle and the body part toward the styloid process, and is connected to the styloid process via the stylohyoid ligament. As shown in FIG. 61C, the cross section of the hyoid bone body on the median sagittal plane is a quadrangular shape with rounded corners. The hyoid bone has a rectangular shape with rounded corners because the X-ray transmission length through the body is much larger than that of other parts of the hyoid bone in lateral head and neck radiography. The large angle is detected continuously with this body part.

  It can be easily executed by a computer having at least one of the predetermined program including the obstructive sleep apnea syndrome risk determination method and the first step and the second step. The type of the computer is not particularly limited, and any of various types of mobile terminals such as a desktop type, a notebook type, and a tablet terminal may be used. This program can be stored in various computer-readable recording media such as a CD-ROM, or can be provided through an electric communication line such as the Internet. Typically, for example, a subject's lateral head and neck radiography is performed using an X-ray diagnostic system including a computer having the program, and a risk determination method for obstructive sleep apnea syndrome based on the results, and The hyoid bone subsidence determination method is executed. The computer and the X-ray diagnosis system may be connected by wire or wirelessly.

  The obstructive sleep apnea syndrome risk determination method according to the fifteenth embodiment based on the subject's lateral head and neck radiography will be specifically described.

  FIG. 62 shows a flowchart of this obstructive sleep apnea syndrome risk determination method. A program according to this flowchart is created and executed by a computer.

  In step S141, the center of the hyoid bone, S, Go, and Me are detected by X-ray imaging of the subject's lateral head and neck. That is, the subject's lateral head and neck X-ray imaging is performed, and the center of the hyoid bone, S, Go, and Me are detected from the captured image or photograph. Photographing is performed at the central occlusal position or a position corresponding thereto. Further, the photographing is performed by setting the inclination of the head in the front-rear direction so that the Frankfurt plane of the subject's head is parallel to the floor surface.

Detection of the center of the hyoid bone, S, Go, and Me can be performed, for example, in the following manner while a captured image is displayed on a display connected to a computer. First, for S, Go, and Me, the cursor is moved to S, Go, and Me using the mouse on the display and clicked. Alternatively, when a touch panel display is used, S, Go, and Me are touched with a finger or a touch pen on the display. Thus, S, Go, and Me can be detected. The body part of the hyoid bone can be detected as follows. That is, a plurality of points representing the entire contour are clicked on the contour line of the body part of the hyoid bone (hyoid bone body) on the photographed image by using the mouse, and these points are connected by a straight line or a curved line. Connects these points with a smooth curve. A program for connecting these points with straight lines or curves can be easily created. The outline of the body of the hyoid bone (hyoid body) observed on the captured image is generally a rectangular shape with four rounded corners and is relatively simple, so the number of these points is usually Four to ten points are sufficient, but the more the number of points, the more accurately the outline can be drawn. Alternatively, when a touch panel display is used, the hyoid bone body may be enlarged and displayed as necessary, and the contour of the hyoid bone body may be traced on the display with a finger or a touch pen. The center of the hyoid bone body part can be detected by obtaining the center of the figure formed by the contour of the hyoid bone body part (hyoid bone body) detected as described above. An example is shown in FIGS. 63A and B. As shown in FIG. 63A, in this example, points P _{1 to} P ₁₀ are clicked with the mouse so as to represent the entire contour on the contour line of the body part (hyoid body) of the hyoid bone on the photographed image, By smoothly connecting the points P _{1 to} P ₁₀ with a curved line, as shown in FIG. 63B, an input image of the hyoid bone part (hyoid bone body) can be obtained. The center of the hyoid bone body part can be obtained as follows from the input image of the hyoid bone body part thus obtained. That is, for example, it is assumed that the input image of the body part of the hyoid bone is displayed on an xy coordinate plane with the x axis in the horizontal direction and the y axis in the vertical direction. On the xy coordinate plane, the y-coordinate of the uppermost point and the lowermost point of the input image is obtained, and the y-coordinate of the uppermost point is y ₁ and the y-coordinate of the lowermost point is y ₂ . At this time, the y coordinate of the center of the input image of the body part of the hyoid bone is (y ₁ + y ₂ ) / 2. Next, if a straight line represented by y = (y ₁ + y ₂ ) / 2 (a straight line parallel to the x-axis) is drawn and the x coordinates of two points where the straight line intersects the input image are x ₁ and x ₂ , respectively. The x coordinate of the center of the input image of the body part of the hyoid bone is = (x ₁ + x ₂ ) / 2. As described above, the coordinates of the center of the input image of the body part of the hyoid bone can be obtained as ((x ₁ + x ₂ ) / 2, (y ₁ + y ₂ ) / 2). Alternatively, the center of the hyoid bone body part can be obtained by calculating the center of gravity of the figure formed by the contour of the hyoid bone body part. The position of the center of gravity is almost the same as the above center of coordinates ((x ₁ + x ₂ ) / 2, (y ₁ + y ₂ ) / 2) unless the body of the hyoid bone has a unique shape. To do.

  The center of the hyoid bone can also be detected as follows using image recognition technology. That is, the shape of the entire hyoid bone observed on a captured image obtained by lateral head and neck X-ray photography is substantially the same, and has a curved shape as shown in FIG. The body part (hyoid bone) constitutes the right part of the hyoid bone. Therefore, the position of the hyoid bone body (hyoid body) is detected using a conventionally known pattern recognition technique, specifically, for example, a template matching technique. That is, image data of a captured image obtained by lateral head and neck X-ray imaging is taken into a computer, and the standard shape of the hyoid bone shown in FIG. 64 is used as a standard image, that is, a template, and the captured image is used as an input image. Here, since the hyoid bone exists at the lowermost part of the photographed image, the input image can be limited to the lowermost part of the photographed image, so that the data amount of the input image can be greatly reduced. Then, the position of the hyoid bone on the captured image can be detected by moving the template on the input image. When the position of the hyoid bone is thus detected, the body part of the hyoid bone (hyoid bone body) can be detected as the right part of the hyoid bone, and the center of the hyoid bone body part can be detected.

  In step S142, it is determined whether or not the center of the detected body part of the hyoid bone is in a region above a perpendicular line extending from Me to an extension line of the line segment S-Go.

  If it is determined in step S142 that the center of the detected hyoid bone body is in a region above the perpendicular line extending from Me to the extension of the line segment S-Go, in step S143, the OSAS Determine that there is no risk.

  In step S144, a determination result that there is no risk of OSAS is output to, for example, a display.

  If it is determined in step S142 that the center of the detected hyoid bone body is in a region above the perpendicular line extending from Me to the extension of the line segment S-Go, in step S145, the OSAS Determine that there is a risk.

  In step S146, a determination result that there is an OSAS risk is output to, for example, a display.

  If necessary, in addition to the above determination, the doctor can finally determine the risk of developing OSAS by using the results of other tests conventionally used for OSAS tests. The same applies to the case where the center of the detected body part of the hyoid bone is a border line located on or very close to the perpendicular line extending from Me to the extension of the line segment S-Go.

  According to the obstructive sleep apnea syndrome risk determination method according to the fifteenth embodiment, based on the center of the hyoid bone detected by lateral head and neck radiography, S, Go and Me, The risk of developing OSAS can be determined objectively, in a short time, with a certain degree of accuracy, regardless of the experience of the doctor, etc., and the second, fourth, sixth, eighth, tenth, By combining with the determination result by the obstructive sleep apnea syndrome risk determination method according to the twelfth or fourteenth embodiment, the risk of developing OSAS can be determined with higher accuracy.

<16. Sixteenth Embodiment>
In the sixteenth embodiment, the subject is combined with the obstructive sleep apnea syndrome risk determination method according to the second, fourth, sixth, eighth, tenth, twelfth or fourteenth embodiment. An obstructive sleep apnea syndrome risk determination method based on lateral head and neck radiography will be described.

  FIG. 65 shows a flowchart of this obstructive sleep apnea syndrome risk determination method. A program according to this flowchart is created and executed by a computer.

  In step S151, the center of the hyoid bone, S, Go, and Me are detected by X-ray imaging of the subject's lateral head and neck. That is, the subject's lateral head and neck X-ray imaging is performed, and the center of the hyoid bone, S, Go, and Me are detected from the captured image or photograph. Photographing is performed at the central occlusal position or a position corresponding thereto. Further, the photographing is performed by setting the inclination of the head in the front-rear direction so that the Frankfurt plane of the subject's head is parallel to the floor surface.

  Detection of the center of the hyoid bone, S, Go, and Me can be performed, for example, in the following manner while a captured image is displayed on a display connected to a computer. First, for S, Go, and Me, the cursor is moved to S, Go, and Me using the mouse on the display and clicked. Alternatively, when a touch panel display is used, S, Go, and Me are touched with a finger or a touch pen on the display. Thus, S, Go, and Me can be detected. Thus, S, Go, and Me can be detected. The body part of the hyoid bone can be detected as follows. That is, a plurality of points representing the entire contour are clicked on the contour line of the body part of the hyoid bone (hyoid bone body) on the photographed image by using the mouse, and these points are connected by a straight line or a curved line. Connects these points with a smooth curve. A program for connecting these points with straight lines or curves can be easily created. The outline of the body of the hyoid bone (hyoid body) observed on the captured image is generally a rectangular shape with four rounded corners and is relatively simple, so the number of these points is usually Four to ten points are sufficient, but the more the number of points, the more accurately the outline can be drawn. Alternatively, when a touch panel display is used, the hyoid bone body may be enlarged and displayed as necessary, and the contour of the hyoid bone body may be traced on the display with a finger or a touch pen. The center of the hyoid bone body part can be detected by obtaining the center of the figure formed by the contour of the hyoid bone body part (hyoid bone body) detected as described above.

  In step S152, the center of the detected body part of the hyoid bone is formed by the extension line of the line segment S-Go, the perpendicular line extending from the Me to the extension line of the line segment S-Go, and the line segment Go-Me. It is determined whether it is included within the first triangle (hereinafter referred to as “area 1”).

  If it is determined in step S152 that the center of the detected hyoid bone body is included in the area 1, it is determined in step S153 that there is no risk of OSAS.

  In step S154, the determination result that there is no risk of OSAS is output to a display, for example.

  When it is determined in step S152 that the center of the detected hyoid bone body is not included in the area 1, in other words, below the area 1, there is a risk of OSAS in step S155. judge.

  In step S156, a determination result that there is an OSAS risk is output to, for example, a display.

  If necessary, in addition to the above determination, the doctor can finally determine the risk of developing OSAS by using the results of other tests conventionally used for OSAS tests. The center of the body part of the detected hyoid bone is on or very close to the base of area 1 (perpendicular line extending from Me to the extension of line S-Go) or side (extension of line S-Go). The same applies to the border line located at.

  According to the obstructive sleep apnea syndrome risk determination method according to the sixteenth embodiment, based on the center of the hyoid bone detected by lateral head and neck radiography, S, Go and Me, The risk of developing OSAS can be determined objectively, in a short time, with a certain degree of accuracy, regardless of the experience of the doctor, etc., and the second, fourth, sixth, eighth, tenth, By combining with the determination result by the obstructive sleep apnea syndrome risk determination method according to the twelfth or fourteenth embodiment, the risk of developing OSAS can be determined with higher accuracy.

<17. Seventeenth Embodiment>
In the seventeenth embodiment, the subject is combined with the obstructive sleep apnea syndrome risk determination method according to the second, fourth, sixth, eighth, tenth, twelfth or fourteenth embodiment. An obstructive sleep apnea syndrome risk determination method based on lateral head and neck radiography will be described.

  FIG. 66 shows a flowchart of this obstructive sleep apnea syndrome risk determination method. A program according to this flowchart is created and executed by a computer.

  In step S161, the center of the hyoid bone, S, Go, Me, and Cd are detected by X-ray imaging of the subject's lateral head and neck. That is, the subject's lateral head and neck X-ray imaging is performed, and the center of the hyoid bone, S, Go, Me, and Cd are detected from the captured image or photograph. Photographing is performed at the central occlusal position or a position corresponding thereto. Further, the photographing is performed by setting the inclination of the head in the front-rear direction so that the Frankfurt plane of the subject's head is parallel to the floor surface.

  Detection of the center of the hyoid bone, S, Go, Me, and Cd can be performed, for example, in the following manner in a state where a photographed image is displayed on a display connected to a computer. First, for S, Go, Me, and Cd, move the cursor over S, Go, Me, and Cd using the mouse on the display and click. Alternatively, when a touch panel display is used, S, Go, Me, and Cd are touched with a finger or a touch pen on the display. Thus, S, Go, Me, and Cd can be detected. The body part of the hyoid bone can be detected as follows. That is, a plurality of points representing the entire contour are clicked on the contour line of the body part of the hyoid bone (hyoid bone body) on the photographed image by using the mouse, and these points are connected by a straight line or a curved line. Connects these points with a smooth curve. A program for connecting these points with straight lines or curves can be easily created. The outline of the body of the hyoid bone (hyoid body) observed on the captured image is generally a rectangular shape with four rounded corners and is relatively simple, so the number of these points is usually Four to ten points are sufficient, but the more the number of points, the more accurately the outline can be drawn. Alternatively, when a touch panel display is used, the hyoid bone body may be enlarged and displayed as necessary, and the contour of the hyoid bone body may be traced on the display with a finger or a touch pen. The center of the hyoid bone body part can be detected by obtaining the center of the figure formed by the contour of the hyoid bone body part (hyoid bone body) detected as described above.

  In step S162, the center of the detected body part of the hyoid bone is formed by an extension line of the line segment S-Go and a perpendicular line extending from the Me to the extension line of the line segment S-Go and the line segment Go-Me. It is determined whether or not it is included within the first triangle, that is, area 1.

  If it is determined in step S162 that the center of the detected hyoid bone body is included in area 1, it is determined in step S163 that there is no risk of OSAS.

  In step S164, the determination result that there is no risk of OSAS is output to a display, for example.

  If it is determined in step S162 that the center of the detected hyoid bone body is not included in area 1, in other words, below the area 1, the detected hyoid bone is detected in step S165. The center of the body is formed by an extension of the line segment Cd-Go, a perpendicular line extending from Me to an extension line of the line segment Cd-Go, and a perpendicular line extending from Me to the extension line of the line segment S-Go. It is determined whether or not it is contained within a triangle of 2 (hereinafter referred to as “area 2”).

  If it is determined in step S165 that the center of the detected hyoid bone body is included in the area 2, it is determined in step S166 that there is a risk of OSAS.

  In step S167, the determination result that there is an OSAS risk is output to, for example, a display.

  When it is determined in step S165 that the center of the detected hyoid bone body is not included in the area 2, in other words, below the area 2, that is, in the area 3, the OSAS of the OSAS is determined in step S168. Judge that the risk is high.

  In step S169, the determination result that the risk of OSAS is high is output to, for example, a display.

  If necessary, in addition to the above determination, the doctor can finally determine the risk of developing OSAS by using the results of other tests conventionally used for OSAS tests. The center of the body part of the detected hyoid bone is on or very close to the base of area 1 (perpendicular line extending from Me to the extension of line S-Go) or side (extension of line S-Go). Borderline that is located at or near the bottom of area 2 (perpendicular line extending from Me to the extension of line Cd-Go) or side (extension of line Cd-Go) The same applies to the case of.

  According to the obstructive sleep apnea syndrome risk determination method according to the seventeenth embodiment, based on the center of the hyoid bone detected by lateral head and neck radiography, S, Go, Me, and Cd In addition to being able to determine the risk of developing OSAS objectively and in a short time with a certain degree of accuracy, regardless of the experience of the doctor, etc., also determine the high risk of developing OSAS. In combination with the determination result by the obstructive sleep apnea syndrome risk determination method according to the second, fourth, sixth, eighth, tenth, twelfth or fourteenth embodiment, higher accuracy can be achieved. The risk of developing OSAS can be determined.

[Example 7]
The OSAS was examined by PSG and 16 head and neck radiographs of 16 patients diagnosed as severe, moderate or mild were taken. Photographing was performed at the central occlusal position or a position corresponding to it with the Frankfurt plane set parallel to the floor.

The transmission drawings of the patients 41 to 56 are shown in FIGS. 67 to 82. The AHI (supposed position) and SaO ₂ (minimum value) of patients 41 to 56 obtained by PSG are as follows. However, the patient 53, showing the SpO ₂ (minimum value) instead of SaO ₂ (minimum value). The patients 41 to 56 are the same as the patients 11, 6, 7, 18, 4, 12, 19, 21, 9, 15, 13, 14, 3, 22, 2, 23, respectively.

Patient AHI SaO ₂
(%)
41 43.1 70
42 36.8 87
43 30.2 83
44 62.9 73
45 53.5 71
46 25.7 79
47 112.5 85
48 11.9 93
49 35.5 80
50 66.0 76
51 24.8 92
52 9.6 90
53 41.1 68 (SpO ₂ )
54 59.7 80
55 71.2 71
56 43.9 85

  As a control group, five subjects 57 to 61 in which no breathing disorder was observed during sleep were employed. Head and neck X-ray standard photographs were taken for these subjects 57-61.

  The transmission drawings of the subjects 57 to 61 are shown in FIGS.

  As a result of detecting the center of the body part of the hyoid bone of the patients 41 to 56, the area where the center of the body part of the hyoid bone exists was as follows.

Patient Area where the center of the hyoid bone exists OSAS risk 41 Area 3 Yes (high)
42 area 3 available (high)
43 Area 2 Yes 44 Area 2 Yes 45 Area 3 Yes (High)
46 Area 2 Yes 47 Area 3 Yes (High)
48 Area 2 Yes 49 Area 2 Yes 50 Area 3 Yes (High)
51 Area 2 Yes 52 Area 2 Yes 53 Area 2 Yes 54 Area 3 Yes (High)
55 area 2 available 56 area 2 available

  As a result of detecting the center of the hyoid bone body of subjects 57 to 61, the area where the center of the hyoid bone body part was present was as follows.

Subject Area where the center of the hyoid bone exists OSAS risk 57 Area 1 None 58 Area 1 None 59 Area 1 None 60 Area 1 None 61 Area 1 None

  As can be seen from the above results, by taking a head and neck X-ray standard photograph and detecting whether the center of the body part of the hyoid bone exists in the area 1, 2 or 3 from the photographed image or the photographed photograph. The risk of developing OSAS can be determined.

<18. Eighteenth Embodiment>
In the fourth embodiment, the subject is combined with the obstructive sleep apnea syndrome risk determination method according to the second, fourth, sixth, eighth, tenth, twelfth or fourteenth embodiment. A method for determining the risk of obstructive sleep apnea syndrome based on back-front head and neck radiography will be described.

  FIG. 88 is a flowchart of this obstructive sleep apnea syndrome risk determination method. A program according to this flowchart is created and executed by a computer.

  In step S161, the subject's anteroposterior head and neck X-ray imaging is performed, and the hyoid bone is detected from the captured image. Photographing is performed at the central occlusal position or a position corresponding thereto. Further, the photographing is performed by setting the inclination of the head in the front-rear direction so that the Frankfurt plane of the subject's head is parallel to the floor surface.

  The hyoid bone can be detected, for example, in the following manner using an image recognition technique in a state where a captured image is displayed on a display connected to a computer. That is, the shape of the entire hyoid bone observed on a captured image obtained by anteroposterior head and neck X-ray photography is substantially the same, and as a whole, both ends are obliquely upward outward with respect to the central portion. It has a bent shape (see FIGS. 61A and B). Therefore, the position of the hyoid bone is detected using a conventionally known pattern recognition technique, specifically, for example, a template matching technique. That is, image data of a captured image obtained by anteroposterior head and neck X-ray imaging is taken into a computer, the standard shape of the entire hyoid bone is used as a standard image, that is, a template, and the captured image is used as an input image. Here, since the hyoid bone exists at the lowermost part of the photographed image, the input image can be limited to the lowermost part of the photographed image, so that the data amount of the input image can be greatly reduced. Then, the hyoid bone on the photographed image can be detected by moving the template on the input image.

  In step S162, it is determined whether or not the hyoid bone is detected.

  If the hyoid bone is detected in step S162, it is determined in step S163 that there is a risk of OSAS.

  In step S164, a determination result that there is an OSAS risk is output to, for example, a display.

  If the hyoid bone is not detected in step S162, it is determined in step S165 that there is no risk of OSAS.

  In step S166, the determination result that there is no risk of OSAS is output to, for example, a display.

  If necessary, in addition to the above determination, the doctor can finally determine the risk of developing OSAS by using the results of other tests conventionally used for OSAS tests.

  According to the obstructive sleep apnea syndrome risk determination method according to the eighteenth embodiment, whether or not the hyoid bone is detected by anteroposterior head and neck X-ray imaging does not depend on the experience of the doctor or the like. In addition, the risk of developing OSAS can be determined objectively and in a short time with a certain degree of accuracy, and the second, fourth, sixth, eighth, tenth, twelfth or fourteenth implementation By combining with the determination result by the obstructive sleep apnea syndrome risk determination method according to the form, the risk of developing OSAS can be determined with higher accuracy.

[Example 8]
A lateral head and neck X-ray standard photograph and a posterior anterior head and neck X-ray standard photograph of a subject 62 with unknown presence or absence of OSAS were taken. Photographing was performed at the central occlusal position or a position corresponding to it with the Frankfurt plane set parallel to the floor.

  A transmission diagram of a lateral head and neck X-ray standard photograph of the subject 62 is shown in FIG. In addition, a posterior front head and neck X-ray standard photograph of the subject 62 is shown in FIG.

  From FIG. 89, the center of the hyoid bone, S, Go, Me, and Cd, was detected, and it was found that the center of the hyoid bone was inside area 3 and there was a high risk of developing OSAS. . On the other hand, when the hyoid bone was detected from FIG. 90, the hyoid bone was detected below the lower jaw. That is, it can be determined that there is a risk of developing OSAS due to the detection of the hyoid bone, and considering that the center of the body of the hyoid bone is present in the area 3, the subject 62 has the OSAS. It can be determined that the risk of developing is high.

  According to the obstructive sleep apnea syndrome risk determination method according to the eighteenth embodiment, whether or not the hyoid bone is detected by anteroposterior head and neck X-ray imaging does not depend on the experience of the doctor or the like. In addition, the risk of developing OSAS can be determined objectively and in a short time with a certain degree of accuracy, and the second, fourth, sixth, eighth, tenth, twelfth or fourteenth implementation By combining with the determination result by the obstructive sleep apnea syndrome risk determination method according to the form, the risk of developing OSAS can be determined with higher accuracy.

<19. Nineteenth Embodiment>
In the nineteenth embodiment, the obstructive sleep apnea syndrome risk determination method according to the second, fourth, sixth, eighth, tenth, twelfth, fourteenth to eighteenth embodiments can be implemented. An X-ray diagnostic system will be described.

  In other words, this X-ray diagnostic system is based on captured images obtained by lateral head X-ray imaging, lateral head and neck X-ray imaging, posterior anterior head and neck X-ray imaging, and anteroposterior head and neck X-ray imaging. An obstructive sleep apnea syndrome risk determination method according to one or more of the second, fourth, sixth, eighth, tenth, twelfth, and fourteenth to eighteenth embodiments using a computer A computer storing a program to be executed;

  According to the nineteenth embodiment, any one of lateral head X-ray imaging, lateral head and neck X-ray imaging, anteroposterior head and neck X-ray imaging, and anteroposterior head and neck X-ray imaging of the subject is performed. Based on the obtained photographed image, obstructive sleep according to one or more of the second, fourth, sixth, eighth, tenth, twelfth, and fourteenth to eighteenth embodiments By executing the apnea syndrome risk determination method, it is possible to determine a subject's risk of developing OSAS.

<20. 20th Embodiment>
In the twentieth embodiment, the subject in the obstructive sleep apnea syndrome risk determination method according to the second, fourth, sixth, eighth, tenth, twelfth, eighteenth to eighteenth embodiments. A cephalo X-ray imaging apparatus suitable for use in lateral head X-ray imaging, lateral head and neck X-ray imaging, posterior front head and neck X-ray imaging, and front and rear head and neck X-ray imaging will be described. In this cephalo X-ray imaging apparatus, there is no obstructive sleeplessness according to one or more of the second, fourth, sixth, eighth, tenth, twelfth, fourteenth to eighteenth embodiments. By combining with a computer storing a program for executing the respiratory syndrome risk determination method by a computer, an X-ray diagnostic system capable of determining obstructive sleep apnea syndrome risk can be constructed.

  FIG. 91 shows a Cephalo X-ray imaging apparatus according to the twentieth embodiment. As shown in FIG. 91, this cephalo X-ray imaging apparatus includes an X-ray generation unit 211, arms 212 and 213, an arm control device 214, and an X-ray detection unit 215. The X-ray generator 211 has an X-ray tube 211a, and X-rays are generated from the X-ray tube 211a. The arm control device 214 is supported on the floor surface by a support portion (not shown).

  X-rays generated from the X-ray tube 211a are applied to the head and neck of the subject, and X-rays transmitted through the head and neck enter the X-ray detection unit 215 to obtain a transmitted X-ray image. Although the X-ray detection part 215 is not specifically limited, For example, an X-ray film, an imaging plate, a semiconductor detector etc. are used. The transmitted X-ray image is converted into, for example, a digital image signal as necessary. Although illustration is omitted, a transmission X-ray image obtained by the X-ray detection unit 215 is captured by the image collection unit.

  The arms 212 and 213 are provided to face each other with a reference line 216 parallel to the vertical line and orthogonal to the center X-ray. Upper portions of the arms 212 and 213 are attached to the arm control device 214. The arms 212 and 213 can be rotated around the reference line 216 by the arm control device 214, can be moved up and down in a direction parallel to the reference line 216, and can be translated in opposite directions in the horizontal direction. The lower portions of the arms 212 and 213 are gradually narrowed toward the lower end, and the lower end is circular (see FIG. 92). In addition, the lower ends of the arms 212 and 213 are bent inward at a predetermined angle with respect to the vertical line, and then again parallel to the vertical line. In the arms 212 and 213, at least a portion to which X-rays are irradiated at the time of imaging is made of a transparent material, and generally almost all of the portion is made of a transparent material. Cylindrical ear rods 217 and 218 each having a pointed tip are coaxially provided on inner surfaces of the lower ends of the arms 212 and 213 facing each other. As the ear rods 217 and 218, conventionally known ones can be used, and their contours are captured at the time of photographing.

  A head tilt setting device 219 for setting the tilt in the front-rear direction of the head of the subject is attached to at least one outer surface of the arms 212 and 213. FIG. 91 shows an example in which the head tilt setting device 219 is attached to the outer surface of the arm 213. In this case, the head tilt setting device 219 is made of a rectangular transparent plate perpendicular to the central axis of the ear rod 218. As the transparent plate, a transparent plastic plate such as an acrylic plate or a PET (polyethylene terephthalate) plate, a glass plate, or the like can be used. The transparent plate may have a thickness that provides the necessary mechanical strength and is difficult to bend. For example, the transparent plate has a thickness of 2 mm or more and 10 mm or less. The method of attaching the head tilt setting device 219 is not particularly limited, and any method such as adhesion or screwing may be used.

  Details of the head tilt setting device 219 are shown in FIG. FIG. 92 is a diagram of the head tilt setting device 219 viewed from a direction perpendicular to the surface. As shown in FIG. 92, the lower end surface (base) of the head tilt setting device 219 is parallel to the horizontal plane. The lower end surface of the head tilt setting device 219 coincides with the tangential direction drawn perpendicularly to the central axis of the ear rod 218 at the uppermost point of the ear rod 218. The head tilt setting device 219 has an angle scale 219a centered on the uppermost point of the ear rod 218, and has a function of a protractor. In FIG. 92, the angle scale 219a is formed at intervals of 10 ° from 0 ° to 90 °. However, the method of attaching the angle scale 219a is not limited to this, and is formed at intervals of 5 ° or 1 °, for example. Alternatively, the angle scale 219a may be formed by an angle within a specific range, for example, from 0 ° to 30 °. The line where the angle scale 219a is 0 ° coincides with the lower end surface of the head tilt setting device 219. The angle scale 219a is typically formed by, for example, a black colored line as in the case of a normal protractor, but is not limited thereto. The angle scales 219a excluding 0 ° may be provided on one side of the head tilt setting device 219, but are preferably provided at positions corresponding to each other on both sides. Thus, by providing the angle scale 219a at positions corresponding to each other on both sides of the head tilt setting device 219, when the angle scale 219a is viewed from the horizontal direction, the direction in which the angle scales 219a on both sides coincide is the horizontal direction. If there is no coincidence, it can be determined that there is a deviation from the horizontal direction. A horizontal plate 220 is provided on the lower end surface of the head tilt setting device 219 so as to protrude inward perpendicularly to the head tilt setting device 219. FIG. 93 shows a plan view of the head tilt setting device 219 and the horizontal plate 220. As shown in FIG. 93, the horizontal plate 220 has a wide portion at a portion away from the ear rod 218. The horizontal plate 220 is preferably colored in order to facilitate visual recognition when checking the horizontal plane, specifically, for example, black. The material, thickness, horizontal width, and the like of the horizontal plate 220 are preferably selected so as to appear in an X-ray transmission image. The material of the horizontal plate 220 is, for example, a transparent plastic such as acrylic, an opaque plastic, or a metal. Although the thickness of the horizontal plate 220 is 0.2 mm or more and 2 mm or less, for example, it is not limited to this. The horizontal width of the horizontal plate 220 is, for example, 1 mm or more and 30 mm or more, but is not limited thereto.

  Next, a method for performing head and neck X-ray imaging of a subject using the Cephalo X-ray imaging apparatus will be described.

(1) Method for Taking Lateral Head and Neck X-Ray Standard Photograph In FIG. 91, the arms 212 and 213 are translated outward in the horizontal direction so as to be separated from each other by a sufficient distance and moved to a sufficiently high position. In this state, as shown in FIG. 94, the subject's head 221 is positioned between the arms 212 and 213 so that the median sagittal plane is perpendicular to the center X-ray from the X-ray tube 211a. Position. The subject may be sitting on a chair or standing. Next, the arms 212 and 213 are moved down so that the ear rods 217 and 218 come to the height positions of the left and right outer ear holes of the head 221 of the subject. Next, the arms 212 and 213 are translated inward in the horizontal direction, and the ear rods 217 and 218 are inserted into the left and right outer ear holes of the head 221 of the subject. Then, the head 221 is fixed by making the uppermost points of the ear rods 217 and 218 contact the polyion so that the irradiation direction of the central X-ray coincides with the central axis of the ear rods 217 and 218. Next, the examiner searches for a predetermined reference point (second reference point) on the face of the head 221 such as an orbitale (Or), an orbital border immediately below the center of the pupil, and the center of the eyelid cleft. For example, when the orbitale is used as the reference point, the examiner can search by touching the vicinity of the lower edge of the eye socket with the fingertip. Then, as shown in FIG. 95, a circular small colored sticker 222 is attached to the reference point thus searched. The seal 222 may basically have any color, for example, red, yellow, green, blue, white, black, and the like. If it is difficult to see the sticker 222 attached to the reference point from the side of the head 221, the sticker 222 is also placed at a position, for example, 5 to 20 mm away from the sticker 222 on the face in the horizontal direction. Paste. Next, as shown in FIG. 96, the examiner looks at the head tilt setting device 219 in the horizontal direction from the outside. At this time, the seal 222 can be seen through the head tilt setting device 219 made of a transparent plate. Then, the angle scale 219a of the head tilt setting device 219 is used to set a straight line connecting Polion (which coincides with the highest point of the ear rod 218) and the orbitale to a desired angle. In FIG. 96, as an example, a case where the plane connecting Polion and Orbitale, that is, the Frankfurt plane is set horizontally is shown. In this way, when the Frankfurt plane is set to be horizontal, the horizontal plate 220 whose angle scale 219a is 0 ° is observed from the outside. At this time, when the horizontal plate 220 looks linear, the observation is from the horizontal direction. Therefore, the head 221 is tilted in the front-rear direction so that the straight line connecting the polyion and the orbitale coincides with the horizontal plate 220. Set. In this way, the Frankfurt plane of the head 221 is set to be parallel to the horizontal plane (floor surface).

  By performing X-ray imaging in a state where the inclination of the head 221 is set to a desired inclination as described above, a lateral head and neck X-ray standard photograph is taken.

  As an example of taking a lateral head and neck X-ray standard photograph at a position where the Frankfurt plane of the head 221 is inclined at a positive or negative angle with respect to the horizontal plane, the Frankfurt plane of the head 221 is tilted by 10 ° with respect to the horizontal plane. FIG. 97 shows a case where a lateral head and neck X-ray standard photograph is taken at (high face). As shown in FIG. 97, in this case, the angle scale 219a of the head tilt setting device 219 is used to adjust the tilt of the head 221 in the front-rear direction so that the straight line connecting the polyion and the orbitale is at an angle of 10 °. Set.

(2) Method for Taking Back-Anterior Head and Neck X-ray Standard Photographs As shown in FIG. Then, as shown in FIG. 99, ear rods 217 and 218 are inserted into the left and right outer ear holes of the head 221 of the subject, as in the case of taking a lateral head and neck X-ray standard photograph, The head 21 is fixed by making the top point of 218 contact the polyion. In this case, the face of the head 221 faces the X-ray detection unit 215. The irradiation direction of the central X-ray is orthogonal to the central axis of the ear rods 217 and 218. It is assumed that a sticker 222 is stuck on a predetermined reference point on the face of the head 221, specifically, for example, an orbitale. Next, the examiner looks at the head tilt setting device 219 in the horizontal direction from the outside. At this time, the seal 222 can be seen through the head tilt setting device 219. Then, in the same manner as when taking a lateral head and neck X-ray standard photograph, the angle scale 219a of the head tilt setting device 219 is used to photograph a lateral head and neck X-ray standard photograph of a straight line connecting Polion and Orbitale. Set to the same angle as you did. Then, by performing X-ray imaging at this position, a posterior anterior head and neck X-ray standard photograph is taken in a state where the front-and-back inclination of the head 221 is the same as that at the time of lateral head and neck X-ray standard photography Can do. For example, both a lateral head and neck X-ray standard photograph and a back frontal head and neck X-ray standard photograph can be taken at a position where the Frankfurt plane of the head 221 is parallel to the horizontal plane (the floor).

(3) Method of Taking Front and Back Head and Neck X-ray Standard Photographs The method of taking front and rear head and neck X-ray standard pictures is to position head 221 so that the face of head 221 faces X-ray generator 211. Except for this, it is the same as the method for taking a posterior anterior head and neck X-ray standard photograph.

According to the Cephalo X-ray imaging apparatus according to the twentieth embodiment, the following various advantages can be obtained. That is, by using the head tilt setting device 219 to set the tilt in the front-rear direction of the head 221 at the time of imaging to a desired tilt, the lateral head X-ray standard photograph, the lateral head and neck X-ray standard A photograph, a posterior anterior head and neck X-ray standard photograph, an anteroposterior head and neck X-ray standard photograph, a head and neck X-ray photograph in an arbitrary direction between the posterior anterior direction and the anteroposterior direction, etc. It is possible to shoot easily and with high reproducibility with the same tilt in the front-rear direction. Therefore, the lateral temporal X-ray of the subject in the obstructive sleep apnea syndrome risk determination method according to the second, fourth, sixth, eighth, tenth, twelfth, and fourteenth to eighteenth embodiments. Detection of the position of the center of the hyoid bone, S, A, X _i , Go and Cd based on radiography, lateral head and neck radiography, posterior anterior head and neck radiography and anteroposterior head and neck radiography The reliability of the risk determination of obstructive sleep apnea syndrome can be improved. In addition, for example, when taking a lateral head-and-neck X-ray standard photograph or a posterior anterior head-and-neck X-ray standard photograph at a certain time, for example, when taking a picture one year after taking a picture at a certain time, Images can be taken with the same inclination of the part 221 in the front-rear direction. As described above, since the head 221 can always be photographed with the same inclination in the front-rear direction, it is possible to easily superimpose the lateral head-and-neck X-ray standard photograph or the front-and-rear head-neck X-ray standard photograph. it can. This makes it possible to accurately examine the secular change of the maxilla and mandible of the head 221 and to accurately examine the growth and development of the maxilla and mandible.

[Example 9]
Using the head tilt setting device 219, the position of the Frankfurt plane of the head 221 is parallel to the floor surface by using the head tilt setting device 219 for the lateral head and neck X-ray standard photograph and the posterior front head and neck X-ray standard photograph of the subjects 63 and 64 Taken with Photographing was performed at a central occlusal position or a position corresponding thereto. 100 and 102 show lateral head and neck X-ray standard photographs of subjects 63 and 64, respectively. Here, the white line in the horizontal direction seen in FIGS. 100 and 102 is an image of the horizontal plate 220 attached to the lower end of the head tilt setting device 219 and indicates the Frankfurt plane. 101 and 103 show posterior anterior head and neck X-ray standard photographs of subjects 63 and 64, respectively.

  100 to 103, both the subjects 63 and 64 can take a lateral head and neck X-ray standard photograph and a longitudinal head and neck X-ray standard photograph at a position where the Frankfurt plane of the head is parallel to the floor surface. I understand that.

  Although the embodiments and examples of the present invention have been specifically described above, the present invention is not limited to the above-described embodiments and examples, and various modifications based on the technical idea of the present invention. Is possible.

  For example, the numerical values, flowcharts, and the like given in the above-described embodiments and examples are merely examples, and different numerical values, flowcharts, and the like may be used as necessary. In addition, if necessary, two or more of the obstructive sleep apnea syndrome risk determination methods according to the second, fourth, sixth, eighth, tenth, twelfth, and fourteenth to eighteenth embodiments. You may combine.

  If necessary, the center of the body of the hyoid bone, Sera S, gonion Go, Menton Me, and Condillion Cd are detected by X-ray imaging of the subject's lateral head and neck, and the detected body of the hyoid bone is detected. The center is the area above the vertical line extending from Me to the extended line of S-Go, the vertical line extending from Me to the extended line of S-Go, and from Me to the extended line of Cd-Go. By determining which of the area between the vertical line and the area below the vertical line extending from Me to the extended line of Cd-Go, obstructive sleep apnea syndrome risk determination is performed. You may make it perform.

  In the formula (1), (S-Pog), (S-Gn) or (S-Me) may be used instead of (SB), and (Go-B) may be used instead of (Go-B). Pog) or (Go-Gn) may be used. In the formula (2), (S-Pog), (S-Gn) or (S-Me) may be used instead of (SB), and (Go-Me) may be used instead of (Go-Me). Pog) or (Go-Gn) may be used. Further, if necessary, (S−A) of the denominator of the above formulas (1) to (3) may be replaced with ((S−A) + (S−N)). In some cases, Gn or Pog at a position close to Me may be used instead of Me shown in FIG.

  DESCRIPTION OF SYMBOLS 10 ... Data processing device, 11 ... Auxiliary storage device, 12 ... Memory, 13 ... CPU, 14 ... Input part, 15 ... Output part, 16 ... Input / output interface, 111 ... Program, 112 ... Compiler, 113 ... Execution module, 211 ... X-ray generator, 211a ... X-ray tube, 212, 213 ... arm, 214 ... arm controller, 215 ... X-ray detector, 216 ... reference line, 217,218 ... ear rod, 219 ... head tilt setting device 220 ... horizontal plate, 221 ... head, 222 ... seal

Claims (6)

The distance between Sera S and the deepest point A on the mid-sagittal plane between the tip of the anterior nasal spine and the foremost tip of the alveolar process between the maxillary central incisors , as measured by X-ray photography of the subject's head (S-A), the distance between S and the deepest point B between the foremost tip of the alveolar process between the mandibular central incisor and the pogonion (S- B ), the distance between the gonions Go and A (Go-A) ) , A distance between Go and B (Go-B), a distance between Go and Menton Me (Go-Me), and a distance between Cdillion Cd and Go (Cd-Go) Using the chosen distance,
The obstructive sleep apnea syndrome risk determination index P is calculated by at least one of the following formulas (1) to (6) :
Or
When calculating P by the formula (1) or (2), further round down the fourth decimal place of P / 4,
Q = (P / 4) × 1000
Calculate
When calculating P by equation (3), further round off the fourth decimal place of P,
Q = (P− [P]) × 1000 ([] is a Gaussian symbol) (however, 2.000 ≦ P <3.000)
Or
Q = (P − ([P] +1)) × 1000 ([] is a Gaussian symbol) (where P <2.000)
Calculate
When calculating P according to equation (5) or (6), further round off the fourth decimal place of P,
Q = P × 1000 is calculated,
When calculating P by equation (1), whether or not this P is 2.772 or more and 3.200 or less, or whether or not Q calculated from this P is 693 or more and 800 or less,
When calculating P by equation (2), whether this P is 2.840 or more and 3.184 or less, or whether Q calculated from this P is 710 or more and 796 or less,
When calculating P by equation (3), whether or not this P is 2.062 or more and 2.297 or less, or whether or not Q calculated from this P is 62 or more and 297 or less,
When calculating P by equation (4), whether this P is 7 mm or more and 20 mm or less,
When calculating P by equation (5), whether this P is 0.085 or more and 0.229 or less, or whether Q calculated from this P is 85 or more and 229 or less,
When calculating P by equation (6), whether P is 0.093 or more and 0.298 or less, or whether Q calculated from this P is 93 or more and 298 or less is determined. A method of calculating an obstructive sleep apnea syndrome risk determination index for determining a risk of obstructive sleep apnea syndrome of a subject by determining.
P = ((SB) + (Go−B) + (Cd−Go)) / (SA) (1)
P = ((SB) + (Go-Me) + (Cd-Go)) / (SA) (2)
P = ((S− B ) + (Go− Me )) / (S−A) (3)
P = (Go-A)-(Go-B) (4)
P = ((Go−A) − (Go−B)) / (Go−A) (5)
P = ((Go−A) − (Go−B)) / (Go−B) (6) The distance between Sera S and the deepest point A on the mid-sagittal plane between the tip of the anterior nasal spine and the foremost tip of the alveolar process between the maxillary central incisors, as measured by X-ray photography of the subject's head (SA), the distance between S and the deepest point B between the foremost tip of the alveolar process between the mandibular central incisors and the pogonion (SB), the distance between the gonions Go and A (Go-A) ), A distance between Go and B (Go-B), a distance between Go and Menton Me (Go-Me), and a distance between Cdillion (Cd and Go) (Cd-Go). Using the chosen distance,
The obstructive sleep apnea syndrome risk determination index P is calculated by at least one of the following formulas (1) to (6):
Or
When calculating P by the formula (1) or (2), further round down the fourth decimal place of P / 4,
Q = (P / 4) × 1000
Calculate
When calculating P by equation (3), further round off the fourth decimal place of P,
Q = (P− [P]) × 1000 ([] is a Gaussian symbol) (however, 2.000 ≦ P <3.000)
Or
Q = (P − ([P] +1)) × 1000 ([] is a Gaussian symbol) (where P <2.000)
Calculate
When calculating P according to equation (5) or (6), further round off the fourth decimal place of P,
Q = P × 1000 is calculated,
When calculating P by equation (1), whether or not this P is 2.772 or more and 3.200 or less, or whether or not Q calculated from this P is 693 or more and 800 or less,
When calculating P by equation (2), whether this P is 2.840 or more and 3.184 or less, or whether Q calculated from this P is 710 or more and 796 or less,
When calculating P by equation (3), whether or not this P is 2.062 or more and 2.297 or less, or whether or not Q calculated from this P is 62 or more and 297 or less,
When calculating P by equation (4), whether this P is 7 mm or more and 20 mm or less,
When calculating P by equation (5), whether this P is 0.085 or more and 0.229 or less, or whether Q calculated from this P is 85 or more and 229 or less,
When calculating P by equation (6), whether P is 0.093 or more and 0.298 or less, or whether Q calculated from this P is 93 or more and 298 or less is determined. Obstructive sleep apnea syndrome risk determination executed by a computer having a calculation formula of P or Q and a program including the determination formula of P or Q, which performs risk determination of obstructive sleep apnea syndrome of a subject by determining Method.
P = ((SB) + (Go−B) + (Cd−Go)) / (SA) (1)
P = ((SB) + (Go-Me) + (Cd-Go)) / (SA) (2)
P = ((SB) + (Go-Me)) / (SA) (3)
P = (Go-A)-(Go-B) (4)
P = ((Go−A) − (Go−B)) / (Go−A) (5)
P = ((Go−A) − (Go−B)) / (Go−B) (6) Furthermore, using at least the hyoid bone, sera S, gonion Go, and Menton Me detected by the subject's lateral head and neck radiography, the center of the detected hyoid bone body is a segment S- The method for determining the risk of obstructive sleep apnea syndrome according to claim 2, wherein it is determined whether or not the region is included in a region above a perpendicular line extending from an extended line of Go. The obstructive sleeplessness according to claim 2 or 3, wherein it is further determined whether or not a hyoid bone is detected in a photographed image obtained by anteroposterior head and neck X-ray imaging or front and back head and neck X-ray imaging of the subject. Respiratory syndrome risk assessment method. A program for causing a computer to execute at least one of the method for calculating an obstructive sleep apnea syndrome risk determination index or the obstructive sleep apnea syndrome risk determination method according to claim 1. A computer having the program according to claim 5.