成人骨性Ⅱ类上气道与颅颌面关系初探  

A Three-Dimensional Study of Upper Airway in Adult Skeletal Class ⅡPatients with Different Vertical Patterns

作　　者：王天虎[1] 李永明[1] 杨芳[1] 张明烨[1] 陈金武[2] 

机构地区：[1]第四军医大学口腔医学院正畸科,陕西西安710032 [2]第四军医大学口腔医学院放射科,陕西西安710032

出　　处：《现代生物医学进展》2013年第15期2901-2907,2851,共8页Progress in Modern Biomedicine

基　　金：国家自然科学基金面上项目(30970697)

摘　　要：目的:比较骨性Ⅱ类不同垂直骨面型成人上气道鼻咽、腭咽、舌咽大小的差异,并探讨其与颅面部骨骼形态的关系。方法:将64名(男34例,女30例)成人骨性Ⅱ类错患者按GoGn-SN角大小分为高角、均角、低角三组。分别行颅面部锥体束计算机断层扫描(CBCT),对各段的矢状径、横径、长度、截面积以及容积等指标进行测量分析,比较三组间的差异。同时,对上气道各测量项目与颅颌面结构指标进行相关性分析。结果:在上气道各线性测量项目中,鼻咽和腭咽长度(Ln、Lp)随着垂直骨面型增大而逐渐减小,差异有统计学意义(P<0.05)。高角组舌咽段的高度(Hg)与均角、低角组存在差异,差异有统计学意义(P<0.05),均角组和低角组间并无统计学差异(P>0.05)。上气道各段宽度在不同垂直骨面型之间均无统计学差异。不同垂直骨面型上气道总体积(Vt)无明显差异。高角组舌咽段体积(Vg)及鼻咽段横截面积(CSAn)与均角、低角组存在差异,差异有统计学意义(P<0.05),均角组和低角组间并无统计学差异(P>0.05)。而其余测量项目在各垂直骨面型间均未发现统计学差异。由相关性分析可知,舌咽和腭咽的体积与横截面积与上下颌骨垂直向不调指数(ODI)正相关,而腭咽体积和横截面积与下颌平面角负相关。结论:随着垂直骨面型增大上气道结构存在着差异,且主要影响腭咽段和舌咽段,对鼻咽段影响较小。Objective： To analyze whether nasopharyngeal and Palate-pharyngeal and glossopharyngeal airways differed among adult skeletal Class Ⅱ patients with different vertical patterns,and to study the potential association of vertical skeletal facial patterns with different parts of upper airway.Methods： Cone-beam computed tomography（CBCT）records of 64 adult skeletal Class Ⅱ patients（34 male and 30 female）were used to evaluate the pharyngeal airway dimensions and volume（nasopharynx,palatopharynx,glossopharynx）.The sample was divided into three groups according to the GoGn-SN angle（low angle,normalangle,or high angle）.Upper airway differrences were measured and compared among different vertical facial type groups.Results： In the linear measurements of upper airways,a significant tendency for reduced upper airway dimension in the superior part（nasopharynx and palatopharynx） was found in the low angle,normal angle,and high angle subgroups,in that order,with statistically significant difference（P0.05）.No statistically significant difference for upper airway width was observed among different vertical skeletal facial morphologies.There was no difference in upper airway total volume among different vertical skeletal patterns.The glossopharynx height（Hg） and volume（Vg） of the high angle group was statistically significant difference with that of the low and the normal angle group（P0.05）,No difference between glossopharynx height（Hg） and volume（Vg） of the low angle group and that of normal angle group was found.Vp,Vg,Hp,Hg,CSAp and CSAg were significantly positively correlated with ODI.Vp,Hp and CSAp were significantly negatively correlated with FMA angle as well as GoGn-SN angle.Conclusion： The vertical skeletal patterns may be contributory factors for the variation of the nasopharynx and palatopharynx.

关 键 词：骨性Ⅱ类 垂直骨面型 CBCT 上气道形态 三维重建 

分 类 号：R783[医药卫生—口腔医学]