腺样体肥大对儿童颅颌面及上气道形态发育的影响研究  

Effects of adenoid hypertrophy on craniofacial and upper airway development in children

作　　者：羊红梅 周盛平 李欧 蔡虹 YANG Hongmei;ZHOU Shengping;LI Ou;CAI Hong(Department of Otolaryngology,The Second People's Hospital of Deyang City,Deyang,Sichuan 618099,China)

机构地区：[1]四川省德阳市第二人民医院耳鼻喉科,四川德阳618099

出　　处：《中国优生与遗传杂志》2021年第1期115-118,共4页Chinese Journal of Birth Health & Heredity

摘　　要：目的探讨腺样体肥大对儿童颅颌面及上气道形态发育的影响。方法本研究由两部分组成。第一部分,选取我院32例行口腔正畸且伴重度腺样体肥大的患儿为病例组,同期无腺样体组织水肿的32例患儿为对照组,比较两组患儿上气道矢状径相关指标的差异。第二部分,选取我院53例重度腺样体肥大伴颅颌面畸形的患儿为研究对象,进行X线头颅侧位片及电子鼻咽镜检查后分析相关数据。结果 (1)与对照组相比,病例组患儿鼻咽腔气道、口咽气道上部大小明显不同,A值显著较大、PNS-R、PNS-UPW显著较小(P<0.05);但骨性结构及上气道中下部结构差异不大。(2)53例患儿中,39例长窄面型,36例颚盖高拱,27例鼻孔偏小。以中国人正steiner分析法测量均值,骨性Ⅰ类、Ⅱ类、Ⅲ类分别为13例(24.5%)、32例(60.4%)、8例(15.1%)。(3)在电子鼻咽镜下,33例患儿腺样体大小占后鼻孔范围≥50%(阻塞组),20例患儿腺样体大小占后鼻孔范围<50%(非阻塞组)。单因素分析显示,两组患儿在骨面型角度、骨面型线距、牙性指标等方面均无明显差异(P>0.05)。但阻塞组患儿的PNS-ad2值显著高于非阻塞组(P<0.001),其余气道线距指标,包括骨性鼻咽PNS-Ba、PNS-ad1、PSP-SPPW、P-MPA、Tb-TPPW等无明显差异(P>0.05)。结论腺样体肥大对儿童颅颌面及上呼吸道形态均有明显的不良影响,易造成Ⅱ类高骨角面型。Objective To investigate the effect of adenoidal hypertrophy on the development of craniofacial and upper airway in children. Methods In the first part, 32 cases of oral orthodontic and severe adenoid hypertrophy were selected as case group, and 32 children without adenoid edema were used as control group at the same time. The difference of upper airway related indexes was compared between the two groups. In the second part, 53 cases of severe adenoid hypertrophy with craniofacial malformation were selected as the subjects, and the related data were analyzed after the X-ray of the lateral head of the skull and the electronic nasopharynx. Results(1) Compared with the control group, the A value of the case group was larger, the PNS-R and PNS-UPW were smaller(P<0.05), but the N value, SPP-SPPW, U-MPW, TB-TPPW, V-LPW and so on were significantly different(P>0.05).(2) Of the 53 cases, 39 cases were long and narrow face type, 36 cases were covered with high arch, 27 cases had small nostrils.(3) Among the 53 cases, 13 cases, 32 cases and 8 cases were bony class I, class II and class III. High angle, average angle and low angle were 41 cases, 9 cases and 3 cases respectively.(4) The size of adenoids in 33 cases accounted for more than 50% of the posterior nostrils, and the size of adenoids in 20 children occupied 50% of the posterior nostril area.(5) There was no significant difference between the two groups in terms of facial type angle, facial type line distance and dental index(P>0.05).(5) Compared with the non obstructive group, the PNS-ad2 value of the children in the obstructive group was significantly higher(P<0.001), but there was no significant difference in other indexes(P>0.05). Conclusion Adenoidal hypertrophy has obvious adverse effects on cranio maxillofacial and upper respiratory tract morphology in children.

关 键 词：腺样体肥大 颅颌面形态 电子鼻咽镜 

分 类 号：R766[医药卫生—耳鼻咽喉科]