骨性Ⅲ类错牙合畸形患者正颌术后口咽气道变化的研究  

Changes of oropharyngeal airway after orthognathic surgery in patients with skeletal class Ⅲ malocclusion

作　　者：刘美丽 安玮[1] 姚志涛[1] LIU Meili;AN Wei;YAO Zhitao(Department of Orhognathic Surgery for Marillofacial Trauma,the First Afiliated Hospital of Xinjiang Medical Unirersiy/Afiliated Stomatological Hospital,Unumchi 830000,China)

机构地区：[1]新疆医科大学第一附属医院/附属口腔医院颌面创伤正颌外科,新疆乌鲁木齐830000

出　　处：《中国耳鼻咽喉颅底外科杂志》2021年第2期218-221,共4页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：新疆医科大学教育教学研究与改革项目(YG2019073)。

摘　　要：目的分析和测量下颌骨后退量对骨性Ⅲ类错牙合畸形患者正颌术前、术后口咽气道容积的变化。方法选取19例下颌前突和ANB角小于-2°诊断为骨性Ⅲ类错牙合畸形的患者,其中男6例,女13例,按照正颌手术中下颌骨后退量分为两组,实验Ⅰ组:下颌后退量<5 mm,共9例;实验Ⅱ组:下颌后退量≥5 mm,共10例。所有患者采用双侧下颌骨升支矢状劈开截骨后退(BSSRO)术进行治疗,患者均在正颌外科手术前1周和术后3~6个月分别行CT和肺功能检查。应用Mimics 21.0软件进行图像处理和测量研究,使用SPSS 23.0软件对所有测量值进行统计学分析。观察患者下颌骨后退量与口咽气道的关系。结果在腭咽段,两组治疗后与治疗前相比,腭咽段术后各组数据均较术前有所增大,但经配对t检验,差异无统计学意义(P>0.05)。在舌咽段,两组手术后数值均减小,在横截面积和容积方面,两组的减小量有显著差异(P<0.05),即实验Ⅱ组较实验Ⅰ组减小更加明显。结论正颌手术中BSSRO术会引起骨性Ⅲ类错牙合畸形患者舌咽段横截面积和容积明显减小,下颌骨后退量较大者舌咽段气道横截面积和容积减小明显。Objective To measure and analyze the effect of the amount of mandible setback on the oropharyngeal airway in patients with skeletal class Ⅲ malocclusion.Methods Nineteen patients(13 females and 6 males) with skeletal class Ⅲ malocclusion were divided into two groups according to the amount of mandible setback. GroupⅠ(9 patients) had the amount of mandible setback less than 5 mm and groupⅡ(10 patients) equal to or more than 5 mm. All patients underwent bilateral sagittal split ramus osteotomy(BSSRO) for mandible setback. They received CT scanning and pulmonary function examination 1 week before and 3 to 6 months after surgery. Mimics 21.0 software was used for image processing and measurement, and SPSS 23.0 software was used for statistical analysis.Results In velopharynx, the values of both groupⅠand II were increased after surgery, but the differences were statistically insignificant(both P>0.05). In glossopharynx, the values of groupⅠand II were both decreased after surgery. The reductions of the cross-sectional areas and volumes in group II were more obvious than groupⅠ, and the differences were statistically significant(both P<0.05).Conclusion In orthognathic surgery, BSSRO causes significant reduction in the cross-sectional areas and volumes of the glossopharyngeal segment in patients with skeletal class Ⅲ malocclusion, and the patients with greater amount of mandible setback may have more reduction.

关 键 词：口咽气道容积 下颌骨 正颌手术 骨性Ⅲ类错牙合畸形 双侧下颌骨矢状劈开截骨后退术 

分 类 号：R782.2[医药卫生—口腔医学]