不同治疗对上气道狭窄伴牙颌畸形儿童上气道的影响  

Effect of different treatment methods on upper airway of children with upper airway stenosis and dentomaxillofacial malformation

作　　者：郭靖晗 郭姜莉 陈伟[3] 杨洁 林惠 原工杰 GUO Jinghan;GUO Jiangli;CHEN Wei;YANG Jie;LIN Hui;YUAN Gongjie(Department of Stomatology,Shanghai Childrens Hospital,Shanghai Jiao Tong University,Shanghai 200001,China)

机构地区：[1]上海市儿童医院,上海交通大学附属儿童医院口腔科,上海200001 [2]上海市口腔病防治院正畸科,上海200001 [3]上海市儿童医院,上海交通大学附属儿童医院耳鼻咽喉科,上海200001

出　　处：《口腔医学》2022年第2期144-148,共5页Stomatology

摘　　要：目的比较手术治疗与正畸治疗对上气道狭窄伴牙颌畸形儿童上气道的影响。方法选取20例上气道狭窄伴牙颌畸形儿童,其中正畸组10例,手术组10例,分别接受上颌扩弓与双牙合垫矫治器的正畸治疗和切除肥大腺样体扁桃体的手术治疗,获取治疗前后的锥形束计算机断层扫描(cone beam computed tomography,CBCT),使用Dolphin11.8;测量患儿治疗前后上气道及颅面变化,使用SPSS 21.0进行组内相关系数计算并对数据进行配对t检验。结果治疗后手术组与正畸组患儿上气道狭窄情况好转,上气道体积增加。手术组治疗后,患儿鼻咽部体积(P=0.007),上气道上间隙(P=0.009)比正畸组显著增大。正畸组治疗后,患儿上气道中间隙(P=0.044),上气道下间隙(P=0.002)比手术组显著增大。治疗后正畸组患儿ANB较手术组明显减小(P=0.000)。结论手术治疗与正畸治疗均可改善儿童上气道狭窄问题,前者主要作用于上气道中部及上部,后者则主要作用于上气道下部,在增大气道体积的同时还可帮助儿童牙颌面部正常生长发育。手术与正畸的协同治疗可能取得更好的疗效。Objective To compare effects of surgical treatment and orthodontic treatment on the upper airway of children with upper airway stenosis and dentomaxillofacial malformation.Methods Twenty children with upper airway stenosis and dentomaxillofacial malformation were selected,including 10 in the orthodontic group and 10 in the surgical group.They respectively received orthodontic treatment with maxillary expansion and Twin-block and surgical treatment for the removal of hypertrophic adenoid tonsils.Cone beam computed tomography(CBCT)before and after surgery were obtained,and images were analyzed using Dolphin imaging software;11.8.SPSS21.0 was used to calculate the intra-group correlation coefficient(ICC)and the data were paired with t-test.Results After treatment,the narrow airway of children in the surgery group and the orthodontic group were improved,and the upper airway volume increased.After treatment in the surgery group,the volume of nasopharynx(P=0.007),and the upper airway space(P=0.009)increased significantly than that in orthodontic group.After orthodontic treatment,the middle space of upper airway(P=0.044)and the lower upper airway space(P=0.002)increased significantly than that in surgery group.After treatment,the ANB of children in the orthodontic group decreased more significantly than surgery group(P=0.000).Conclusion Both surgical treatment and orthodontic treatment can improve the narrow airway of children.The former mainly acts on the middle and upper part of the upper airway,while the latter mainly acts on the lower part of the upper airway,which can increase the volume of airway and help children′s dental and maxillofacial normal growth.Synergistic treatment of surgery and orthodontics may achieve better results.

关 键 词：手术 正畸 儿童 气道 

分 类 号：R783.5[医药卫生—口腔医学]