双颌手术对骨性Ⅱ类错颌畸形患者舌解剖位置及形态的影响  

Effect of bimaxillary orthognathic surgery on the anatomical position and morphology of tongue in patients with skeletal classⅡmalocclusion

作　　者：张昆 胡小蓓 张建云 王育新[2] Zhang Kun;Hu Xiaobei;Zhang Jianyun;Wang Yuxin(Department of Orthodontics,Nanjing Stomatological Hospital/Affiliated Hospital of Medical School,Institute of Stomatology,Nanjing University,Nanjing 210008,China;Department of Oral and Maxillofacial Trauma Orthognathic Plastic Surgery,Nanjing Stomatological Hospital,Affiliated Hospital of Medical School,Institute of Stomatology,Nanjing University,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属口腔医院/南京市口腔医院/南京大学口腔医学研究所口腔正畸科,南京210008 [2]南京大学医学院附属口腔医院/南京市口腔医院/南京大学口腔医学研究所口腔颌面创伤正颌整形外科,南京210008

出　　处：《中华解剖与临床杂志》2025年第3期177-182,共6页Chinese Journal of Anatomy and Clinics

基　　金：江苏省重点研发计划(社会发展)专项资金(BE2021609)。

摘　　要：目的基于螺旋CT探讨骨性Ⅱ类错颌畸形患者双颌手术前后舌解剖位置及形态的变化,以及其与上下颌骨矢状向移动量之间的相关性。方法横断面研究。选取南京大学医学院附属口腔医院2019年6月—2024年5月行LeFortⅠ型截骨后退术+双侧下颌骨矢状劈开前徙术的27例骨性Ⅱ类错颌畸形患者,其中男13例、女14例,年龄18~26(21.7±3.4)岁。收集患者术前1周、术后1个月、术后6个月的螺旋CT数据,测量手术前后舌相对于颅底的矢状向和垂直向位置、口内舌的相对位置体积,以及舌长度、高度和矢状面积等舌位置和形态指标。观察指标:(1)比较患者手术前后舌位置和形态指标的差异;(2)分析患者术后6个月较术前1周舌位置及形态变化量与上下颌骨矢状向移动距离间的相关性。结果患者术后1、6个月,舌矢状向位置、口内舌相对位置指标D6和D7(口内舌前距离)、舌长度、口内舌体积均较术前1周增大,术后6个月较术前1周分别增大(3.8±4.9)mm、(1.9±2.8)mm、(2.9±3.2)mm、(5.5±7.3)mm、(7.8±9.2)cm^(3);口内舌相对位置指标D3和D4(口内舌上距离)均较术前1周减小,术后6个月较术前1周分别相差(-1.7±2.6)mm、(-1.9±2.9)mm:差异均有统计学意义(P值均<0.05)。术后6个月时,舌位置及形态变化量与上牙槽座点(A点)矢状向移动距离均无相关性(P值均>0.05),而舌矢状向位置、口内舌体积变化量与下牙槽座点(B点)矢状向移动距离呈正相关(r=0.438、0.497,P值均<0.05)。结论骨性Ⅱ类错颌畸形患者进行双颌手术后会造成舌向前移动,口内舌的相对位置更靠前、下方,舌长度及口内舌体积增大;舌向前移动距离、口内舌体积增大量与下颌骨前移量呈正相关。Objective This study aimed to evaluate the changes of the anatomical position and morphology of tongue in patients with skeletal ClassⅡmalocclusion after bimaxillary orthognathic surgery by spiral computed tomography and to explore the relationships between the changes in the anatomical morphology of the tongue and the sagittal movement distance of the maxilla and mandible.Methods This work is a cross-sectional study.A total of 27 patients with skeletal ClassⅡmalocclusion who underwent LeFort I osteotomy and bilateral sagittal split mandibular osteotomy form June 2019 to May 2024 in the School of Medicine of NanjingUniversity-Affiliated Stomatology Hospital were enrolled.The patients included 13 males and 14females,aged 18-26(21.7±3.4)years.Spiral CT data were collected one week before surgery,onemonth after surgery,and six months after surgery.The tongue positions,length,height,area,andvolume in the oral cavity proper before and after surgery were measured.Observation target:(1)Thedifferences of tongue positions and morphology in different periods were compared.(2)Thecorrelation between the changes of tongue positions and morphology and the sagittal movementdistance of the maxilla and mandible six months after surgery and one week before surgery wasanalyzed.Results The tongue sagittal position,the D6 and D7 distance,tongue length,and tonguevolume in the oral cavity proper increased significantly at one month and six months after surgery,and the amounts of increase were(3.8±4.9)mm,(1.9±2.8)mm,(2.9±3.2)mm,(5.5±7.3)mm,and(7.8±9.2)cm^(3)at six months after surgery compared with one week before surgery,respectively.TheD3,D4 distance decreased significantly,and the amounts of decrease were(−1.7±2.6)and(−1.9±2.9)mm at six months after surgery compared with one week before surgery,respectively.The abovedifferences were statistically significant(all P values<0.05).At six months after operation,nocorrelation existed between the position and morphology of the tongue and the sagittal movementdistance at poin

关 键 词：颌畸形 双颌手术 舌 体层摄影术 螺旋计算机 

分 类 号：R782.2[医药卫生—口腔医学]