双侧下颌骨矢状劈开截骨后退术对骨性Ⅲ类错牙合畸形患者上气道的影响

doi:10.13701/j.cnki.kqyxyj.2020.10.012

口腔医学研究 ›› 2020, Vol. 36 ›› Issue (10): 938-941.DOI: 10.13701/j.cnki.kqyxyj.2020.10.012

双侧下颌骨矢状劈开截骨后退术对骨性Ⅲ类错牙合畸形患者上气道的影响

刘刚^*, 张良, 李长顺

徐州医科大学附属口腔医院江苏徐州 221000

收稿日期:2020-03-11 出版日期:2020-10-28 发布日期:2020-10-19
通讯作者: *刘刚,E-mail:1213573916@qq.com
作者简介:刘刚(1974~ ),男,江苏徐州人,副主任医师,本科,研究方向:颌面外科。

Change of Upper Airway after Mandibular Setback by BSSRO in Patients with Skeletal Ⅲ Malocclusion

LIU Gang^*, ZHANG Liang, LI Changshun

The Affiliated Stomatological Hospital of Xuzhou Medical University, Xuzhou 221000, China

Received:2020-03-11 Online:2020-10-28 Published:2020-10-19

摘要/Abstract

摘要： 目的: 通过头颅定位侧位片分析骨性Ⅲ类错牙合患者行双侧下颌支矢状劈开后退术前后上气道变化。方法: 就诊于2016年1月~2019年6月徐州市口腔医院25例骨性Ⅲ类错牙合患者,男性13例,女性12例,平均年龄22.15岁。术前后均拍摄头颅定位侧位片,术中双侧下颌行矢状劈开行完成后退。术后1周,1月,3月及6个月分别测量上气道矢状向间隙变化,包括鼻咽、软腭、舌根及会厌后区,并评估舌骨位置改变。结果: 术后上气道三处解剖平面(软腭、舌根及会厌后区)均出现矢状向缩小;男性舌骨位置较女性向后下方移位明显。不同性别间之间上气道间隙变化无统计学差异。结论: 骨性Ⅲ错颌畸形患者行下颌骨升支矢状劈开后退术后,上气道均出现不同程度的缩窄及舌骨下后方移位。下颌骨后退距离过大可能导致阻塞性睡眠呼吸障碍。

关键词: 头颅定位侧位片, 上气道, 下颌骨矢状劈开术

Abstract: Objective: To evaluate the change in pharyngeal airway space and the position of hyoid bone after mandibular setback in patients with skeletal Ⅲ malocclusion. Methods: 25 patients with skeletal Ⅲ malocclusion were collected from Jan. 2016 to Jun.2019 in Xuzhou Stomatological Hospital, in which male were 13 and female were 12. The mean age was 22.15. The bilateral sagittal split ramus osteotomy (BSSRO) was applied. Lateral cephalometric radiographs were taken before and after surgery. The changes of airway in soft palate, tongue, epiglottis region, and hyoid bone position were measured in sagittal direction. Results: After the operation, the soft palate, base of tongue, and posterior area of epiglottis were narrowed, and hyoid bone shifted backwards and downward in all patients. There was no significant statistical difference in upper airway between male and female, while hyoid bone position in males was lower than that in females. Conclusion: The study indicated that BSSRO made upper airway narrow in different degrees and hyoid bone shifting after operation. Obstructive sleep apnea-hypopnea syndrome would be caused by the great amount of mandibular setback

Key words: lateral cephalometric radiograph, upper airway, mandibular setback

刘刚, 张良, 李长顺. 双侧下颌骨矢状劈开截骨后退术对骨性Ⅲ类错牙合畸形患者上气道的影响[J]. 口腔医学研究, 2020, 36(10): 938-941.

LIU Gang, ZHANG Liang, LI Changshun. Change of Upper Airway after Mandibular Setback by BSSRO in Patients with Skeletal Ⅲ Malocclusion[J]. Journal of Oral Science Research, 2020, 36(10): 938-941.

参考文献

[1] Canellas JV, Barros HL, Medeiros PJ, et al. Sleep-disordered breathing following mandibular setback: a systematic review of the literature [J]. Sleep Breath, 2016, 20(1):387-394.
[2] Lyberg T, Krogstad O, Djupesland G. Cephalomatric analysis in patiants with obstructive sleep apnoea syndrome Ⅰ Skeletal morphology [J]. J Laryngol Otol,1989, 103(3):287-292.
[3] Lyberg T, Krogstad O, Djupesland G. Cephalomatric analysis in patiants with obstructive sleep apnoea syndrome Ⅱ Soft tissue morphology [J]. J Laryngol Otol, 1989, 103(3):293-297.
[4] Jeong S, Sung J, Kim S, et al. Upper airway morphologic changes after mandibular setback surgery in skeletal class Ⅲ malocclusion patients measured using cone beam computed tomography superimposition[J]. Int J Oral Maxillofac Surg, 2018, 47(11):1405-1410.
[5] Fernández-Ferrer L, Montiel-Company JM, Pinho T, et al. Effects of mandibular setback surgery on upper airway dimensions and their influence on obstructive sleep apnoea-a systematic review[J]. J Craniomaxillofac Surg, 2015, 43(2):248-253.
[6] Hsu PP, Tan BY, Chan YH, et al. Clinical predictors in obstructive sleep apnea patients with computer-assisted quantitative videoendoscopic upper airway analysis[J]. Laryngoscope, 2004, 114(5):791-799.
[7] 刘文君,赵蕾丽.声反射技术在测量正常人咽腔中的应用[J].青岛医药卫生,2003,35(6):408-409.
[8] Cho HW, Kim IK, Cho HY, et al. Retrospective study of changes in pharyngeal airway space and position of hyoid bone after mandibular setback surgery by cephalometric analysis[J]. Maxillofac Plast Reconstr Surg, 2015,37(1):38.
[9] Brunetto DP, Velasco L, Koerich L, et al. Prediction of 3-dimensional pharyngeal airway changes after orthognathic surgery: a preliminary study[J]. Am J Orthod Dentofacial Orthop,2014,146(3):299-309.
[10] Pereira-Filho VA, Castro-Silva LM, de Moraes M, et al. Cephalometric evaluation of pharyngeal airway space changes in class Ⅲ patients undergoing orthognathic surgery[J]. J Oral Maxillofac Surg, 2011, 69(11):e409-e415.
[11] Jeong S, Sung J, Kim S, et al. Upper airway morphologic changes after mandibular setback surgery in skeletal class Ⅲ malocclusion patients measured using cone beam computed tomography superimposition[J]. Int J Oral Maxillofac Surg, 2018, 47(11):1405-1410.
[12] Brunetto DP, Velasco L, Koerich L, et al. Prediction of 3-dimensional pharyngeal airway changes after orthognathic surgery: a preliminary study[J]. Am J Orthod Dentofacial Orthop, 2014, 146(3):299-309.
[13] Park SB, Kim YI, Son WS, et al. Cone-beam computed tomography evaluation of short- and long-term airway change and stability after orthognathic surgery in patients with Class Ⅲ skeletal deformities: bimaxillary surgery and mandibular setback surgery[J]. Int J Oral Maxillofac Surg, 2012, 41(1):87-93.
[14] Eggensperger N, Smolka W, Iizuka T. Long-term changes of hyoid bone position and pharyngeal airway size following mandibular setback by sagittal split ramus osteotomy[J]. J Craniomaxillofac Surg, 2005, 33(2):111-117.
[15] Azevêdo MS, Machado AW, Barbosa Ida S, et al. Evaluation of upper airways after bimaxillary orthognathic surgery in patients with skeletal Class Ⅲ pattern using cone-beam computed tomography[J]. Dental Press J Orthod, 2016, 21(1):34-41.
[16] Gonçales ES, Duarte MA, Palmieri C Jr, et al. Retrospective analysis of the effects of orthognathic surgery on the pharyngeal airway space[J]. J Oral Maxillofac Surg, 2014, 72(11):2227-2240.
[17] Chen CM, Lai S, Chen KK, et al. Correlation between the pharyngeal airway space and head posture after surgery for mandibular prognathism[J]. Biomed Res Int, 2015, 2015:251021.
[18] Lee UL, Oh H, Min SK, et al. The structural changes of upper airway and newly developed sleep breathing disorders after surgical treatment in class Ⅲ malocclusion subjects[J]. Medicine (Baltimore), 2017, 96(22):e6873.

双侧下颌骨矢状劈开截骨后退术对骨性Ⅲ类错牙合畸形患者上气道的影响

Change of Upper Airway after Mandibular Setback by BSSRO in Patients with Skeletal Ⅲ Malocclusion

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