鼻气道阻塞对儿童下颌骨生长模式的影响

Impacts of Nasal Airway Obstruction on the Mandibular Growth Pattern in Children

目的:探讨长期鼻气道阻塞(NAO)对儿童下颌骨生长模式的影响。方法:选择NAO病史大于2年、A/N≥0.71、伴或不伴扁桃体肿大(≥Ⅱ度)者为病例组,共30例,无鼻病史、A/N≤0.60且扁桃体≤Ⅰ度者为对照组,共27例,对两组儿童的声反射鼻测量和X线头颅测量指标进行分析。结果:声反射鼻测量显示病例组鼻阻力明显大于对照组(P<0.01),鼻最小横截面积明显小于对照组(P<0.01),鼻咽腔容积明显小于对照组(P<0.01);头颅测量显示鼻气道阻塞组儿童面部形态呈明显的垂直向生长,下颌平面变斜,下颌角变大;直线相关分析显示鼻咽腔容积与面高比例明显相关(r=0.390,P<0.05)。结论:长期鼻呼吸阻塞可影响儿童的颌面发育,主要是对下颌的位置和形态有影响。

Objective：To assess the effect of the mandibular growth pattern in children with nasal airway obstruction（NAO）. Methods：There were two groups of children,aged from 3 to 12 years. In the NAO group,30 children,who had symptom of NAO for more than two years and A/N ≥0.71 （the adenoids/nasapharynx according to the cephalometry） and or no tonsil hypertrophy （ ≥ degree Ⅱ ） were selected. In the control group,27 children,who had no symptom of NAO and A/N≤0.60 and tonsil hypertrophy （≤ degree Ⅰ ） were selected. All patients＇ data of Acoustic rhinometry （AR） and cephalometry were analyzed. Results： Compared with the control, the Total nasal airway resistance （TNAR） significantly increased （ P 〈 0.01 ） , the bilaterior nasal cavity minimal cross sectional area （MCSA） significantly decreased （ P 〈 0. 01 ）, and the nasopharyngeal volume （NPV）significantly decreased （P 〈 0. 01 ） ; There were significant differences between the case group and the controls in TNAR, NPV and MCSA. Compared with the control, the children with adenoid hypertrophy showed apparent vertical growth pattern,and larger gonion and retrusion chin;There was some correlation between NPV and FH ratio. Conclusion：It seems that the nasal airway obstructive might be one of the factors related to the difference of craniofacial morphology,especially of the mandibular growth pattern.