可调试口腔矫治器治疗儿童阻塞性睡眠呼吸暂停综合征颅咽结构变化的临床研究

Clinical Research of the Changes in the Structure of Craniopharyngeal after the Treatment of Adjustable Oral Appliances in Children with Obstructive Sleep Apnea Syndrome

目的：应用X线头影测量分析方法,探讨作者设计的可调式口腔矫治器治疗儿童阻塞性睡眠呼吸暂停综合征（OSAS）患儿,下颌前伸时上气道及周围结构的变化。方法：45例患儿,治疗前经多导睡眠监测（PSG）确诊为OSAS。使用可调式口腔矫治器治疗治疗前后进行X线头影测量。患儿年龄5～12岁,平均年龄7.71±2.01岁,其中男32例、女13例。结果：45名OSAS患儿SNB角增加2.21%、ANB角减少21.29%、SN-FH角增加13.39%、AH-MP距减少37.27%,AH-Ge距减少8.55%,AH-CVP距增5.31%,AH-FH距减少5.84%,V-T减少1.64%,SPP-SPPW距增加26.92%,U-MPW距增加15.07%,TB-TPPW增加24.79%,V-LPW距增加14.39%,LPW-CVP减少19.35%,V-Ge距增加18.38%,均有统计学意义。结论：OSAS患儿戴入可调式口腔矫治器后,上气道及其周围组织结构发生了明显的改变,上气道间隙明显增大。

Objective： To use X cephalometric analysis methods to explore the changes in the structure of craniopharyngeal when the children patients with obstructive sleep apnea syndrome （OSAN） advance mandibulas as treated by the author-designed adjustable oral appliances. Methods： Datas were analyzed by X-cephalometry before and after the treatment of adjustable oral appliances in 45 cases of children patients who were diagnosed with obstructive sleep apnea syndrome （OSAS） before treatment by polysomnography （PSG）. Those children were aged from 5 to 12 years old with an average age of 7.71 ± 2.01 years old. Results： In the 45 children patients with OSAS, the an gle of SNB increased by 2.21%; the angle of ANB reduced by 21.29 %; the angle of SN-FH increased by 13. 39% ; the distance of AH- MP decreased by 37.27% ; the distance of AH- Ge decreased by 8.55% ; the distance of AH-CVP increased by 5.31%; the distance of AH-FH decreased by 5.84%; the distance of V-T reduced by 1.64%; the distance of SPP--SPPW decreased by 26.92%; the distance of U-MPW increased by 15.07%; the distance of TB-TPPW increased by 24.79% ; the distance of V--LPW decreased by 14.39% ; the distance of LPW -CVP decreased by 19.35% ; the distance of V-Ge increased by 18.38%： all of them have statistical significance. Conclusion： After wearing adjustable oral appliances, OSAS children patients＇ upper airway and the surrounding structures have changed significantly with their upper airway space increased significantly.