骨性Ⅲ类错患者双颌手术后鼻咽及口咽部气道及其周围软硬组织的变化

Changes in nasopharynx,oropharynx,soft and hard tissues around pharyngeal airway after bimaxillary surgery for patients with skeletal Class Ⅲ malocclusion

目的:通过锥形束CT(cone beam computer tomography,CBCT)观察骨性Ⅲ类错患者双颌手术后鼻咽及口咽部气道及其周围软硬组织的变化。方法:纳入双颌手术治疗的骨性Ⅲ类错患者19例,女性12名,男性7名,平均年龄23.8岁。分别于术前1周及术后3个月拍摄CBCT扫描照片,通过Mimics 10.01建立术前及术后鼻咽、口咽气道三维影像并进行测量。结果:术后患者口咽部容积与气道总容积(包括鼻咽与口咽)均显著减小(P<0.05),口咽部气道容积平均减小8.37%,气道总容积平均减小6.91%。术后软腭处气道横截面积平均减小19.83%(P<0.05)。舌骨位置、软腭形态均有明显变化(P<0.05)。术后气道分别与舌骨位置(H-X,H-Y)、软腭形态变化(PNS-UT,U-T,UT/ANS)有显著相关性(P<0.05),软腭形态变化与舌骨位置变化也具有显著相关性(P<0.05)。结论:骨性Ⅲ类错患者双颌术后气道容积减小。

Objective： To compare the changes of nasopharynx,oropharynx,soft and hard tissues around the pharyngeal airway in the patients with skeletal Class Ⅲ malocclusion after bimaxillary surgery.Methods： 19 patients（12 women,7 men,average age：23.8） with skeletal Class Ⅲ malocclusion underwent bimaxillary surgery were involved in this study.Cone Beam Computer Tomography（CBCT） examination was performed 1 week before and 3 months after the surgery.The nasopharynx and oropharynx for volumetric analysis was conducted by the use of 3D CBCT images built by Mimics 10.01.Results： After surgery the oropharynx volume and the pharyngeal airway（including nasopharynx and oropharynx） decreased（P0.05）.On average the oropharynx volume and pharyngeal airway decreased by 8.37% and 6.91% respectively.The cross-sectional area behind the soft palate decreased by 19.83%（P0.05）.The position of the hyoid bone and the morphology of the soft palate changed significantly（P0.05）.Pharyngeal airway space was correlated with the position of the hyoid bone（H-X,H-Y） or the morphology of the soft palate（PNS-UT,U-T,UT/ANS）.The morphology of the soft palate was correlated with the position of the hyoid bone.Conclusion： Bimaxillary surgery can not prevent pharyngeal airway space from narrowing in the correction of Class Ⅲ malocclusion.