成人骨性Ⅱ类不同垂直骨面型上气道及舌骨形态位置的三维研究

A Three-dimensional Study on Upper Airway and Hyoid Bone in Adult Skeletal Class Ⅱ Patients with Different Vertical Patterns

目的:研究成人骨性II类不同垂直骨面型上气道与舌骨形态及位置的差异。方法:随机选择60名成人骨性II类患者,男女比例1:1,依据GoGn-SN角分为三组(高角组、均角组及低角组),在自然头位下拍摄CBCT,运用MIMICS软件对上呼吸道及舌骨进行三维建模并测量21项相关指标,分析不同垂直骨面型之间上气道各段之间及舌骨形态、位置的差异。结果:不同垂直骨面型之间鄂咽上界平面矢状径长度(PNSL)存在显著性差异(P<0.05),上气道各段高度(UTH、ETH)及宽度(PNSW、UTW、ETW)之间比较无统计学差异(P>0.05)。高角组上气道鄂咽下界及舌咽下界矢状径长度(UTL、ETL)与均角和低角组均存在显著差异(P<0.01),随着垂直骨面型增大,呈现高角<均角<低角的趋势。高角组上气道鄂咽及舌咽体积明显小于均角和低角,差异有统计学意义(P<0.05)。舌骨形态及位置在不同垂直骨面型之间无差异(P>0.05)。结论:不同垂直向生长方式对上气道产生影响较大,而对舌骨的生长发育无影响。

Objective： To study the differences between different the patterns ofhyoid bones and the upper airway form in skeletal Class Ⅱ patients. Methods： The sample （30 males and 30 females）of skeletal Class Ⅱ patients were randomly selected. According to the GoGn-SN angle, the patients were divided into three groups （high angle group, normal angle, or low angle）. Cone-Beam computed to- mography （CBCT） were carried out under natural head postures. The 3D modeling of upper airway form and hyoid bone were generated by using MIMICS software, and 21 indices were measured. The lengths of airway, dimentions and locations of hyoid bones were com- pared among the three groups. Results： The length of the sagittal in the palatopharynx of the high angle group was statistically different from that of the low and the normal angle group（P〈0.05）. No difference was found for palatopharynx and glossopharyn heights（UTH and ETH） between the low angle group and that of normal angle group. Also, no significant difference was observed for the width of upper airway among different vertical skeletal facial（P〉0.05）. In the cross-length of upper airway, a significant tendency for reduced upper air- way dimension in the glossopharynx was found in the low angle, normal angle, and high angle subgroups, in that order, with statistically significant differences （P〈0.01）. There were different in palatopharynx and glossopharynx volumes among different vertical skeletal pat- terns （P〈0.05）. But no differece was found between the shape and position of hyoids among different vertical skeletal facial （P 〉0.05）. Conclusion： Different vertical patterns of skeletal ClassⅡ were related to the shape of upper airway, but this effect was not observed for the hyoid bone.