锥形束CT扫描研究不同矢状骨面型成人上气道形态及舌骨的差异

Difference of the Upper Airway Morphology and Hyoid Position among Adults with Sagittal Skeletal Malocclusions by CBCT Analysis

目的研究不同矢状骨面型成人上气道形态及舌骨位置的差异,探讨三类骨面型的气道形态特征及具体的量化值,用以指导错颌畸形及气道疾病的治疗。方法选取Ⅰ、Ⅱ、Ⅲ类骨面型患者各30例进行CBCT(Cone beam computed tomography,锥形束CT)扫描,借助Invivo Dental 5图像分析软件进行三维重建,分别测量硬腭平面至会厌谷底段上气道横径、矢状径、横截面积、气道长度、高度、容积等,及测量与舌骨位置相关的项目,并对结果进行统计分析。结果Ⅱ类骨面型的气道总高度、长度分别为(65.83±7.24)mm、(69.19±7.57)mm,明显大于Ⅰ类﹝(61.91±7.40)mm、(65.15±6.90)mm,P均<0.05﹞及Ⅲ类﹝(57.75±6.85)mm、(60.14±5.88)mm,P均<0.01﹞;Ⅱ类骨面型的气道总容积、最小截面面积分别为(15.07±2.29)ml、(171.33±42.67)mm2,明显小于Ⅰ类﹝(16.53±1.78)ml、(223.83±61.73)mm2,P均<0.05﹞及Ⅲ类﹝(25.55±2.89)ml、(300.45±64.99)mm2,P均<0.01﹞;三种骨面型之间的舌骨位置评价参数Hy-C3Me、HyMP均存在显著性差异(P<0.01)。结论不同矢状骨面型成人上气道形态及舌骨位置之间存在显著性差异,舌骨位置随着下颌骨远中向的移动而向后下移动,气道形态随之改变。

Objective To investigate the difference of the upper airway morphology and hyoid position among different sagittal skeletal patterns,so as to guide the treatment of micromaxillary deformity and airway disease.Methods ClassⅠ,Ⅱ,Ⅲ patients with sagittal skeletal malocclusions（ 30 cases in each） were selected,scaned by CBCT,and Invivo Dental 5 software was used for three dimensional reconstruction. The anteroposterior and lateral dimensions,the cross- sectional areas,length,volume,height of airway and the position of hyoid were measured. Results The total height and length of airway ﹝（ 65. 83 ± 7. 24） mm,（ 69. 19 ± 7. 57） mm respectively ﹞ in class Ⅱwere greater than those ﹝（ 61. 91 ± 7. 40） mm,（ 65. 15 ± 6. 90） mm respectively ﹞ in classⅠ（ P〈0. 05） and those ﹝（ 57.75 ± 6. 85） mm,（ 60. 14 ± 5. 88） mm respectively ﹞ in class Ⅲ（ P〈0. 01）. The total volume and minimum sectional area of airway were（ 15. 07 ± 2. 29） ml,and（ 171. 33 ± 42. 67） mm2 respectively ﹞ in class Ⅱ,and significantly smaller than than those in classⅠ﹝（ 16. 53 ± 1. 78） ml,（ 223. 83 ± 61. 73） mm2 respectively ﹞（ P〈0. 05） and Ⅲ﹝（ 25. 55 ± 2. 89） ml,（ 300. 45 ± 64. 99） mm2 respectively ﹞（ P〈0. 01）. At the same time the Hy- C3 Me and Hy- MP had significant differences among class Ⅰ,Ⅱ and Ⅲ groups（ P〈0. 01）. Conclusion Differences of upper airway morphology and hyoid position are statistically significant among adults with different sagittal bones types. Hyoid position moves backward with the movement of mandibular far to next,then airway morphology changes.