骨性Ⅲ类错采用正畸联合双颌手术治疗前后上气道变化的Meta分析

Volumetric changes in the upper airway after orthodontic-orthoganthic surgery for the treatment of skeletal Class Ⅲ malocclusion: A meta-analysis

目的:用Meta分析系统性地评价骨性Ⅲ类错采用正畸联合双颌手术治疗前后上气道体积的改变情况。方法:电子检索中英文数据库:Cochrane library、Embase、Pub Med、Web of Science、Wan Fang、VIP、CBM、CNKI,收集有关研究骨性Ⅲ类错采用正畸联合双颌手术治疗前后上气道体积改变情况的文献。参照Cochrane协作网提供的NOS量表对纳入文献进行质量评价,用统计学软件Rev Man 5.3对纳入文献进行统计分析。结果:共纳入9篇文献,204例研究对象。鼻咽体积、总体积变化没有统计学意义(P>0.05),口咽体积变化有统计学意义(P<0.05)。结论:对于具有阻塞性睡眠呼吸暂停低通气综合征相关危险因素的骨性Ⅲ类错患者可优先选择双颌手术,但采用正畸联合双颌手术的方式仍有发生气道狭窄的风险。

Objective： To evaluate volumetric changes in the upper airway after orthodontic-bimaxiUary surgery for the treatment of skeletal class Ⅲ malocclusion. Methods： Literatures about volumetric changes in the upper airway after orthodontic-bimaxillary surgery for the treatment of skeletal class Ⅲ malocclusion were searched from the database. Cochrane library, Embase, PubMed, Web of Science, Wangfang, China Science and Technology Journal Database （VIP）, Chinese Biomedical Medicine Database （CBM） and China National Knowledge Infrastructure（CNKI）. All the literatures were evaluated by Newcastle-Ottawa Scale（NOS） and analyzed by RevMan 5.3. Results： 9 studies with 204 cases about volumetric changes in the upper airway after orthodontic- bimaxillary surgery for the treatment of skeletal Ⅲ malocclusion were included. Meta-analysis showed that after treatment there was no statistical difference about the nasopharyngeal volume change and the total volume change（P 〉 0. 05 ） ; there was statistically significant difference about oropharyngeal volume change（P 〈 0. 05）. Conclusion： It might be better to consider orthodontic-bimaxillary surgery for skeletal class Ⅲ malocclusion with certain risk factors about OSAHS, but there was still a risk of airway narrow after orthodontic-bimaxillary surgery for skeletal class Ⅲ malocclusion.