骨性Ⅱ类错[牙合]畸形患者双颌外科手术后上气道三维结构变化的研究

The research of the three-dimensional structure changes of the upper airway space following two-jaw orthognathic surgery for skeletal classⅡ patients

目的研究双颌外科手术对骨性Ⅱ类错[牙合]畸形患者上气道三维结构的影响。方法本研究选取35例成人骨性Ⅱ类错[牙合]畸形患者,行双颌外科手术矫治牙颌面畸形。分别获取术前1周(T1)和术后至少半年(T2)的锥形束CT(cone beam computed tomography,CBCT)数据,进行上气道相关三维指标的测量、分析。应用SPSS20.0软件,采用一致性检验、配对t检验和非参数Wilcoxon秩和检验的统计学方法对所得数据进行统计分析。结果通过双颌外科手术,患者上气道总容积、鼻咽容积、腭咽容积、舌咽容积、喉咽容积,最小横截面积、最小横截面最大前后径均显著增加,增加百分比分别为24.78%(P=0.000)、9.66%(P=0.007).11.19%(P=0.023).55.92%(P=0.000).31.19%(P=0.000).17.84%(P=0.001)和14.30%(P=0.008),差异均具有统计学意义(P<0.05)。上气道长度、最小横截面的位置和最小横截面最大横径在治疗前后均未见明显变化(P>0.05)。结论骨性Ⅱ类错[牙合]畸形患者在行双颌外科手术后,上气道总容积及各部分容积均增加,其中以舌咽容积增加最为显著。上气道的矢状向宽度增加显著,而其长度未发生明显改变。

Objective To study the influence on the three-dimensional structure changes of the upper airway space following 2-jaw orthognathic surgery for skeletal class Ⅱ patients. Methods 35 skeletal class Ⅱ patients were assembled. All the patients were treated by maxilla-mandibular surgery. Cone-beam computed tomograms obtained before surgery (T1) and at least 6 months after surgery (T2) were analyzed and measured for upper airway space,The three-dimensional morphological parameters of the upper airway before and after treatment were analyzed by Consistency test , Paired t-test or rank sum test,by SPSS 20. 0 software. Results There was a statistically significant increase in the total upper airway volume and nasopharyngeal, palatopharyngeal, glossopharyngeal, hypopharyngeal airway volume, minimum cross sectional area, anteroposterior length following 2-jaw orthognathic surgery(P<0.05), changes for them were 24. 78%(P=0. 000), 9. 66%(P=0.007), 11.19%(P=0.023), 55. 92%(P=0.000), 31..19%(P=0. 000), 17. 84%(P=0. 001) and 14.30%(P=0. 008). The difference of the upper airway length, level of most constricted area and width of the most constricted area after the treatment were not found(P>0. 05). Conclusions Patients with skeletal class Ⅱ will have a wide upper airway volume and four wide parts volume,especially the glossopharyngeal volume. There was a significant increase in anteroposterior length, but no significant difference in the upper airway length.