骨性Ⅰ类和Ⅲ类不同性别青少年上气道口腔锥束CT测量研究

Cone-beam computed tomography measurement of upper airway in adolescents of different genders with skeletal classⅠand classⅢ

目的应用口腔锥束CT(cone-beam computed tomography,CBCT)和Dolphin软件测量不同性别青少年上气道的三维形态,为临床了解不同性别青少年上气道的三维形态提供理论依据。方法随机选取就诊于贵阳市口腔医院正畸科的骨性Ⅲ类患者52例(男26例,女26例),骨性Ⅰ类患者52例(男26例,女26例)。均拍摄CBCT,用Dolphin软件测量正中矢状面上硬腭水平(HP),软腭下部(SP)及会厌顶点(TE)的矢状径、冠状径、横截面积,各段体积及总体积,分别比较骨性Ⅰ类男女青少年的上气道及骨性Ⅲ类男女青少年的上气道的差异。结果骨性Ⅰ类男性青少年的上气道测量指标与骨性Ⅰ类女性青少年的上气道进行比较,发现男性舌咽段的矢状径、冠状径及鼻咽段的体积大于女性,而鼻咽段的矢状径、冠状径、横截面积,腭咽段的矢状径、冠状径、横截面积及体积,舌咽段的横截面积、体积及总体积差异无统计学意义(P>0.05)。骨性Ⅲ类男性青少年的上气道测量指标与骨性Ⅲ类女性青少年的上气道进行比较,发现鼻咽段、腭咽段、舌咽段的矢状径、冠状径、横截面积、各段体积及总体积差异均无统计学意义(P>0.05)。结论骨性Ⅲ类青少年可暂不考虑男女上气道的差异,为简化正畸治疗程序提供了一定临床依据。而骨性Ⅰ类青少年则需要考虑男女性别上气道的差异,从而拟定合理治疗计划。

Objective To apply cone-beam computed tomography(CBCT)and Dolphin software for measuring the three-dimensional shape of the upper airway in adolescents of different genders,and provide a theoretical basis for clinical understanding of the three-dimensional shape of the upper airway in adolescents of different genders.Methods Fifty-two patients(26 males and 26 females)with skeletal classⅢand 52 patients(26 males and 26 females)with skeletal classⅠwere randomly selected from the Department of Orthodontics of Guiyang Hospital of Stomatology.CBCT was taken in all the patients.Dolphin software was used to measure the median sagittal plane hard palate plane(HP),the plane of the inferior margin of the soft palate(SP)and the sagittal diameter,coronal diameter and cross-sectional area of the epiglottis top plane(TE),and the volume of each section and the total volume.The differences of upper airway between male and female adolescents with skeletal classⅠand those between male and female adolescents with skeletal classⅢwere compared.Results A comparison of the upper airway measurement indexes was conducted between the male adolescents with skeletal classⅠand the female adolescents with skeletal classⅠ,and the results showed that the sagittal diameter and coronal diameter of the glossopharyngeal segment and the volume of nasopharynx in the males were larger than those in the females,but there were no significant differences in the sagittal diameter,coronal diameter and cross-sectional area of the nasopharyngeal segment,and in the sagittal diameter,coronal diameter,cross-sectional area and volume of the palatine pharynx,and in the cross-sectional area,volume and total volume of the glossopharyngeal segment(P>0.05).There were no significant differences in the sagittal diameter,coronary diameter,cross-sectional area,volume of each segment and total volume of nasopharynx,palatopharyngeal and glossopharyngeal segments between the upper airway measurement indexes of the male adolescents with skeletal classⅢand the female adolescents with skeletal classⅢ(P>0.05).Conclusion The difference of upper airway between male adolescents with skeletal classⅢand female adolescents with skeletal classⅢshould not be considered for the time being,which provides a certain clinical basis for simplifying the orthodontic treatment procedure.However,the difference of upper airway between male adolescents with skeletal classⅠand female adolescents with skeletal classⅠshould be considered to make a reasonable treatment plan.