骨性Ⅲ类患者手术先行治疗后上气道及其周围组织变化的三维评价

Three-dimensional evaluation of pharyngeal airway volume and surrounding tissues after bimaxillary surgery in skeletal class Ⅲ patients using surgery-first orthognathic approach

目的评价骨性Ⅲ类患者手术先行治疗后上气道及其周围组织的形态学变化.方法研究对象为接受手术先行治疗的骨性Ⅲ类患者16例(男性7例,女性9例),年龄(27.3±9.1)岁.将患者术前(T0)和术后1年(T1)拍摄的CBCT数据导入Mimics软件测量,使用SPSS软件进行统计学分析,手术前后测量数据采用配对样本t检验,P<0.05表示差异具有显著性.结果骨性Ⅲ类患者手术先行治疗1年后,舌咽气道容积减小(1726.62±1609.78)mm^3(P=0.007).软腭尖处横截面积减小(77.47±115.23)mm(P=0.017),矢状径减小(2.73±3.97)mm(P=0.015).会厌顶处横截面积减小(95.73±100.64)mm^2(P=0.002),横径,矢状径分别减小(1.63±2.22)mm(P=0.010),(3.13±3.33)rmm(P=0.002).术后软腭长度增加(3.23±2.45)mm(P=0.000),厚度减小(0.76±0.98)mm(P=0.007).结论骨性Ⅲ类患者手术先行治疗1年后,患者腭咽,舌咽气道有一定的缩窄,而鼻咽气道形态未发现显著的改变.

Objective To evaluate postoperative airway volumes and surrounding tissues change in patients with classⅡdentofacial deformities using surgery-first orthognathic approach,Methods Sixteen skeletal classⅡsubjects(7 males,9 females,27.3±9.1 years old)underwent bimaxillary surgery using surgery first orthognathic approach were consisted.Cone beam computed tomography scans before and at an average of 1 year after surgery were collected.All measurements were performed with Mimics software and the results were statistically analyzed with SPSS.Paired-t tests were used to compare the pre-and post-surgery data,and P<0.05 was set as statistical significance.Results One year after the surgery,the volume of retroglossal oropharynx decreased by(1726.62±1609.78)mm^3(P=0.007).The cross-sectional area at the soft palate tip decreased by(77.47±115.23)mm^2(P=0.017),and the sagittal diameter decreased by(2.73±3.97)mm(P=0.015).The cross-sectional area at the top of the epiglottis decreased by(95.73±100.64)mm^2(P=0.002),and the transverse and sagittal diameters decreased by(1.63±2.22)mm(P=0.010)and(3.13±3.33)mm(P=0.002),respectively.The soft palate length increased by(3.23±2.45)mm(P=0.000),and the thickness decreased by(0.76±0.98)mm(P=0.007).Conclusions One year after surgery-first orthognathic approach in skeletal classⅡpatients,morphological narrowing were found in retropalatal oropharynx and retroglossal oropharynx structures.While there was no significant morphological effect on nasopharynx.