下颌升支截骨术对骨性Ⅲ类错[牙合]伴下颌偏斜患者咽腔容积的影响

Effect of Mandibular Ramus Osteotomy on Pharyngeal Volume in Patients with Skeletal Class Ⅲ Malocclusion and Mandibular Deviation

目的评价下颌升支截骨术对骨性Ⅲ类错[牙合]伴下颌偏斜患者咽腔容积的影响,指导临床检查及手术方案设计。方法以2017年9月至2018年9月就诊于郑州大学第一附属医院口腔颌面外科的20例骨性Ⅲ类错牙合伴下颌偏斜患者为研究对象,利用锥形束CT和Mimics 17.0医用图像处理软件分析患者术后咽腔容积是否改变,以及这种改变是否存在恢复趋势。结果术前、术后6个月及术后1 a,口咽部容积分别为(20194.15±8530.85)、(17443.70±7093.89)、(17721.35±7126.81)mm 3,下咽部容积分别为(16566.45±8196.10)、(14020.55±6862.12)、(14482.20±7005.60)mm 3。术后6个月和1 a,口咽部、下咽部容积均小于术前(P<0.017),术后1 a口咽部、下咽部容积均大于术后6个月(P<0.017)。结论采用下颌升支截骨术纠正骨性Ⅲ类错[牙合]伴下颌偏斜的同时会造成咽腔容积减小,这种影响存在逐渐恢复的趋势。

Objective To evaluate the effect of mandibular ramus osteotomy on the volume of pharyngeal cavity in patients with skeletal class Ⅲ malocclusion and mandibular deviation,and to guide clinical examination and surgical plan design.Methods Twenty patients with skeletal class Ⅲ malocclusion and mandibular deviation who were admitted to the Department of Oral and Maxillofacial Surgery of the First Affiliated Hospital of Zhengzhou University from September 2017 to September 2018 were the research objects.Cone-beam CT and Mimics 17.0 medical image processing software were used to analyze whether the volume of the pharyngeal cavity changed after the operation,and whether there was a tendency to recover from this change.Results Before operation,6 months after operation and 1 year after the operation,oropharyngeal volume was(20194.15±8530.85),(17443.70±7093.89),and(17721.35±7126.81)mm 3,and hypopharyngeal volume was(16566.45±8196.10),(14020.55±6862.12),and(14482.20±7005.60)mm 3.Six months and 1 year after operation,volumes of oropharynx and hypopharynx were smaller than those before operation(P<0.017).The volumes of oropharynx and hypopharynx 1 year after operation were greater than those 6 months after operation(P<0.017).Conclusion The use of mandibular ramus osteotomy for the treatment of skeletal class Ⅲ malocclusion with mandibular deflection would meanwhile reduce the volume of pharyngeal cavity,and this effect has a tendency to gradually recover.