伴扁桃体肥大Ⅲ类错[牙合]畸形儿童早期矫治的临床诊疗策略

Clinical diagnosis and strategies for early orthodontic treatment of ClassⅢmalocclusion with tonsillar hypertrophy in children

腺样体/扁桃体肥大是儿童上气道阻塞相关牙颌面畸形的常见病因,由此引起的睡眠打鼾、张口呼吸、睡眠不宁等临床症状已日益为患儿家长所重视。由于腺样体/扁桃体肥大不仅可能导致患儿出现突面或凹面畸形,还可能造成儿童阻塞性睡眠呼吸暂停,因此临床诊疗往往需要多学科协作。目前,国内外研究对儿童腺样体肥大相关的Ⅱ类错[牙合]畸形关注度较高,而对扁桃体肥大相关的Ⅲ类错[牙合]畸形缺乏足够认识。本文结合文献回顾和笔者的临床体会,对以扁桃体肥大为主要特征的儿童Ⅲ类错[牙合]畸形临床诊疗策略进行探讨,以期为正畸临床治疗提供参考。

Adenotonsillar hypertrophy is the most frequent cause of upper airway obstruction and related dentofacial abnormalities in children.Its clinical symptoms,including sleep snoring,mouth breathing,and restless sleep,have been increasingly noticed by the children’s parents.Adenotonsillar hypertrophy does not only cause prognathism or retrognathism malocclusion in children but also pediatric obstructive sleep apnea(OSA),the clinical diagnosis and treatment of which often requires multidisciplinary collaboration.To our knowledge,most of the existing studies have paid more attention to ClassⅡmalocclusion caused by adenoid hypertrophy in children,and only a few have investigated ClassⅢmalocclusion associated with tonsillar hypertrophy.With the aim of providing reference for orthodontic treatment,this paper examines the clinical diagnosis and treatment strategies of ClassⅢmalocclusion with tonsillar hypertrophy in children based on a literature review and actual clinical experience.