成年人翼钩及其周围组织的CBCT影像学研究

doi:10.13591/j.cnki.kqyx.2024.10.002

摘要/Abstract

摘要：

目的分析CBCT影像下成年人翼钩结构形态及其与附近组织位置关系,建立成年人群翼钩解剖结构的参考数据,为临床辅助诊治翼钩综合征及阻塞性睡眠呼吸暂停低通气综合征提供依据。方法收集江苏省第二中医医院口腔科2020年8月—2023年12月患者符合纳入标准的151人CBCT图像,其中男73人,女78人,通过CBCT的MIP和VR模式重建,观察统计151人302侧翼钩冠状面形态、长度、宽度、垂直高度、外展角度、翼钩表面黏膜厚度、翼钩到腭中缝的距离及翼钩到腭大孔的距离,分析翼钩及其附近组织在不同位置、不同性别、不同年龄人群中的差异。结果翼钩末端朝向内侧6侧,朝向外侧296侧;翼钩末端尖锐突出46侧,圆钝256侧。左右翼钩除宽度外,各项指标无统计学差异。男性翼钩长度、宽度、高度、翼钩到腭中缝的距离、翼钩表面黏膜厚度均大于女性,差异具有统计学意义。女性翼钩外展角度大于男性,差异具有统计学意义。随着年龄增长,翼钩长度、高度先变长后变短,差异有统计学意义。结论口腔CBCT在检查翼钩相关疾病方面具有辐射量剂小、操作方便、图像清晰的优势,为临床翼钩相关疾病诊断治疗提供帮助。

关键词: 翼钩, 阻塞性睡眠呼吸暂停低通气综合征, CBCT

Abstract:

Objective To analyze the morphology of the pterygoid hamulus and its relationship with adjacent tissues on CBCT images, establish reference data of the anatomical structure of the pterygoid hamulus in the adult population, in order to provide a basis for clinical assisted diagnosis and treatment of pterygoid hamulus syndrome and obstructive sleep apnea hypopnea syndrome. Methods A total of 151 patients with CBCT images who met the inclusion criteria were collected from August 2020 to December 2023 in the Department of Stomatology at the Second Traditional Chinese Medicine Hospital of Jiangsu Province. The CBCT images were reconstructed using the maximum intensity projection(MIP) and volume rendering(VR) modes of cone-beam CT. The morphology, length, width, vertical height, abduction angle, mucosal thickness, distance from the pterygoid hamulus to the midline of the palate, and distance from the pterygoid hamulus to the greater palatine foramen were observed and statistically analyzed in 302 bilateral cases. The differences in the morphology of the pterygoid hamulus and its adjacent tissues were analyzed in different places, genders and age groups. Results The apex of the pterygoid hamulus faced inward on 6 sides and outward on 296 sides. The apex of the pterygoid hamulus was sharp on 46 sides and blunt on 256 sides. The pterygoid hamulus showed no statistically significant differences in various parameters between the left and right sides, except for the width. In males, the length, width, height, distance from the pterygoid hamulus to the mid-palatal suture, and mucosal thickness on the surface of the hamulus were all greater than those in females, demonstrating statistically significant differences. Females also exhibited a larger outward angle of the pterygoid hamulus than males, which was statistically significant. Moreover, with the increase of age, the length and height of the pterygoid hamulus initially increased and then decreased, exhibiting statistically significant differences. Conclusion CBCT has the advantages of low radiation dosage, convenient operation, clear imaging, stable measurement data, and clear images in the examination of pterygoid hamulus. It helps in the diagnosis and treatment of pterygoid hamulus-related diseases in a clinical setting.

Key words: pterygoid hamulus, obstructive sleep apnea hypopnea syndrome, CBCT

中图分类号:

R323.1

王振婷, 李北, 季意, 张娟, 杨晨, 单华, 刘锐. 成年人翼钩及其周围组织的CBCT影像学研究[J]. 口腔医学, 2024, 44(10): 728-733.

WANG Zhenting, LI Bei, JI Yi, ZHANG Juan, YANG Chen, SHAN Hua, LIU Rui. CBCT imaging study on adult pterygoid hamulus and their adjacent tissues[J]. Stomatology, 2024, 44(10): 728-733.

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位置	样本量	L/mm	W/mm	H/mm	D/mm	A/(°)	M/mm	N/mm	T/mm
右	151	6.76±0.10	5.56±0.07	5.96±0.11	2.03±0.18	122.89±0.59	20.61±0.03	13.67±0.16	4.93±0.12
左	151	6.90±0.11	5.87±0.07	6.06±0.10	2.07±0.17	123.35±0.57	20.43±0.05	14.04±0.19	5.06±0.12
t		0.914	3.011	0.657	0.631	0.566	-0.746	1.522	0.767
P		0.361	0.003	0.512	0.529	0.572	0.456	0.129	0.443

性别	样本量	L/mm	W/mm	H/mm	D/mm	A/(°)	M/mm	N/mm	T/mm
男	146	7.56±0.10	5.98±0.08	6.77±0.10	2.05±0.03	120.74±0.51	21.20±0.14	13.77±0.14	5.42±0.11
女	156	6.15±0.09	5.47±0.06	5.30±0.08	2.05±0.05	125.35±0.58	19.89±0.18	13.94±0.20	4.59±0.12
t		10.815	5.197	11.851	-0.067	-5.982	5.629	-0.692	5.103
P		<0.001	<0.001	<0.001	0.947	<0.001	<0.001	0.490	<0.001

年龄/岁	样本量	L/mm	W/mm	H/mm	D/mm	A/(°)	M/mm	N/mm	T/mm
18~39	98	6.61±0.14	5.67±0.08	5.82±0.13	2.04±0.04	123.41±0.76	20.51±0.29	13.81±0.23	4.91±0.18
40~59	132	7.07±0.12	5.84±0.09	6.23±0.12	1.98±0.03	123.02±0.67	20.74±0.17	13.69±0.17	5.11±0.12
≥60	72	6.85±0.17	5.59±0.11	6.04±0.17	2.12±0.06	121.98±0.78	20.23±0.21	14.35±0.30	5.21±0.17
F		4.464	2.162	3.800	2.702	1.014	1.119	2.180	1.264
P		0.012	0.117	0.023	0.068	0.364	0.328	0.115	0.284