骨性Ⅲ类高角伴偏颌对上气道形态及舌骨位置的影响

doi:10.13591/j.cnki.kqyx.2024.09.004

摘要/Abstract

摘要：

目的应用锥形束CT(CBCT)测量分析骨性Ⅲ类高角伴偏颌对上气道形态及舌骨位置的影响。方法选取120例2019年9月—2022年12月于我院就诊的骨性Ⅲ类高角错牙合患者,所有受试者均拍摄CBCT,根据颏下点偏离正中矢状面的程度(mandibular deviation, MD),将120例患者分为3组:非偏颌组、轻度偏颌组、重度偏颌组。分别测量以上3组上气道体积以及舌骨位置并进行分析比较。结果 3组之间鼻咽段,腭咽段体积和最小横截面积以及喉咽段最小横截面积,舌骨(hyoid bone,HB)在Y轴上的位置(Y-HB)和Z轴上位置(Z-HB)差异无统计学意义(P>0.05),偏颌重度组与其余两组相比,舌咽段、喉咽段体积、总体积和舌咽段最小横截面积显著减小(P<0.05),舌骨(hyoid bone,HB)在X轴的位置(X-HB)显著增大(P<0.05)。结论骨性Ⅲ类高角伴重度偏颌患者,舌咽段、喉咽段和上气道总体积以及舌咽段最小横截面积比其余两组小,X-HB比非偏颌组大,表明偏颌主要对上气道舌咽段以及喉咽段形态产生影响;偏颌对于舌骨的影响体现在X-HB,表明偏颌可导致舌骨偏离正中矢状面。

关键词: 骨性Ⅲ类, 高角, 偏颌, 上气道, 舌骨

Abstract:

Objective To apply cone beam CT measurements(CBCT)to analyze the effect of skeletal Class Ⅲ high angle with deviation on upper airway morphology and hyoid position. Methods A total of 120 patients with skeletal Class Ⅲ high angle malocclusion who visited our hospital from September 2019 to December 2022 were selected. CBCT was taken in all subjects. According to the degree of mandibular deviation (MD) of the point under the chin from the median sagittal plane, the 120 patients were divided into three groups: non-migratory, mildly migratory, and severely migratory groups, and the volume of the upper airway as well as the position of the hyoid bone of three groups were measured and analyzed respectively. Results There was no significant difference in the volume and minimum cross-sectional area of the nasopharyngeal segment, palatopharyngeal segment, and minimum cross-sectional area of the laryngopharyngeal segment. No siginificant difference was found between the position of the hyoid bone(HB) on the Y-axis (Y-HB) and the position of the hyoid bone on the Z-axis(Z-HB) among the three groups(P>0.05). Compared with the other two groups, the volume and total volume of the nasopharyngeal segment, the laryngopharyngeal segment, and minimum cross-sectional area of the laryngopharyngeal segment in the group of severe deviation were significantly reduced(P<0.05) and X-HB was significantly larger(P<0.05). Conclusion In patients with skeletal Class Ⅲ hyperkeratosis with severe deviation, the total volume of the glossopharyngeal segment, laryngopharyngeal segment, and upper airway, as well as the minimum cross-sectional area of the glossopharyngeal segment were smaller than those of the othertwo groups. In patients with severe deviation, the position of the hyoid bone(HB) in the X-axis(X-HB) was larger than that of the non-migratory group, indicating that migratory jaws mainly affect the morphology of the lingual-pharyngeal segment as well as the laryngopharyngeal segment of the upper airway;the effect of migratory jaws on the hyoid bone is reflected in the X-HB, indicating that migratory jaws can lead to the deviation of the hyoid bone from the median sagittal plane.

Key words: skeletal Class Ⅲ, high angle, deviated jaw, upper airway, hyoid bone

中图分类号:

R783.5

王港, 唐金侨, 冯瑜, 李孟如, 王小琴. 骨性Ⅲ类高角伴偏颌对上气道形态及舌骨位置的影响[J]. 口腔医学, 2024, 44(9): 658-662.

WANG Gang, TANG Jinqiao, FENG Yu, LI Mengru, WANG Xiaoqin. The effect ofskeletal Class Ⅲ high angle with deviation on upper airway morphology and hyoid position[J]. Stomatology, 2024, 44(9): 658-662.

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组别	例数	鼻咽段	腭咽段	舌咽段	喉咽段	总体积
非偏颌组	40	5 984.82±1 628.83	9 874.53±3 056.34	6 048.72±1 338.62	2 989.25±668.20	24 897.33±3 220.92
轻度偏颌组	40	6 045.21±1 583.37	9 657.63±2 878.59	5 894.40±1 384.36	2 755.56±583.63	24 352.80±3 689.41
重度偏颌组	40	6 036.74±1 468.49	9 735.58±2 755.43	5 018.34±1 405.86	2 587.59±616.13	22 378.25±3 235.59
F		0.018	0.057	6.519	4.018	5.071
P		0.985	0.944	0.002	0.021	0.011

组别	例数	X-HB	Y-HB	Z-HB
非偏颌组	40	1.48±1.03	51.66±5.04	101.63±7.46
轻度偏颌组	40	1.62±0.94	53.67±4.99	100.11±8.24
重度偏颌组	40	2.81±1.12	52.49±5.37	99.68±9.21
F		20.225	1.536	0.603
P		<0.001	0.220	0.549

组别	例数	鼻咽	腭咽	舌咽	喉咽
非偏颌组	40	258.37±76.49	304.71±59.62	228.51±52.12	174.29±48.95
中度偏颌组	40	245.92±68.18	311.52±64.25	219.45±57.62	189.68±58.25
重度偏颌组	40	265.62±61.35	298.84±68.59	181.32±50.29	168.35±47.15
F		0.400	0.532	3.960	0.144
P		0.675	0.594	0.028	0.866