计算机辅助测量唇腭裂继发颌骨畸形患者手术前后口腔及气道容积的变化

doi:10.13591/j.cnki.kqyx.2022.04.011

Abstract

Abstract: Objective Using computer-assisted three-dimensional reconstruction technology, to measure and compare changes of oral cavity proper and upper airway volume in patients with jaw deformity secondary to unilateral complete cleft lip and palate (UCLP) before and after bimaxillary surgery, and to evaluate the effect of digital surgery guided orthognathic surgery on airway and speech. Method 3D reconstruction of maxillofacial CBCT and oral scan data before and after bimaxillary surgery was operated for 5 patients with jaw deformity secondary to UCLP admitted from July 2015 to December 2019. Mimics 20.0 software was used to divide boundaries of the oral cavity proper and upper airway on 3D model to measure and analyze the oral cavity proper and upper airway volume and related indicators before the surgery as well as one month and three months after the surgery, and patients' ventilation and voice status was followed up before and after the surgery. Results In these 5 patients, there was no significant difference in measurement values of total oral cavity proper volume and upper airway volume before, 1 month and 3 months after bimaxillary surgery (P>0.05). The lower volume, median sagittal area, length, width and length of the mandible of oral cavity proper were significantly reduced (P<0.05), and the upper volume and height were significantly increased (P<0.05). The upper airway volume of the nasopharyngeal segment and velopharyngeal segment was significantly increased after surgery (P<0.05), and the glossopharyngeal segment and the minimum cross-sectional area were significantly reduced (P<0.05). One patient had slight snoring symptoms after operation, and the mandible moved slightly forward 3 months after operation. There was no significant change in speech of 5 patients. Conclusion There is no significant difference in the total volume of oral cavity proper and the total volume of upper airway in patients with jaw deformity secondary to UCLP before and after orthognathic surgery. This parameter can be personalized and slightly adjust the design process of digital surgery, and can effectively assist the implementation of orthognathic surgery in patients with jaw deformity secondary to cleft lip and palate.

Key words: cleft lip and palate, computer-assisted, oral volume

CLC Number:

R782.2

WU Diqing, LI Zhiping, MENG Jian, CHEN Bin. Computer-assisted measurement of changes in oral and airway volume in patients with jaw deformity secondary to cleft lip and palate before and after surgery[J]. Stomatology, 2022, 42(4): 339-344.

References

[1] 石冰, 傅豫川, 尹宁北, 等. 唇腭裂序列治疗与关键技术的应用[J]. 华西口腔医学杂志, 2017, 35(1):8-17.
[2] 何三纲. 口腔解剖生理学[M]. 8版. 北京:人民卫生出版社, 2020:167-179.
[3] 代杰文, 王璧霞, 魏弘朴, 等. 数字化正颌外科流程及临床效果回顾性分析[J]. 上海交通大学学报(医学版), 2016, 36(9):1333-1340.
[4] Moss ML. The functional matrix hypothesis revisited. 1. The role of mechanotransduction[J]. Am J Orthod Dentofacial Orthop, 1997, 112(1):8-11.
[5] Tan SK, Leung WK, Tang ATH,et al. Effects of mandibular setback with or without maxillary advancement osteotomies on pharyngeal airways:An overview of systematic reviews[J]. PLoS One, 2017, 12(10):e0185951.
[6] 夏韫晖,蔡鸣,王博,等.正颌正畸联合治疗唇腭裂继发颌骨畸形的稳定性评价[J].中华医学美学美容杂志,2019,25(4):261-265.
[7] Kloukos D,Fudalej P,Sequeira-Byron P,et al. Maxillary distraction osteogenesis versus orthognathic surgery for cleft lip and palate patients[J]. Cochrane Database Syst Rev,2018,8(8):CD010403.
[8] Pai BCJ, Hung YT, Wang RSH,et al. Outcome of patients with complete unilateral cleft lip and palate:20-year follow-up of a treatment protocol[J]. Plast Reconstr Surg, 2019, 143(2):359e-367e.
[9] Foltán R, Hoffmannová J, Donev F,et al. The impact of Le Fort Ⅰ advancement and bilateral sagittal split osteotomy setback on ventilation during sleep[J]. Int J Oral Maxillofac Surg, 2009, 38(10):1036-1040.
[10] Jiang YY. Correlation between hyoid bone position and airway dimensions in Chinese adolescents by cone beam computed tomography analysis[J]. Int J Oral Maxillofac Surg, 2016, 45(7):914-921.
[11] Fernández-Ferrer L, Montiel-Company JM, Pinho T,et al. Effects of mandibular setback surgery on upper airway dimensions and their influence on obstructive sleep apnoea-a systematic review[J]. J Craniomaxillofac Surg, 2015, 43(2):248-253.
[12] Susarla SM, Abramson ZR, Dodson TB,et al. Cephalometric measurement of upper airway length correlates with the presence and severity of obstructive sleep apnea[J]. J Oral Maxillofac Surg, 2010, 68(11):2846-2855.
[13] Ooi K, Inoue N, Matsushita K, et al. Comparison of Postoperative Stability Between BSSRO and Le Fort 1 Osteotomy with BSSRO in Skeletal Class Ⅲ Malocclusion with Severe Open Bite[J].J Maxillofac Oral Surg,2020,19(4):591-595.
[14] 苏咏宽, 韩霖霏, 李媛, 等. 非综合征唇腭裂患者与骨性Ⅰ类人群的上气道三维分析研究[J]. 口腔医学, 2019, 39(8):697-700.
[15] Souza Pinto GN, Iwaki Filho L, Previdelli ITDS,et al. Three-dimensional alterations in pharyngeal airspace, soft palate, and hyoid bone of class Ⅱ and class Ⅲ patients submitted to bimaxillary orthognathic surgery:A retrospective study[J]. J Craniomaxillofac Surg, 2019, 47(6):883-894.
[16] Yamashita AL, Iwaki Filho L, Leite PCC,et al. Three-dimensional analysis of the pharyngeal airway space and hyoid bone position after orthognathic surgery[J]. J Craniomaxillofac Surg, 2017, 45(9):1408-1414.
[17] Alaluusua S, Harjunpää R, Turunen L,et al. The effect of maxillary advancement on articulation of alveolar consonants in cleft patients[J]. J Craniomaxillofac Surg, 2020, 48(5):472-476.
[18] 邹萍萍, 胡明芳, 李幸. 腭裂术后患者舌面音异常的语音特点及康复训练[J]. 听力学及言语疾病杂志, 2021, 29(2):168-173.
[19] Rana SS, Kharbanda OP, Agarwal B. Influence of tongue volume, oral cavity volume and their ratio on upper airway:A cone beam computed tomography study[J]. J Oral Biol Craniofac Res, 2020, 10(2):110-117.

Computer-assisted measurement of changes in oral and airway volume in patients with jaw deformity secondary to cleft lip and palate before and after surgery

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