上海口腔医学

上海口腔医学 ›› 2023, Vol. 32 ›› Issue (5): 485-490.doi: 10.19439/j.sjos.2023.05.007

• 论著 • 上一篇    下一篇

骨性Ⅲ类错𬌗畸形患者双颌手术后上气道形态变化及相关性分析

鄢洁雅1, 林怡君1, 李雅欣1, 劳安2, 廖盛轩1, 刘加强1   

  1. 1.上海交通大学医学院附属第九人民医院 口腔颅颌面科,上海交通大学口腔医学院,国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海市口腔医学研究所,上海 200011;
    2.上海交通大学医学院附属新华医院 口腔科,上海 200092
  • 收稿日期:2022-07-22 修回日期:2022-10-12 出版日期:2023-10-25 发布日期:2023-11-03
  • 通讯作者: 刘加强,E-mail: liujqmj@163.com
  • 作者简介:鄢洁雅（1997-）,女,在读硕士研究生,E-mail: yayayan97@163.com
  • 基金资助:
    国家自然科学基金（82071081）; 上海市卫生健康委员会卫生行业临床研究专项（卓越项目）（20224Z0010）

Morphological changes of upper airway in patients with skeletal Class Ⅲ malocclusion after bimaxillary surgery and correlation analysis

YAN Jie-ya1, LIN Yi-jun1, LI Ya-xin1, LAO An2, LIAO Sheng-hsuan1, LIU Jia-qiang1   

  1. 1. Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology. Shanghai 200011;
    2. Department of Stomatology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200092, China
  • Received:2022-07-22 Revised:2022-10-12 Online:2023-10-25 Published:2023-11-03

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摘要： 目的：分析骨性Ⅲ类错𬌗畸形患者双颌手术后上气道的形态变化及相关影响因素。方法：选择20例接受Le Fort I型截骨术前移,双侧下颌支矢状劈开术（BSSRO）后退的骨性Ⅲ类患者,于术前（T0）和术后3~6个月（T1）进行CT扫描,结合Dolphin Imaging 11.9软件对图像进行三维重建。测量气道各部分体积、横截面积及各软硬组织标记点的变化。采用SPSS 25.0软件包对数据进行统计学分析。结果：术后鼻咽气道容积增加（P<0.05）,口咽气道容积显著减小（P<0.01）。第二颈椎平面气道横截面积显著减小（P<0.01）,冠状径、矢状径均减小（P<0.05）。鼻咽气道容积的变化量与后鼻棘点的矢状向变化量呈中度正相关（r=0.460,P<0.05）,口咽、喉咽气道容积变化量与软腭中点垂直向变化量呈正相关（r=0.496、0.696,P<0.05）。第二、第三颈椎平面气道横截面积、第三颈椎平面气道矢状径的变化量与软腭中点垂直向变化量呈正相关（r=0.474、0.629、0.547,P<0.05）。第三颈椎平面气道横截面积的变化量与下颌平面角的变化量为中度负相关（r=-0.536,P<0.05）。结论：双颌手术后骨性Ⅲ类患者口咽气道容积及横截面积减小,但上气道总容积无显著变化,上气道的变化与部分软硬组织标记点的变化存在相关性。

关键词: 骨性Ⅲ类错𬌗, 上气道, 正颌手术, 三维重建, 相关性

Abstract: PURPOSE: To analyze the morphological changes of the upper airway and related influencing factors in patients with skeletal Class Ⅲ malocclusion after bimaxillary surgery. METHODS: Twenty skeletal Class Ⅲ patients who underwent Le Fort I osteotomy and bilateral sagittal split ramus osteotomy(BSSRO) for maxillary advancement and mandibular setback were selected. The patients received CT scans before(T0) and 3-6 months after surgery, and the images were reconstructed three-dimensionally with Dolphin Imaging 11.9 software. Changes in the volume, cross-sectional area, and landmarks of each soft and hard tissue of the airway were measured. Statistical analysis of the data was performed using SPSS 25.0 software package. RESULTS: The volume of nasopharyngeal airway increased after operation (P<0.05), and the volume of oropharyngeal airway decreased significantly(P<0.01). The cross-sectional area of the airway at the plane of the second cervical vertebra was significantly decreased (P<0.01), and the coronal and sagittal diameters were decreased(P<0.05). The change of nasopharyngeal airway volume was moderately positively correlated with the sagittal change of the posterior nasal spine (r=0.460, P<0.05), and the change of oropharynx and laryngopharyngeal airway volume was positively correlated with the vertical change of the midpoint of the soft palate(r=0.496, 0.696, P<0.05). The airway cross-sectional area in the second and third cervical vertebra planes and the sagittal diameter of the airway in the third cervical vertebra plane were positively correlated with the vertical changes of the midpoint of the soft palate(r=0.474, 0.629, 0.547, P<0.05). The change of airway cross-sectional area at the third cervical vertebra plane was moderately negatively correlated with the change of mandibular plane angle(r=-0.536, P<0.05). CONCLUSIONS: The volume and cross-sectional area of oropharyngeal airway in skeletal Class Ⅲ patients after bimaxillary surgery will decrease. However, the total upper airway volume doesn't change significantly. The changes in the upper airway are correlated with the changes in some soft and hard tissue landmarks.

Key words: Skeletal Cass Ⅲ malocclusion, Upper airway, Orthognathic surgery, Three-dimensional reconstruction, Correlation

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