Zucconi M, Caprioglio A, Calori G, Ferini-Strambi L, Oldani A, Castronovo C, Smirne S
Sleep Disorders Center, Dept of Neurology, State University and IRCCS H San Raffaele, Milan, Italy.
Eur Respir J. 1999 Feb;13(2):411-7. doi: 10.1183/09031936.99.13241199.
Habitual snoring and obstructive sleep apnoea in children, which are frequently associated with adenotonsillar hypertrophy, may begin early in life and in relation with orocraniofacial features. The aim of this study was to detect the presence of early bone craniofacial modifications in young children with a long history of habitual snoring. Twenty-six habitually snoring children (mean age 4.6 yrs) were studied by nocturnal portable recording or diurnal polysomnography, cephalometry and orthodontic evaluation. A comparison of cephalometric findings was made between the studied group and 26 age-matched children (mean age 5.1 yrs) with no history of snoring or respiratory problems during sleep. The cephalometric analyses showed a significant increase in craniomandibular intermaxillar, lower and upper goniac angles with a retroposition and posterior rotation of the mandible (high angle face) and a reduction in the rhinopharynx space caused by higher thickness of adenoids in habitually snoring children compared with controls. Cross-bites and labial incompetence as well as daytime symptoms and familiarity for habitual snoring were found in most of the studied group of snorers compared with controls. The results indicate that upper airway obstruction during sleep is associated with mild but significant cephalometric and craniofacial modifications in children complaining of habitual snoring. Whether this skeletal conformation is genetically determined or influenced by the early onset of habitual snoring remains to be assessed.
儿童习惯性打鼾和阻塞性睡眠呼吸暂停常与腺样体扁桃体肥大有关，可能在生命早期就开始出现，且与口颅面特征有关。本研究的目的是检测有长期习惯性打鼾病史的幼儿早期颅骨面部改变的情况。通过夜间便携式记录或日间多导睡眠监测、头影测量和正畸评估，对26名习惯性打鼾儿童（平均年龄4.6岁）进行了研究。将研究组与26名年龄匹配的儿童（平均年龄5.1岁）进行头影测量结果比较，后者无打鼾或睡眠呼吸问题病史。头影测量分析显示，与对照组相比，习惯性打鼾儿童的颅下颌颌间、下颌角和上颌角显著增大，下颌后移并向后旋转（高角面），腺样体厚度增加导致鼻咽间隙减小。与对照组相比，大多数研究的打鼾儿童组中发现了反咬合和唇部功能不全，以及日间症状和习惯性打鼾家族史。结果表明，睡眠期间上气道阻塞与主诉习惯性打鼾的儿童轻微但显著的头影测量和颅面改变有关。这种骨骼形态是由基因决定的，还是受习惯性打鼾的早期发作影响，仍有待评估。
