Onodera Kieko, Niikuni Naoko, Chigono Tomoko, Nakajima Ichiro, Sakata Hideaki, Motizuki Hiroshi
Nihon University School of Dentistry, Department of Pediatric Dentistry, 1-8-13 Kanda Surugadai, Chiyoda-ku, Tokyo, Japan.
Int J Pediatr Otorhinolaryngol. 2006 Mar;70(3):453-61. doi: 10.1016/j.ijporl.2005.07.016. Epub 2006 Jan 6.
We evaluated the craniofacial and airway morphology in children with achondroplasia complicated by snoring and apnea during sleep (AP group) in comparison with children with snoring and apnea during sleep without chromosomal aberrations (adenoid group) and healthy children without sleep disordered breathing or malalignment (healthy group). Lateral cephalograms in 10 children each (four males and six females) in the three groups were analyzed. When the AP and healthy groups were compared, the AP group showed significantly lower values for facial depth, nasal floor length, point A, point pog, and saddle angle (p<0.01) and significantly higher values for mandibular plane angle and gonial angle (p<0.01) regarding craniofacial morphology and significantly lower values for D-AD1, D-AD2, and upper pharynx (p<0.01) regarding airway morphology. When the AP and adenoid groups were compared, the AP group showed significantly lower values for facial depth, nasal floor length, point A, point pog, and saddle angle (p<0.01) and significantly higher values for mandibular plane angle and gonial angle (p<0.01) regarding craniofacial morphology and significantly lower values for D-AD1, D-AD2, and upper pharynx (p<0.05) regarding airway morphology. Thus, the craniofacial/airway morphology in the AP group was characterized by upper airway stenosis, a retruded position of the chin, and an increased mandibular plane angle due to partial early ossification of cranial bones, and an increased lower facial height due to an increased mandibular angle, which may tend to induce sleep snoring and apnea.
我们评估了患有软骨发育不全并伴有睡眠时打鼾和呼吸暂停的儿童（AP组）的颅面和气道形态，并与睡眠时打鼾和呼吸暂停但无染色体异常的儿童（腺样体组）以及无睡眠呼吸障碍或牙列不齐的健康儿童（健康组）进行了比较。对三组中每组10名儿童（4名男性和6名女性）的头颅侧位片进行了分析。当比较AP组和健康组时，就颅面形态而言，AP组的面部深度、鼻底长度、A点、颏点和鞍角的值显著较低（p<0.01），而下颌平面角和下颌角的值显著较高（p<0.01）；就气道形态而言，D-AD1、D-AD2和上咽部的值显著较低（p<0.01）。当比较AP组和腺样体组时，就颅面形态而言，AP组的面部深度、鼻底长度、A点、颏点和鞍角的值显著较低（p<0.01），而下颌平面角和下颌角的值显著较高（p<0.01）；就气道形态而言，D-AD1、D-AD2和上咽部的值显著较低（p<0.05）。因此，AP组的颅面/气道形态特征为上气道狭窄、下巴后缩、由于颅骨部分早期骨化导致下颌平面角增加，以及由于下颌角增加导致下面部高度增加，这可能易于诱发睡眠打鼾和呼吸暂停。
