Korbmacher Heike, Koch Lutz E, Kahl-Nieke Bärbel
Universitätsklinikum Hamburg-Eppendorf, Zentrum für Zahn-, Mund- und Kieferheilkunde, Poliklinik für Kieferorthopädie, Hamburg.
Int J Orofacial Myology. 2005 Nov;31:26-38.
352 children radiologically identified with asymmetry in the occipito-cervical region were assessed on a number of myofunctional measures. In all children an orthopedic examination was conducted including a functional test of the upper cervical spine and the iliac joint, the postural test by Matthiass, as well as gait analysis. During a second examination the orofacial myofunctional status was recorded. In general, about 70% of the children revealed orofacial myofunctional disorders. Correlational analysis was conducted in order to determine whether specific myofunctional variables were associated with postural and orthopedic alterations. A weak body posture correlated statistically significantly with all assessed myofunctional variables. On the other hand, all orthopedic items correlated significantly with a reclined head position. A blockade of the iliac spine correlated significantly with persistent habits, articulation disorders and tongue dysfunction, whereas functional asymmetry of the upper cervical spine correlated significantly with incompetent lips. A finding of at least five statistically significant correlations within each orofacial variable underlined the complex symptomatology of myofunctional disorders, so that consideration needs to be given to adequate treatment approaches. The data generated by the present study stress the importance of early interdisciplinary screening in children to ensure a physiological development of the orofacial region and the still growing vertebral column. To help understand the complexity of symptoms influencing orofacial development, an explanatory model of the "interactive functional box system" is given.
对352名经放射学检查确定枕颈区域不对称的儿童进行了多项肌功能测量评估。对所有儿童都进行了骨科检查，包括上颈椎和髂关节的功能测试、马蒂亚斯姿势测试以及步态分析。在第二次检查中记录了口面部肌功能状态。总体而言，约70%的儿童存在口面部肌功能障碍。进行了相关性分析，以确定特定的肌功能变量是否与姿势和骨科改变相关。虚弱的身体姿势与所有评估的肌功能变量在统计学上显著相关。另一方面，所有骨科项目与头部后仰位置显著相关。髂嵴阻滞与持续习惯、发音障碍和舌功能障碍显著相关，而上颈椎功能不对称与唇部功能不全显著相关。每个口面部变量内至少有五个统计学上显著的相关性这一发现突出了肌功能障碍的复杂症状，因此需要考虑适当的治疗方法。本研究产生的数据强调了对儿童进行早期多学科筛查的重要性，以确保口面部区域和仍在生长的脊柱的生理发育。为了帮助理解影响口面部发育的症状的复杂性，给出了一个“交互式功能盒系统”的解释模型。
