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正畸问题儿童的鼻咽通畅情况及头影测量图像

Patency of nasopharynx and a cephalometric image in the children with orthodontic problems.

作者信息

Wysocki Jarosław, Krasny Marta, Skarzyński Piotr H

机构信息

Clinic of Otolaryngology and Rehabilitation II Medical Faculty, Warsaw Medical University, Poland.

出版信息

Int J Pediatr Otorhinolaryngol. 2009 Dec;73(12):1803-9. doi: 10.1016/j.ijporl.2009.10.001. Epub 2009 Oct 30.

Abstract

OBJECTIVES

To study a possible impact of adenoidectomy on malocclusion on the base of cephalometry.

METHODS

Retrospective analysis of 148 patients qualified into the orthodontic treatment (77 girls and 71 boys) at the age of 9-11 years (an average age: 10 years and 3 months). Material was divided into three groups, equalized regarding sex and age. The first one consisted of the patients after adenoidectomy, at the moment of orthodontic assessment without any organic pathology within a nasal cavity or nasopharynx. To the second group were included children who for different reasons were not a subject of adenoidectomy despite clinical diagnosis of adenoid hypertrophy. In the third group were patients whose only problem was malocclusion. X-ray pictures taken on a cephalostate were scanned and given to cephalometric assessment. In statistics Bartlett's test, Tukey's test and Pearson's correlation coefficients were used.

RESULTS

The significant differences with respect to many skull parameters appeared among the groups. The inappropriate respiratory habits find their reflection mainly within anterior and lower anterior facial height, angle of mandibular plane, nasopharyngeal flow and dental parameters. An evident beneficial influence of adenoidectomy is observed within a period of 36-41 months after an operation. Nasopharyngeal flow is the most sensitive parameter indicating the respiratory conditions, and is strongly connected with the key cephalometric parameters.

CONCLUSIONS

In cases of malocclusion of skeletal character, coexisting with adenoid hypertrophy, adenoidectomy should be carried out as early as possible.

摘要

目的

基于头影测量法研究腺样体切除术对牙颌面畸形的可能影响。

方法

对148例9至11岁(平均年龄10岁零3个月)接受正畸治疗的患者(77名女孩和71名男孩)进行回顾性分析。将材料分为三组,在性别和年龄方面进行均衡。第一组由腺样体切除术后的患者组成,在正畸评估时鼻腔或鼻咽部无任何器质性病变。第二组包括因不同原因尽管临床诊断为腺样体肥大但未接受腺样体切除术的儿童。第三组是仅存在牙颌面畸形问题的患者。对头影测量仪拍摄的X线片进行扫描并进行头影测量评估。在统计学分析中使用了巴特利特检验、图基检验和皮尔逊相关系数。

结果

各组之间在许多颅骨参数方面存在显著差异。不适当的呼吸习惯主要反映在面部前部和下部前部高度、下颌平面角、鼻咽部气流和牙齿参数上。在手术后36至41个月的时间段内观察到腺样体切除术有明显的有益影响。鼻咽部气流是最能表明呼吸状况的敏感参数,并且与关键的头影测量参数密切相关。

结论

在伴有腺样体肥大的骨性牙颌面畸形病例中,应尽早进行腺样体切除术。

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