Vezina Jean-Philippe, Blumen Marc, Buchet Isabelle, Chabolle Frédéric
Department of Otolaryngology, Head and Neck Surgery, Foch Hospital, Suresnes, France.
J Oral Maxillofac Surg. 2012 Jun;70(6):1442-8. doi: 10.1016/j.joms.2011.03.042. Epub 2011 Jul 28.
Cephalometry can be helpful for choosing the optimal treatment of sleep apnea. The presence or absence of maxillomandibular retrusion can contribute to the choice of treatment with an oral appliance or a skeleton-based or soft tissue surgery. To measure the position of the maxillomandibular complex, the analysis of Tweed has been cited most often. It uses dental landmarks. The analysis of Delaire relies on deeper skeletal points. The present study compared these 2 analyses for the diagnosis of maxillomandibular retrusion in a context of sleep-disordered breathing by determining the correlation between retrusion and the apnea-hypopnea index (AHI) for both methods.
A retrospective cohort study was conducted in a tertiary care university hospital. The population consisted of patients diagnosed with sleep-disordered breathing for whom polysomnographic and cephalometric data were available. Tweed and Delaire cephalometric analyses were performed for each case. The main outcome was the correlation between the degree of maxillomandibular retrusion and the AHI, as determined by Pearson coefficients.
A total of 243 patients (42 females and 201 males) were included. For maxillary retrusion, the correlation coefficient with the AHI was -0.109 (P = .089) for Tweed and -0.160 (P = .012) for Delaire. For mandibular retrusion, the coefficient was -0.090 (P = .16) for Tweed and -0.201 (P = .002) for Delaire. Statistical significance was found only for the analysis of Delaire.
The correlation between maxillomandibular retrusion and the AHI was better using the analysis of Delaire. If cephalometry is to be included in the workup of sleep-disordered breathing, the analysis of Delaire might be preferable.
头影测量有助于选择睡眠呼吸暂停的最佳治疗方法。上下颌后缩的存在与否有助于选择使用口腔矫治器或基于骨骼或软组织的手术进行治疗。为了测量上下颌复合体的位置，最常被引用的是Tweed分析法。它使用牙齿标志点。Delaire分析法依赖于更深层的骨骼点。本研究通过确定两种方法中后缩与呼吸暂停低通气指数（AHI）之间的相关性，比较了这两种分析法在睡眠呼吸障碍背景下对上下颌后缩的诊断。
在一家三级医疗大学医院进行了一项回顾性队列研究。研究对象为被诊断为睡眠呼吸障碍且有多导睡眠图和头影测量数据的患者。对每个病例进行Tweed和Delaire头影测量分析。主要结果是通过Pearson系数确定的上下颌后缩程度与AHI之间的相关性。
共纳入243例患者（42例女性和201例男性）。对于上颌后缩，Tweed分析法与AHI的相关系数为-0.109（P = 0.089），Delaire分析法为-0.160（P = 0.012）。对于下颌后缩，Tweed分析法的系数为-0.090（P = 0.16），Delaire分析法为-0.201（P = 0.002）。仅在Delaire分析法中发现统计学意义。
使用Delaire分析法时，上下颌后缩与AHI之间的相关性更好。如果头影测量要纳入睡眠呼吸障碍的检查中，Delaire分析法可能更可取。
