Department of Otorhinolaryngology Head and Neck Surgery, Universidade Federal de São Paulo, São Paulo, Brazil.
Am J Orthod Dentofacial Orthop. 2011 Oct;140(4):486-92. doi: 10.1016/j.ajodo.2011.06.017.
Childhood oral breathing can alter muscular balance and lead to facial deformities. No articles in the literature have reported on the alteration of facial growth patterns in patients who have received tracheotomies. The purpose of this study was to evaluate craniofacial developmental consequences originating from variations in breathing mechanisms in children who are nasal breathers or oral breathers, and those who have been tracheotomized.
The sample was divided into 3 groups of 10 each. The nasal group had a mean age of 13.9 years, the oral group had a mean age of 12.7 years, and the tracheotomy group had a mean age of 12.8 years. The masseter and suprahyoid muscles were evaluated with electromyography. The following measurements were made: facial, maxillary, and mandibular widths; nasion-sella-gnathion angle; and facial index.
The tracheotomized group was similar to the nasal group for greater activity of the masseter muscles than of the suprahyoid muscles during mastication, as well as in the measurements of facial, maxillary, and mandibular widths. The oral group showed reductions in each category. The tracheotomized group was similar to the oral group during maximum dental occlusion for significantly higher activity of the suprahyoid muscles compared with the masseter muscles, with reductions in vertical values.
A childhood tracheotomy might affect facial development in a way comparable with that of oral breathers, including abnormal facial growth variations.
儿童时期的口呼吸可能会改变肌肉平衡,导致面部畸形。目前文献中尚无报道显示气管切开术会改变经口呼吸或鼻呼吸患者的面部生长模式。本研究旨在评估因呼吸机制改变而导致的鼻呼吸、口呼吸和气管切开患儿的颅面发育后果。
将样本分为每组 10 人的 3 组。鼻呼吸组的平均年龄为 13.9 岁,口呼吸组的平均年龄为 12.7 岁,气管切开组的平均年龄为 12.8 岁。使用肌电图评估咀嚼时的嚼肌和舌骨上肌群。进行以下测量:面部、上颌和下颌宽度;鼻根-蝶鞍-下颌角;以及面指数。
与口呼吸组相比,气管切开组在咀嚼时嚼肌的活动度大于舌骨上肌群,且在面部、上颌和下颌宽度的测量方面也相似。口呼吸组在各个类别中均有所减少。在最大牙咬合时,气管切开组与口呼吸组的舌骨上肌群的活动度显著高于嚼肌,垂直值减小。
儿童时期的气管切开术可能会以类似于口呼吸的方式影响面部发育,包括异常的面部生长变化。