Spruijt Nicole E, Kon Moshe, Mink van der Molen Aebele B
Department of Plastic Surgery, University Medical Center, Utrecht, The Netherlands.
Arch Plast Surg. 2014 Jul;41(4):344-9. doi: 10.5999/aps.2014.41.4.344. Epub 2014 Jul 15.
An abnormally obtuse cranial base angle, also known as platybasia, is a common finding in patients with 22q11.2 deletion syndrome (22q11DS). Platybasia increases the depth of the velopharynx and is therefore postulated to contribute to velopharyngeal dysfunction. Our objective was to determine the clinical significance of platybasia in 22q11DS by exploring the relationship between cranial base angles and speech resonance.
In this retrospective chart review at a tertiary hospital, 24 children (age, 4.0-13.1 years) with 22q11.2DS underwent speech assessments and lateral cephalograms, which allowed for the measurement of the cranial base angles.
One patient (4%) had hyponasal resonance, 8 (33%) had normal resonance, 10 (42%) had hypernasal resonance on vowels only, and 5 (21%) had hypernasal resonance on both vowels and consonants. The mean cranial base angle was 136.5° (standard deviation, 5.3°; range, 122.3-144.8°). The Kruskal-Wallis test showed no significant relationship between the resonance ratings and cranial base angles (P=0.242). Cranial base angles and speech ratings were not correlated (Spearman correlation=0.321, P=0.126). The group with hypernasal resonance had a significantly more obtuse mean cranial base angle (138° vs. 134°, P=0.049) but did not have a greater prevalence of platybasia (73% vs. 56%, P=0.412).
In this retrospective chart review of patients with 22q11DS, cranial base angles were not correlated with speech resonance. The clinical significance of platybasia remains unknown.
异常钝的颅底角,也称为扁平颅底,是22q11.2缺失综合征(22q11DS)患者的常见表现。扁平颅底会增加腭咽的深度,因此推测其会导致腭咽功能障碍。我们的目的是通过探究颅底角与语音共鸣之间的关系来确定扁平颅底在22q11DS中的临床意义。
在一家三级医院进行的这项回顾性病历审查中,24名年龄在4.0至13.1岁之间的22q11.2DS患儿接受了语音评估和头颅侧位X线片检查,以便测量颅底角。
1名患者(4%)有鼻音不足共鸣,8名(33%)有正常共鸣,10名(42%)仅在元音时有高鼻音共鸣,5名(21%)在元音和辅音时均有高鼻音共鸣。平均颅底角为136.5°(标准差为5.3°;范围为122.3 - 144.8°)。Kruskal - Wallis检验显示共鸣评级与颅底角之间无显著关系(P = 0.242)。颅底角与语音评级不相关(Spearman相关系数 = 0.321,P = 0.126)。有高鼻音共鸣的组平均颅底角明显更钝(138°对134°,P = 0.049),但扁平颅底的患病率并不更高(73%对56%,P = 0.412)。
在这项对22q11DS患者的回顾性病历审查中,颅底角与语音共鸣不相关。扁平颅底的临床意义仍然未知。