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腺样体扁桃体肥大作为韩国儿童牙颌面异常的一个风险因素。

Adenotonsillar hypertrophy as a risk factor of dentofacial abnormality in Korean children.

作者信息

Kim Dong-Kyu, Rhee Chae Seo, Yun Pil-Young, Kim Jeong-Whun

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, South Korea.

Departments of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 173 Goomi-ro, Bundang-gu, 463-707, Seongnam, South Korea.

出版信息

Eur Arch Otorhinolaryngol. 2015 Nov;272(11):3311-6. doi: 10.1007/s00405-014-3407-6. Epub 2014 Dec 10.

Abstract

No studies for the role of adenotonsillar hypertrophy in development of dentofacial abnormalities have been performed in Asian pediatric population. Thus, we aimed to investigate the relationship between adenotonsillar hypertrophy and dentofacial abnormalities in Korean children. The present study included consecutive children who visited a pediatric clinic for sleep-disordered breathing due to habitual mouth breathing, snoring or sleep apnea. Their palatine tonsils and adenoids were graded by oropharyngeal endoscopy and lateral cephalometry. Anterior open bite, posterior crossbite, and Angle's class malocclusions were evaluated for dentofacial abnormality. The receiver-operating characteristic curve analysis was used to identify age cutoffs to predict dentofacial abnormality. A total of 1,083 children were included. The presence of adenotonsillar hypertrophy was significantly correlated with the prevalence of dentofacial abnormality [adjusted odds ratio = 4.587, 95% CI (2.747-7.658)] after adjusting age, sex, body mass index, allergy, and Korean version of obstructive sleep apnea-18 score. The cutoff age associated with dentofacial abnormality was 5.5 years (sensitivity = 75.5%, specificity = 67%) in the children with adenotonsillar hypertrophy and 6.5 years (sensitivity = 70.6%, specificity = 57%) in those without adenotonsillar hypertrophy. In conclusion, adenotonsillar hypertrophy may be a risk factor for dentofacial abnormalities in Korean children and early surgical intervention could be considered with regards to dentofacial abnormality.

摘要

在亚洲儿童群体中,尚未有关于腺样体扁桃体肥大在牙颌面异常发育中作用的研究。因此,我们旨在调查韩国儿童腺样体扁桃体肥大与牙颌面异常之间的关系。本研究纳入了因习惯性口呼吸、打鼾或睡眠呼吸暂停而到儿科诊所就诊的连续性儿童。通过口咽内镜检查和头颅侧位测量对他们的腭扁桃体和腺样体进行分级。评估前牙开颌、后牙反颌和安氏错颌以确定牙颌面异常情况。采用受试者工作特征曲线分析来确定预测牙颌面异常的年龄临界值。共纳入1083名儿童。在对年龄、性别、体重指数、过敏情况和韩国版阻塞性睡眠呼吸暂停-18评分进行校正后,腺样体扁桃体肥大的存在与牙颌面异常的患病率显著相关[校正比值比 = 4.587,95%可信区间(2.747 - 7.658)]。在有腺样体扁桃体肥大的儿童中,与牙颌面异常相关的临界年龄为5.5岁(敏感性 = 75.5%,特异性 = 67%),在无腺样体扁桃体肥大的儿童中为6.5岁(敏感性 = 70.6%,特异性 = 57%)。总之,腺样体扁桃体肥大可能是韩国儿童牙颌面异常的一个危险因素,对于牙颌面异常可考虑早期手术干预。

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