三维气道容积减小是特雷彻·柯林斯综合征骨骼形态异常的一个表现。
Reduced three-dimensional airway volume is a function of skeletal dysmorphology in Treacher Collins syndrome.
作者信息
Ma Xiaoyang, Forte Antonio J, Persing John A, Alonso Nivaldo, Berlin Nicholas L, Steinbacher Derek M
机构信息
New Haven, Conn.; Beijing, People's Republic of China; and São Paulo, Brazil From the Section of Plastic and Reconstructive Surgery, Yale University School of Medicine; the Department of Plastic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College; the Department of Plastic Surgery, University of São Paulo; and the Yale University School of Public Health.
出版信息
Plast Reconstr Surg. 2015 Feb;135(2):382e-392e. doi: 10.1097/PRS.0000000000000993.
BACKGROUND
Children with Treacher Collins syndrome frequently present with obstructive sleep apnea and respiratory insufficiency. The purpose of this study was to three-dimensionally calculate upper airway volume in these patients. The authors also assessed the correlation between bony craniofacial morphology and spatial position with airway volume.
METHODS
Thirty Treacher Collins syndrome patients who have not been operated on were compared with a sample of 35 age- and sex-matched unaffected controls. Upper airway volume was stratified into retropalatal and retroglossal aspects. Three-dimensional craniometric findings were compared between patients and controls. Among Treacher Collins syndrome patients, the authors assessed the relationship of craniofacial morphology and spatial positioning to airway volume. Statistical analyses included independent sample t tests and Pearson correlation coefficient analyses.
RESULTS
Decreased total upper airway volume (p = 0.034) was found in the Treacher Collins syndrome group, attributable primarily to a decrease in retroglossal airway volume (p = 0.009). Regarding three-dimensional craniometric variables, maxillary and mandibular length (r = 0.76, p < 0.001; and r = 0.68, p < 0.001), and the anterior and posterior cranial base (r = 0.61, p < 0.001; and r = 0.77, p < 0.001) were positively correlated with airway volume in Treacher Collins syndrome patients. Transverse internal diameters of the upper airway were also positively correlated with airway volume (r = 0.635, p = 0.001; and r = 0.511, p = 0.006); however, no correlation was shown for the anteroposterior airway diameters.
CONCLUSIONS
Three-dimensional analysis revealed diminished upper airway volume in Treacher Collins syndrome, with the retroglossal region being the most severely constricted. Maxillomandibular dysmorphologies, and their relationship to the cranial base, correlated significantly with airway findings.
背景
患有特雷彻·柯林斯综合征的儿童经常出现阻塞性睡眠呼吸暂停和呼吸功能不全。本研究的目的是三维计算这些患者的上气道容积。作者还评估了骨性颅面形态和空间位置与气道容积之间的相关性。
方法
将30例未接受手术的特雷彻·柯林斯综合征患者与35例年龄和性别匹配的未受影响对照样本进行比较。上气道容积分为腭后和舌后部分。比较患者和对照之间的三维颅骨测量结果。在特雷彻·柯林斯综合征患者中，作者评估了颅面形态和空间定位与气道容积的关系。统计分析包括独立样本t检验和Pearson相关系数分析。
结果
在特雷彻·柯林斯综合征组中发现总上气道容积减少（p = 0.034），主要归因于舌后气道容积减少（p = 0.009）。关于三维颅骨测量变量，上颌和下颌长度（r = 0.76，p < 0.001；r = 0.68，p < 0.001）以及前颅底和后颅底（r = 0.61，p < 0.001；r = 0.77，p < 0.001）与特雷彻·柯林斯综合征患者的气道容积呈正相关。上气道的横向内径也与气道容积呈正相关（r = 0.635，p = 0.001；r = 0.511，p = 0.006）；然而，前后气道直径未显示相关性。
结论
三维分析显示特雷彻·柯林斯综合征患者的上气道容积减小，舌后区域收缩最严重。上颌下颌畸形及其与颅底的关系与气道结果显著相关。
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