Ma Xiaoyang, Forte Antonio Jorge, Berlin Nicholas Lee, Alonso Nivaldo, Persing John A, Steinbacher Dereck Matthew
New Haven, Conn.; Beijing, China; and São Paulo, Brazil From the Section of Plastic and Reconstructive Surgery at Yale University School of Medicine; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, and Department of Plastic Surgery, Peking Medical College; Yale University School of Public Health; and Department of Plastic and Reconstructive Surgery, University of São Paulo.
Plast Reconstr Surg. 2015 May;135(5):885e-894e. doi: 10.1097/PRS.0000000000001160.
Airway insufficiency decreases quality of life and may be life threatening in patients with Treacher Collins syndrome. The authors calculated the three-dimensional nasal airway volume in patients with Treacher Collins syndrome to identify correlations between nasal airway volume and craniofacial morphology and provide guidance for surgical planning.
Thirty nonoperated patients with Treacher Collins syndrome were compared with 35 unaffected age- and gender-matched controls. Anatomic variables of the cranial base, the maxilla complex, and internal diameters of nasal airway were compared between patients and control subjects using three-dimensional craniometric analyses. In the Treacher Collins group, the relation of craniofacial morphology to nasal airway volume was assessed separately. Statistical analyses were performed using independent sample t tests and Pearson correlation coefficient analyses.
Nasal airway volume was decreased 38.6 percent in patients with Treacher Collins syndrome relative to controls (p = 0.001). A positive correlation of maxillary position and nasal airway volume was shown in Treacher Collins patients (r = +0.463, p = 0.013). Maxillary, nasal bone, and orbitale width were also positively correlated with nasal airway volume (r = +0.582, p = 0.001; r = +0.408, p = 0.035; and r = +0.677, p < 0.001, respectively). Shortened internal diameters of the nasal airway all positively correlated with nasal airway volume.
Nasal airway volume is reduced in patients with Treacher Collins syndrome. Reduced projection of the maxilla and transverse maxillary deficiency are correlated with reduced nasal airway volume and are primarily responsible for obstruction of the nasal airway.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, II.
气道功能不全降低了生活质量，对于患有特雷彻·柯林斯综合征的患者可能会危及生命。作者计算了患有特雷彻·柯林斯综合征患者的三维鼻腔气道容积，以确定鼻腔气道容积与颅面形态之间的相关性，并为手术规划提供指导。
将30例未经手术治疗的特雷彻·柯林斯综合征患者与35例年龄和性别匹配的未受影响的对照者进行比较。使用三维颅骨测量分析比较患者和对照者之间颅底、上颌复合体的解剖学变量以及鼻腔气道的内径。在特雷彻·柯林斯综合征组中，分别评估颅面形态与鼻腔气道容积的关系。使用独立样本t检验和Pearson相关系数分析进行统计分析。
与对照组相比，患有特雷彻·柯林斯综合征的患者鼻腔气道容积减少了38.6%（p = 0.001）。在特雷彻·柯林斯综合征患者中，上颌位置与鼻腔气道容积呈正相关（r = +0.463，p = 0.013）。上颌、鼻骨和眶宽也与鼻腔气道容积呈正相关（分别为r = +0.582，p = 0.001；r = +0.408，p = 0.035；r = +0.677，p < 0.001）。鼻腔气道内径缩短均与鼻腔气道容积呈正相关。
患有特雷彻·柯林斯综合征的患者鼻腔气道容积减小。上颌前突减少和上颌横向发育不足与鼻腔气道容积减小相关，并且是鼻腔气道阻塞的主要原因。
临床问题/证据级别：风险，II级。
