Dong Xian, Zhu Chenyuan, Qian Yumei, Zhang Fuqiang, Jiao Ting
Department of Prosthodontics, Ninth People's Hospital, affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, 639 Zhi Zao Ju Road, Shanghai, PR China; Department of Prosthodontics, Shanghai Institute of Health Sciences, 279 Zhou Zhu Gong Road, Shanghai, PR China.
Department of Prosthodontics, Ninth People's Hospital, affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, 639 Zhi Zao Ju Road, Shanghai, PR China.
PLoS One. 2015 May 26;10(5):e0127597. doi: 10.1371/journal.pone.0127597. eCollection 2015.
The study evaluated the effects of obturators on respiratory function by analyzing the changes in nasal anatomic structures and physiologic function in maxillectomy patients with and without obturators. Twenty-six patients who underwent maxillectomy were chosen and rehabilitated with obturators by a single maxillofacial prosthodontist. The geometric shape of the nasal cavity, the nasal airway resistance, and the ratio of residual volume to total lung capacity (RV/TLC) were evaluated using acoustic rhinometry, rhinomanometry, and a pulmonary function test apparatus, respectively. All patients were tested twice, with and without their obturators. The results were statistically analyzed with a paired t-test. The nasal cavities (0-7 cm to the anterior nostril) of the patients with obturators had a significantly smaller volume ([-8.92, -0.60], P = 0.027), smaller effective nasal cross-sectional area MCA2 ([-3.80, -1,81], P < 0.0001), increased airflow in the nasal cavity ([17.76, 147.39], P = 0.015), reduced nasal airway resistance ([-0.11, -0.02], P = 0.009), and reduced RV/TLC ([-5.32, -1.30], P = 0.004) compared with the patients without obturators. According to the results of this study, obturators can improve respiratory function by effectively decreasing the volume of enlarged nasal cavities as well as the nasal air resistance and volume of anatomical dead space after maxillectomy.
该研究通过分析有无闭孔器的上颌骨切除患者鼻腔解剖结构和生理功能的变化，评估了闭孔器对呼吸功能的影响。选择了26例行上颌骨切除的患者，并由一名口腔颌面修复医生用闭孔器进行修复。分别使用鼻声反射仪、鼻阻力计和肺功能测试仪器评估鼻腔的几何形状、鼻气道阻力以及残气量与肺总量之比（RV/TLC）。所有患者在佩戴和不佩戴闭孔器的情况下各进行了两次测试。结果采用配对t检验进行统计学分析。与未佩戴闭孔器的患者相比，佩戴闭孔器的患者鼻腔（距前鼻孔0 - 7 cm）体积显著减小（[-8.92, -0.60]，P = 0.027），有效鼻腔横截面积MCA2更小（[-3.80, -1.81]，P < 0.0001），鼻腔气流增加（[17.76, 147.39]，P = 0.015），鼻气道阻力降低（[-0.11, -0.02]，P = 0.009），RV/TLC降低（[-5.32, -1.30]，P = 0.004）。根据本研究结果，闭孔器可通过有效减小上颌骨切除术后扩大的鼻腔体积、鼻空气阻力和解剖死腔体积来改善呼吸功能。
