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口呼吸者的快速上颌扩弓:对鼻腔的短期骨骼和软组织影响

Rapid maxillary expansion in mouth breathers: a short-term skeletal and soft-tissue effect on the nose.

作者信息

Badreddine Fauze Ramez, Fujita Reginaldo R, Alves Fabio Eduardo Maiello Monteiro, Cappellette Mario

机构信息

Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.

Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.

出版信息

Braz J Otorhinolaryngol. 2018 Mar-Apr;84(2):196-205. doi: 10.1016/j.bjorl.2017.01.009. Epub 2017 Feb 24.

Abstract

INTRODUCTION

Rapid maxillary expansion can change the form and function of the nose. The skeletal and soft tissue changes can influence the esthetics and the stability of the results obtained by the procedure.

OBJECTIVE

The aim of this retrospective study was to evaluate the short-term effects of rapid maxillary expansion on the skeletal and soft tissue structures of the nose, in mouth-breathing patients, using a reliable and reproducible, but simple methodology, with the aid of computed tomography.

METHODS

A total of 55 mouth-breathing patients with maxillary hypoplasia were assessed and were divided into an experimental group treated with rapid maxillary expansion(39 patients, 23 of which were male and 16 female, with an average age of 9.7 years and a standard deviation of 2.28, ranging from 6.5 to 14.7 years) and a control group (16 patients, 9 of which were male and 7 female, with an average age of 8.8 years, standard deviation of 2.17, ranging from 5.11 to 13.7 years). The patients of the experimental group were submitted to multislice computed tomography examinations at two different points in time: (T1) pre-rapid maxillary expansion and (T2) three months after the procedure. The control group underwent to the same exams at the same intervals of time. Four skeletal and soft tissue variables were assessed, comparing the results of T1 and T2.

RESULTS

There was in the experimental group a significant increases in all the skeletal and soft tissue variables (p<0.05) but no significant alteration was found in the control group. When comparing the experimental group and the control group, the most important change occurred in the width of the pyriform aperture (p<0.001).

CONCLUSION

Rapid maxillary expansion is capable of altering the shape and function of the nose, promoting alterations in skeletal and soft tissue structures. This kind of study may, in the future, permit the proper planning of esthetic procedures at the tip and base of the nose and also the performance of objective measurements in early or late surgical outcomes.

摘要

引言

上颌快速扩弓可改变鼻子的形态和功能。骨骼及软组织的变化会影响该手术效果的美观性和稳定性。

目的

本回顾性研究旨在借助计算机断层扫描,采用可靠、可重复且简便的方法,评估上颌快速扩弓对口呼吸患者鼻部骨骼和软组织结构的短期影响。

方法

共评估了55例上颌发育不全的口呼吸患者,分为实验组(39例患者,其中男性23例,女性16例,平均年龄9.7岁,标准差2.28,年龄范围6.5至14.7岁)和对照组(16例患者,其中男性9例,女性7例,平均年龄8.8岁,标准差2.17,年龄范围5.11至13.7岁)。实验组患者在两个不同时间点接受多层计算机断层扫描检查:(T1)上颌快速扩弓前和(T2)手术后三个月。对照组在相同时间间隔接受相同检查。评估了四个骨骼和软组织变量,比较T1和T2的结果。

结果

实验组所有骨骼和软组织变量均显著增加(p<0.05),而对照组未发现显著变化。比较实验组和对照组时发现,最重要的变化发生在梨状孔宽度上(p<0.001)。

结论

上颌快速扩弓能够改变鼻子的形状和功能,促进骨骼和软组织结构的改变。这类研究未来可能有助于合理规划鼻尖和鼻基底的美容手术,以及对早期或晚期手术效果进行客观测量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/72cc/9449176/c1ae5be9891e/gr1.jpg

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