Ant Ayca, Kemaloglu Yusuf Kemal, Yilmaz Metin, Dilci Alper
*Department of Otorhinolaryngology, Faculty of Medicine, Gazi University †Department of Otorhinolaryngology, Ankara Oncology Education and Research Hospital, Ankara ‡Department of Otorhinolaryngology, Eskisehir Yunus Emre State Hospital, Eskisehir, Turkey.
J Craniofac Surg. 2017 May;28(3):625-628. doi: 10.1097/SCS.0000000000003409.
Nasal obstruction mainly caused by adenoid hypertrophy in children affects the craniofacial growth and development process, and the craniofacial deviations and/or differences reported in the children are very similar to those in the adults with obstructive sleep apnea syndrome (OSAS). The authors aimed to look for relationships of the linear craniofacial dimensions in the children suffering from nasal obstruction with age, degree of clinical nasal obstruction score (CNOS), and relative size of the adenoid mass within the nasopharynx in their study.Fifty-five children suffering from nasal obstruction were retrospectively enrolled, and clinical data was used to calculate CNOS. On the lateral cephalometric radiographies, 9 linear variables were measured and adenoidal-nasopharyngeal ratio (ANR) was calculated.The data presented that, not CNOS, but ANR shown decrease by age, while many skeletal variables with exception of the nasopharyngeal and adenoidal postero-anterior dimensions were increased by age. Further, it was found that while CNOS were negatively correlated with the anterior cranial base length, anterior-superior facial height, and maxillary depth, ANR disclosed significant correlation only with the anteriorsuperior facial height. The authors' results support that nasal obstruction in the children was related not only to the adenoidal hypertrophy. Although relative size of the adenoidal mass in relation to the nasopharynx decreased by age, nasal obstruction was still present. Further, these results support that craniofacial deviations and/or differences in the children with nasal obstruction is similar to the adult OSAS patients. Smaller dimensions related to the naso-maxillary complex in the children with more severe nasal obstruction appear to be continuous by age. Hence, it could be said that narrow naso-maxillary complex could contribute to proceed nasal obstruction by age, which may contribute to OSAS in the adults.
儿童腺样体肥大引起的鼻阻塞会影响颅面生长发育过程，且儿童中报告的颅面偏差和/或差异与阻塞性睡眠呼吸暂停综合征（OSAS）成人患者的情况非常相似。在他们的研究中，作者旨在寻找患有鼻阻塞的儿童的线性颅面尺寸与年龄、临床鼻阻塞评分（CNOS）程度以及鼻咽部腺样体肿块相对大小之间的关系。
回顾性纳入了55名患有鼻阻塞的儿童，并使用临床数据计算CNOS。在头颅侧位X线片上，测量了9个线性变量并计算了腺样体-鼻咽比（ANR）。
数据显示，不是CNOS，而是ANR随年龄增长而降低，而除鼻咽部和腺样体前后径外的许多骨骼变量随年龄增长而增加。此外，发现虽然CNOS与前颅底长度、前上颜面高度和上颌深度呈负相关，但ANR仅与前上颜面高度呈显著相关。作者的结果支持，儿童鼻阻塞不仅与腺样体肥大有关。尽管腺样体肿块相对于鼻咽部的相对大小随年龄增长而减小，但鼻阻塞仍然存在。此外，这些结果支持，患有鼻阻塞的儿童的颅面偏差和/或差异与成人OSAS患者相似。鼻阻塞更严重的儿童中与鼻上颌复合体相关的较小尺寸似乎随年龄持续存在。因此，可以说狭窄的鼻上颌复合体可能随年龄增长导致鼻阻塞，这可能导致成人患OSAS。
