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锥形束计算机断层扫描评估Ⅲ类骨骼畸形患者双颌正颌手术后咽气道空间变化:一项6年随访研究

Cone-Beam Computed Tomography Evaluation of Pharyngeal Airway Space Changes After Bimaxillary Orthognathic Surgery in Patients With Class III Skeletal Deformities: A 6-Year Follow-Up Study.

作者信息

An Jae Hwa, Park Soo-Byung, Choi Youn-Kyung, Lee Sang Hoon, Kim Ki Beom, Kim Yong-Il

机构信息

Resident, Department of Orthodontics, Dental Research Institute, Pusan National University Dental Hospital, Yangsan, South Korea.

Professor, Department of Orthodontics, Dental Research Institute, Pusan National University Dental Hospital, Yangsan, South Korea.

出版信息

J Oral Maxillofac Surg. 2019 Dec;77(12):2534-2544. doi: 10.1016/j.joms.2019.07.013. Epub 2019 Aug 1.

Abstract

PURPOSE

The aim of the present study was to investigate the volumetric and 2-dimensional (2D) changes in the pharyngeal airway space (PAS) after bimaxillary orthognathic surgery (maxillary advancement and mandibular set back) in patients with skeletal Class III deformities.

PATIENTS AND METHODS

In the present retrospective study, patients with skeletal Class III deformities were treated at Pusan National University Hospital (Busan, South Korea) and had undergone cone-beam computed tomography examination preoperatively, immediately postoperatively, 6.0 ± 0.6 months postoperatively, and 6.2 ± 1.3 years postoperatively. The anteroposterior length (APL), largest transverse width (LTW), and cross-sectional area (CSA) at 4 reference planes and the PAS volume were measured. Spearman's correlation analysis was used to assess the correlation between the PAS changes and skeletal movements.

RESULTS

The subjects included 11 men and 12 women. Their mean age was 22.7 ± 4.7 years (range, 18 to 33 years). The APL and CSA on the PNS-V, CV, and CV planes, the LTW on the CV plane, and the oropharyngeal and total volume had decreased at 6 months postoperatively. However, thereafter, no significant 2D or volumetric changes were observed until 6.2 years postoperatively. The long-term change of the LTW on the CV plane correlated negatively with mandibular relapse.

CONCLUSIONS

The volume and morphology of the 6-month postoperative changes in PAS were stable at 6 years for patients who had undergone maxillary advancement and mandibular setback.

摘要

目的

本研究旨在调查骨骼Ⅲ类畸形患者接受双颌正颌手术(上颌前徙和下颌后退)后咽气道间隙(PAS)的容积及二维(2D)变化。

患者与方法

在本回顾性研究中,骨骼Ⅲ类畸形患者在韩国釜山国立大学医院接受治疗,并在术前、术后即刻、术后6.0±0.6个月以及术后6.2±1.3年接受了锥形束计算机断层扫描检查。测量了4个参考平面的前后径长度(APL)、最大横径宽度(LTW)和横截面积(CSA)以及PAS容积。采用Spearman相关性分析评估PAS变化与骨骼移动之间的相关性。

结果

研究对象包括11名男性和12名女性。他们的平均年龄为22.7±4.7岁(范围18至33岁)。术后6个月时,PNS-V、CV和CV平面的APL和CSA、CV平面的LTW以及口咽和总体积均减小。然而,此后直到术后6.2年,未观察到明显的二维或容积变化。CV平面LTW的长期变化与下颌复发呈负相关。

结论

接受上颌前徙和下颌后退手术的患者,术后6个月时PAS的容积和形态在6年时保持稳定。

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