Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China.
J Craniofac Surg. 2021;32(2):564-568. doi: 10.1097/SCS.0000000000006957.
Oral breathing (OB) was considered associated with specific craniofacial structures and same for pediatric obstructive sleep apnea (OSA). This study aimed to investigate the differences of craniofacial structures between OB and OSA.
In this retrospective study, 317 children under age 18 years were recruited and divided into OB group, OSA group, and control group. OSA group (15 boys, 4 girls) were referred from qualified sleep center and diagnosed as pediatric OSA with full-night polysomnography. OB group (10 boys, 10 girls) were mostly referral from pediatric or ENT department, some of whom undertook polysomnography and were not OSA. Control group consisted of orthodontic patients within the same period. Lateral cephalograms were obtained in all groups and their parameters were compared with Chinese normal values and each other.
R-PNS of OB group (18.04 ± 2.49 mm) was greater than OSA group (14.27 ± 4.36 mm) and even control group (16.22 ± 3.91 mm) (P < 0.01). U1-NA was also the greatest in OB group (7.15 ± 2.92 mm), followed by OSA group (4.88 ± 2.66 mm), while control group was the smallest (5.71 ± 2.94 mm) (P < 0.05). In addition, OB group presented the smallest adenoids and tonsils among three groups. Bony nasopharynx development, mandibular length and growth direction of mandible of OB group were all better than OSA group.
Despite of oral breathing, anatomical morphology (well-developed dentoalveolar structures; mild adenotonsillar hypertrophy) might protect children from developing OSA.
口腔呼吸（OB）被认为与特定的颅面结构有关，同样适用于小儿阻塞性睡眠呼吸暂停（OSA）。本研究旨在探讨 OB 与 OSA 儿童颅面结构的差异。
在这项回顾性研究中，共招募了 317 名年龄在 18 岁以下的儿童，分为 OB 组、OSA 组和对照组。OSA 组（男 15 例，女 4 例）由合格的睡眠中心转介，经整夜多导睡眠图诊断为小儿 OSA。OB 组（男 10 例，女 10 例）大多由儿科或耳鼻喉科转介，其中部分患者进行了多导睡眠图检查，并非 OSA。对照组由同期的正畸患者组成。所有组均获得侧位头颅侧位片，并与中国正常值及各组之间的参数进行比较。
OB 组的 R-PNS（18.04±2.49mm）大于 OSA 组（14.27±4.36mm），甚至大于对照组（16.22±3.91mm）（P<0.01）。U1-NA 也在 OB 组最大（7.15±2.92mm），其次是 OSA 组（4.88±2.66mm），而对照组最小（5.71±2.94mm）（P<0.05）。此外，OB 组三组中腺样体和扁桃体最小。骨性鼻咽部发育、下颌长度和下颌生长方向均优于 OSA 组。
尽管存在口腔呼吸，但解剖形态（发育良好的牙牙槽结构；轻度腺样体扁桃体肥大）可能使儿童免于发生 OSA。
