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儿童阻塞性睡眠呼吸暂停对上颌骨皮质宽度的潜在影响。

Potential impact of pediatric obstructive sleep apnea on mandibular cortical width dimensions.

机构信息

School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.

Multidisciplinary Department of Medical-Surgical and Dental Specialties, Orthodontic Program, University of Campania Luigi Vanvitelli, Naples, Italy.

出版信息

J Clin Sleep Med. 2021 Aug 1;17(8):1627-1634. doi: 10.5664/jcsm.9262.

Abstract

STUDY OBJECTIVES

To analyze differences in mandibular cortical width (MCW) among children diagnosed with obstructive sleep apnea (OSA) or at high- or low-risk for OSA.

METHODS

A total of 161 children were assessed: 60 children with polysomnographically diagnosed OSA, 56 children presenting symptoms suggestive of high-risk for OSA, and 45 children at low risk for OSA. Children at high- and low-risk for OSA were evaluated through the Pediatric Sleep Questionnaire. MCW was calculated using ImageJ software from panoramic radiograph images available from all participants. Differences between MCW measurements in the 3 groups were evaluated using analysis of covariance and Bonferroni post-hoc tests, with age as a covariate. The association between MCW and specific cephalometric variables was assessed through regression analysis.

RESULTS

The participants' mean age was 9.6 ± 3.1 years (59% male and 41% female). The mean body mass index -score was 0.62 ± 1.3. The polysomnographically diagnosed OSA group presented smaller MCW than the group at low-risk for OSA (mean difference = -0.385 mm, = .001), but no difference with the group at high-risk for OSA (polysomnographically diagnosed OSA vs high-risk OSA: = .085). In addition, the MCW in the group at high-risk for the OSA was significantly smaller than the group at low-risk for the OSA (mean difference = -0.301 mm, = .014). The cephalometric variables (Sella-Nasion-A point angle (SNA) and Frankfort - Mandibular Plane angle (FMA)) explained only 8% of the variance in MCW.

CONCLUSIONS

Reductions in MCW appear to be present among children with OSA or those at high-risk for OSA, suggesting potential interactions between mandibular bone development and/or homeostasis and pediatric OSA.

CITATION

Fernandes Fagundes NC, d'Apuzzo F, Perillo L, et al. Potential impact of pediatric obstructive sleep apnea on mandibular cortical width dimensions. . 2021;17(8):1627-1634.

摘要

研究目的

分析诊断为阻塞性睡眠呼吸暂停(OSA)或有中高度 OSA 风险的儿童的下颌骨皮质宽度(MCW)差异。

方法

共评估了 161 名儿童:60 名经多导睡眠图诊断为 OSA 的儿童,56 名有中高度 OSA 风险的症状提示的儿童,45 名低 OSA 风险的儿童。中高度 OSA 风险的儿童通过儿科睡眠问卷进行评估。MCW 使用所有参与者的全景放射图像,使用 ImageJ 软件计算。使用协方差分析和 Bonferroni 事后检验评估 3 组 MCW 测量值之间的差异,年龄为协变量。通过回归分析评估 MCW 与特定头影测量变量之间的关联。

结果

参与者的平均年龄为 9.6 ± 3.1 岁(59%为男性,41%为女性)。平均体重指数 - 评分 0.62 ± 1.3。经多导睡眠图诊断为 OSA 的组的 MCW 小于低 OSA 风险组(平均差异 = -0.385 毫米, =.001),但与高 OSA 风险组无差异(经多导睡眠图诊断为 OSA 与高 OSA 风险: =.085)。此外,高 OSA 风险组的 MCW 明显小于低 OSA 风险组(平均差异 = -0.301 毫米, =.014)。头影测量变量(Sella-Nasion-A 点角(SNA)和法兰克福 - 下颌平面角(FMA))仅解释 MCW 方差的 8%。

结论

OSA 儿童或高 OSA 风险儿童的 MCW 似乎减少,提示下颌骨发育和/或内稳态与儿科 OSA 之间可能存在相互作用。

引文

Fernandes Fagundes NC, d'Apuzzo F, Perillo L, et al. 潜在影响儿科阻塞性睡眠呼吸暂停对下颌皮质宽度维度的影响。. 2021;17(8):1627-1634.

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