Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea.
Department of Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Sci Rep. 2021 May 10;11(1):9881. doi: 10.1038/s41598-021-89302-4.
In children with mandibular hypoplasia, airway management is challenging. However, detailed cephalometric assessment data for this population are sparse. The aim of this study was to find risk factors for predicting difficult airways in children with mandibular hypoplasia, and compare upper airway anatomical differences using three-dimensional computed tomography (3D CT) between children with mandibular hypoplasia and demographically matched healthy controls. There were significant discrepancies in relative tongue position (P < 0.01) and anterior distance of the hyoid bone (P < 0.01) between patients with mandibular hypoplasia and healthy controls. All mandibular measures were significantly different between the two groups, except for the height of the ramus of the mandible. After adjusting for age and sex, the anterior distance of hyoid bone and inferior pogonial angle were significantly associated with a difficult airway (P = 0.01 and P = 0.02). Quantitative analysis of upper airway structures revealed significant discrepancies, including relative tongue position, hyoid distance, and mandible measures between patients with mandibular hypoplasia and healthy controls. The anterior distance of the hyoid bone and inferior pogonial angle may be risk factors for a difficult airway in patients with mandibular hypoplasia.
在下颌骨发育不全的儿童中，气道管理具有挑战性。然而，针对该人群的详细头影测量评估数据较为匮乏。本研究旨在寻找预测下颌骨发育不全儿童困难气道的危险因素，并通过三维计算机断层扫描（3D CT）比较下颌骨发育不全儿童与人口统计学匹配的健康对照组之间的上呼吸道解剖结构差异。下颌骨发育不全患者与健康对照组的相对舌位置（P<0.01）和舌骨前距（P<0.01）存在显著差异。两组之间所有下颌骨测量值均存在显著差异，除下颌骨升支高度外。在调整年龄和性别后，舌骨前距和下颌角后下间距与困难气道显著相关（P=0.01 和 P=0.02）。对上气道结构的定量分析显示，下颌骨发育不全患者与健康对照组之间存在显著差异，包括相对舌位置、舌骨距离和下颌骨测量值。舌骨前距和下颌角后下间距可能是下颌骨发育不全患者发生困难气道的危险因素。
