Division of Sleep Surgery, Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Division of Sleep Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
J Clin Sleep Med. 2022 Apr 1;18(4):1187-1202. doi: 10.5664/jcsm.9866.
There is increasing recognition that environmental factors affect human craniofacial development and our risk for disease. A scoping review of the literature was performed looking at environmental influences on craniofacial development to better understand this relationship and investigate what further study is needed to determine how this relationship may impact obstructive sleep apnea.
A comprehensive literature search was performed using the Ovid Medline database from inception to May 2020 with relevance to craniofacial development in 5 clinically oriented variables: diet, secular change, breastfeeding/nonnutritive sucking habits, nasal obstruction/mouth breathing, and masticatory muscle function. The Oxford Centre for Evidence-Based Medicine Levels of Evidence was used to assess studies based on study design.
We initially identified 18,196 articles, of which 260 studies were fully reviewed and 97 articles excluded. The remaining 163 articles were categorized as follows: secular change (n = 16), diet (n = 33), breastfeeding/nonnutritive sucking habits (n = 28), nasal obstruction/mouth breathing (n = 57), and masticatory muscle function (n = 35). Ninety-three percent of included studies reported a significant association between craniofacial morphology and environmental factors. The majority of studies were characterized as low-level-of-evidence studies, with 90% of studies being a level-of-evidence of 4 or 5.
The studies in this review suggest that environmental factors are associated with changes in craniofacial development. However, most studies were heterogeneous and low-level studies, making strong conclusions about these relationships difficult. Future rigorous studies are needed to further our understanding of environmental influences on craniofacial development and obstructive sleep apnea risk.
Yu JL, Tangutur A, Thuler E, Evans M, Dedhia RC. The role of craniofacial maldevelopment in the modern OSA epidemic: a scoping review. . 2022;18(4):1187-1202.
越来越多的人认识到环境因素会影响人类颅面发育和我们患病的风险。对文献进行了范围综述，以了解环境对颅面发育的影响，更好地理解这种关系，并探讨需要进一步研究什么，以确定这种关系如何影响阻塞性睡眠呼吸暂停。
使用 Ovid Medline 数据库从成立到 2020 年 5 月进行了全面的文献检索，涉及 5 个临床相关变量的颅面发育：饮食、世俗变化、母乳喂养/非营养吸吮习惯、鼻阻塞/口呼吸和咀嚼肌功能。使用牛津循证医学中心证据水平来评估基于研究设计的研究。
我们最初确定了 18196 篇文章，其中 260 篇研究进行了全面审查，97 篇研究被排除在外。其余 163 篇文章分类如下：世俗变化（n=16）、饮食（n=33）、母乳喂养/非营养吸吮习惯（n=28）、鼻阻塞/口呼吸（n=57）和咀嚼肌功能（n=35）。93%的纳入研究报告称，颅面形态与环境因素之间存在显著关联。大多数研究的证据水平较低，其中 90%的研究为 4 级或 5 级。
本综述中的研究表明，环境因素与颅面发育的变化有关。然而，大多数研究是异质的和低水平的研究，使得很难对这些关系得出强有力的结论。需要进一步进行严格的研究，以进一步了解环境对颅面发育和阻塞性睡眠呼吸暂停风险的影响。
Yu JL, Tangutur A, Thuler E, Evans M, Dedhia RC. 颅面发育不良在现代阻塞性睡眠呼吸暂停流行中的作用：范围综述。睡眠呼吸医学杂志。2022;18(4):1187-1202.
