Xu Qiuping, Wang Xiaoya, Li Na, Wang Ying, Xu Xin, Guo Jing
Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, China.
Department of Stomatology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Front Pediatr. 2023 Mar 31;11:1124610. doi: 10.3389/fped.2023.1124610. eCollection 2023.
To identify craniofacial and upper airway morphological characteristics associated with the presence and severity of obstructive sleep apnea (OSA) in children.
This study consisted of 82 OSA children and 77 controls (age 5-10 years). All subjects underwent cephalograms and were divided into a 5-7 age group and an 8-10 age group. Cephalometric variables were compared between OSA children and controls, and hierarchical regression analysis was performed to examine the relationship between cephalometric variables and OSA severity [expressed by the obstructive apnea-hypopnea index (OAHI)] in different age groups.
Increased A/N ratio, narrowed posterior airway space, decreased SNA and SNB angles, and shortened ramus height were observed among OSA children in different age groups. In the 5-7 age group, the A/N ratio and a lower gonial angle explained 40.0% and 14.7% of the variance in the OAHI, respectively. In the 8-10 age group, the BMI z-score and A/N ratio explained 25.2% and 6.6% of the variance in the OAHI, followed by a lower gonial angle and the hyoid-retrognathion distance (19.1% in total).
Adenoid hypertrophy was a major factor associated with OSA in preschool children, whereas obesity replaced adenoid hypertrophy as the main contributor to OSA in late childhood. Several craniofacial skeletal variables such as the SNB angle, ramus height, lower gonial angle, and hyoid position are also associated with the presence and/or severity of OSA, which could be used to help recognize children at a higher risk for OSA.
确定与儿童阻塞性睡眠呼吸暂停（OSA）的存在及严重程度相关的颅面和上气道形态特征。
本研究包括82名OSA儿童和77名对照儿童（年龄5至10岁）。所有受试者均接受了头影测量，并被分为5至7岁年龄组和8至10岁年龄组。对头影测量变量在OSA儿童和对照儿童之间进行比较，并进行分层回归分析，以检查不同年龄组头影测量变量与OSA严重程度[由阻塞性呼吸暂停低通气指数（OAHI）表示]之间的关系。
在不同年龄组的OSA儿童中观察到A/N比值增加、后气道间隙变窄、SNA和SNB角度减小以及下颌升支高度缩短。在5至7岁年龄组中，A/N比值和较小的下颌角分别解释了OAHI变异的40.0%和14.7%。在8至10岁年龄组中，BMI z评分和A/N比值分别解释了OAHI变异的25.2%和6.6%，其次是较小的下颌角和舌骨-下颌后缩距离（总共19.1%）。
腺样体肥大是学龄前儿童OSA的主要相关因素，而在儿童后期，肥胖取代腺样体肥大成为OSA的主要促成因素。几个颅面骨骼变量，如下颌骨SNB角、下颌升支高度、下颌角和舌骨位置，也与OSA的存在和/或严重程度相关，可用于帮助识别OSA风险较高的儿童。
