下颌骨牵引成骨术对 Pierre Robin 序列婴儿头影测量的影响。
The Impact of Mandibular Distraction Osteogenesis on Cephalometric Measurements in Infants with Pierre Robin Sequence.
机构信息
Hanoi Medical University, Hanoi, Vietnam.
Vietnam National Children's Hospital, Hanoi, Vietnam.
出版信息
Kobe J Med Sci. 2023 Nov 16;69(3):E106-E114. doi: 10.24546/0100485259.
BACKGROUND
The obstruction of the upper airway (UAO) in infants diagnosed with Robin Sequence (RS) is caused by micrognathia, and in severe cases, it can result in obstructive sleep apnea (OSA). Mandibular distraction osteogenesis (MDO) is a secure and efficient remedy for significant UAO. However, there is insufficient data on the related cephalometric changes. Therefore, this study meticulously analyzes the mandibular cephalometric changes in infants with RS who have undergone MDO using internal devices. The aim is to gain a more comprehensive understanding of the short- and long-term impacts of distraction on the mandible.
METHODS
The study examined 73 consecutive cases of mandibular distraction osteogenesis (MDO) performed by a single surgeon. Preoperative and postoperative lateral cephalograms, as well as CT scans of the mandible, were utilized to assess population averages for both time points. A two-sample T-Test with equal variance was used for this analysis.
RESULTS
After the MDO procedure, 19 out of 21 cephalometric parameters exhibited significant morphological changes. On average, there were notable improvements of 20.3 mm (60.7%) in length, 9.8 mm (49.7%) in height, 12.6 mm (36.1%) in width, and 211% in airway parameters. However, most parameters showed only mild regression at the time of device removal and 6 to 12 months post-MDO. Nonetheless, the cephalometric parameters remained significantly improved compared to the preoperative measurements.
CONCLUSIONS
The use of cephalometric measurement is a potent approach that provides a clear and measurable understanding of how MDO influences both immediate and long-term growth of the mandible. This quantitative assessment of the effects of mandibular distraction allows for the refinement of surgical techniques and the optimization of outcomes. Therefore, incorporating cephalometric measurements in the evaluation of patients undergoing MDO can lead to better surgical planning and more favorable results.
背景
患有 Robin 序列（RS）的婴儿的上呼吸道（UAO）阻塞是由小下颌引起的，在严重的情况下，可能导致阻塞性睡眠呼吸暂停（OSA）。下颌骨牵引成骨术（MDO）是治疗严重 UAO 的安全有效的方法。然而，关于相关的头影测量变化的数据不足。因此，本研究使用内部装置仔细分析了接受 MDO 的 RS 婴儿的下颌骨头影测量变化。目的是更全面地了解牵引对下颌骨的短期和长期影响。
方法
本研究检查了由一位外科医生进行的 73 例连续的下颌骨牵引成骨术（MDO）。使用术前和术后侧位头颅侧位片以及下颌骨 CT 扫描来评估两个时间点的人群平均值。使用具有相等方差的两样本 T 检验进行此分析。
结果
MDO 手术后，21 个头影测量参数中有 19 个表现出明显的形态变化。平均而言，长度增加了 20.3 毫米（60.7%），高度增加了 9.8 毫米（49.7%），宽度增加了 12.6 毫米（36.1%），气道参数增加了 211%。然而，在去除器械时和 MDO 后 6 至 12 个月，大多数参数仅显示轻度回归。尽管如此，与术前测量相比，头影测量参数仍明显改善。
结论
使用头影测量是一种有力的方法，可以清楚地理解 MDO 如何影响下颌骨的即时和长期生长。这种对下颌骨牵引影响的定量评估可以改进手术技术并优化结果。因此，在评估接受 MDO 的患者时纳入头影测量可以导致更好的手术计划和更有利的结果。
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