Hammood Afnan R, Saloom Hayder F
Department of Orthodontics, College of Dentistry, University of Baghdad, Baghdad, Iraq.
J Orthod Sci. 2024 Sep 17;13:35. doi: 10.4103/jos.jos_20_24. eCollection 2024.
This study aims to determine whether there were cephalometric changes between grades II and IV adenoid hypertrophy.
A cross-sectional study was conducted on 120 6-12-year-old patients selected from the ear, nose, and throat department at Imam Al-Hussein Medical City in Karbala. Patients were classified into three groups (each = 40) based on endoscopic findings: control, grade II, and grade IV. The findings were confirmed with cephalometric radiographs. Specific cephalometric points were identified to measure sella-nasion-point A (SNA), sella-nasion-point B (SNB), point A-nasion-point B (ANB), sella-nasion-pogonion (SNPog), sella nasion plane-palatal plane (SNPP), palatal plane-mandibular plane (PPMP), sella nasion plane-mandibular plane (SNMP), saddle, articular, gonial angles, and the -axis. Additionally, superior-posterior airway space (SPAS), posterior air way space (PAS), mandibular plane-hyoid bone (MP-H), third cervical vertebra-hyoid bone (C3-H), total anterior facial height (TAFH), total posterior facial height (TPFH), upper anterior facial height (UAFH), lower anterior facial height (LAFH), and the Jarabak ratio were measured.
Analysis of variance (ANOVA) and Welch tests indicated statistically significant differences ( < 0.05) among the three groups in SNA, SNB, SNPog, PPMP, SNMP, gonial angle, -axis, SPAS, PAS, MP-H, and the Jarabak ratio. Tukey's honestly significant difference (HSD) and Games-Howell tests indicated a statistically significant difference between grade II and grade IV in SNA, SNMP, -axis, SPAS, PAS, MP-H, and Jarabak ratio.
The present study demonstrated that craniofacial changes start to occur at the moderate adenoid enlargement throughout the downward backward mandibular rotation. More changes would become evident at the severe stage; therefore, an urgent medical intervention and the establishment of nasal breathing by orthodontic treatment with breathing activity would be needed.
本研究旨在确定Ⅱ度和Ⅳ度腺样体肥大之间是否存在头颅测量学变化。
对从卡尔巴拉伊玛目侯赛因医疗城耳鼻喉科选取的120例6至12岁患者进行了横断面研究。根据内镜检查结果将患者分为三组（每组40例）：对照组、Ⅱ度组和Ⅳ度组。通过头颅侧位X线片对结果进行确认。确定了特定的头颅测量点以测量蝶鞍-鼻根-点A（SNA）、蝶鞍-鼻根-点B（SNB）、点A-鼻根-点B（ANB）、蝶鞍-鼻根-颏前点（SNPog）、蝶鞍鼻根平面-腭平面（SNPP）、腭平面-下颌平面（PPMP）、蝶鞍鼻根平面-下颌平面（SNMP）、蝶鞍角、关节角、下颌角以及Y轴。此外，还测量了上后气道间隙（SPAS）、后气道间隙（PAS）、下颌平面-舌骨（MP-H）、第三颈椎-舌骨（C3-H）、全面部前高（TAFH）、全面部后高（TPFH）、面上部前高（UAFH）、面下部前高（LAFH）以及贾拉巴克比率。
方差分析（ANOVA）和韦尔奇检验表明，三组在SNA、SNB、SNPog、PPMP、SNMP、下颌角、Y轴、SPAS、PAS、MP-H和贾拉巴克比率方面存在统计学显著差异（P<0.05）。图基诚实显著差异（HSD）检验和盖姆斯-豪厄尔检验表明，Ⅱ度和Ⅳ度在SNA、SNMP、Y轴、SPAS、PAS、MP-H和贾拉巴克比率方面存在统计学显著差异。
本研究表明，在腺样体中度增大时，随着下颌向下向后旋转，颅面变化开始出现。在严重阶段会有更明显的变化；因此，需要紧急医疗干预，并通过正畸治疗结合呼吸训练来建立鼻腔呼吸。
