上颌反复快速扩缩对上气道影响的锥束CT研究

摘要

Objective:To evaluate the changes of different parts of upper airway after alternating rapid palatal expansion and constriction via three dimensional measurement, compared with the protocol of ra-pid palatal expansion alone.Methods: In the study, 36 patients with retrognathic maxilla were selected and randomized to either group A or group B.The patients in group A were treated with rapid palatal expansion alone.The patients in group B were treated with alternating rapid palatal expansion and constriction.Three dimensional analyses were performed on all pre-and post-treatment cone-beam computed tomography (CBCT) images with the software Dolphin.Results: Two subjects in group B were lost to follow up during the treatment.The gender distributions, ages and all measuring items before treatment had no significant difference between group A and group B (P>0.05).Nasal floor width, nasal lateral width, nasal volume, and nasopharynx volume increased significantly in each group after rapid palatal expansion alone or rapid palatal expansion and constriction (P<0.05).The variations of oropharyngeal volume and hypopharyngeal volume had no significant difference (P>0.05).No significant difference was observed in the nasal floor width and nasal lateral width increment among the anterior, median and posterior parts in each group either (P>0.05).No significant difference in all the measuring items was observed between the two groups (P>0.05).Conclusion:Alternating rapid palatal expansion and constriction could increase the volume of nasal and naopharynx cavities by the similar way of rapid palatal expansion alone, and had no obvious effect on oropharynx and hypopharynx cavities.%目的:使用锥束CT(cone-beam computed tomography,CBCT)以传统的上颌单次快速扩弓的方法为对照,研究上颌反复快速扩缩后上气道不同部位的三维变化.方法:选择36例上颌骨发育不足患儿,随机分为A、B两组,每组18例,A组上颌单次快速扩弓,B组上颌反复快速扩缩.使用Dolphin软件对所有病例扩弓或扩缩前后CBCT影像进行测量.结果:B组2例患者在治疗中失访.A、B两组性别分布、年龄及治疗前各测量项目差异均无统计学意义(P>0.05).组内对比显示,两组患者在上颌单次快速扩弓或反复快速扩缩后,鼻腔底部宽度、鼻腔外缘宽度、鼻腔体积及鼻咽体积均较治疗前显著增大(P<0.05),口咽体积、下咽腔体积治疗前后差异均无统计学意义(P>0.05),鼻腔底部及外缘前/中/后三段宽度增加量差异均无统计学意义(P>0.05).两组组间所有测量项目的变化量差异均无统计学意义(P>0.05).结论:上颌反复快速扩缩可使鼻腔、鼻咽体积增大,增大程度与上颌单次扩弓相似,对口咽及下咽腔无明显影响.