青少年单侧不完全性唇腭裂植骨术后上颌骨及上气道的CBCT研究

目的:评估青少年单侧不完全性唇腭裂患者术后上颌骨及上气道的三维形态结构特征，并探索二者之间的相关性。方法:选取8～12岁青少年单侧不完全性唇腭裂术后患者30例及与年龄、性别相匹配的非唇腭裂骨性Ⅰ类错 畸形患者30例，拍摄CBCT影像并对其上颌骨及上气道进行三维结构参数的测量分析，分析唇腭裂组上颌骨及上气道三维结构参数的相关性。 结果:唇腭裂组在上颌长度、上颌高度、上颌体积及硬腭长度分别为(44.60±3.01) mm、(48.33±4.32) mm、(36.75±6.87)×10 3 mm 3、(40.46±4.90) mm上与对照组分别为(49.04±3.23) mm、(51.86±2.98) mm、(42.24±6.71)×10 3 mm 3、(47.09±2.76) mm相比明显减小；其腭咽气道容积及上气道总容积分别为(5.34±2.15)×10 3 mm 3、(14.59±6.72)×10 3 mm 3与对照组相比分别为(8.82±3.46)×10 3 mm 3、(19.46±6.33)×10 3 mm 3也明显减小，差异具有统计学意义( P<0.05)。唇腭裂组鼻咽气道容积与上颌高度呈显著的正相关性，而与硬腭高度呈显著的负相关性；腭咽气道容积与硬腭高度呈显著的正相关性；舌咽气道容积及上气道总容积与上颌体积呈显著的正相关性。 结论:青少年单侧不完全性唇腭裂患者术后上颌骨主要在矢状向和垂直向上发育受限；腭咽气道容积及上气道总容积明显减小。上气道容积与上颌骨垂直向和体积等相关三维结构参数呈显著的相关性。

Evaluation of maxilla and pharyngeal airway in post bone grafting adolescent patients with incomplete unilateral cleft lip and palate: a CBCT study

Objective:The aims of this study were to evaluate the three-dimensional (3D) structural features of maxilla and pharyngeal airway in repaired incomplete unilateral cleft lip and palate (UCLP) adolescent patients, and to investigate the morphological relationship between them.Methods:Thirty repaired incomplete UCLP adolescent patients with age range 8-12 years and thirty age and gender matched non-cleft skeletal class Ⅰ malocclusion patients were selected in this study. CBCT was performed for each group. 3D structure parameters of the maxilla and the pharyngeal airway were measured and compared, and a multiple linear regression was completed.Results:The UCLP group demonstrated a significant decrease ( P<0.05) in maxillary length, maxillary height, maxillary volume, palatal length, the volume of palatopharyngeal airway and total pharyngeal airway (44.60±3.01) mm, (48.33±4.32) mm, (36.75±6.87)×10 3 mm 3, (40.46±4.90) mm, (5.34±2.15)×10 3 mm 3, (14.59±6.72)×10 3 mm 3, respectively) as compared to the control group (49.04±3.23) mm, (51.86±2.98) mm, (42.24±6.71)×10 3 mm 3, (47.09±2.76) mm, (8.82±3.46)×10 3 mm 3, (19.46±6.33)×10 3 mm 3, respectively. Linear regression revealed that the volume of nasopharyngeal airway was positively related to the maxillary height, and negatively related to the palatal height; the volume of palatopharyngeal airway was positively related to the palatal height; the volume of glossopharyngeal airway and total pharyngeal airway were positively related to the maxillary volume. Conclusions:Significant hypoplasia of the maxilla in repaired incomplete UCLP group existed in the sagittal and vertical direction. The UCLP adolescent patients demonstrated a significant decrease in the volume of palatopharyngeal airway and total pharyngeal airway. The maxillary height and maxillary volume contribute to the variability of the volume of pharyngeal airway.