手术辅助上颌快速扩弓对鼻气道形态和鼻阻力的影响

中国口腔颌面外科杂志 ›› 2015, Vol. 13 ›› Issue (2): 147-150.

手术辅助上颌快速扩弓对鼻气道形态和鼻阻力的影响

聂萍, 陶丽, 唐艳梅, 赵彦惠, 王晓玲, 朱敏

上海交通大学医学院附属第九人民医院·口腔医学院口腔颅颌面科,上海市口腔医学重点实验室,上海 200011

收稿日期:2014-04-14 修回日期:2014-06-26 出版日期:2015-03-20 发布日期:2015-04-23
通讯作者: 朱敏,Tel:021-23271699-5735,E-mail:zminnie@126.com
作者简介:聂萍（1984-）,女,硕士,主治医师,E-mail:nieping1011@sina.com
基金资助:
上海高校青年教师培养资助计划（shjdy029）; 上海市卫计委青年项目（20144Y0124）

Effect of surgically assisted rapid maxillary expansion on the dimension of the nasal air way and nasal air resistance

NIE Ping, TAO Li, TANG Yan-mei, ZHAO Yan-hui, WANG Xiao-ling, ZHU Min

Department of Oral and Craniomaxillofacial Science, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology. Shanghai 200011, China

Received:2014-04-14 Revised:2014-06-26 Online:2015-03-20 Published:2015-04-23
Supported by:
Supported by Shanghai University Young Teacher Training Program (shjdy029) and Shanghai Health and Family Planning Commission Project (20144Y0124)

摘要/Abstract

摘要： 目的: 评价手术辅助上颌快速扩弓（surgically assisted rapid maxillary expansion, SARME）对成人鼻腔容积及鼻阻力的影响。方法: 16例上颌横向发育不足,伴一侧或双侧后牙反牙合成人患者进行手术辅助上颌快速扩弓。所有研究对象均在治疗前（T1）、扩弓保持3个月后（T2）拍摄螺旋CT,测量鼻腔宽度及鼻腔容积变化,并采用鼻声反射测量（AR）检查鼻腔最小横截面积及鼻阻力的改变。应用SPSS 16.0 软件包中的配对t检验比较治疗前（T1）、扩弓保持3个月后（T2）鼻腔宽度、鼻腔最小横截面积、鼻腔容积和鼻阻力的改变。结果: 上颌快速扩弓后,鼻腔上部及中部宽度无显著变化（P>0.05）,而鼻底宽度显著增加（P<0.01）。鼻腔容积及鼻腔最小横截面积显著增加（P<0.05）,而鼻阻力显著减小（P<0.01）。结论: 手术辅助上颌快速扩弓可对成人鼻气道形态产生影响,使鼻阻力降低。

关键词: 上颌快速扩弓, 鼻气道, 鼻阻力

Abstract: PURPOSE: To evaluate the effect of surgically assisted rapid maxillary expansion (SARME) on the volume of the nasal cavity and nasal air resistance in adults. METHODS: The sample comprised 16 patients with maxillary transverse deficiency. They had unilateral or bilateral posterior crossbites. Spiral CT scans and acoustic rhinometry were taken to evaluate the changes of nasal cavity width, nasal cavity volume, minimal cross-sectional area and nasal airway resistance before and 3 months after SARME. The parameters were analyzed with SPSS16.0 software package for paired t test. RESULTS: No statistically significant differences were found in the upper or middle part of the nasal cavity widths (P>0.05), but there was a significant increase in nasal floor width (P<0.01). And there were significant increases in nasal volume and minimal cross-sectional area (P<0.05), and decrease in nasal resistance (P<0.01). CONCLUSIONS: SARME is likely to improve the dimension of the nasal air way in adults, and decrease the nasal resistance.

Key words: Rapid maxillary expansion, Nasal air way, Nasal air resistance

中图分类号:

R782.2

聂萍, 陶丽, 唐艳梅, 赵彦惠, 王晓玲, 朱敏. 手术辅助上颌快速扩弓对鼻气道形态和鼻阻力的影响[J]. 中国口腔颌面外科杂志, 2015, 13(2): 147-150.

NIE Ping, TAO Li, TANG Yan-mei, ZHAO Yan-hui, WANG Xiao-ling, ZHU Min. Effect of surgically assisted rapid maxillary expansion on the dimension of the nasal air way and nasal air resistance[J]. China J Oral Maxillofac Surg, 2015, 13(2): 147-150.

参考文献

[1] Peltomäki T. The effect of mode of breathing on craniofacial growth-revisited [J]. Eur J Orthod, 2007, 29(5): 426-429.
[2] Bretos JL, Pereira MD, Gomes HC, et al. Sagittal and vertical maxillary effects after surgically assisted rapid maxillary expansion (SARME) using Haas and Hyrax expanders [J]. J Craniofac Surg, 2007, 18(6): 1322-1326.
[3] 钱玉梅, 陈丽萍, 吴亚东, 等. 人体上呼吸道三维数值模型的建立与气体流场数值模拟分析[J]. 上海口腔医学, 2010, 19(3): 310-314.
[4] 袁晓培, 郭荃容, 王旻, 等. 结构性鼻炎患者鼻通气功能的主客观评估 [J]. 中国耳鼻咽喉头颈外科, 2012, 19(3): 143-146.
[5] Katyal V, Pamula Y, Daynes CN, et al. Craniofacial and upper airway morphology in pediatric sleep-disordered breathing and changes in quality of life with rapid maxillary expansion[J]. Am J Orthod Dentofacial Orthop, 2013, 144(6): 860-871.
[6] 程晨景,叶京英. 鼻阻力与阻塞性睡眠呼吸暂停低通气综合征 [J]. 国际耳鼻喉科头颈外科杂志, 2008, 32(5): 269-271.
[7] Ceroni Compadretti G, Tasca I, Alessandri-Bonetti G, et al. Acoustic rhinometric measurements in children undergoing rapid maxillary expansion[J]. Int J Pediatr Otorhinolaryngol,2006,70(1): 27-34.
[8] Cross DL, McDonald JP. Effect of rapid maxillary expansion on Skeletal, dental, and nasal structures: a postero-anterior cephalometric study [J]. Eur J Orthod, 2000, 22(5): 519-528.
[9] Enoki C, Valera FC, Lessa FC, et al. Effect of rapid maxillary expansion on the dimension of the nasal cavity and on nasal air resistance [J]. Int J Pediatr Otorhinolaryngol, 2006, 70(7): 1225-1230.
[10] Nada RM, van Loon B, Schols JG, et al. Volumetric changes of the nose and nasal airway 2 years after tooth-borne and bone-borne surgically assisted rapid maxillary expansion [J]. Eur J Oral Sci, 2013, 121(5): 450-456.
[11] Magnusson A, Bjerklin K, Nilsson P, et al. Nasal cavity size, airway resistance, and subjective sensation after surgically assisted rapid maxillary expansion: a prospective longitudinal study[J]. Am J Orthod Dentofacial Orthop,2011, 140(5):641-651.
[12] De Felippe NL, Bhushan N, Da Silveira AC, et al. Long-term effects of orthodontic therapy on the maxillary dental arch and nasal cavity [J]. Am J Orthod Dentofacial Orthop, 2009, 136(4): 490.e1-8.
[13] 李辉. 鼻声反射测量的准确性—与CT、鼻内镜、流体位移法的比较 [J]. 临床耳鼻咽喉头颈外科杂志, 2010, 24(17): 810-813.