CAJ | 학술논문

目的探讨上颌前方牵引治疗对唇腭裂患者上气道的影响.方法 21名上颌发育不足的唇腭裂术后的单侧完全性唇腭裂(unilateral cleft lip and palate,UCLP)患者进行前方牵引治疗,并于治疗前后拍摄头颅侧位片;21名相同年龄分布的暂时不能进行前方牵引治疗的UCLP患者做为对照,分别于首诊及一年后拍摄头颅侧位片.通过21个项目的头影测量比较两组患者经过治疗或观察后颅面形态与上气道的变化,并探讨变化的影响因素.结果两组患者治疗前年龄、治疗或观察时间无统计学差异.两组患者治疗前颅面形态与上气道宽度均无统计学差异.前方牵引治疗组患者在治疗后SNA、A-TFH、OJ、A-Pg增大,SNB、P-TFH减小、下颌平面角增大,差异有统计学意义.治疗组患者经过前方牵引上气道鼻咽宽度增大(PNS-Ad1,PNS-Ad2,OAW1)分别为(1.79±0.89)mm,(1.76±0.94)mm和(1.79±0.69)mm而上气道中段和下段宽度变化无统计学意义.未发现患者气道的变化与上下颌骨的变化相关.结论前方牵引治疗后唇腭裂患者上气道上段宽度增加,前方牵引对唇腭裂患者上气道宽度产生影响.
목적 탐토상합전방견인치료대진악렬환자상기도적영향.방법 21명상합발육불족적진악렬술후적단측완전성진악렬(unilateral cleft lip and palate,UCLP)환자진행전방견인치료,병우치료전후박섭두로측위편;21명상동년령분포적잠시불능진행전방견인치료적UCLP환자주위대조,분별우수진급일년후박섭두로측위편.통과21개항목적두영측량비교량조환자경과치료혹관찰후로면형태여상기도적변화,병탐토변화적영향인소.결과 량조환자치료전년령、치료혹관찰시간무통계학차이.량조환자치료전로면형태여상기도관도균무통계학차이.전방견인치료조환자재치료후SNA、A-TFH、OJ、A-Pg증대,SNB、P-TFH감소、하합평면각증대,차이유통계학의의.치료조환자경과전방견인상기도비인관도증대(PNS-Ad1,PNS-Ad2,OAW1)분별위(1.79±0.89)mm,(1.76±0.94)mm화(1.79±0.69)mm이상기도중단화하단관도변화무통계학의의.미발현환자기도적변화여상하합골적변화상관.결론 전방견인치료후진악렬환자상기도상단관도증가,전방견인대진악렬환자상기도관도산생영향.
Objective To investigate the effect of maxillary protraction on the upper pharyngeal widths in the UCLP(unilateral cleft lip and palate) patients. Methods 21 operated UCLP patients with underdeveloped maxilla treated with maxillary protraction headgear were chosen as the study group, lateral cephalograms before and after treatment were taken for each patients; 21 UCLP patients with the same age range and also with anterior erossbite were taken as controls, lateral cephalogram were taken at first visit and one year after for each patient. Cephalomerics of 21 measurements was carried out before and after treatment or observation to find the factors which affected the upper airway. Results There was no significant difference between the treated and control groups in age, treatment duration or observing time. SNA, A-TFH, OJ, A-Pg, MP-SN increased and SNB. P-TFH decreased after maxillary protraction in the treated group. The upper airway widths (PNS-Ad1, PNS-Ad2 and OAW1) increased (1.79±0. 89)mm, (1. 765±0. 94)mm and (1.79±0. 69)mm respectively after maxillary protraction. There were no significant changes in middle and lower oral airway space. There was no correlation between the changes of upper airway and the maxillary structure. Conclusions Maxillary protraction increased the pharyngeal width in the nasopharygeal level, and there were no significant changes of pharyngeal widths on other levels.