摘要目的 评估上颌骨Le Fort Ⅰ型截骨上颌骨前移术对鼻腔通气功能的影响.方法 对13例Ⅲ类错颌畸形患者进行前瞻性的研究,年龄18 ～35岁,手术方案包括上颌骨Le Fort Ⅰ型单块截骨并前移.术前3d及术后3、6个月对研究对象分别进行前鼻镜及鼻声反射检查.术前3d、术后6个月,对所有研究对象进行NOSE量表的主观性评估.并对术前及术后的结果进行统计学分析.结果 鼻声反射检测结果显示术前3d及术后3、6个月鼻腔总阻力分别为(1.189±0.38)cm H2O/L/mi、(1.081±0.43) cm H2O/L/mi和(1.111±0.40) cm H2O/L/mi,鼻腔总容积分别为( 14.920±1.95) ml、(16.380±4.32)ml和(15.660±4.25) ml,鼻腔平均截面积分别为(0.500±0.09) cm2、(0.570±0.15) cm2和(0.560±0.14) cm2,但术前后比较差异无统计学意义(P＞0.05).NOSE量表的主观性评估结果显示,术后6个月时的评估分值较术前下降,即主观症状改善,术前、后比较差异无统计学意义.结论 上颌骨Le Fort Ⅰ型单块截骨上颌骨前移手术不会对患者的鼻腔通气功能产生不良影响.同时利用客观性检测(鼻声反射检测)及主观性检测(NOSE量表)手段可以有效地对鼻腔结构及功能进行评估.

abstractsObjective To assess the nasal airway changes after maxillary advancement following Le Fort Ⅰ osteotomy. Methods 13 cases with class Ⅲ malocclusion,aged 18-35 years old,were studied prospectively. All the patients underwent Le Fort Ⅰ osteotomy and maxillary advancement.Rhinological inspectum,acoustic rhinometry(AR) were performed before operation,3 and 6 months after operation.The Nasal Obstruction Symptom Evaluation (NOSE) scale was also completed by 13 patients before and after operation.SPSS was used for statistical assay.Results AR assessment showed that NAR was (1.189±0.38) cm H2O/L/mi、(1.081±0.43) cm H2 O/L/mi and (1.111 ±0.40) cm H2O/L/mi before operation,3 and 6 months after operation; NV was ( 14.920 ± 1.95) ml、( 16.380 ±4.32) ml and (15.660±4.25) ml;and MCA was (0.500 ±0.09) cm2、(0.570 ±0.15) cm2 and (0.560 ±0.14)cm2,respectively. However,no significant improvement was showed. For the whole cohort,significant improvement in nasal breathing was documented ( by NOSE scores) at 6 months after surgery.Conclusions Le Fort Ⅰ osteotomy with maxillary advancement doesn' t cause bad effect on nasal airways in patients with maxillary dysplasia.And the combination of objective (AR) and subjective (NOSE scale) assessment can better evaluate of the structure and function of the nose.