摘要目的 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.

abstractsObjective 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.