Correlation between cephalometric variables and obstructive sleep apnoea severity in children
Correlation between cephalometric variables and obstructive sleep apnoea severity in children
复制标题
DOI：
10.23804/ejpd.2019.20.01.09
复制
发表时间：
2019-01-01
影响因子：
3.6
通讯作者：
D'Anto, V
中科院分区：
文献类型：
--
作者：
Galeotti, A.;Festa, P.;D'Anto, V
目的颅面生长的改变与儿童阻塞性睡眠呼吸暂停有关。本研究的主要目的是分析头影测量变量和阻塞性呼吸暂停低通气指数（OAHI）之间的相关性，以调查颅面特征是否可能影响阻塞性睡眠呼吸暂停的严重程度，并研究上鼻咽宽度与矢状面和垂直面上颌骨骨骼差异之间的相关性。研究了头影测量变量与阻塞性睡眠呼吸暂停/低通气指数之间的相关性以及上气道间隙与上下颌骨骼差异之间的相关性。47例经夜间睡眠检查（多导睡眠图）诊断为阻塞性睡眠呼吸暂停的儿童接受了侧位X线片、正畸和耳鼻喉检查。根据Kirjavainen进行了头影测量分析，以确定骨骼和上呼吸道变量。统计学分析：OAHI与所有头影测量变量之间进行斯皮尔曼相关分析。对上气道间隙的头影测量变量和与上下颌不齐相关的头影测量变量进行Pearson相关分析。采用卡方检验比较腺样体和扁桃体肥大患者的咬合特征。结果OAHI与ANB角测量的上下颌差异呈正相关（rho=0.32; p=0.023）。上鼻咽部宽度与上下颌骨垂直差呈显著相关：1）ad 1-PNS与下颌平面/SellaNasion角相关（r=-0.36; p=0.012），腭平面/下颌平面角（2）ad 2-PNS与腭平面/下颌平面角相关（r =-0.39; p= 0.007）。OAHI和咬合变量或腺样体和扁桃体肥大之间的非参数检验无统计学显著差异。结论本研究表明，上下颌差异和OSA的严重程度之间存在显着的相关性。此外，鼻咽宽度的减少与上下颌过度扩张型生长模式相关。这些结果支持睡眠呼吸障碍和颅面特征之间存在相关性，即使因果关系尚不清楚。基于这些证据，我们建议正畸评估的重要性，在管理的儿童阻塞性睡眠呼吸暂停。
Aim Alterations in craniofacial growth have been associated with obstructive sleep apnoea in children. The main objectives of this study were to analyse the correlation between cephalometric variables and Obstructive Apnea/Hypopnea Index (OAHI) in order to investigate if craniofacial features may influence the severity of obstructive sleep apnoea and to study the correlation between upper nasopharyngeal width and maxillomandibular skeletal discrepancy in sagittal and vertical plane.Materials and methods Study Design: Correlations between cephalometric variables and obstructive sleep apnoea/hypopnea index and between upper airways space and maxillomandibular skeletal discrepancy were investigated. Forty-seven children with obstructive sleep apnoea diagnosed by overnight sleep study (polysomnography) underwent a lateral radiograph, orthodontic and ear-nose-throat examinations. Cephalometric analysis according to Kirjavainen has been performed to define skeletal and upper airways variables. Statistics: Spearman's correlation analysis was performed between OAHI and all cephalometric variables. Pearson's correlation analysis was performed between cephalometric variables of upper airway space and cephalometric variables related to maxillomandibular discrepancy. Chi-square test was used to compare occlusal features with adenoidal and tonsillar hypertrophy. Kruskal-Wallis rank test was used to compare OAHI with occlusal variables and adenotonsillar hypertrophy.Results The results show a positive correlation between OAHI and maxillomandibular discrepancy measured by ANB angle (rho=0.32; p=0.023). A significant correlation was found between upper nasopharyngeal width and vertical maxillomandibular skeletal discrepancy: 1) ad1-PNS were correlated to Mandibular Plane/SellaNasion angle (r=-0.36; p=0.012), Palatal Plane/Mandibular Plane angle (r= -0.39; p= 0.007), and Posterior-Anterior Facial Height % (r=0.29; p =0.045); 2) ad2-PNS was correlated to Palatal Plane/Mandibular Plane angle (r= -0.39; p= 0.007). No statistically significant differences were found in non-parametric tests between OAHI and occlusal variables or adenoidal and tonsillar hypertrophy.Conclusions The present study shows a significant correlation between maxillomandibular discrepancy and the severity of OSA. Moreover, the reduction of nasopharyngeal width was correlated to maxillomandibular hyperdivergent growth pattern. These results support the presence of a correlation between sleep-disordered breathing and craniofacial features even if the cause-effect relation is still unclear. Based on these evidences, we suggest the importance of orthodontic evaluation in the management of paediatric OSA.