Upper Airway Obstruction and Craniofacial Morphology
Upper Airway Obstruction and Craniofacial Morphology
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DOI：
10.1177/019459989110400621
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发表时间：
1991-06
期刊：
影响因子：
--
通讯作者：
J. J. Principato-J.
中科院分区：
文献类型：
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作者：
J. J. Principato-J.
耳鼻喉科医生越来越频繁地被要求评估正畸患者上呼吸道的充分性并治疗上呼吸道阻塞问题。最近的研究提供了动力，这些研究旨在将上气道阻塞与牙齿和颅骨形态的变化联系起来。据推测，儿童在关键生长时期延长口腔呼吸会引发一系列通常导致牙齿和骨骼变化的事件。在慢性口呼吸患者中，磨牙过度萌出几乎是一个恒定的特征，导致生长中的下颌骨顺时针旋转，前下垂直面高度不成比例地增加。前下部垂直面高度的这种增加通常与下颌后缩和开牙合相关。口腔呼吸时出现的低舌位会阻碍上颌骨的侧向扩张和前部发育。耳鼻喉科医生有能力客观、准确地评估上呼吸道的通畅情况。使用局部鼻减充血剂之前和之后的鼻测量评估，结合临床检查，可以提供有关上呼吸道通畅性和任何现有阻塞性病理状况原因的宝贵信息。研究应该仔细设计，以控制影响幼儿面部成长的众多变量，以便在我们自己的领域获得关于这个具有挑战性的话题的有意义的数据。
Otolaryngologists are being asked with increasing frequency to assess adequacy of the upper airway and to treat upper airway obstructive problems in orthodontic patients. The incentive has been provided by recent studies that purport to relate upper airway obstruction to dental and craniomorphologic changes. It is hypothesized that prolonged oral respiration during critical growth periods in children initiates a sequence of events that commonly results in dental and skeletal changes. In the chronic mouth-breather excessive molar tooth eruption is almost a constant feature, causing a clockwise rotation of the growing mandible, with a disproportional increase in anterior lower vertical face height. Such increases in anterior lower vertical face height are often associated with retrognathia and open bites. Low tongue posture seen with oral respiration impedes the lateral expansion and anterior development of the maxilla. Otolaryngologists have the ability to objectively and accurately assess upper airway patency. Rhinometric assessment before and after application of topical nasal decongestant, in conjunction with clinical examination, provides valuable information regarding upper airway patency and the cause of any existing obstructive pathologic condition. Studies should be designed carefully to control the numerous variables that have an impact on the growing face of a young child so that meaningful data can be obtained in our own field regarding this challenging topic.