Effects Of Upper Airway Obstruction On Craniomaxillofacial Development And Airway Morphology Analysis In Children

Objective: To study the effects of upper airway obstruction on craniomaxillofacial growth and development,and use two-dimensional cephalometrics and three-dimensional reconstruction of cone beam computed tomography to analyze the features of upper airway morphology.Method: 1.Craniomaxillofacial examination was carried respectively on 176 patients with upper airway obstruction in ENT department and on 485 primary and middle students.The total prevalence of malocclusion and the prevalence of malocclusion of different dental stages were compared.Then count the malocclusion constitute ratio on Angel,s classification.2.There were 32 patients with upper airway obstruction from ENT department in orthodontic treatment served as experimental group,while 32 patients without the upper airway obstruction in orthodontic clinic served as controls.Measure the cephalometrics of craniomaxillofacial soft and hard tissue,upper airway sagittal dimension and hyoid bone position,then statistical analysis was done by independent-sample t-test.3.42 children were enrolled and divided into two groups according to the degree of adenoid hypertrophy.The CBCT was used to reconstruct the three-dimensional airway,and measure the difference in volume,cross-sectional area,transverse diameter and sagittal diameter.Result: 1.The total prevalence of malocclusion in ENT clinic was 92.05%,while it was 74.85% in primary and secondary school.The total prevalence of malocclusion and prevalence of malocclusion of mixed dentition period in ENT clinic was higher than that in primary and secondary school students with statistical significance.There was no significant difference between the two groups in permanent dentition period.2.In craniomaxillofacial soft and hard tissue measurements,only SNGo Gn had statistical difference.There were significant differences in three parameters of upper airway: posterior nasal spine point to the pharyngeal wall(PNS-UPW),after soft palate to the posterior pharyngeal wall(SPP-SPPW)and narrowest airway clearance(Mc1-Mc2).The measurements H-PP,H-PNS,H-MP and H-C3(V)representing the vertical position of the hyoid bone had statistically significant differences while no other measurements were statistically significant.3.Patients with hypertrophy adenoid had significantly decreased nasopharyngeal and pharyngeal volumes.HP plane airway cross-sectional area(CSA),HP plane airway cross-sectional area of LAT and AP,adenoid plane airway cross-sectional area was significantly reduced,while other measurements had no differences.Conclusion: The prevalence of malocclusion in children with upper airway obstruction is significantly higher than that of the normal population,which is one of the important causes of malocclusion.Children with upper airway obstruction in the growth and development prone to leading vertical mandibular growth and lower hyoid position.Obstruction of the upper airway leads to a reduction in the upper pharyngeal space.