| ObjectivesTo investigate the differences in the upper airway morphology among adolescents of 12～15 years with different skeletal facial types.MethodsCone-beam computed tomography(CBCT)of 187 adolescents aged 12～15 years who sought orthodontic treatments were collected from the radiography database of the Stomatological Hospital of Shandong University.Dolphin 11.95 software was used to measure the parameters in relation to the upper airway morphology that were defined in this study,including transverse and sagittal diameters and their ratio,minimum cross-sectional area,nasopharynx,palatopharyngeal,glossopharynx and laryngeal area,total area of median sagittal plane,volume of each segment and total volume.Gender differences in the upper airway morphology were analyzed by independent sample t-test.One-way analysis of variance(ANOVA)was used to compare the differences of the upper airway morphology between different sagittal skeletal facial types and vertical facial patterns.Turkey LSD analysis was used to perform post-hoc pairwise comparisons.Results1.There are gender differences in the upper airway morphology in adolescents aged 12～15 years:(1)Line distance measurement of the upper airway:① Transverse diameter:males exhibited lower transverse diameter on the posterior nasal spine plane than females(P<0.05).② Sagittal diameter:males showed significant higher sagittal diameter at soft palate apical plane and epiglottis base plane than females(P<0.05).③ Ratio of transverse to sagittal diameter:Males had a significant lower transverse to sagittal diameter ratio on both the soft palate apical plane and epiglottis base plane(P<0.05).(2)Area:male(239.31mm2)showed a significant higher glossopharyngeal area than female(219.72mm2)(P<0.05).No significant gender difference was found in the nasopharynx,palatopharyngeal,larynx and total area,and in the minimum cross-sectional area.(3)Volume:there was no significant difference in the volume of each segment and total volume of the upper airway between different genders.2.Difference in the upper airway morphology between skeletal facial types.2.1 Sagittal skeletal pattern2.1.1 Male samples:(1)Line distance measurement of the upper airway:① Transverse diameter:the transverse diameters on the posterior nasal spine,soft palate apex and epiglottis floor showed no significant differences among different sagittal skeletal facial types.② Sagittal diameter:the sagittal diameters of posterior nasal spines were significantly different among different skeletal facial types.Post-hoc pairwise comparison showed that there were statistically significant differences between skeletal class I and skeletal class Ⅲ,and between skeletal class Ⅱ and skeletal class Ⅲgroups(P<0.05).③ Ratio of transverse diameter to sagittal diameter:the ratio on the posterior nasal spine plane was significantly different among different sagittal skeletal facial types,and there were significant differences between skeletal class Ⅰ and skeletal classⅡ,between skeletal class Ⅱ and skeletal class Ⅲ groups(P<0.05).(2)Area:The palatopharyngeal area and total area were significantly different among different sagittal skeletal facial types.Post-hoc pairwise comparison showed that there were significant differences between skeletal class Ⅱ and skeletal class Ⅲgroup(P<0.05).There was no significant difference in the area of nasopharynx,glossopharynx,larynx and the minimum cross-sectional between different sagittal skeletal facial types.(3)Volume:There was no significant difference in the volume of each segment and total volume of the upper airway with different sagittal skeletal facial types.2.1.2 Females:(1)Line distance measurement of the upper airway:there was no significant difference in the transverse diameter,sagittal diameter and transverse sagittal diameter ratio on the plane of posterior nasal spine,soft palate apex and epiglottis floor among different sagittal skeletal facial types.(2)Area:there were significant differences in velopharyngeal area among different sagittal skeletal facial types,and the difference was statistically significant between skeletal Class I and Skeletal Class III group(P<0.05).There was no significant difference in the area and total area of nasopharynx,glossopharynx,laryngopharynx and nasopharynx among different sagittal skeletal facial types.(3)Volume:there was no significant difference in the volume of each segment and total volume of the upper airway with different sagittal skeletal facial types.2.2 Vertical skeletal facial types2.2.1 Males:(1)Line distance measurement of the upper airway:There was no significant difference in the transverse diameter,sagittal diameter and transverse to sagittal diameter ratio on the plane of posterior nasal spine,soft palate apex and epiglottis floor among different vertical skeletal facial types.(2)Area:there were significant differences in the total midsagittal area among different skeletal facial types,and the difference between the low-angle group and the high-angle group was statistically significant(P<0.05).The pharynx area and minimum cross-sectional area of nasopharynx,velum and glossopharyngeal were not significantly different among different vertical skeletal facial types.(3)Volume:there was no significant difference in the volume of each segment and total volume of the upper airway among different vertical skeletal facial types.2.2.2 Females:(1)Line distance measurement of the upper airway:① Transverse diameter:there was no significant difference in the transverse diameter on the posterior nasal spine plane,soft palate apex and epiglottis floor among different vertical skeletal facial types.② Sagittal diameter:there were significant differences in the sagittal diameter on the epiglottis floor plane among different skeletal facial types.There were significant differences between the low-angle group and the average-angle group,and between the average-angle group and the high-angle group(P<0.05).③ Ratio of transverse diameter to sagittal diameter:the diameter ratio on the posterior nasal spine plane and the epiglottis floor plane was significantly different between different vertical skeletal facial types(P<0.05).The diameter ratio on the posterior nasal spine plane was significantly different between average-angle group and high-angle group,and the diameter ratio on the epiglottis floor plane was significantly different between low-angle group and average-angle group,and between average-angle group and high-angle group(P<0.05).(2)Area:there were significant differences in laryngopharyngeal area and total median sagittal area among different skeletal facial types.There were significant differences in laryngopharyngeal area and total median sagittal area between the low-angle group and the average-angle group,and between the average-angle group and the high-angle group(P<0.05).There were no significant differences in the areas of nasopharynx,velum and glossopharyngeal among different vertical skeletal facial types.(3)Volume:The glossopharyngeal volume was significantly different among different skeletal facial types,and the difference between the low-angle group and the average-angle group was statistically significant(P<0.05).There was no significant difference in the volume of nasopharynx,velum,laryngopharynx and total volume among different vertical skeletal facial types.Conclusions1.There are gender differences in the morphology of the upper airway in adolescents aged 12～15 years,and gender affects the size and morphology of the horizontal section of the upper airway and the glossopharyngeal area.However,there was no significant gender differences in the areas of nasopharynx,velum and laryngopharynx,the total median sagittal area,the minimum cross-sectional area and volume of each segment of the upper airway.2.There are significant differences in upper airway morphology among adolescents of 12～15 years with different skeletal facial types.Based on this study,the airway morphology of male adolescents may be easier to be influenced by the sagittal skeletal facial types,while the airway morphology of female adolescents are easier to be influenced by the vertical skeletal facial types.Therefore,it is necessary to consider the different effects of sagittal and vertical changes of the maxillary and mandible on the morphology of the upper airway between male and female when making orthodontic and orthopedic treatment plans for adolescents. |
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