口面部肌功能治疗对改善阻塞性睡眠呼吸暂停患儿腺样体扁桃体切除术术后面部形态的影响

doi:10.19439/j.sjos.2021.04.010

上海口腔医学 ›› 2021, Vol. 30 ›› Issue (4): 389-393.doi: 10.19439/j.sjos.2021.04.010

口面部肌功能治疗对改善阻塞性睡眠呼吸暂停患儿腺样体扁桃体切除术术后面部形态的影响

单华清^1,2, 王愉惠^1,2, 於丽明^1,2, 李晓艳³, 刘月华^1,2

1.复旦大学附属口腔医院（筹）,上海市口腔医院口腔正畸科,上海 200001;
2.上海市颅颌面发育与疾病重点实验室,上海 200001;
3.上海市儿童医院耳鼻喉科-头颈外科,上海 200333

收稿日期:2020-12-04 修回日期:2021-01-25 出版日期:2021-08-25 发布日期:2021-09-23
通讯作者: 刘月华,E-mail:liuyuehua@fudan.edu.cn
作者简介:单华清（1985-）,女,硕士研究生,主治医师,E-mail:shanerzhu@163.com
基金资助:
上海申康医院发展中心三年行动计划（16CR2044B）; 上海申康医院发展中心第二轮三年行动计划（SHDC2020CR2043B）

Orofacial myofunctional therapy improves facial morphology of children with obstructive sleep apnea after adenotonsillectomy

SHAN Hua-qing^1,2, WANG Yu-hui^1,2, YU Li-ming^1,2, LI Xiao-yan³, LIU Yue -hua^1,2

1. Department of Orthodontics, Shanghai Stomatological Hospital, Fudan University. Shanghai 200001;
2. Shanghai Key Laboratory of Craniomaxillofacial Department and Diseases, Fudan University. Shanghai 200001;
3. Department of Otolaryngology & Head and Neck Surgery, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200333, China

Received:2020-12-04 Revised:2021-01-25 Online:2021-08-25 Published:2021-09-23

摘要/Abstract

摘要： 目的: 评估口面部肌功能治疗对腺样体扁桃体切除术（adenotonsillectomy,AT）后仍有口呼吸症状的阻塞性睡眠呼吸暂停综合征（obstructive sleep apnea,OSA）患儿面部形态的影响。方法: 纳入10例4~7岁腺样体扁桃体切除术1个月后仍然张口呼吸的OSA患儿,进行口面部肌功能治疗。在口面部肌功能治疗前和治疗结束后6个月,分别拍摄照片,进行软组织测量。选择面部软组织12个具有标志性的点,进行比例和角度测量,采用Graphpad Prism 8 软件进行统计分析,比较口面部肌功能治疗前、后患者面部形态改变。结果: 与治疗前相比,OSA患儿治疗后人中与上唇比例增加（P=0.0002）,上唇与面下1/3比例增加（P<0.05）,鼻唇角增大（P=0.0005）,颏唇角增大（P=0.0026）,面型角减小（P<0.05）。结论: 口面部肌功能治疗能够有效改善OSA患儿AT术后面部形态,可作为OSA患儿AT术后的一种补充治疗,解决患儿术后仍持续存在的张口呼吸问题。

关键词: 腺样体扁桃体手术, 口面部肌功能治疗, 张口呼吸, 面部形态学

Abstract: PURPOSE: This study investigated the effectiveness of orofacial myofunctional therapy(OMT) in improving facial morphology of children with obstructive sleep apnea (OSA) after adenotonsillectomy (AT). METHODS: Ten children aged from 4-7 years with persistent oral breathing for more than 1 month after adenotonsillectomy were chosen to receive orofacial myofunctional therapy. The patients were required to take photos before and after orofacial myofunctional therapy. In order to compare the soft changes before and after OMT treatment, twelve representative mark points were selected and used for proportion and angle measurements. Graphpad Prism 8 statistical software was used for statistical analysis, to compare the differences in facial morphology of patients before and after treatment. RESULTS: Compared with before OMT, a significant difference was found in the proportion of Sn-Ls/Sn-Stms(P=0.0002), Sn-Stms/Sn-Me'(P<0.05), as well as in the angle of Gs-Sn-Pos (P<0.05), nasolabial angle(P=0.0005), mentolabial angle (P=0.0026) after OMT treatment. CONCLUSIONS: Orofacial myofunctional therapy can be considered as an effective complementary treatment for OSA patients with oral breathing after adenotonsillectomy.

Key words: Obstructive sleep apnea, Orofacial myofunctional therapy, Oral breathing, Facial morphology

中图分类号:

R783.5

单华清, 王愉惠, 於丽明, 李晓艳, 刘月华. 口面部肌功能治疗对改善阻塞性睡眠呼吸暂停患儿腺样体扁桃体切除术术后面部形态的影响[J]. 上海口腔医学, 2021, 30(4): 389-393.

SHAN Hua-qing, WANG Yu-hui, YU Li-ming, LI Xiao-yan, LIU Yue -hua. Orofacial myofunctional therapy improves facial morphology of children with obstructive sleep apnea after adenotonsillectomy[J]. Shanghai Journal of Stomatology, 2021, 30(4): 389-393.

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口面部肌功能治疗对改善阻塞性睡眠呼吸暂停患儿腺样体扁桃体切除术术后面部形态的影响

Orofacial myofunctional therapy improves facial morphology of children with obstructive sleep apnea after adenotonsillectomy

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