头颅测量和声学咽测量在儿童中重度阻塞性睡眠呼吸暂停治疗前评估中的应用价值。
Utility of Cephalometry and Acoustic Pharyngometry for the Assessment of Moderate to Severe Obstructive Sleep Apnea Before Treatment in Childhood.
文献信息
| PMID | 42703366 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Plamen Bokov |
| 作者单位 | Service de Physiologie Pédiatrique-Centre du Sommeil, Hôpital Robert Debré, AP-HP, Université Paris Cité, INSERM NeuroDiderot, Paris, France. |
| 期刊 | Nature and science of sleep |
| SCI 分区 | Q2 |
| IF | 4 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
目的： 关于儿童阻塞性睡眠呼吸暂停（OSA）的ERS声明指出，头颅测量和声学咽测量可能是OSA管理中有用的检查。我们这项横断面研究的目的是评估因OSA转诊治疗的儿童中，OSA严重程度，即阻塞性呼吸暂停低通气指数（OAHI），与声学咽测量和头颅测量所得指标之间的相关性。
方法： 因中重度OSA（AHI ≥ 5次/小时）转诊治疗的儿童接受了坐位和仰卧位声学咽测量（测量咽部容积并计算估计咽部顺应性）以及头颅测量（测量法兰克福下颌平面角：FMA和法兰克福下颌切牙角：FMIA、舌骨至下颌平面的距离）。
结果： 连续纳入205名儿童（平均年龄 ± 标准差：11.2 ± 3.7岁，73名女性，1型OSA“扁桃体肥大”：55名儿童，2型“肥胖”：80名，3型“综合征”：70名）。在多因素回归分析中，仅FMA和舌骨距离仍与OAHI独立相关（模型校正r2：0.12，p< 0.001，解释力较弱）。FMA角可区分正常发散（21°< FMA < 29°：41%的儿童）、高发散（FMA ≥ 29°：32%）和低发散（≤ 21：27%）。高发散的参与者更年轻、肥胖程度较低，并且下面部更长（腺样体面容）。在多因素回归分析中，仅身高和FMIA仍与咽部容积独立相关（模型校正r2：0.32，p<0.001，中等解释力）。
结论： 儿童OSA可与低发散相关。其严重程度与颅面形态相关，头颅测量可为选定的儿童提供额外的内型信息。
英文摘要
PURPOSE: The ERS Statement dealing with childhood obstructive sleep apnea (OSA) declared that cephalometry and acoustic pharyngometry may be useful exams for the management of OSA. The objective of our cross-sectional study was to evaluate the correlations between the severity of OSA, namely obstructive apnea-hypopnea index (OAHI), and indices obtained from both acoustic pharyngometry and cephalometry in children referred for OSA treatment.
METHODS: Children referred for treatment of their moderate to severe OSA (AHI ≥ 5/hour) underwent acoustic pharyngometry in sitting and supine positions (measurement of pharyngeal volume and calculation of estimated pharyngeal compliance) and cephalometry (measurement of Frankfort Mandibular plane Angle: FMA and Frankfort Mandibular Incisal Angle: FMIA, hyoid bone distance to mandibular plane).
RESULTS: Two hundred and five consecutive children were enrolled (mean age ± SD: 11.2 ± 3.7 years, 73 females, type 1 OSA "enlarged tonsils": 55 children, type 2 "obese": 80, type 3 "syndromes": 70). In a multiple regression analysis, only FMA and hyoid bone distance remained independently linked to OAHI (adjusted r2 of the model: 0.12, p< 0.001, weak explanatory power). The FMA angle allowed differentiating normodivergence (21°< FMA < 29°: 41% of the children), hyperdivergence (FMA ≥ 29°: 32%), and hypodivergence (≤ 21: 27%). The participants with hyperdivergence were younger, less obese, and had a longer lower face (adenoid facies). In a multiple regression analysis, only height and FMIA remained independently linked to pharyngeal volume (adjusted r2 of the model: 0.32, p<0.001, moderate explanatory power).
CONCLUSION: Childhood OSA can be associated with hypodivergence. Its severity is linked to craniofacial morphology, and cephalometry provides additional endotypic information in selected children.