摘要： 目的： 通过对颌面部创伤导致下颌骨骨折患者的头颅侧位片进行测量分析，探讨不同部位骨折患者上气道间隙及舌骨位置的变化情况，为治疗方案的选择提供参考。方法：210名研究对象均拍摄标准X线头颅定位侧位片，将髁突骨折组、下颌角骨折组、下颌体骨折组、颏/颏旁骨折组分别与正常组做比较，分析4种下颌骨骨折上气道间隙及舌骨位置的变化情况。结果：与正常组比较， 不同部位骨折对上气道间隙的影响不同，尤其是双侧下颌体骨折和颏/颏旁粉碎性骨折对下口咽气道间隙、喉咽气道间隙影响显著，影响患者通气功能，重者易发生通气障碍。结论：下颌骨不同部位骨折与患者的上气道结构及舌骨位置的变化密切相关，双侧下颌体骨折和颏/颏旁粉碎性骨折对下口咽气道间隙影响显著。
关键词:
下颌骨骨折,
上气道间隙,
舌骨位置,
X线头影测量,
髁突骨折,
下颌角骨折,
下颌体骨折,
颏/颏旁骨折
Abstract: Objective：The aim of this study was to analyze the variations of upper airway space and hyoid position in cases of different sites of mandible fracture through lateral cephalometric radiography. Methods: 180 mandible fracture patients were consisted in this study and divided into 4 groups according to fracture location site. Group 1 (n=40) were cases with fracture of mandibular condyle. Group 2 (n=44) were cases with fracture of angle of mandible. Group 3 (n=36) were cases with fracture of body of mandible. Group 4 (n=60) were cases with fracture of anterior part of mandible. 30 medical students with normal occlusal relations were used as control. Lateral cephalometric radiographs were examined. Information of bone and soft tissue profile were used to evaluate airway alterations. Results：Different types of mandibular fractures affected the upper airway space in various degree. In particular, the bilateral mandibular body or parasymphyseal fractures had shown a significant influence on the lower oropharyngeal and laryngopharyngeal airway spaces. The ventilatory function of those patients was found severely restricted with serious obstructions. Conclusion：Different types of mandibular fractures are closely related with upper airway structure and hyoid position. The bilateral mandibular body or parasymphyseal fractures have significantly effect on the lower oropharyngeal airway spaces. Clinicians should understand this complication.
Key words:
mandible fracture,
upper airway space,
hyoid position,
X?鄄ray cephalometry,
mandibular condylar fractures,
mandibular angle fracture,
mandibular body fracture,
parasymphyseal fracture
中图分类号:
魏玉清，程立军，赵民朝，潘祥峰. 下颌骨不同部位骨折患者上气道间隙及舌骨位置变化的X线头影测量分析[J]. 《口腔颌面外科杂志》, 2012, 22(4): 265-269.
WEI Yu-qing, CHENG Li-jun, ZHAO Min-chao, PAN Xiang-feng. Cephalometric Radiography of Upper Airway Space and Hyoid Position in Mandible Fractures[J]. 《Journal of Oral and Maxillofacial Surgery》, 2012, 22(4): 265-269.