国际口腔医学杂志

国际口腔医学杂志 ›› 2022, Vol. 49 ›› Issue (3): 249-254.doi: 10.7518/gjkq.2022056

• 专家笔谈 •    下一篇

伴扁桃体肥大Ⅲ类错𬌗畸形儿童早期矫治的临床诊疗策略

贺红()   

  1. 口腔基础医学省部共建国家重点实验室培育基地和口腔生物医学教育部重点实验室，武汉大学口腔医学院；武汉大学口腔医院正畸一科 武汉 430079
  • 收稿日期:2022-01-27 修回日期:2022-02-24 出版日期:2022-05-01 发布日期:2022-05-09
  • 通讯作者: 贺红
  • 作者简介:贺红，教授，博士，Email：drhehong@whu.edu.cn|贺红，博士，教授，博士研究生导师，武汉大学口腔医学院正畸教研室主任，武汉大学口腔医院正畸一科主任。现任中华口腔医学会正畸专业委员会副主任委员、中国医师协会睡眠医学专业委员会副主任委员、中华口腔医学会唇腭裂专业委员会常务委员，国际牙医师学院（International College of Dentists，ICD）院士、英国皇家爱丁堡牙外科学院正畸院士及考试委员会委员、世界正畸医师联盟理事、香港大学牙医学院名誉教授。主持国家自然科学基金4项及省部级科研项目7项；主编主译著作2部，参编参译著作10余部，以第一作者或通信作者发表相关学术论文110余篇。

Clinical diagnosis and strategies for early orthodontic treatment of Class Ⅲ malocclusion with tonsillar hypertrophy in children

He Hong.()   

  1. The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) ＆ Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatolgy, Wuhan University； Dept. of Orthodontics 1, College of Stomatology, Wuhan University, Wuhan 430079, China
  • Received:2022-01-27 Revised:2022-02-24 Online:2022-05-01 Published:2022-05-09
  • Contact: Hong. He

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摘要：

腺样体/扁桃体肥大是儿童上气道阻塞相关牙颌面畸形的常见病因，由此引起的睡眠打鼾、张口呼吸、睡眠不宁等临床症状已日益为患儿家长所重视。由于腺样体/扁桃体肥大不仅可能导致患儿出现突面或凹面畸形，还可能造成儿童阻塞性睡眠呼吸暂停，因此临床诊疗往往需要多学科协作。目前，国内外研究对儿童腺样体肥大相关的Ⅱ类错𬌗畸形关注度较高，而对扁桃体肥大相关的Ⅲ类错𬌗畸形缺乏足够认识。本文结合文献回顾和笔者的临床体会，对以扁桃体肥大为主要特征的儿童Ⅲ类错𬌗畸形临床诊疗策略进行探讨，以期为正畸临床治疗提供参考。

关键词: 儿童, 扁桃体肥大, 腺样体/扁桃体肥大, Ⅲ类错𬌗畸形

Abstract:

Adenotonsillar hypertrophy is the most frequent cause of upper airway obstruction and related dentofacial abnormalities in children. Its clinical symptoms, including sleep snoring, mouth breathing, and restless sleep, have been increasingly noticed by the children’s parents. Adenotonsillar hypertrophy does not only cause prognathism or retrognathism malocclusion in children but also pediatric obstructive sleep apnea (OSA), the clinical diagnosis and treatment of which often requires multidisciplinary collaboration. To our knowledge, most of the existing studies have paid more attention to Class Ⅱ malocclusion caused by adenoid hypertrophy in children, and only a few have investigated Class Ⅲ malocclusion associated with tonsillar hypertrophy. With the aim of providing reference for orthodontic treatment, this paper examines the clinical diagnosis and treatment strategies of Class Ⅲ malocclusion with tonsillar hypertrophy in children based on a literature review and actual clinical experience.

Key words: children, tonsillar hypertrophy, adenotonsillar hypertrophy, Class Ⅲ malocclusion

中图分类号: 

  • R 783.5

图 1

扁桃体大小Brodsky分级标准0度：扁桃体位于扁桃体窝内；1度：扁桃体占据口咽气道比例小于25%；2度：扁桃体占据口咽气道比例为25%~50%；3度：扁桃体占据口咽气道比例为50%~75%；4度：扁桃体占据口咽气道比例大于75%。"

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