(3.236.118.225) 您好!臺灣時間:2021/05/17 09:49
字體大小: 字級放大   字級縮小   預設字形  
回查詢結果

詳目顯示:::

我願授權國圖
: 
twitterline
研究生:盛昌民
研究生(外文):Chang- Min Sheng
論文名稱:自孩童至年輕成人其咽呼吸道深度及舌骨位置之發育變化
論文名稱(外文):Developmental Changes of Pharyngeal Airway Depth and Hyoid Bone Position from Childhood to Young Adulthood
指導教授:蔡�痟f
指導教授(外文):Hung-Huey Tsai
學位類別:碩士
校院名稱:臺北醫學大學
系所名稱:牙醫學系碩博士班
學門:醫藥衛生學門
學類:牙醫學類
論文種類:學術論文
論文出版年:2008
畢業學年度:96
語文別:中文
論文頁數:44
中文關鍵詞:發育改變呼吸道舌骨
外文關鍵詞:DevelopmentChangeAirwayHyoid bone
相關次數:
  • 被引用被引用:0
  • 點閱點閱:114
  • 評分評分:
  • 下載下載:0
  • 收藏至我的研究室書目清單書目收藏:0
對於個體應有的正常生長發育變化有充分的瞭解,才有足夠的知識以為根據進而判斷異常狀況的發生。針對咽呼吸道深度及舌骨位置,過去的研究多著重在治療結果所造成兩者的變化。然而,此二者之正常發育情形,回顧以往的文獻,多偏重於三十歲之後的生長變化,而對於在此年紀之前的生長情形,所知有限。故對於自孩童至年輕成人時期,其咽呼吸道深度及舌骨位置之生長發育,實有進一步了解的必要性。
這個研究的目的有三方面:(1)了解正常台灣人,自孩童至年輕成人,其咽呼吸道深度及舌骨位置之發育變化, (2)探討是否有性別差異性存在? 以及(3)試圖找出與舌骨垂直位置有關之顱顏型態項目。
研究材料是239張正常台灣人的側方測顱放射攝影片。其中女性有132位,男性有107位,年齡介於7歲至27歲。所有材料根據齒齡(dental age)分成三組:混合齒列期,早期恆齒列期與恆齒列期。每一張側方測顱放射攝影片皆進行23項線性的(linear)與20項角度的(angular)測量。男女之間之性別差異(sexual dimorphism)是以t檢定(Student''s t-test)進行分析;各齒齡組別之間,則是以變異數分析(analysis of variance, ANOVA)進行比較。逐步迴歸分析(stepwise regression analysis)則用以探討與舌骨垂直位置有關之顱顏型態項目。所有統計分析之顯著水準(level of significance)定為P< 0.05。
研究結果顯示:(1)自孩童至年輕成人,咽呼吸道深度之發育變化為逐漸增加,性別差異出現在口咽下端,此處深度之增加量男性較女性為大。(2)自孩童至年輕成人,隨年齡增長,舌骨垂直位置在男性有較明顯之向下方移動的情形;舌骨位置於年輕成人恆齒列期出現明顯性別差異。(3)影響舌骨垂直位置之顱顏型態項目為下顎枝長度與顏面角(facial angle),其表現方式則有性別差異。
Interpretation of the significance of variations in the growth and function is dependent on an understanding of the normal developmental changes. It is necessary to know the changes in the pharyngeal airway depth and hyoid bone position that occur in the normal subjects during their active growth years and beyond. Most of the previous studies emphasized the treatment effect on the pharyngeal airway size and hyoid bone position; however, the developmental changes of the pharyngeal airway and hyoid bone position seemed to receive little attention in the past.
The purposes of the present study were threefold: (1) To understand the developmental changes in the pharyngeal airway depth and hyoid bone position from childhood to young adulthood in normal Taiwanese persons, (2) to identify the existence of any sexual dimorphism, and (3) to find the predictive value of selective variables for the hyoid bone position.
Lateral cephalometric radiographs of 239 normal Taiwanese (132 females and 107 males; aged 7~27 years) were separated into three stages (mixed dentition stage, early permanent dentition stage, and permanent dentition stage) according to the dental age. Twenty-three linear and 20 angular measurements were taken in all subjects. Sexual dimorphism was analyzed by Student’s t-test. Analysis of variance (ANOVA) was used to compare among three stages in both genders. A stepwise regression analysis was carried out to predict the hyoid bone position. The level of significance for all analyses was set at P<0.05.
Our data showed that the pharyngeal airway depth increased from the mixed dentition stage to the permanent dentition stage in both genders. There was sexual dimorphism in the lower pharyngeal airway depth. The hyoid bone position showed an obvious difference in the permanent dentition stages between genders, and the hyoid descends more obviously in males. The vertical position of the hyoid bone was associated with the ramus length and the facial angle, but the relationship in males was reversed compared to that in females.
致謝……………………………………………………………………I
中文摘要…………………………………………………………..…II
英文摘要……………………………………………………………..IV
目錄…………………………………………………………………...VI

第一章 緒論……………………………………………………….1
第一節 研究動機與重要性…………………………………..1
第二節 研究目的………………………………………………2
第三節 研究假設………………………………………............3

第二章 文獻回顧………………………………………………...4
第一節 咽呼吸道 (Pharyngeal Airway)…………………….4
1-1咽(pharynx)…………………………………………………4
1-2咽呼吸道之狹窄與塌陷 (Narrowing and Collapse of
Pharyngeal Airway)…………………………………………5
1-3正常人其咽呼吸道大小與年齡相關性之研究…………...5
1-4使用側方測顱放射攝影(lateral cephalometric
radiography)於咽呼吸道之評估........................................6
第二節 舌骨位置 (Hyoid Bone Position)…………………..7
2-1舌骨(Hyoid Bone)……………………………......................7
2-2舌骨位置隨生長發育化之研究………………………...….8
2-3舌骨位置與下顎骨位置之關係…………………………....8
2-4舌骨位置與呼吸障礙疾病(breathing-disordered diseases)...9
第三節 阻塞性睡眠呼吸中止/呼吸不全症
候群 (Obstructive Sleep Apnea/Hypopnea
Syndrome,簡稱OSAHS)……………......................10
3-1 定義………………………………………………………...10
3-2 影響 ……………………………………………………….10
3-3 OSAHS之側方測顱研究………………………………...10

第三章 研究材料與方法……………………………………....12
第一節 研究材料………………………………………………..12
第二節 研究方法……………………………………………….13
第三節 方法誤差……………………………………………….13
第四節 統計方法………………………………………….........14

第四章 結果……………………………………………………......15
第一節 咽呼吸道之發育變化………………………………..15
第二節 舌骨位置之發育變化………………………………..15
第三節 與舌骨位置有關之顱顏型態項目………………...16

第五章 討論……………………………………………………….17
第一節 咽呼吸道之發育變化………………………………..17
1-1 各齒齡組差異……………………………………………..17
1-2 性別差異…………………………………………………..18
第二節 舌骨位置之發育變化………………………………..19
2-1 性別差異…………………………………………………..19
2-2 舌骨位置與下咽呼吸道深度(lower pharyngeal depth)…..19
2-3 舌骨垂直位置(vertical position of hyoid bone)之變化…...20

第六章 結論……………………………………………………….22
參考文獻…………………………………………………………….23
附圖與附表……………………...................................................30
圖1.………………………………………………………………..30
圖2.……………………………………………………………......31
圖3.……………………………………………………………….32
圖4.………………………………………………………………..33
圖5.………………………………………………………………..34
圖6.………………………………………………………………..35
圖7………………………………………………………………..36
表1………………………………………………………………...37
表2………………………………………………………………..37
表3………………………………………………………………...38
表4………………………………………………………………...39
表5………………………………………………………………..40
表6………………………………………………………………..41
表7………………………………………………………………..42
表8………………………………………………………………..43
表9………………………………………………………………..44
1.Harvold EP, Tomer BS, Vargervik K, Chierici G. Primate experiments on oral respiration. Am J Orthod, 79: 359-382, 1981.
2.Bresolin D, Shapiro PA, Shapiro GG, Chapko MK. Dassel S. Mouth breathing in allergic children: its relationship to dentofacial development. Am J Orthod, 83: 334-340, 1983.
3.Ricketts RM. The interdependence of the nasal and oral capsules. In: McNamara JA (ed). Naso-Respiratory Function and Craniofacial Growth. Ann Arbor, MI, University of Michigan Press, pp.165-198, 1979.
4.Nicole E, Koord S, Alexander J, Akram R, Urs T, Tateyuki I. Long-term changes of hyoid bone and pharyngeal airway size following advancement of the mandible. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 99: 404-410, 2005.
5.Nicole E, Wenko S, Tateyuki I. Long-term changes of hyoid bone position and pharyngeal airway size following mandibular setback by sagittal split ramus osteotomy. J Craniomaxillofac Surg, 33:111-117, 2005.
6.Kondo E, Aoba TJ. Nonsurgical and nonextraction treatment of skeletal class III open bite: its long-term stability. Am J Orthod Dentofacial Orthop, 117: 267-287, 2000.
7.Hoekema A, Hovinga B, Stegenga B, De Bont LGM. Craniofacial morphology and obstructive sleep apnoea: a cephalometric analysis. J Oral Rehabil, 30: 690-696, 2003.
8.Young T, Skatrud J, Peppard PE. Risk factors for obstructive sleep apnea in adults. JAMA, 291:2013-2016, 2004.
9.Strohl KP, Redline S. Recognition of obstructive sleep apnea. Am J Respir Crit Care Med, 154: 279-289, 1996.
10.Miles PG, Vig PS, Weyant RJ, Forrest TD, Rockette HE. Craniofacial structure and obstructive sleep apnea syndrome-a qualitative analysis and meta-analysis of the literature. Am J Orthod Dentofacial Orthop, 109: 163-172, 1996.
11.Pae EK, Lowe AA, Fleetham JA. Shape of the face and tongue in obstructive sleep apnea patients—statistical analysis of coordinate data. Clin Orthod Res, 2: 10-18, 1999.
12.Tsai HH. The positional changes of hyoid bone in children. J Clin Pediatr Dent, 27: 29-34, 2002.
13.Praud JP, Reix P. Upper airways and neonatal respiration. Respir Physiol Neurobiol, 149: 131-141, 2005.
14.Hiatt JL, Gartner LP. Textbook of Head and Neck Anatomy. New York, NY: Appleton-Century-Crofts, pp.48-56, 1982.
15.Schwab RJ. Upper airway imaging. Clin Chest Med, 19: 33-54, 1998.
16.Sperber GH. Craniofacial Embryology. Dental Practitioner Handbook, No. 15. Bristol: John Wright and Sons Limited, pp. 54-69, 1973.
17.Rajagopal MR, Jerry P. Applied anatomy and physiology of the airway and breathing, Indian J. Anaesth, 49:251-256, 2005.
18.Deegan PC, McNicholas WT. Pathophysiology of obstructive sleep apnoea. Eur Respir J, 8: 1161-1178, 1995.
19.Benumof JL. Obstructive sleep apnea in the adult obese patient: implications for airway management. Anesthesiol Clin North America, 20: 789-811, 2002.
20.Haponik EF, Smith PL, Bohlman ME, Allen RP, Goldman SM, Bleecker ER. Computerized tomography in obstructive sleep apnea, correlation of airway size with physiology during sleep and wakefulness. Am rev Respir Dis, 127: 221-226, 1983.
21.Brown IG, Zamel N, Hoffstein V. Pharyngeal cross-sectional area in normal men and women. J Appl Physiol, 61: 890-895, 1986.
22.Martin SE, Mathur R, Marshall I, Douglas NJ. The effect of age, sex, obesity and posture on upper airway size. Eur Respir J, 10: 2087-2090, 1997.
23.Vig PS. Respiration, nasal airway, and orthodontics: A review of current clinical concepts and research. In: Johnston Jr LE (ed). New Vistas in Orthodontics. Philadelphia, PA: Lea and Febiger, pp.76-102, 1985.
24.Linder-Aronson S. Adenoids-Their effect on mode of breathing and nasal airflow and their relationship to characteristics of the facial skeleton and the dentition. Acta Otolarynol, 265(suppl): 1-132, 1970.
25.Kollias I, Krogstad O. Adult craniocervical and pharyngeal changes- a longitudinal cephalometric study between 22 and 42 years of age. Part II: morphological uvulo-glossopharyngeal changes. Eur J Orthod, 21: 345-355, 1999.
26.Tsai HH. Developmental changes of pharyngeal airway structures from young to adult persons. J Clin Pediatr Dent, 31: 221-223, 2007.
27.Biby RE, Preston CB. The hyoid triangle. Am J Orthod, 80:92-97, 1981.
28.Athanasius AE, Toutountzakis N, Mavreas B, Ritsau M, Wenzel A. Alterations of hyoid bone position and pharyngeal depth and their relationship after surgical correction of mandibular prognathism. Am J Orthod Dentofacial Orthop, 100: 259-265, 1991.
29.Bench RW. Growth of the cervical vertebrae as related to tongue, face, and denture behavior. Am J Orthod, 49: 183-214, 1963.
30.Tallgren A, Solow B. Hyoid bone position, facial morphology and head posture in adults. Eur J Orthod, 9: 1-8, 1987.
31.Adamidis IP, Spyropoulos MN. Hyoid bone position and orientation in class I and Class III malocclusions. Am J Orthod Dentofacial Orthop, 101: 308-312, 1992.
32.Tsai HH, HO CY, Lee PL, Tan CT. Cephalometric analysis of nonobese snorers either with or without obstructive sleep apnea syndrome. Angle Orthod, 77; 1054-1061, 2007.
33.Mozer NJ, Philips B, Berry DT, Harbison L. What is hypopnea anyway? Chest, 105: 426-428, 1994.
34.Young T, Blustein J, Finn L, Palta M. Sleep-disordered breathing and motor vehicle accidents in a population-based sample of employed adults. Sleep, 20: 608-613, 1997.
35.Shahar E, Whitney CW, Redline S, Lee ET, Newman AB, Nieto FJ, O’connor GT, Boland LL, Schwartz JE, Samet JM. Sleep-disordered breathing and cardiovascular disease cross-sectional results of the Sleep Heart Health Study. Am J Respir Crit Care Med, 163: 19-25, 2001.
36.Battagel JM, L’Estrange PR. The cephalometric morphology of patients with obstructive sleep apnoea (OSA). Eur J Orthod, 18: 557-569, 1996.
37.Dahlberg G. Statistical methods for medical and biological students. In : Seipel C M Variation of tooth position. Lund Hakan Ohlsson Boktryckeri, 25-28, 1946.
38.Scammon RE: The measurement of the body in childhood, in The Measurement of Man. Minneapolis, University of Minnesota Press, 1930.
39.Özbek MM, Memikoglu TUT, Gogen H, Lowe AA, Caspian E. Oropharyngeal airway dimensions and functional-orthopedic treatment in skeletal Class II cases. Angle Orthod, 68: 327-336, 1998.
40.Pierce RJ, Worsnop CJ. Upper airway function and dysfunction in respiration. Clin Exp Pharm Physiol, 26:1-10, 1999.
41.Spyropoulos MN, Tsolakis AI, Alexandridis C, Katsavrias E, Dontas I. Role of suprahyoid musculature on mandibular morphology and growth orientation in rats. Am J Orthod Dentofac Orthop, 122: 392-400,2002.
42.Young T, Palta M, Dempsey J, Skatrud J,Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med, 328:1230–1235, 1993.
QRCODE
 
 
 
 
 
                                                                                                                                                                                                                                                                                                                                                                                                               
第一頁 上一頁 下一頁 最後一頁 top