Análisis de la vía aérea mediante telerradiografía de perfil en clase II esquelética con tendencia horaria de crecimiento / Airway Cephalometric Analysis of Skeletal Class II with Clockwise Growth Tendency

Amapola Cristina Murúa Araya, Pamela Villalón Pooley, Alejandra Camus S., Hernán Palomino Montenegro

Abstract


Antecedentes: la clase II (CII) esquelética, en conjunto con un patrón horario de crecimiento, puede predisponer anatómicamente a una vía aérea superior más estrecha. Objetivo: determinar si, según la etiología de la CII esquelética (maxilar, mandibular, mixta o mixta en retroposición), en pacientes con tendencia horaria de crecimiento, se observan características particulares en el diámetro de la vía aérea. Métodos: este estudio descriptivo de corte transversal contempla la obtención de 301 telerradiografías de perfil digitales de pacientes en crecimiento, de ambos sexos, que poseen un diagnóstico de CII esquelética con tendencia horaria. Se analizó el diámetro faríngeo en sus tres niveles (VAP-A, VAP-Mx1, VAP-B), la longitud del paladar blando y la distancia del hioides al plano mandibular. Se realizó un cuestionario de calidad de vida de los sujetos. Los análisis estadísticos utilizados fueron: Anova post-Hok Tukey, T-test, chi cuadrado y test de Fisher. Resultados: el diámetro laringofaríngeo (VAP-B) en las 4 etiologías (p = 0,001) se encuentra disminuido respecto a la norma; los niños presentan un paladar blando de mayor longitud que las niñas (p = 0,018); y un 22 % de la muestra con etiología mandibular reporta apnea. Conclusiones: no se observan características particulares en el diámetro de la vía aérea en los distintos grupos estudiados. Todos presentaron un déficit laringofaríngeo con respecto a la norma, así como una deficiencia en la calidad de vida. El grupo con etiología mandibular es el único que reporta eventos de apnea durante el sueño. 

 

Background: Skeletal Class II (CII) combined with a clockwise growth pattern can anatomically predispose to a narrow upper airway. Purpose: To establish if according to the skeletal CII etiology (mandibular, maxillary, mixed, or backwards mixed position) in cases with a clockwise growth tendency is possible to observe special characteristics on the airway diameter. Methods: This cross-sectional study used 301 lateral tele-cephalograms of growing skeletal CII with clockwise tendency patients of both sexes. Analysis included pharyngeal diameter in three levels (VAP-A VAP-Mx1, VAP-B), soft palate length, and hyoid-mandibular plane distance. Patients also responded a questionnaire about quality of life. Data were analyzed through ANOVA, post-Hok Tukey, T, Square Chi, and the Fisher’s tests. Results: Significant differences were found for the laryngeal-pharyngeal diameter (VAP-B) in the 4 etiologies (p=0.001) according to the standard; male children showed a longer soft palate when compared with females (p=0.018); and 22% with mandibular etiology presented apnea. Conclusions: No special characteristics were observed in the airway of the different groups of the study. All groups had a deficit at the laryngeal-pharyngeal level as well as a quality of life deficiency. The group with mandibular etiology is the only one that reported sleep apnea. 


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DOI: http://dx.doi.org/10.11144/Javeriana.uo33-71.avam

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