[Percentage of tonsil hypertrophy in orthodontic patients with different sagittal skeletal relationship].

Objective: To investigate the prevalence of tonsil hypertrophy in patients with different sagittal skeletal craniofacial patterns, as well as the correlation between tonsil hypertrophy and the type of skeletal pattern. Methods: Lateral cephalograms of patients who visited the Department of Orthodontics Division 1, School of Stomatology, Wuhan University during January to August, 2019 were retrospectively collected. Patients (children: age≥6 and ≤12 year; adults: age≥18 year) were divided into three groups according to the ANB (subspinale-nasion-supramental) angle: the skeletal class Ⅰ group (0°≤ANB≤4°), skeletal class Ⅱ group (ANB>4°) and skeletal class Ⅲ group (ANB<0°). Tonsil hypertrophy was diagnosed with lateral cephalogram by two specifically trained orthodontists independently, according to the Baroni's method. The between-group differences in tonsil hypertrophy prevalence were analyzed using chi-square tests with Bonferroni correction (α=0.017). Results: A total of 1 776 patients (593 children and 1 183 adults) were included, among which 672 (37.8%) were with class Ⅰ, 849 (47.8%) with class Ⅱ, and 255 (14.4%) with class Ⅲ skeletal pattern. The prevalence of tonsil hypertrophy in children was 66.3% (393/593). The proportion of children with tonsil hypertrophy in class Ⅲ group [87.0% (60/69)] were significantly higher than that in class Ⅰ [65.6% (145/221), χ²=11.56, P<0.017] and class Ⅱ [62.0% (188/303), χ²=15.69, P<0.017] groups. The prevalence of tonsil hypertrophy in adults was 23.2% (275/1 183). The proportion of adults with tonsil hypertrophy in class Ⅲ group [42.5% (79/186)] was significantly higher than that in class Ⅰ [19.1% (86/451), χ²=36.50, P<0.017] and class Ⅱ [20.2% (110/546), χ²=35.00, P<0.017] groups. However, there was no significant difference in the prevalence of tonsil hypertrophy between class Ⅰ and class Ⅱ groups for both children (χ²=0.70, P>0.017) and adults (χ²=0.18, P>0.017). Conclusions: The prevalence of tonsil hypertrophy in skeletal class Ⅲ patients was significantly higher than that in patients with skeletal class Ⅰ and Ⅱmalocclusion. Tonsil hypertrophy could be an important risk factor for skeletal class Ⅲ patients.目的： 调查儿童与成年不同骨面型正畸患者的扁桃体肥大率，探讨扁桃体肥大是否与特定骨面型的发生相关，以期为扁桃体肥大伴错（牙合）畸形的早期干预提供参考。 方法： 回顾性收集2019年1至8月就诊于武汉大学口腔医学院正畸一科的正畸患者初诊头颅侧位X线片，根据患者年龄分为儿童组（年龄≥6岁且≤12岁）和成人组（年龄≥18岁），再根据ANB角（上牙槽座点、鼻根点与下牙槽座点构成的角）分为3类：Ⅰ类骨面型（ANB角≥0°且≤4°）、Ⅱ类骨面型（ANB角>4°）及Ⅲ类骨面型（ANB角<0°）。由2名经过专门培训的口腔正畸专业主治医师，根据Baroni法在头颅侧位X线片上测量扁桃体阻塞口咽气道的情况，以此判断患者是否存在扁桃体肥大。采用Bonferroni校正χ²检验比较不同骨面型扁桃体肥大率的差异（α=0.017）。 结果： 最终纳入1 776例正畸患者的头颅侧位X线片，其中儿童组593例，成人组1 183例；Ⅰ类骨面型占37.8%（672/1 776），Ⅱ类骨面型占47.8%（849/1 776），Ⅲ类骨面型占14.4%（255/1 776）。儿童组扁桃体肥大率为66.3%（393/593），其中Ⅲ类骨面型扁桃体肥大率［87.0%（60/69）］显著大于Ⅰ类和Ⅱ类骨面型［分别为65.6%（145/221）和62.0%（188/303）］（χ²=11.56和15.69，P<0.017）。成人组扁桃体肥大率为23.2%（275/1 183），其中Ⅲ类骨面型扁桃体肥大率［42.5%（79/186）］显著大于Ⅰ类和Ⅱ类骨面型［分别为19.1%（86/451）和20.2%（110/546）］（χ²=36.50和35.00，P<0.017）。儿童组或成人组的Ⅰ类与Ⅱ类骨面型扁桃体肥大率差异均无统计学意义（χ²=0.70和0.18，P>0.017）。 结论： 儿童与成年Ⅲ类骨面型正畸患者的扁桃体肥大率均显著大于对应人群Ⅰ类及Ⅱ类骨面型，扁桃体肥大可能是Ⅲ类骨面型发生的重要危险因素之一。.