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Obstructive sleep apnea syndrome (Obstructive sleep apnea syndrome, OSAS) is the upper respiratory paragraphs recurrent complete or partial obstruction during sleep, resulting in blood oxygen saturation decreased, thereby affecting the circulatory, respiratory, nervous, function of the endocrine and other major systems. The increased emphasis on the more serious harm and a higher incidence of clinical. OSAS patients with airway obstruction during sleep may be caused by changes in the anatomical structures of the upper airway. Skull, jaw, palatal, hyoid and other maxillofacial hard tissue forming the upper airway stent, and its change in the position can affect the position and the tension of attachment on or adjacent soft tissue, which affects the size and stability of the airway . Structural abnormalities of the upper airway of OSAS severity of a positive correlation, the the the hyoid position change is an important factor for OSAS incidence. Research OSAS individual on airway and hyoid position is abnormal, it is necessary to the normal samples. In this study, the natural head under normal (?) Crowd the upper airway and hyoid position X cephalometric study. 61 cases in Guangdong Supreme airway disorders purpose natural head shot of normal bone surface normal (?) Skull lateral radiographs of the crowd, cephalometric analysis and research, aimed at obtaining the normal Scots crowd in Guangdong airway and hyoid Cephalometric measurement values, gender comparative analysis for clinical reference. Materials and methods Guangzhou two vocational College's students (about 7000 more than people) healthy subjects select qualified students 61 cases (male 20, female 41 cases), the average age of 18.77 ± 1.72 years, age the range of 16.00 to 22.08 years of age. Sample inclusion criteria: (1) the first permanent molars and canines for neutral relationship front teeth covered (?), Covering the relationship is normal. ② dentition complete absence (except third molars), the upper and lower teeth arranged in neat rows, good bite. The ③ face symmetrical, cephalometric coordination, natural closure of the upper and lower lip in the middle of the bit. ④ orthodontic or orthognathic treatment history and uvula velopharyngeal angioplasty treatment history. ⑤ no snoring at night and daytime sleepiness history, no chronic rhinitis, turbinate and tonsil hypertrophy on respiratory disease history, nor bronchitis, chronic respiratory diseases such as asthma and emphysema. ⑥ mouth opening, open the normally closed type, temporomandibular joint disease. ⑦ Hometown Guangdong Province, no clinical diagnosis of overweight history no mouth breathing history of bad habits, the headless neck radiotherapy, and trauma surgery. ⑧ health, no psychiatric disorders. ⑨ All subjects in this experiment to understand the purpose and process of voluntary participation throughout the experiment. ⑩ the six cervical Brent Hassel and other mature stage as a reference, the film cephalometric cervical mature indications in the stage of completion that the lower edge of the second, third and fourth cervical vertebral deep concave, and the third and fourth cervical a height greater than the width. 11 normal facial type. Class I sagittal facial type: ANB angle between 0.7 ° and 4.7 °. Normal vertical facial type: GoGn-SN angle at 27.3 ° to 37.7. Between. 2 main material and instrument ① Germany SIRONA Orthophos XG PLUS X optical panoramic machine. ② Chinese Lenovo Group the C200-Chang Yue desktop computer, Japan RISE Corporation Winceph7.0 cephalometric analysis software. ③ sterile dental instruments: mouth mirror, probe, tweezers. 75% alcohol cotton, sterilized dry cotton balls, barium sulfate paste. ④ head bit auxiliary positioning device: mirror (40cmx25cm), plumb and plumb line. Research methods and the process of (1) screening study history taking to develop the survey questionnaire, including the experimenter basic information (name, sex, date of birth, race, place of birth, height, weight, etc.), the oral specialist medical history ( no history of dental disease, with or without orthodontic or orthognathic treatment history and uvula uvulopalatopharyngoplasty treatment history, the presence or absence of dental treatment history), maxillofacial and neck disease and a history of trauma, a history of breathing whether the nighttime snoring and daytime sleepiness history, general health status, psychological status and systemic disease history. The clinical examination ① face checks: maxillofacial maxillofacial symmetry cephalometric situation. ② intraoral examination: dental health, arrangement of occlusion. Whether the adenoid and tonsillar hypertrophy. ③ the temporomandibular articular check: temporomandibular joint functional movement with or without snapping, pain, joint area for tenderness and tenderness, the opening degree of size, with or without opening limited, open CLOSED normal. ④ X-ray examination: Cephalometric results show ANB angle between 0.7 ° and 4.7 ° GoGn-SN angular located the 27.3 ° to 37.7 °. Shooting (2) cephalometric lateral X-ray of the object of study, Germany SIRONA Orthophos XG PLUS X light panorama machine shot cephalometric piece. X-ray tubes from patients' median sagittal plane 150cm linear amplification rate of 11%, in measurement analysis to enter Winceph7.0 cephalometric analysis software be corrected. Subjects gently marking time, do the most substantial head back and forth, gradually reduce the swing amplitude until a very comfortable position, adjust the head in the muscles, ligaments relax position, also called self-balancing bit (self- balance position). Monitor in front of the mirror, adjust the two look straight ahead through the visual correction system, mirror the bits (mirror position), also known as the natural head. And inserted earplugs inserted to ensure that fixed head position. Told his subjects not to swallow, lips gently closed, the teeth (?) Bit in the middle, relax, calm and natural breathing, end-expiratory breath-hold, and then shooting cephalometric lateral radiographs. Because in the end-expiratory shooting compensatory role in the removal of the upper airway open major muscle muscle traction on the trachea, which can be removed. Before shooting at the the research objects tongue back coated with a thin layer of barium sulfate paste in order to enhance development. Data acquisition and processing using Winceph7.0 cephalometric measurement and analysis software, by the author in a continuous period of time to complete the sentinel of the X-ray measurement conditions remain unchanged. SPSS13.0 statistical software for statistical analysis. All data were presented as mean ± standard deviation, the application of two independent samples t-test measured values ??statistically significant difference between the gender analysis, when for unequal variances, t-test with Satterthwaite approximation correction. The end of all patients with lateral radiographs of the skull measurements from randomly selected 30 cases of repeated measurements to assess the measurement error. Repeated measurements with the first measurement separated by more than four weeks. Paired t-test to detect the error of the two measurements. P lt; 0.05 was considered statistically significant. Results 1 natural head 61 cases in Guangdong normal (?) Cephalometric values ??of the upper airway and hyoid position X in the crowd for clinical reference. 2. Bony nasopharynx: posterior nasal spine to the sella point distance (PNS-S) in males than in females (t = 4.628, P lt; 0.001) to the distance of the first cervical vertebra, the former point, then nasal spine (PNS-Aa ) no significant difference between the gender. No significant difference in the nasopharynx (PNS-ad1, PNS-ad2) men and women of the soft tissue. Pharyngeal wall (P1-P2) before and after the the oropharyngeal soft palate at the tip distance in males than in females (t = 2.212, P = 0.031), while the mouth of the the pharyngeal sidewall distance (Ve1-Ve2) men and women before and after the pharynx the most narrow There was no statistical difference. Pharyngeal wall distance around the hypopharynx: Pas1-Pas2 males larger than females (t = 2.031, P = 0.047); Ph1-Ph2 men than women (t = 2.165, P = 0.034); Va1 by Va2 men also greater than women (t = 2.405, P = 0.019), the differences were statistically significant. The differences between men and women of the soft palate and the palatal plane angle ((PNS-P1) / NL) was statistically significant (t = -4.065, P lt; 0.001), male soft palate compared to women more upright. Thickness of the soft palate (SP1-SP2) males significantly larger than females (t = 3.161, P = 0.002), while the soft palate length (PNS-P1) no significant difference between men and women. Tongue measurements: the length of the male tongue (Val-T) than females (t = 3.328, P = 0.002) tongue thickness (TD-VT) than women (t = 4.178, P lt; 0.001) . Representing the epiglottis position measurement result is: male vallecula lowest point in the vertical direction to the rear the nasal spine Distance (Val-PNS) than females (t = 9.246, P LT; 0.001), the horizontal direction: vallecula lowest point to hyoid most points (Val-H) distance in males than in females (t = 2.833, P = 0.009); men also greater than the distance from the front plane of the third and fourth cervical (Val-CVP) women (t = 3.068, P lt; 0.003); women vallecula the lowest point to the mandible joint lowest point distance (Val-Gpost) male average is greater than the average, but the difference was not significant. Val-CVP and SN ratio between men and women was no significant difference. Val-H SN ratio in males than in females (t = 2.190, P = 0.038), Val-PNS SN ratio in males than in females (t = 4.170, P lt; 0.001). 5. Addition to the H-Gpost-Bo outside the hyoid angle between men and women showed no significant difference. H-Bo-Gpost Triangle the Gpost corner men than women (t = $ 258.3, P = 0.012). 6 the distance of the hyoid bone to the cervical spine males than in females: the H-CV4ia (t = 5.173, P lt; 0.001) H-CV4ip (t = 7.027, P lt; 0.001), the H-CV3ia (t = 7.208, P lt ; 0.001), H-CV2ia (t = 8.489, P lt; 0.001), H-CVT (t = 8.408, P lt; 0.001). Hyoid bone to the Bolton Point (H-Bo) (t = 9.589, P lt; 0.001), the hyoid bone to the joint point (H-Ar) (t = 10.159, P lt; 0.001), the hyoid bone to the sella point (Hm- S) (t = 10.606, P lt; 0.001), anterior skull base plane (H-NSL) (t = 9.253, P lt; 0.001), the hyoid bone to the to the mandibular branch plane (H-RL) (t = 4.606 , P lt; 0.001), the hyoid bone to the palatal plane (H-NL) (t = 7.668, P lt; 0.001) distance in males than in females. Hyoid bone to the distance from the point of submental (H-Me) (t = -2.430, P = 0.018), and hyoid top on point to submental vertex and perpendicular to the mandibular plane line distance (H-MP/GN) (t = -2.362, P = 0.022) men less than women, the difference was statistically significant. Hyoid bone to the mandible the the joint last point distance (H-Gpost), hyoid bone to the chin point distance (H-Pg) the men average of less than the female average of, but the difference was not significant. Hyoid bone to the mandibular plane distance (H-MP), (H-NSLP / N) of the Foot of the hyoid bone the former skull base plane to nasion distance between men and women was no significant difference. Males than females, the gender line significantly different from the ratio of male and SN are larger than females: H-CV4ia/SN (t = 2.770, P = 0.009), H-CV4ip/SN (t = 3.754, P = 0.001), H-CV3ia/SN (t = 4.736, P lt; 0.001), H-CV2ia/SN (t = 5.631, P lt; 0.001), H-Bo/SN (t = 4.964, P lt; 0.001), H-Ar/SN (t = 5.088, P lt; 0.001), Hm-S/SN (t = 4.480, P lt; 0.001), H-RL/SN (t = 3.244, P = 0.002), H-CVT/SN (t = 4.606, P lt; 0.001), H-NSL/SN (t = 3.838, P lt; 0.001), H-NL/SN (t = 4.294, conclusions soft tissue nasopharynx, hard organization nasopharynx (PNS-Aa) and oropharyngeal minimum clearance gender differences, men thickness of the soft palate, tongue length and thickness were significantly larger than females. epiglottis men in the vertical direction is closer to the bottom, while the men and women in the horizontal direction no difference in male hyoid position closer to the top than women below. the hyoid plane relative to the other craniofacial plane angle no gender differences, and hyoid plane variation.
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