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Master's Dissertation
DOI
https://doi.org/10.11606/D.61.2021.tde-18022022-131029
Document
Author
Full name
Lucas Antonio da Costa
Institute/School/College
Knowledge Area
Date of Defense
Published
Bauru, 2021
Supervisor
Committee
Tonello, Cristiano (President)
Alonso, Nivaldo
Antoneli, Melissa Zattoni
Dinarte, Vanessa Ramos Pires
Title in English
Upper airways differences between Pierre Robin sequence and Treacher Collins syndrome
Keywords in English
Airway obstruction
Pierre Robin Sequence
Treacher Collins Syndrome
Abstract in English
Introduction: Pierre Robin Sequence (PRS) and Treacher Collins Syndrome (TCS) are congenital disorders and the subjects may demonstrate similar clinical findings. Risk is equally common in male and female for both conditions. TCS is associated with alterations in the lower and upper airways and is distinct from PRS. The goal of this study was to compare the morphology pharynx taking account of volumes of segments (Nasal cavity, nasopharynx and oropharynx) and minimum sectional area of TCS and patients with non-syndromic PRS. Methods: PRS group were composed by 14 patients (5 male, 9 female) and TCS group formed by 14 patients (6 male, 8 female). Pre-orthodontic cone-beam computed tomography (CBCT) exams of all individuals were evaluated using Mimics Innovation Suite 21.0 (Materialize, Leuven, Belgium). The pharynx was divided into 3 sections: nasopharynx, oropharynx and the hypopharynx. After delimiting the regions, the total volume, nasal cavity volume, nasopharyngeal volume, oropharynx volume and minimum sectional area were determined for each patient at both conditions. Statistical analyzes were performed using Wilcoxon test for independent, paired, non-parametric data for comparative analysis of variables between the conditions PRS and TCS. The mean values and standard deviation of the variables were also determined for the PRS and TCS groups. Values of p < 0.05 were considered significant in all cases. Results: The age of PRS group range from 6 to 23 years old with a mean of 11.07±5.12 years, and at TCS group age were between 6 to 20 years with a mean of 12.00±4.50 years. Regarding the volumes of the segments of the upper airways, when comparing PRS and TCS, a significant difference was observed in total volume (p=0.0494), in nasal cavity volume (p=0.0085), in nasopharynx volume (p=0.0166) and in the minimum section area (p=0.0166). No difference was observed in the oropharynx volume (p = 0.8077). total volume, nasal cavity volume, nasopharynx volume and minimum sectional area were higher in PRS patients than in TCS patients. Conclusion: Patients with TCS have greater involvement of the upper airways with significant loss of total, nasal cavity and nasopharynx volumes compared to patients with non-syndromic PRS.
Title in Portuguese
Diferenças das vias aéreas superiores entre a sequência de Pierre Robin e a Síndrome de Treacher Collins
Keywords in Portuguese
Obstrução das Vias Respiratórias
Síndrome de Pierre Robin
Síndrome de Treacher Collins
Abstract in Portuguese
Introdução: A Sequência de Pierre Robin (SPR) e a Síndrome de Treacher Collins (STC) são doenças congênitas e os indivíduos podem apresentar achados clínicos semelhantes. O risco é igualmente comum em homens e mulheres para ambas as condições. A STC está associada a alterações das vias aéreas inferiores e superiores e é distinta da SPR. O objetivo deste estudo foi comparar a morfologia das vias aéreas superiores levando em consideração os volumes dos segmentos (cavidade nasal, nasofaringe e orofaringe) e área seccional mínima de sujeitos com STC e SPR não sindrômica. Métodos: O grupo SPR era composto por 14 indivíduos (5 homens, 9 mulheres) e o grupo STC era composto por 14 indivíduos (6 homens, 8 mulheres). Exames pré-ortodônticos de tomografia computadorizada de feixe cônico (TCFC) de todos os indivíduos foram avaliados usando o Mimics Innovation Suite 21.0. A faringe foi dividida em 3 seções: nasofaringe, orofaringe e hipofaringe. Após delimitar as regiões, foram determinados o volume total, volume da cavidade nasal, volume nasofaringe, volume orofaringe e área secional mínima para cada paciente em ambas as condições. As análises estatísticas foram realizadas por meio do teste de Wilcoxon para dados independentes, pareados e não paramétricos, para análise comparativa das variáveis entre as condições SPR e STC. Os valores médios e desvio padrão das variáveis também foram determinados para os grupos SPR e STC. Valores de p <0,05 foram considerados significativos em todos os casos. Resultados: A idade do grupo SPR variou de 6 a 23 anos com média de 11,07 ± 5,12 anos, e no grupo STC a idade variou de 6 a 20 anos com média de 12,00 ± 4,50 anos. Em relação aos volumes dos segmentos das vias aéreas superiores, ao comparar SPR e STC, foi observada diferença significativa no volume total (p = 0,0494), no volume da cavidade nasal (p = 0,0085), no volume nasofaringe (p = 0,0166) e na áera seccional mínima (p = 0,0166). Não foi observada diferença no volume de orofaringe (p = 0,8077). Volume total, volume da cavidade nasal, volume da nasofaringe e área seccional mínima foram maiores em pacientes com SPR do que em pacientes com STC. Conclusão: Pacientes com STC apresentam maior comprometimento das vias aéreas superiores com perda significativa dos volumes total, da cavidade nasal e da nasofaringe em comparação aos pacientes com SPR não sindrômica.
 
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Publishing Date
2022-03-18
 
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