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段传新:有一种牙不齐是腺样体肥大惹祸

2017-08-30 05:56:35   中国青年网

记者刘璇 通讯员周建跃 温红蕾

12岁的亮亮换完牙后,牙齿越长越歪,牙齿间的空隙变大了,门牙也向外突出成了“龅牙”,上下嘴唇完全闭不拢。邻居们多次跟亮亮妈妈说,你家亮亮需要矫牙了。7月20日,亮亮暑期补习一结束,妈妈就带着他找到了湖北省妇幼保健院口腔科杨湘晖主任医师。详细检查和问诊后,杨湘晖建议亮亮妈妈先带孩子去耳鼻喉科做个检查。

“我们是来看牙的,怎么还要去耳鼻喉科呀?”亮亮妈妈一脸的不高兴。杨湘晖耐心解释说,孩子上嘴唇厚而翘,上牙突出,下颌后缩,是典型的“腺样体面容”,如果真的是鼻子的问题,单纯矫牙根本没用。耳鼻喉科主任段传新用鼻内窥镜检查发现,亮亮的鼻腔已经被增大的腺样体堵塞了三分之二。

据了解,省妇幼这个暑假接诊了三四十例从本医院和外院口腔科转来的,原本打算做口腔正畸的小患儿。段传新指出,很多孩子表面看是牙齿的问题,其实是鼻子和喉咙出了问题。

用嘴呼吸不仅会变丑

身体、精神和智力都有影响

“晚上睡着了是不是总爱张着嘴巴呼吸,还经常打鼾,白天精神不好,上课注意力也不集中?”“您是怎么知道的?”亮亮妈妈连连点头说是。“亮亮的牙齿长歪就是鼻子被堵后,长时间的张嘴呼吸造成的。”段传新告诉亮亮妈妈,腺样体肥大不仅会影响面容,还会影响孩子的生长发育,建议亮亮先做腺样体切除手术,再去矫正牙齿。

“原本舌尖顶在上颚,舌头处于正常的位置,牙齿里外的压力是平衡的。当一边失去力量,肌肉不平衡了,造成骨骼的发育也不正常了。”段传新说,就会慢慢变成脸部嘴巴这块凹陷以及鼻子变成朝天鼻的“腺样体面容”。上唇短厚翘起、牙龈因为长期开口干燥而色素沉着、牙齿排列不整齐、咬合不良、硬腭高拱、牙弓狭窄、上切牙突出形成龅牙等,这些都是连锁反应。

段传新指出,用嘴巴呼吸,氧气吸入量不够,睡眠质量会差,人在白天就容易打瞌睡,注意力不集中,甚至智力也会受到轻微影响。

睡觉爱用嘴呼吸的孩子

八成是腺样体肥大

段传新指出,12岁以下的孩子很容易患上一种名为“腺样体肥大”的疾病。腺样体是鼻咽部的淋巴组织,长在鼻腔后端鼻咽顶部与后壁交界处,表面呈桔瓣状,随着年龄增长逐渐生理性地增生,在8岁达到顶峰,11岁后逐渐萎缩。此外,呼吸道不断发生感染,比如流行性感冒、急慢性扁桃体炎、鼻窦炎、过敏性鼻炎等,导致腺样体与入侵病菌搏斗时,都会不断刺激腺样体导致其增生,这是造成腺样体肥大最主要的原因。

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