Efecto de la postura de cabeza en mediciones de la vía aérea
Head Posture effect in airway measurements
Pía Villanueva, Saúl Valenzuela, Hugo Santander, Claudia Zúñiga, María Jose Ravera, Rodolfo Miralles
Resumen
Objetivos: el propósito del presente estudio fue medir diámetros anteroposteriores de la vía aérea faríngea en una muestra de 50 sujetos jóvenes adultos sanos y relacionar estas mediciones con la postura de cabeza.
Metodos: a cada sujeto se le tomó una radiografía craniocervical lateral en posición natural de cabeza, estando su mandíbula en máxima intercuspidación. Los diámetros de la vía aérea faríngea fueron medidos a siete niveles, desde la tuberosidad maxilar hasta la vallécula de la epiglotis. La postura de cabeza fue determinada a través del ángulo craniovertebral formado por el plano de MacGregor y el plano odontoídeo (ángulo postero inferior). La muestra estudiada fue dividida en tres grupos de acuerdo con el valor del ángulo craniovertebral: extensión de cabeza (< de 95°); postura normal de cabeza (entre 95° y 106°); flexión de cabeza (> de106°).
Resultados: no se observó una diferencia significativa en ninguna de las mediciones antero-posteriores de la vía aérea faríngea entre los tres grupos de sujetos (ANOVA, p > 0.05). Se observó un significativo efecto del género en la postura de cabeza, presentando las mujeres una mayor frecuencia de postura normal de cabeza y los hombres una mayor frecuencia de flexión de cabeza (test exacto de Fisher, p < 0.01).
Conclusiones: los resultados del presente estudio sugieren un predominio de los mecanismos de adaptación fisiológicos que permiten mantener permeable la vía aérea en la postura erecta, a pesar de la diferencia significativa de la postura de cabeza en la muestra estudiada.
Palabras clave
Abstract
Purpose: the aim of the present study was to measure the antero-posterior diameters of the pharyngeal airway in a sample of 50 healthy young adults and to examine the relation between these diameters and the head posture.
Methods: it was taken for each subject a lateral craniocervical radiograph in a self-balanced, natural head position in erect posture, and without a head holder, with the mandible in maximum intercuspation. Pharyngeal airway diameters were measured at seven levels ranging from the maxillary tuberosity to the vallecula of the epiglottis. The studied sample was divided into three groups according to head posture (craniovertebral angle formed by MacGregor and odontoid plane): head extension (less than 95°); normal head posture (between 95° and 106°); head flexion (more than 106°).
Results: no significant differences in any of the antero-posterior diameters of the pharyngeal airway were observed in the three groups (ANOVA, p > 0.05). A significant gender’s effect on head posture was observed. Females presented higher frequency of normal head posture and males’ higher frequency of head flexion (Fisher’s exact test = 0.002; p < 0.01).
Conclusions: results of the present study suggest that there is a predominance of the physiological adaptation mechanisms that serve to maintain the functional airway adequacy in erect posture, although the significant differences in head posture in the sample studied.
Keywords
Referências
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Submetido em:
08/06/2003
Aceito em:
15/10/2003
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