Yoshida Kazuya, Sakamoto Kiwako, Takagi Akira, Iizuka Tadahiko
Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Japan.
Int J Prosthodont. 2003 Jul-Aug;16(4):350-4.
Persistent vegetative state is a form of wakefulness without awareness. This report describes a dental appliance for the treatment of sleep breathing disorders in this condition. The device can be easily inserted and removed by the patient's family or nurse.
A 19-year-old woman had been in a persistent vegetative state since having hypoxic-ischemic encephalopathy because of cardiopulmonary arrest. Although she exhibited a sleep-wake cycle and normal respiration, she had sleep apnea and snoring, and produced snoring-like sounds even in an awake state. A three-piece device with Herbst attachments was fabricated to treat the symptoms. Overnight sleep studies were carried out to evaluate the effectiveness of the appliance.
The device could be handled by the patient's family. Snoring was satisfactorily reduced after insertion of the device. Sleep apnea, desaturation, and minimal oxygen saturation were markedly improved.
If the family of a persistent vegetative state patient wishes to treat sleep-disordered breathing, the appliance may be helpful as an alternative to relieve the symptoms. The device could be applied for sleep apnea patients who experience difficulties using other types of oral appliances.
持续性植物状态是一种无觉知的觉醒形式。本报告介绍了一种用于治疗处于这种状态的患者睡眠呼吸障碍的牙科矫治器。患者家属或护士可轻松插入和取出该装置。
一名19岁女性因心肺骤停导致缺氧缺血性脑病后一直处于持续性植物状态。尽管她表现出睡眠-觉醒周期且呼吸正常，但她存在睡眠呼吸暂停和打鼾问题，甚至在清醒状态下也会发出类似打鼾的声音。制作了一个带有赫布斯特附件的三件式装置来治疗这些症状。进行了夜间睡眠研究以评估该矫治器的效果。
该装置可由患者家属操作。插入装置后打鼾得到了令人满意的减轻。睡眠呼吸暂停、血氧饱和度下降和最低血氧饱和度均有明显改善。
如果持续性植物状态患者的家属希望治疗睡眠呼吸紊乱，该矫治器作为缓解症状的一种替代方法可能会有所帮助。该装置可应用于使用其他类型口腔矫治器有困难的睡眠呼吸暂停患者。
