Goh Yau Hong, Lim Kheng Ann
Department of Otolaryngology, Singapore General Hospital.
Laryngoscope. 2003 Sep;113(9):1577-82. doi: 10.1097/00005537-200309000-00031.
A prospective study to evaluate the modified maxillomandibular advancement (MMA) technique for the treatment of obstructive sleep apnea (OSA).
Eleven patients underwent modified MMA for the treatment of OSA. All the patients underwent presurgical and postsurgical polysomnography, nasolaryngoscopy, and clinical facial photographic assessment. The results were analyzed after a minimum of 6 months postsurgery (mean, 7.7 months).
The preoperative polysomnography results were as follows: apnea index, 55.7 +/- 19.8; apnea-hypopnea index, 70.7 +/- 15.9; lowest oxygen saturation, 58.6 +/- 12.3%; longest apnea/hypopnea, 67.9 +/- 23.7 seconds; and arousal index, 47.1 +/- 18.2. The postoperative polysomnography results were as follows: apnea index, 3.4 +/- 3.4; apnea/hypopnea index, 11.4 +/- 7.4; lowest oxygen saturation, 83.9 +/- 8.8%; longest apnea/hypopnea, 38.2 +/- 24.6 seconds; and arousal index, 15.1 +/- 7.3. The mean postoperative body mass index (BMI) was 27.2 +/- 3.3. The mean BMI change after surgery was 6.5%.
The preliminary review has demonstrated that the modified MMA technique for the treatment of OSA is highly effective in the treatment of severe OSA without the significant facial profile change commonly associated with the traditional MMA technique.
一项前瞻性研究，旨在评估改良式上颌下颌前移（MMA）技术治疗阻塞性睡眠呼吸暂停（OSA）的效果。
11例患者接受改良式MMA治疗OSA。所有患者均接受术前和术后多导睡眠图检查、鼻咽喉镜检查以及临床面部照片评估。术后至少6个月（平均7.7个月）对结果进行分析。
术前多导睡眠图结果如下：呼吸暂停指数，55.7±19.8；呼吸暂停低通气指数，70.7±15.9；最低血氧饱和度，58.6±12.3%；最长呼吸暂停/低通气时间，67.9±23.7秒；觉醒指数，47.1±18.2。术后多导睡眠图结果如下：呼吸暂停指数，3.4±3.4；呼吸暂停/低通气指数，11.4±7.4；最低血氧饱和度，83.9±8.8%；最长呼吸暂停/低通气时间，38.2±24.6秒；觉醒指数，15.1±7.3。术后平均体重指数（BMI）为27.2±3.3。术后BMI平均变化为6.5%。
初步评估表明，改良式MMA技术治疗OSA对重度OSA疗效显著，且不会出现传统MMA技术常见的明显面部轮廓改变。
