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[悬雍垂腭咽成形术联合上颌下颌前徙术治疗肥胖阻塞性睡眠呼吸暂停低通气综合征患者:初步报告]

[Uvulopalatopharyngoplasty and maxillomandibular advancement for obese patients with obstructive sleep apnea hypopnea syndrome: a preliminary report].

作者信息

Lu Xiao-feng, Zhu Min, He Jian-de, Zhang Rui, Li Zhi-yao, Sun Hong-xia

机构信息

Department of Oral and Maxillofacial Surgery, School of Stomatology; Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200011, China.

出版信息

Zhonghua Kou Qiang Yi Xue Za Zhi. 2007 Apr;42(4):199-202.

Abstract

OBJECTIVE

To evaluate the feasibility and the results of the procedure of maxillomandibular advancement combined with uvulopalatopharyngoplasty for the treatment of obstructive sleep apnea hypopnea syndrome (OSAHS).

METHODS

Nine cases of obese patients with severe OSAHS [age (47.8 +/- 9.7); body mass index (BMI) (35.3 +/- 2.5) kg/m(2); apnea and hypopnea index (AHI) (88.7 +/- 6.7) per hour] underwent the procedure of maxillomandibular advancement (MMA) combined with uvulopalatopharyngoplasty (UPPP). The patients were monitored by polysomnography (PSG) before operation and 3, 6, 12 months after operation, and cephalometric analysis and velopharyngeal closure function were evaluated at the same time.

RESULTS

The maxilla was advanced by (8.3 +/- 1.3) mm and the mandible and chin were advanced by (23.0 +/- 2.2) mm. AHI was (2.1 +/- 1.1) per hour post-operation. All patients had no speaking problem and swallowing difficulty and had a good appearance and occlusions. The OSAHS in this group of patients was cured.

CONCLUSIONS

Good short-term effects were observed with UPPP and MMA in the treatment of obese patients with severe OSAHS. It did not cause the velopharyngeal closure insufficiency and maxillary necrosis. A long-term follow-up is needed.

摘要

目的

评估上颌下颌前徙联合悬雍垂腭咽成形术治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的可行性及效果。

方法

9例重度OSAHS肥胖患者[年龄(47.8±9.7)岁;体重指数(BMI)(35.3±2.5)kg/m²;呼吸暂停低通气指数(AHI)每小时(88.7±6.7)次]接受上颌下颌前徙术(MMA)联合悬雍垂腭咽成形术(UPPP)。术前及术后3、6、12个月采用多导睡眠图(PSG)对患者进行监测,同时评估头影测量分析及腭咽闭合功能。

结果

上颌前徙(8.3±1.3)mm,下颌及颏部前徙(23.0±2.2)mm。术后AHI为每小时(2.1±1.1)次。所有患者均无说话及吞咽困难,外形及咬合良好。该组患者的OSAHS得到治愈。

结论

UPPP和MMA治疗重度OSAHS肥胖患者近期效果良好。未引起腭咽闭合不全及上颌骨坏死。尚需长期随访。

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