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改良上颌下颌前移治疗阻塞性睡眠呼吸暂停综合征的临床研究

[Clinical study on modified maxillomandibular advancement for the treatment of obstructive sleep apnea syndrome].

作者信息

Li Yang, Yi Biao, Wang Xing, Li Zi-li, Liang Cheng, Wang Xiao-xia

机构信息

Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China.

出版信息

Beijing Da Xue Xue Bao Yi Xue Ban. 2010 Oct 18;42(5):570-4.

PMID:20957017
Abstract

OBJECTIVE

To evaluate the modified maxillomandibular advancement (MMMA) technique for the treatment of obstructive sleep apnea syndrome (OSAS) in yellow race of convex profile.

METHODS

Eight patients underwent MMMA for the treatment of OSAHS. All the patients underwent pre-surgical and postsurgical polysomnography, cephalometric analysis and objective results assessment.

RESULTS

The preoperative polysomnography results of the patients were as follows: apnea-hypopnea index, (40.1±16.1) per hour; lowest oxygen saturation, (72.4±7.2)%. The postoperative polysomnography results were as follows: apnea-hypopnea index, (5.4±3.8) per hour; lowest oxygen saturation, (90.6±2.1)%. The mean preoperative SNA was (80.9± 1.7)°, and the mean postoperative SNA was (82.9±1.5)°. The mean preoperative SNB was (72.5±2.6)°, and the mean postoperative SNB was (81.5±1.7)°. The mean preoperative PAS was (5.3 ±1.6) mm, and the mean postoperative PAS was (10.8 ±1.8) mm.

CONCLUSION

The preliminary review has demonstrated that the modified MMA technique for the treatment of OSAS is highly effective in the treatment of severe OSAS without the significant facial profile change commonly associated with the traditional MMA technique. With the introduction of this modified MMA technique for the treatment of OSAS, skeletal surgery may be less perceived as an unattractive treatment modality due to the markedly reduced anticipated facial changes after surgery.

摘要

目的

评估改良上颌下颌前移(MMMA)技术治疗凸面型黄种人阻塞性睡眠呼吸暂停综合征(OSAS)的效果。

方法

8例患者接受MMMA治疗OSAHS。所有患者均进行了术前和术后多导睡眠图检查、头影测量分析及客观结果评估。

结果

患者术前多导睡眠图结果如下:呼吸暂停低通气指数为(40.1±16.1)次/小时;最低血氧饱和度为(72.4±7.2)%。术后多导睡眠图结果如下:呼吸暂停低通气指数为(5.4±3.8)次/小时;最低血氧饱和度为(90.6±2.1)%。术前平均SNA为(80.9±1.7)°,术后平均SNA为(82.9±1.5)°。术前平均SNB为(72.5±2.6)°,术后平均SNB为(81.5±1.7)°。术前平均PAS为(5.3±1.6)mm,术后平均PAS为(10.8±1.8)mm。

结论

初步评估表明,改良的MMA技术治疗OSAS对重度OSAS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。随着这种改良的MMA技术用于治疗OSAS,由于手术后面部预期变化明显减少,骨骼手术可能不再被视为缺乏吸引力的治疗方式。

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