Lachner J, Waite P D, Wooten V
School of Dentistry, University of Alabama, Birmingham.
Dtsch Z Mund Kiefer Gesichtschir. 1990 Jul-Aug;14(4):272-5.
The only surgical means available up to now for treating obstructive sleep apnea syndrome (OSAS) consisted in uvulopalatopharyngoplasty (UPPP), which failed to produce satisfactory results. The ultima ratio frequently resorted to was tracheotomy with all its medical and social drawbacks. Complete advancement of the maxillomandibular complex opens up new avenues for the treatment of upper airways obstruction. The present report is on 13 patients operated for polysomnographically established OSA. The maxillomandibular complex was brought as far forward as possible and esthetically justifiable. This operation was occasionally combined with other procedures to enhance upper airways function, such as conchotomy, palatopharyngoplasty, chin graft and reduction of tongue size. In 85% of the cases the apnea and hypopnea index (RDI) could be lowered to below 10 per hour sleep, i.e. these patients were cured.
到目前为止,治疗阻塞性睡眠呼吸暂停综合征(OSAS)的唯一外科手段是悬雍垂腭咽成形术(UPPP),但该手术未能产生令人满意的效果。最后的手段往往是气管切开术,但其存在诸多医疗和社会方面的弊端。上颌下颌复合体的完全前移为治疗上呼吸道阻塞开辟了新途径。本报告针对13例经多导睡眠图确诊为OSA并接受手术的患者。上颌下颌复合体尽可能向前移动,且在美学上合理。该手术偶尔会与其他增强上呼吸道功能的手术联合进行,如鼻甲切除术、腭咽成形术、下巴移植和缩小舌头尺寸。在85%的病例中,呼吸暂停低通气指数(RDI)可降至每小时睡眠低于10次,即这些患者被治愈。