Beranger Thibaut, Garreau Emilie, Ferri Joël, Raoul Gwenael
Département universitaire de chirurgie maxillo-faciale et stomatologie, hôpital Roger-Salengro, CHU de Lille, rue Émile-Laine, 59037 Lille, France.
Département universitaire de chirurgie maxillo-faciale et stomatologie, hôpital Roger-Salengro, CHU de Lille, rue Émile-Laine, 59037 Lille, France.
Int Orthod. 2017 Mar;15(1):40-53. doi: 10.1016/j.ortho.2016.12.013. Epub 2017 Jan 19.
The aim of this study is to evaluate the experience of patients who have benefited from maxillomandibular advancement surgery for the treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS), and also the morphological modifications measured on pre- and postoperative lateral headfilms.
Twenty-three patients aged 24 to 64 (M=46.8) who had undergone bimaxillary advancement osteotomy for the treatment of OSAHS filled in a questionnaire concerning their overall satisfaction following surgery, the modification of their facial appearance as perceived by themselves and their family and friends, the change in their smile, and the slimmer and more youthful appearance of their face. Measurements of bone and skin points were also performed on lateral cephalograms before and after surgery so as to assess the advancement of the bony bases (maxillary, mandibular and chin advancement) and the impact on soft tissue by analysis of the skin profile.
A total of 91.3% of the patients were satisfied overall following the surgical procedure; 78.3% considered that their faces were improved or unchanged; 39.1% found their faces slimmer and 34.8% thought they looked more youthful. Average maxillary, mandibular and chin advancements with respect to the base of the skull were, respectively, 7.4mm, 11.1mm and 14.1mm. Advancement of the stomion point with respect to the Frankfurt plane was 8.3mm on average, reflecting a significant forward movement of the upper and lower lips.
Despite greater maxillary and mandibular advancements than in traditional orthognathic surgery, patients reacted positively to these morphological changes, considering in more than a third of cases that their faces looked slimmer or more youthful. It can thus be concluded that overall satisfaction is high, with a morphological impact that is satisfactory and well-accepted by patients postoperatively.
本研究旨在评估因阻塞性睡眠呼吸暂停低通气综合征（OSAHS）接受上颌下颌前徙手术的患者的体验，以及术前和术后头颅侧位片上测量的形态学改变。
23例年龄在24至64岁（平均年龄46.8岁）因OSAHS接受双颌前徙截骨术的患者填写了一份问卷，内容涉及他们对手术总体满意度、他们自己以及家人和朋友所感知的面部外观变化、笑容变化以及面部更显瘦削和更显年轻的外观。还在术前和术后的头颅侧位片上对骨骼和皮肤点进行了测量，以便通过分析皮肤轮廓评估骨基（上颌、下颌和下巴前徙）的前徙情况以及对软组织的影响。
共有91.3%的患者对手术总体满意；78.3%的患者认为他们的面部得到改善或没有变化；39.1%的患者发现自己的脸更显瘦削，34.8%的患者认为自己看起来更年轻。相对于颅底，上颌、下颌和下巴的平均前徙量分别为7.4毫米、11.1毫米和14.1毫米。相对于法兰克福平面，口裂点的平均前徙量为8.3毫米，反映出上、下唇有明显的向前移动。
尽管上颌和下颌的前徙量比传统正颌手术更大，但患者对这些形态学变化反应积极，超过三分之一的患者认为自己的脸更显瘦削或更显年轻。因此可以得出结论，总体满意度较高，术后形态学影响令人满意且患者易于接受。
