Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of Otolaryngology-Head and Neck Surgery, Sohag University, Sohag, Egypt.
Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
J Craniomaxillofac Surg. 2018 Jun;46(6):887-892. doi: 10.1016/j.jcms.2018.04.006. Epub 2018 Apr 11.
The aim of this study was to examine and compare morphological and functional outcomes after either isolated mandibular setback or bimaxillary surgery in males and females.
A retrospective study was done on 52 patients, in whom surgical correction for mandibular prognathism was performed either by isolated mandibular setback (30 cases) or by bimaxillary surgery (22 cases). Morphological changes were studied using cephalograms and functional changes studied using impulse oscillometry (IOS) taken before surgery (T0), 3 months (T1) and 1 year after surgery (T2). Also 3% oxygen desaturation index (ODI) was measured at T0 and T2.
Posterior airway space decreased significantly in both groups and both sexes but more so in males after mandibular setback surgery and in females after bimaxillary surgery. Changes in supine R20 (central airway resistance at 20 Hz) and supine R5 (total airway resistance at 5 Hz) in IOS statistically significantly increased in the period T0-T1 in males compared with females after mandibular setback surgery (p < 0.05).
Gender dimorphism is present according to morphological and functional outcomes, with males at a higher risk for obstructive sleep apnea (OSA) after mandibular setback surgery and females after bimaxillary surgery; however, compensatory changes act as a barrier against this.
本研究旨在检查和比较男性和女性接受单纯下颌后退术与双颌手术的形态和功能结果。
对 52 例因下颌前突而行手术矫正的患者进行回顾性研究，其中 30 例行单纯下颌后退术（下颌后退组），22 例行双颌手术（双颌手术组）。采用头影测量研究形态变化，采用脉冲振荡法（IOS）研究功能变化，分别于术前（T0）、术后 3 个月（T1）和 1 年（T2）进行测量。同时，在 T0 和 T2 时测量 3%氧减饱和度指数（ODI）。
两组患者和各性别组的后气道间隙均显著减小，但下颌后退术后男性和双颌手术后女性减小更明显。与女性相比，男性下颌后退术后 IOS 中仰卧位 R20（20Hz 时的中心气道阻力）和仰卧位 R5（5Hz 时的总气道阻力）在 T0-T1 期间的变化统计学显著增加（p<0.05）。
根据形态和功能结果存在性别二态性，男性行下颌后退术后发生阻塞性睡眠呼吸暂停（OSA）的风险更高，女性行双颌手术后发生 OSA 的风险更高；然而，代偿性变化起到了阻碍作用。
