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成人阻塞性睡眠呼吸暂停患者长期上颌下颌前徙术后的口腔功能行为与神经感觉

Oral Functional Behavior and Neurosensation After Adult Maxillomandibular Advancement for Obstructive Sleep Apnea in the Long-Term.

作者信息

Cillo Joseph E, Dattilo David J

机构信息

Associate Professor and Program Director, Division of Oral and Maxillofacial Surgery, Allegheny General Hospital, Pittsburgh, PA.

Associate Professor and Division Director, Division of Oral and Maxillofacial Surgery, Allegheny General Hospital, Pittsburgh, PA.

出版信息

J Oral Maxillofac Surg. 2020 Feb;78(2):255-260. doi: 10.1016/j.joms.2019.08.010. Epub 2019 Aug 22.

Abstract

PURPOSE

We evaluated and correlated the long-term subjective perioral neurosensory deficit intensity and oral functional behavior difficulty after maxillomandibular advancement (MMA) for adult obstructive sleep apnea (OSA).

PATIENTS AND METHODS

We implemented a long-term retrospective cohort study of adult subjects who had undergone MMA for OSA, with subjective assessments using 7-point visual analog scales. Adult subjects who had undergone MMA for OSA with a minimum of 5 years of follow-up data available who had agreed to participate were included in the present study. The 1-sample Wilcoxon signed rank test and Spearman correlation coefficients were used to evaluate the data. Statistical significance was set at the P < .05 level.

RESULTS

Of the 51 eligible subjects, 27 (53% response rate) were included in the present study. The mean age preoperatively was 59.8 years, with a mean follow-up of 12.7 years. Most subjects (85%) had, overall, reported the long-term subjective perioral neurosensory deficit intensity to be none to very mild (mode, 0; mean, 2.20; P < .05) and oral functional behavior to have none to very mild difficulty (mode, 0; mean, 1.6; P < .05). Statistically significant moderate to strong positive correlations between the subjective assessments of oral functional behavior and perioral neurosensory deficit intensity were found for chewing (r = 0.74), kissing (r = 0.50), eating (r = 0.80), speaking (r = 0.81), and drooling (r = 0.67).

CONCLUSIONS

Within the limitations of the present study, more than 12 years after MMA for severe OSA, most subjects (85%) had minimal to no subjective perioral neurosensory deficits and very minimal to no difficulty in the subjective assessment of oral functional behavior. Strong positive correlations between the subjective decreased perioral neurosensory deficit intensity and decreased oral function behavior difficulty suggest that the return of perioral neurosensation might contribute to the return of oral functional behavior.

摘要

目的

我们评估并关联了成年阻塞性睡眠呼吸暂停(OSA)患者接受上颌下颌前移术(MMA)后长期的主观口周神经感觉缺损强度和口腔功能行为困难程度。

患者与方法

我们对接受MMA治疗OSA的成年受试者进行了一项长期回顾性队列研究,使用7分视觉模拟量表进行主观评估。本研究纳入了接受MMA治疗OSA且有至少5年随访数据并同意参与的成年受试者。采用单样本Wilcoxon符号秩检验和Spearman相关系数来评估数据。设定统计学显著性水平为P < 0.05。

结果

在51名符合条件的受试者中,27名(53%的应答率)被纳入本研究。术前平均年龄为59.8岁,平均随访12.7年。总体而言,大多数受试者(85%)报告长期主观口周神经感觉缺损强度为无至非常轻微(众数为0;均值为2.20;P < 0.05),口腔功能行为无至非常轻微困难(众数为0;均值为1.6;P < 0.05)。在咀嚼(r = 0.74)、亲吻(r = 0.50)、进食(r = 0.80)、说话(r = 0.81)和流口水(r = 0.67)方面,发现口腔功能行为的主观评估与口周神经感觉缺损强度之间存在统计学显著的中度至强正相关。

结论

在本研究的局限性范围内,重度OSA患者接受MMA治疗12年多后,大多数受试者(85%)主观口周神经感觉缺损极小或无,口腔功能行为主观评估的困难也极小或无。主观口周神经感觉缺损强度降低与口腔功能行为困难程度降低之间的强正相关表明,口周神经感觉的恢复可能有助于口腔功能行为的恢复。

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