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颅面骨发育不全患者下颌骨牵引成骨术治疗阻塞性睡眠呼吸暂停的呼吸结局:一项回顾性研究。

Respiratory outcome of mandibular distraction osteogenesis on obstructive sleep apnea in craniofacial microsomia: A retrospective study.

机构信息

Department of Cranio-Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, China.

Department of Cranio-Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, China.

出版信息

J Craniomaxillofac Surg. 2023 Jun;51(6):355-359. doi: 10.1016/j.jcms.2023.05.006. Epub 2023 May 27.

Abstract

This study aimed to evaluate the effect of mandibular distraction osteogenesis (MDO) on respiratory function in CFM patients with obstructive sleep apnea (OSA) according to polysomnography (PSG). This study retrospectively analyzed patients with CFM who underwent PSG before surgery and after completion of mandible distraction. Patients who met the inclusion criteria were selected. The Pediatric Sleep Questionnaire (PSQ) was used to assess patients' signs and symptoms related to OSA. The obstructive apnea-hypopnea index (OAHI) and lowest oxygen saturation (LSaO) were imported into SPSS version 26.0. The Wilcoxon signed-rank test was used to assess the differences in PSG before and after MDO. Other data were described using descriptive statistics. A P-value less than 0.05 was considered statistically significant. A total of 25 unilateral CFM patients were included in this study. Most patients (72%) had mild OSA; moderate and severe OSA were 12% and 16%, respectively. Snoring (52%) was the most common symptom among these patients. After completion of mandibular distraction, snoring and other OSA-related symptoms were significantly improved. Twelve patients had normalized PSG and the severity of OSA improved significantly in 3 patients. The total effective rate of MDO for OSA was 60%. The statistical results showed that OAHI (P = 0.045) decreased and LSaO (P = 0.009) increased significantly compared to preoperative values. MDO can improve OSA-related symptoms in CFM patients. In addition, respiratory function was improved in most patients after MDO, based on PSG. CFM patients, especially those with OSA, can benefit from MDO.

摘要

本研究旨在根据多导睡眠图(PSG)评估下颌骨牵引成骨术(MDO)对伴有阻塞性睡眠呼吸暂停(OSA)的髁突骨纤维异常增殖症(CFM)患者呼吸功能的影响。本研究回顾性分析了术前及完成下颌骨牵引后接受 PSG 的 CFM 患者。选择符合纳入标准的患者。采用儿童睡眠问卷(PSQ)评估患者与 OSA 相关的体征和症状。将阻塞性呼吸暂停低通气指数(OAHI)和最低氧饱和度(LSaO)导入 SPSS 版本 26.0。采用 Wilcoxon 符号秩检验评估 MDO 前后 PSG 的差异。其他数据采用描述性统计描述。P 值小于 0.05 为差异有统计学意义。本研究共纳入 25 例单侧 CFM 患者。大多数患者(72%)为轻度 OSA;中度和重度 OSA 分别为 12%和 16%。打鼾(52%)是这些患者最常见的症状。完成下颌骨牵引后,打鼾和其他 OSA 相关症状明显改善。12 例患者 PSG 正常,3 例患者 OSA 严重程度明显改善。MDO 治疗 OSA 的总有效率为 60%。统计结果显示,与术前相比,OAHI(P=0.045)降低,LSaO(P=0.009)升高。MDO 可改善 CFM 患者的 OSA 相关症状。此外,根据 PSG,大多数患者在 MDO 后呼吸功能得到改善。CFM 患者,尤其是伴有 OSA 的患者,可从 MDO 中获益。

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