牵引成骨技术治疗小下颌畸形伴OSAS效果的初步报告  

Management of micrognathia deformity associated with obstructive sleep apnea syndrome by distraction osteogenesis

作　　者：唐友盛[1] 高益鸣[1] 沈国芳[1] 邱蔚六[1] 卢晓峰[1] 徐竹梅 

机构地区：[1]上海第二医科大学口腔医学院口腔颌面外科,200011

出　　处：《中华口腔医学杂志》2000年第1期9-11,I001,共4页Chinese Journal of Stomatology

摘　　要：目的　分析评价下颌骨牵引延长技术治疗小下颌畸形伴阻塞性睡眠呼吸暂停综合征(obstructivesleepapneasyndrome,OSAS)后 ,患者上呼吸道、睡眠呼吸暂停指数及血氧的变化。方法对 5例小下颌畸形伴OSAS患者应用口内型牵引器行下颌骨牵引成骨延长下颌骨体、前伸下颌骨、扩大咽腔。结果　 5例下颌骨体最大牵引幅度为 2 4 40mm ,最小牵引幅度 8 5 0mm。在小颌畸形得到明显改善的同时 ,患者咽腔扩大 ,睡眠呼吸暂停指数明显下降 ,血氧饱和度显著上升。最长随访时间 11个月 ,无复发。牵引过程中未出现牵引器松脱、未成骨或骨缝过早联合等现象。结论　与以往的小下颌畸形伴OSAS的手术治疗相比 ,下颌骨牵引延长术不但手术创伤小、操作简单、避免了植骨及由此带来的供、受区并发症 ,而且其下颌前移、咽腔扩大的效果更为明显且稳定。Objective To review the early results of lengthening of the mandible by distraction osteogenesis for the correction of micrognathia deformity and treatment of the obstructive sleep apnea syndrome (OSAS) simultaneously. Methods 5 cases with micrognathia deformity associated with OSAS resulted from unilateral/bilateral temporomandibular joint ankylosis had undergone mandibular distraction osteogenesis. In all of the patients intraoral device was employed. Cephalometric radiographs and polysomnograms were obtained preoperatively and postoperatively. Results The average distraction distance was 15.28 mm (range 8.5 mm to 24.4 mm). The micrognathia deformity was corrected effectively, at the mean time the incapacious pharyngeal airway was ameliorated. The patients' Apnea Index (AI)had been decreasing, SaO 2 during sleep had got to rise. Conclusions Compared with the traditional surgery for the micrognathia associated with OSAS, the technique of mandibular distraction osteogenesis has the advantages of avoiding bone grafting and donor side morbidity, expanding the surrounding soft tissue concurrently, reducing the extent of operation and stability of the treatment effects.

关 键 词：小下颌畸形 呼吸暂停 睡眠性 牵引成骨术 

分 类 号：R782.2[医药卫生—口腔医学]