Crouzon综合征面中部截骨牵引术后气道改变的影像学分析  

Radiological assessment of upper airway alterations caused by midface osteodistraction in patients with Crouzon syndrome

作　　者：徐梁[1] 段惠川[1] 马晧钧 李东[1] 周思政 俞哲元[1] 韦敏[1] 袁捷[1] XU Liang;DUAN Huichuan;MA Haojun;LI Dong;ZHOU Sizheng;YU Zheyuan;WEI Min;YUAN Jie(Department of Plastic and Reconstructive Surgery,Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院整复外科,上海市200011

出　　处：《组织工程与重建外科》2021年第3期212-216,共5页Journal of Tissue Engineering and Reconstructive Surgery

基　　金：上海市临床重点专科建设项目-整形外科(shslczdzk00901);上海交通大学医学院附属第九人民医院生物样本库项目(YBKB201909)。

摘　　要：目的分析Crouzon综合征患者面中部截骨牵引术后上呼吸道的影像学变化,以及手术对患者呼吸功能的改善。方法2018年9月至2020年9月,收治Crouzon综合征患者15例,予以LefortⅢ或Monobloc截骨+面中部外置牵引器植入手术治疗,术后常规行面中部牵引成骨(1 mm/d),于术前及术后6个月时行影像学测量和多导睡眠呼吸监测检查,分析上气道相关骨性面积、气道狭窄点距离、上气道体积及呼吸功能指数改善情况。结果患者术后腭咽以上气道相关骨性面积较术前显著增大,上气道鼻咽及腭咽处狭窄点宽度明显增宽,上气道体积也有显著性增加;睡眠呼吸监测结果提示,患者呼吸功能相关指数均较术前有显著好转。结论面中部牵引成骨可有效改善Crouzon综合征患者的上呼吸道通气情况,矫正患者阻塞性呼吸障碍。Objective To analyze radiological alterations of upper airway and changes of respiratory function after osteodistraction of the midface in patients suffering from Crouzon syndrome. Methods Fifteen patients with Crouzon syndrome from September 2018 to September 2020 were included in the study. The patients underwent Le Fort Ⅲor monobloc ostectomy followed by midface osteodistraction with a rate of 1 mm per day. Radiological examination and polysomnography were performed preoperatively and six months postoperatively. The changes of osseous airway area,distance between upper airway-related narrowing points and upper airway volume and the improvement of respiratory function-related index were analyzed. Results The osseous area of respiratory tract superior to velopharynx,the distance between narrowing points at velopharyngeal and nasopharyngeal level,upper airway volume and respiratory function-related index were significantly increased six months postoperatively. Conclusion Osteodistraction of midface following Le Fort Ⅲ or monobloc ostectomy result in improvement of upper airway conditions and correction of obstructive respiratory disease.

关 键 词：CROUZON综合征 面中部牵引 阻塞性呼吸障碍 影像学分析 睡眠呼吸监测 

分 类 号：R622[医药卫生—整形外科]