下颌骨后退术后舌根和舌骨位置的改变

Changes of the position of the hyoid and tongue base after mandibular setback surgery

目的 通过下颌后退手术与舌根和舌骨位置变化相关性研究 ,了解二者关系 ,为临床治疗提供依据。方法 描记 18例接受经口内下颌骨升支垂直截骨术矫治下颌前突畸形患者的术前及术后 1个月的标准颅颌侧位头影测量图 ,测量项目 5项 ,测量数值配对t检验 ,并将下颌骨后退距离与各测量项目变化作相关分析。结果 术后 1个月下颌骨后退的平均值是 10 .2 0mm± 1.31mm ,下颌骨后退术后后气道间隙的宽度显著减小 ,舌骨垂直方向显著降低 ,在水平方向上无显著后移。下颌骨后退距离与舌骨垂直方向变化密切相关。结论 双侧下颌升支垂直截骨后退术后舌骨向下移位 ,舌根后移 ,咽腔气道缩小 ,如果患者同时具有超重、短颈、舌体大等其他危险因素 ,下颌骨后退手术可能导致睡眠呼吸暂停综合征的发生。下颌骨后退距离与舌骨垂直方向变化呈正相关。

Objective To evaluate the changes in position of the hyoid and tongue base associated with surgical mandibular setback.Methods Lateral cephalograms of 18 adult patients taken preoperatively and 1 month postoperatively were traced,and 5 parameters were measured.All the quantized figures were analyaed using t-test.The relationship between the distance of the setback of the mandibular and the change of the measured figures were also analyzed.Results The mean amount of mandibular setback was 10.20 ± 1.31mm .The significant variation was following :vertical change of the hyoid bone,the distance from the posterior margin of tongue base to the posterior pharyngeal wall.There was a significant correlation between the amount of mandibular setback and the vertical change of hyoid.Conclusion Mandibular setback surgery causes the hyoid downward,the tongue base moved posteriorly and decreased in pharyngeal airway space.In patients who have other risk factors,for example,overweight.short necks,or large tonues,a mandibular setback procedure may predispose to the development of sleep apnea syndrome.There was a strong correlation between the amount of mandibular setback and the vertical change of hyoid.