摘要
目的:对经腭咽成形术(UPPP)后的睡眠呼吸暂停低通气综合征(OSAHS)患者辅以下颌前移器治疗,探讨UPPP手术后口腔矫治器前移下颌辅助治疗的作用机制。方法:10例OSAHS患者接受UPPP手术后,辅以下颌前移矫治器治疗。所有患者在戴用矫治器后1个月再次进行多导睡眠监测(PSG)。同时,按标准头颅定位片拍摄方法分别拍摄戴用口腔矫治器前、后的头颅定位侧位片,由作者应用正颌外科模拟预测系统(CASSOS 2001)进行头影测量分析。头影测量数据应用SPSS10.0软件包进行配对t检验,各个测量项目的差值分别与呼吸暂停低通气指数(AHI)的差值作相关分析。结果:戴用矫治器后,X线头影测量显示颅中窝和上颌骨后部的相对位置(MCF)有显著改变(P<0.05),而舌骨的上、下位置(∠C3-Rgn-H)以及前颌间高度(Ant In Mx.Ht)有非常显著的变化。各个测量项目的差值分别与AHI的差值作相关分析,结果显示AHI值的变化与前颌间高度(Ant In Mx.Ht)以及正中矢状面上舌面积和颌间面积的比例(T/In Mx.Area)的变化有显著相关性(P<0.05)。结论:经UPPP手术后戴用口腔矫治器的患者,其下颌前移的作用机制主要不是发生在口咽腔,而是由于下颌骨本身的位置改变而产生的一系列效应,从而导致AHI的改变。
PURPOSE: The purpose of this study is to investigate the mechanics of mandibular advancement devices (MAD) assisted uvulopalatopharyngoplasty (UPPP) for treatment of obstructive sleep apnea and hypopnea syndrome (OSAHS). METHODS: 10 patients (8 males, 2 females) were diagnosed as OSAHS by PSG and operated by UPPP. Mandibular advancement devices was used after operation. One month later, all the patients were evaluated by PSG and cephalometric analysis. Paired t test and correlative analysis were carried out using SPSS 10.0 software package. RESULTS: Cephalometric analysis indicated that MCF , ∠C3-Rgn-H, Ant In Mx. Ht were significantly different before and after MAD treatment. AHI was correlative with Ant In Mx. Ht and ratio of tongue area and intermaxillary area (P〈0.05). CONCLUSIONS: MAD in patients undergoing UPPP results in changes of mandibular position, instead of changes of enlargement of velopharynx.Supported by Shanghai Leading Academic Discipline Project(Grant No.Y0203).
出处
《上海口腔医学》
CAS
CSCD
2007年第5期461-465,共5页
Shanghai Journal of Stomatology
基金
上海市重点(优势)学科建设项目(Y0203)
关键词
下颌前移矫治器
腭咽成形术
睡眠呼吸暂停低通气综合征
Mandibular advancement devices
Uvulopalatopharyngoplasty
Obstructive sleep apnea and hypopnea syndrome