联合运用牵张成骨及颏成形术矫治颞下颌关节强直继发小下颌畸形伴OSAHS

目的:讨论矫正治疗颞下颌关节强直并继发小下颌畸形伴OSAHS中应用牵张成骨联合颏成形术的临床效果。方法:选取2014年1月至2016年6月期间,笔者医院进行双侧关节强直继发小下颌畸形伴OSAHS的6例患者,分别用关节成形术与牵张成骨及颏成形术进行分期治疗。对比Ⅰ期、Ⅱ期治疗效果,及随访1年后患者的牵张距离、颏前徙距离以及最大张口度。结果:Ⅰ期治疗有效率为83.3%,Ⅱ期治疗有效率为91.7%;随访1年后,牵张距离平均为(15.3±2.6)mm,颏前徙距离平均为(13.1±1.1)mm,最大张口度平均为(37.5±3.9)mm。结论:颞下颌关节强直继发小下颌畸形伴OSAHS时,应先纠正关节强直,再进行牵张成骨及颏成形术,其治疗效果显著,值得临床广泛应用。

Objective: To discuss the clinical effect of distraction osteogenesis combined with mandibular molars in the treatment of temporomandibular joint ankylosis and secondary mechondrial malformation with OSAHS. METHODS: From January 2014 to June 2016, six patients with OSAHS were treated with arthroplasty and distraction osteogenesis and mandibular plasty. The patients were divided into two groups:. The therapeutic effect of stage I and II was compared with the distraction distance, distance of maxilla and maximal mouth opening after 1 year follow-up. Results: The effective rate was 83.3% in stage I and 91.7% in stage II. The distraction distance was(15.3 ± 2.6) mm after one year of follow-up. 1 ± 1.1) mm, and the maximum aperture was(37.5 ± 3.9) mm. Conclusion:Mandibular malformations with temporomandibular joint ankylosis secondary to OSAHS should be corrected for ankylosis and distraction osteogenesis and chin plasty. The therapeutic effect is significant and worthy of clinical application.