锥体束CT在研究可调式口腔矫治器治疗儿童OSAHS中的应用

Cone-beam computed tomography in the application of the adjustable oral appliance therapy for the treatment of children with OSAHS

目的:探讨锥体束CT(CBCT)在研究可调式口腔矫治器治疗儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)治疗中的应用。方法:在21例戴用可调式口腔矫治器的OSAHS患儿中,选取按医嘱位治疗后主诉症状明显改善且坚持戴用>3个月,同时结合PSG同步监测证实达到有治疗意义标准的15例患者,进行回顾性研究。在治疗前、医师医嘱位和患者调节位分别行CBCT检查。结果:CBCT显示可调式口腔矫治器于治疗前、医嘱位和患者调节位的下颌骨位置总体比较,矢状向指标(PAS)有明显变化,垂直向指标(H-MP)变化较小,舌后气道最小截面积有较大变化;相比治疗前舌后气道最小截面积与PAS位置重叠例数降低。结论:可调式口腔矫治器可以改变下颌的位置,使气道截面积加大,是治疗轻中度儿童OSAHS的一种有效方法。CBCT能形象直观地显示可调式口腔矫治器对下颌及气道的影响,可为临床确定最终调节位提供参考。

Objective:To explore cone-beam computed tomography in the application of the adjustable oral appliance therapy for the treatment of children with obstructive sleep apnea hypopnea syndrom.Methods:In 21 cases with adjustable oral appliance in children with OSAHS,15 cases were selected.According to the prescribed treatment,their symptoms were improved obviously,and their wearing time was more than 3 months.At the same time,combined with the PSG synchronous monitoring,results showed that they achieved therapeutic significance of standard.We retrospectively reviewed the clinical data.Patients were given CBCT examination at before treatment,the physician prescribed position and patients adjust position.Results:We compared the mandibular position before treatment,the physician prescribed position and patients adjust position of the adjustable oral appliance,CBCT displayed that sagittal index(PAS) had obvious changes;the vertical index(H-MP) change was small;the tongue of minimum section area of airway had large changes.Compared with before treatment,the tongue of minimum section area of airway and PAS position overlapping cases were all reduced.Conclusion:The adjustable oral appliance can change the mandibular position,and increase the sectional area.It is an effective method for treatment of mild and moderate OSAHS in children.CBCT can vividly and visually display effect of adjustable oral appliance on mandibular and airway.It can determine the final adjustment position to provide the reference for clinical.