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目的探讨阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopneasyndrome,OSAHS)外科治疗的解剖形态学基础。方法小下颌畸形伴 OSAHS 患者共9例,平均年龄28.6岁(18～39岁),所有患者均经正颌外科和(或)颌骨牵引成骨治疗,手术前、后行多道睡眠监测仪监测及螺旋 CT 扫描,分别评价手术疗效并比较患者上气道三维结构的变化。结果 9例患者经外科治疗后均达临床治愈标准;手术后上气道的矢状径、横径、横截面积及容积均较术前明显增加,其中矢状径的增加最显著,变化主要发生在口咽及舌咽,喉咽变化不明显。结论正颌外科及颌骨牵引成骨是使腭咽及舌咽的矢状径增加从而有效治疗小下颌畸伴 OSAHS。
Objective To investigate the anatomical basis of surgical treatment of obstructive sleep apnea hypopnea syndrome (OSAHS). Methods A total of 9 patients with small chin malformation accompanied with OSAHS were enrolled in this study. The mean age was 28.6 years (18-39 years). All patients underwent orthognathic surgery and / or mandibular distraction osteogenesis. Before and after operation, Monitoring and spiral CT scans, respectively, to evaluate the efficacy of surgery and compare the three-dimensional structure of the upper airway changes. Results All of the 9 patients achieved the standard of clinical cure after surgical treatment. The sagittal diameter, transverse diameter, cross-sectional area and volume of the upper airway were significantly increased after operation, in which the sagittal diameter increased most significantly Occur in the oropharyngeal and glossopharyngeal, laryngeal changes were not obvious. Conclusion Orthognathic surgery and mandibular distraction osteogenesis is an effective treatment of small mandibular abnormalities with OSAHS due to the increased sagittal diameter of velopharyngeal and lingual pharynx.