双侧拉杆式口腔矫治器治疗阻塞型睡眠呼吸暂停综合征前后舌骨位置变化及相关因素分析

目的 观察轻、中度阻塞型睡眠呼吸暂停综合征（OSAHS）患者戴用双侧拉杆式口腔矫治器前后的舌骨位置变化，并对相关因素进行分析，探讨其治疗OSAHS的机制。方法 采用双侧拉杆式口腔矫治器对多导睡眠监测仪及白天嗜睡量表诊断为轻、中度OSAHS的9例男性患者进行治疗，于未戴口腔矫治器和戴用口腔矫治器3个月后对患者进行CT扫描和图像三维重建，分析戴用矫治器前后上气道总容积和舌骨水平位置的变化，并对与舌骨位置 变化可能的相关因素进行分析。结果 戴用双侧拉杆式口腔矫治器后，舌骨在水平方向前移（5.90±2.27）mm，在垂直 方向上移（3.31±1.82）mm，上气道总体积增大了（32.36±14.58）%。ΔH-C3hor、ΔH-C3ver均与Δvolume%正相关（r=0.77， P<0.05；r=0.79，P<0.05），与FH-MP负相关（r=-0.83，P<0.05；r=-0.76，P<0.05）。结论 双侧拉杆式口腔矫治器使 OSAHS患者的舌骨向前上方移位。下颌平面角较小的患者舌骨向前移位较多。

Position change of hyoid bone induced by oral appliance of double-pull rods in patients with obstructive sleep apnea and hypopnea syndrome and analysis of relevant factors

 Objective  The objective of this study is to investigate the position change of hyoid bone in obstructive sleep apnea and hypopnea syndrome（OSAHS） induced by oral appliance（OA） of double-pull rods and analyze rele- vant factors, subsequently investigate treatment mechanism of OA for OSAHS. Methods  Nine OSAHS patients（male）, confirmed by polysomnography and excessive daytime sleepiness, were treated with OA of double-pull rods. After a 3- months treatment period, CT scan and three-dimensional reconstruction were made to each patient in central relation with and without OA respectively. The volume of upper airway and hyoid bone position were three-dimensional re- constructed and measured. Results  After treatment with OA of double-pull rods, the hyoid bone position was obviously changed in horizontal （5.90±2.27）mm and vertical position （3.31±1.82）mm, the volume of upper airway was enlarged（32.36±14.58）%. ΔH-C3hor and ΔH-C3ver were positively related to Δvolume%（r=0.77, P<0.05; r=0.79, P< 0.05）, negatively related to FH-MP（r=-0.83, P<0.05; r=-0.76, P<0.05）. Conclusion  The hyoid bone position significantly change after using OA of double-pull rods. Patients with smaller FH-MP have larger horizontal change of hyoid bone.