牵引成骨技术治疗小下颌畸形伴OSAS效果的初步报告

目的分析评价下颌骨牵引延长治疗小下颌畸形伴阻塞性睡眠呼吸暂停综合征后，患者上呼吸道、睡眠呼吸暂停指数及血的变化，方法 对５例小下颌畸形伴ＯＳＡＳ患者应用口内型牵引器行牵引颌骨牵引成骨管长下颌骨体、前伸下颌骨、扩大咽腔。结果 ５例下颌骨体最大牵引幅度为２４．４０ｍｍ最小牵引幅度８．５０ｍｍ。在小颌畸形得到明显改善的同时，患者咽腔扩大，睡眠呼吸暂停指数明显下降，血氧饱和度显著上升。最长随访时间１１个月

Management of micrognathia deformity associated with obstructive sleep apnea syndrome by distraction osteogenesis

Objective To review the early results of lengthening of the mandible by distraction osteogenesis for the correction of micrognathia deformity and treatment of the obstructive sleep apnea syndrome (OSAS) simultaneously. Methods 5 cases with micrognathia deformity associated with OSAS resulted from unilateral/bilateral temporomandibular joint ankylosis had undergone mandibular distraction osteogenesis. In all of the patients intraoral device was employed. Cephalometric radiographs and polysomnograms were obtained preoperatively and postoperatively. Results The average distraction distance was 15.28 mm (range 8.5 mm to 24.4 mm). The micrognathia deformity was corrected effectively, at the mean time the incapacious pharyngeal airway was ameliorated. The patients' Apnea Index (AI)had been decreasing, SaO 2 during sleep had got to rise. Conclusions Compared with the traditional surgery for the micrognathia associated with OSAS, the technique of mandibular distraction osteogenesis has the advantages of avoiding bone grafting and donor side morbidity, expanding the surrounding soft tissue concurrently, reducing the extent of operation and stability of the treatment effects.