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目的 评估正颌外科技术矫治14例颞颌关节强直所致OSAS的效果。方法 手术采用患侧关节成形,下颌升支、体部的“L”形半层截骨及健侧矢状截骨术,将患侧下颌升支加高固定,下颌前部整体前移。结果14例颞颌关节强直伴OSAS患者术后张口度达2.5～3.5cm,术后2年随访张口度仍维持在2.5～3.2cm之间。所有患者的AHI指数下降了20以上,12例患者的打鼾症状消失,持续血氧饱和度平均提高了18.45％（P<0.01）,达到了正常人的范围,持续血氧饱和度最低值由术前的58％提高至术后的95％以上,OSAS得以治愈。结论 颞颌关节强直伴OSAS患者通过正颌外科手术可以在关节成形的同时,解决患者下颌后缩的缺陷,解除上气道狭窄,从而缓解或纠正患者的低氧血症。
Objective To evaluate the effect of orthognathic surgery in treating 14 patients with temporomandibular joint ankylosis-induced OSAS. Methods The ipsilateral arthroplasty, mandibular ascending branch, “L” shaped half osteotomy and contralateral sagittal osteotomy were used in the operation. The mandibular ascending branch was elevated and fixed, and the anterior mandibular anterior whole was advanced. Results In 14 patients with temporomandibular joint ankylosis with OSAS, the mouth opening degree was 2.5 ~ 3.5cm. The mouth opening degree remained at 2.5 ~ 3.2cm at 2 years after operation. The AHI index decreased by more than 20 in all patients, and snoring symptoms disappeared in 12 patients. The continuous oxygen saturation increased by 18.45% (P <0.01) on average, reaching the range of normal people. The lowest continuous oxygen saturation value 58% before the increase to more than 95% after surgery, OSAS was cured. Conclusion Orthognathic surgical treatment of temporomandibular joint ankylosis with OSAS can relieve or correct the hypoxemia in patients with mandibular retrusion defect and upper airway stenosis.