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目的探讨使用颅外固定牵引装置矫治儿童患者小下颌畸形伴发阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)。方法 6例均为双侧颞下颌关节强直伴重度小下颌畸形及 OSAHS 患者。男性4例,女性2例,年龄1.5～14岁。全麻下颌下手术入路,下颌骨体部截骨并在远心骨段小型钛板固定,然后安置颅外固定牵引装置并与下颌骨上的钛板连接。同内置式牵引成骨方案。结果 6例手术前后面型、后气道间隙和多道睡眠监测结果均有明显改变,患者术后睡眠及日间状态恢复正常,未发生术后不良反应。4个月后拆除牵引装置及固定钛板,牵引区新骨生长良好。结论治疗重度小下颌畸形伴 OSAHS 时颅外固定牵引装置具有手术简便、成骨质量好、牵引幅度大、牵引方向精确并可调等优点,特别适于下颌骨体积过小、无法安放较长内置式下颌骨牵引器的儿童患者。
Objective To investigate the use of extracranial fixed traction device in the treatment of small mandibular anomalies in children with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods Six cases were bilateral temporomandibular joint ankylosis with severe small mandibular deformity and OSAHS patients. 4 males and 2 females, aged 1.5 to 14 years old. Submandibular surgery under general anesthesia, mandibular body osteotomy and distal plate in a small titanium plate fixation, and then placed extracranial fixed traction device and connected to the titanium plate on the mandible. With built-in traction osteogenic program. Results The surface and airway clearance and multi-channel sleep monitoring results of 6 cases before and after surgery all changed obviously. The postoperative sleep and daytime status returned to normal without any postoperative adverse reactions. After 4 months, the traction device and the fixed titanium plate were removed, and the new bone growth in the traction area was good. Conclusion The treatment of severe mandibular deformity with OSAHS extracranial fixed traction device has the advantages of simple operation, good osteogenesis, large traction amplitude, precise and adjustable traction direction and so on, particularly suitable for mandibular volume is too small, can not be placed longer built Patient with mandible tractor.