治疗阻塞性睡眠呼吸暂停的手术规划
Isaac Mordukhovich1,2, Anthony DeLeonibus1, Ian Zelko1
1Department of Plastic and Reconstructive Surgery.
The Journal of craniofacial surgery
|December 15, 2025
概括
上下 (MMA) 手术有效治疗阻塞性睡眠呼吸暂停 (OSA). 然而,目前的规划缺乏标准化的指导方针,依赖于不一致的解剖学地标,不考虑气道功能以获得最佳的患者结果.
科学领域:
- 口腔和牙面部外科手术
- 睡眠医学 睡眠医学
- 手术规划 手术规划
背景情况:
- 上 (MMA) 是阻塞性睡眠呼吸暂停 (OSA) 的主要手术治疗方法.
- 尽管它是有效的,但手术规划缺乏明确的指导方针,包括确定进展幅度和手术技术.
- 目前用于评估气道结构和术后结果的现有方法并不能完全为手术规划提供信息.
研究的目的:
- 系统地审查当前关于上前进 (MMA) 规划阻塞性睡眠呼吸暂停 (OSA) 的文献.
- 确定外科医生如何确定MMA的大小和方法.
- 评估解剖学标志的一致性和在手术规划中将呼吸道功能纳入.
主要方法:
- 从1989年1月到2025年1月,对英语文学进行系统审查.
- 分析了74篇文章,涉及2238名接受MMA治疗OSA的患者.
- 检查手术技术 (传统与轮换),辅助程序和报告的规划方法.
主要成果:
- 旋转MMA的受欢迎程度有所增加,在2015年后占73.6%的病例.
- 旋转和常规MMA都在术后呼吸暂停-呼吸暂停指数 (AHI) 和后呼吸道空间方面取得了类似的显著改善.
- MMA的大小与手术前或手术后的AHI无关;规划依赖于不一致的解剖学地标,呼吸道功能没有整合.
结论:
- 目前对OSA的MMA规划缺乏标准化的指导方针和对解剖学地标的一致使用.
- 气道功能并没有系统地纳入MMA手术的规划过程.
- 需要进一步的研究来开发基于证据的MMA规划协议,以优化OSA治疗结果.
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