做過拔牙矯正,因為呼吸中止再做正顎手術

做過拔牙矯正,因為呼吸中止再做正顎手術
術前症狀手術計畫
中度睡眠呼吸中止症、下巴及下顎後縮3D客製化正顎手術、下巴前移手術、多層次呼吸道拓寬

這位患者之前就做過一次拔牙矯正,但後來她發現她有的問題及困擾,遠超過牙齒是否整齊。

這一次她是由睡眠專科牙醫師轉診到本中心,主要是想解決她嚴重的白天嗜睡及睡覺時的打呼問題,經過睡眠檢查,診斷出有中度的睡眠呼吸中止(AHI=19.4),電腦斷層也顯示,她的呼吸道狹窄,是來至於下顎骨的嚴重後縮而壓迫後咽壁(posterior airway space)。

在整體考量到她的睡眠呼吸中止的明顯症狀(嗜睡、打呼)、病因(骨骼狹窄、空間不足)、她對外觀及咬合關係的期待,我們為她設計上下顎骨逆旋前移的正顎手術(MMA: maxillo-mandibular advancement),同時拓寬呼吸道及改善外觀、咬合。

術後的牙齒矯正由轉診醫師用隱適美(Invisilign)治療。術後半年睡眠檢查結果AHI=1.4,已降低到正常狀態,打呼及嗜睡的症狀消失,她也更喜歡術後自己的樣子。

This patient had previously undergone four teeth extraction and orthodontic treatment, but later discovered that her issues and discomfort extended far beyond the alignment of her teeth. This time, she was referred to our center by a sleep specialist dentist, primarily to address her severe daytime sleepiness and severe snoring problems. After a sleep study, she was diagnosed with moderate sleep apnea (AHI=19.4). A CT scan also showed that her airway was narrowed due to severe mandibular retrusion, which compressed the posterior airway space. Considering her significant symptoms of obstructive sleep apnea (sleepiness, snoring), the underlying facial skeleton abnormality, and her expectations regarding facial appearance and occlusion, we designed a maxillo-mandibular advancement (MMA) surgery for her. This procedure simultaneously opens up the airway and improves appearance and occlusion. Postoperative orthodontic treatment was carried out by the referring doctor using Invisalign. Six months after the surgery, sleep study showed an AHI of 1.4, which is within the normal range. Her snoring and sleepiness symptoms disappeared, and she is quite satisfied with her appearance after the surgery.

手術前後對比照

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斷層掃描

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睡眠呼吸中止指數

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溫 馨 提 醒

  1. 請依照醫師及護理人員指示,定期服藥、注意飲食忌諱及維持傷口清潔。
  2. 術後可能有出血,感染,發炎等併發症,根據個人體質差異其程度有所不同,需加小心護理,若上述情況發生請盡快與我們聯絡。
  3. 術後3~6個月手術部位會暫時性知覺遲緩、表情較不自然為正常現象;透過自主按摩及表情練習,大部分患者術後6~12個月將逐漸好轉。
  4. 麻醉有其一定風險,與患者自身身體狀況有關,患者需誠實且清楚地向治療醫師及麻醉科醫師報告健康狀態及治療歷史,切勿有所隱瞞。
  5. 建議術前與醫師溝通並清楚表達治療需求,惟術後外觀美感屬於主觀認定範圍,不得作為手術成果判斷根據。
  6. 手術成效因人而異,需由專業醫師評估。案例圖片經當事人授權同意公開使用做為診療的輔助說明、衛生教育及醫療知識分享,僅供參考。