| Preoperative symptoms | surgical plan |
| Moderate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
斷層掃描
睡眠呼吸中止指數
