正颚手术如何改善睡眠呼吸中止症？
正颚手术原本是设计来改善患者的咬合以及外观，但在治疗阻塞型睡眠呼吸中止的这个领域，正颚手术（上下颚骨的前移）（Maxillo-Mandibular Advancement/MMA）变成是拉紧塌陷（松弛）肌肉的手段，而非目的，外观及咬合的改善变成是上下颚骨前移的附加价值。
- Maxillomandibular advancement (MMA) is a surgical procedure used to treat severe obstructive sleep apnea (OSA). Here's how it works:
- Expansion of Airway: MMA involves moving the upper and lower jaws (maxilla and mandible) forward. This expansion increases the size of the airway, reducing the likelihood of it collapsing during sleep.
- Stabilization: By advancing the jaws, the soft tissues and muscles around the airway are also pulled forward, which helps stabilize the airway and keeps it open.
- Improved Airflow: The increased space and stabilization result in better airflow, reducing the occurrence of apnea events (breathing pauses) and hypopnea events (shallow breathing).
诊疗计画及术后改变
透过上呼吸道肌群的拉紧，睡眠时呼吸道变得稳定而不容易塌陷，所以得以保持畅通。从患者术前术后的照片及电脑断层可以看出，正颚手术将上下颚骨往前方（远离脊椎的方向）固定，拉紧其后方肌群，软腭肌群、舌肌群、舌骨、舌骨上肌群也明显被往前、往上拉开，远离后胭壁，脸部线条有所支撑，咬合也顺道改善。
Orthognathic surgery was originally designed to improve the patient's occlusion and appearance. However, in the field of treating obstructive sleep apnea, orthognathic surgery (maxillo-mandibular advancement/MMA) has become a means to tighten collapsed (loosened) muscles rather than the purpose itself. The improvement in appearance and occlusion has become an added value of maxillo-mandibular advancement. By tightening the upper airway muscles, the airway becomes stable and less likely to collapse during sleep, thus remaining unobstructed. From the preoperative and postoperative photos and CT scans of the patients, it can be seen that orthognathic surgery fixes the maxilla and mandible forward (away from the spine), tightening the muscles behind the upper and lower jaw bones. The soft palate muscles, tongue muscles, hyoid bone, and suprahyoid muscles are also significantly pulled forward, away from the posterior pharyngeal wall. The facial soft tissue envelope is supported, and the occlusion is also improved.
AHI（呼吸暂停指数）从36.5降为0.9（学术上定义AHI如果20以下为手术成功，5以下为手术治愈），最低血氧浓度从67%，升高到91%。除了这些睡眠指标的改善，最重要的是，患者本身感觉手术后，睡眠品质大增，已没有日间嗜睡的问题，精神变好也更有活力！ ！ ！
The AHI (apnea-hypopnea index) decreased from 36.5 to 0.9 (defined as surgical success if AHI is below 20, and surgical cured if below 5). The lowest blood oxygen concentration increased from 67% to 91%. In addition to these improvements in sleep indicators, the most important thing is that the patient feels that the quality of sleep has greatly increased after the surgery, no longer has daytime sleepiness, and feels more energetic and vibrant!
外观改变
