做过拔牙矫正,因为呼吸中止再做正颚手术

做过拔牙矫正,因为呼吸中止再做正颚手术
术前症状手术计画
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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温馨提醒

  1. 请依照医师及护理人员指示,定期服药、注意饮食忌讳及维持伤口清洁。
  2. 术后可能有出血,感染,发炎等并发症,根据个人体质差异其程度有所不同,需加小心护理,若上述情况发生请尽快与我们联络。
  3. 术后3~6个月手术部位会暂时性知觉迟缓、表情较不自然为正常现象;透过自主按摩及表情练习,大部分患者术后6~12个月将逐渐好转。
  4. 麻醉有其一定风险,与患者自身身体状况有关,患者需诚实且清楚地向治疗医师及麻醉科医师报告健康状态及治疗历史,切勿有所隐瞒。
  5. 建议术前与医师沟通并清楚表达治疗需求,惟术后外观美感属于主观认定范围,不得作为手术成果判断根据。
  6. 手术成效因人而异,需由专业医师评估。案例图片经当事人授权同意公开使用做为诊疗的辅助说明、卫生教育及医疗知识分享,仅供参考。