Mandibular ramus distraction osteogenesis and Lefort I osteotomy for obstructive sleep apnea: A case report monitored with home respiratory polygraphy

Q3 Dentistry

Oral and Maxillofacial Surgery Cases Pub Date : 2024-11-28 DOI:10.1016/j.omsc.2024.100377

Galder Hernando Martín , Pilar Rubio-Bueno , Ana Martínez Gil-Ortega , Joaquín Durán-Cantolla

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引用次数: 0

Abstract

A new monitoring protocol for orthognathic surgery for addressing obstructive sleep apnea syndrome in adult patients using bilateral internal ramus distraction (BIRD) followed by Lefort I osteotomy and monitored by HRP is presented. This strategy is part of an outpatient major surgery protocol and includes preoperative 3d virtual planning, followed by surgery under general anesthesia with endoscopic assistance.

Following the procedure, patients are typically discharged on the same day, with the vertical lengthening of the mandibular ramus starting after a 5-day period and progressing at a speed of 0.5–1 mm per day over a period of 10–50 days. The process carries on until the negative dental overjet exceeds 10 mm or the apnea-hypopnea index falls beneath 15 events per hour, demonstrating a curative level.

Mandibular advancement monitorization based on clinical, polygraphic, or polysomnographic criteria enables the surgeon to meet the individual needs of each patient. The distractors are typically maintained in position for six months following elongation of 10–25 mm to ensure proper consolidation.

BIRD followed by LeFort I osteotomy, has demonstrated significant efficacy as a treatment for obstructive sleep apnea syndrome in adult patients, irrespective of the presence of retrognathia. Furthermore, this approach may offer particular advantages for patients with severe cardiovascular disease or diabetes.

查看原文本刊更多论文

下颌支牵张成骨和Lefort I截骨治疗阻塞性睡眠呼吸暂停：1例家庭呼吸测谎监测报告

提出了一种新的监测方案，用于治疗成人患者的阻塞性睡眠呼吸暂停综合征的正颌手术，采用双侧内支牵张术（BIRD）和Lefort I截骨术，并由HRP监测。该策略是门诊大手术方案的一部分，包括术前3d虚拟计划，随后在内镜辅助下全身麻醉手术。手术后，患者通常在同一天出院，5天后开始下颌支垂直延长，以每天0.5-1 mm的速度进展，持续10-50天。这一过程一直持续到牙齿负覆盖超过10毫米或呼吸暂停低通气指数降至每小时15次以下，表明治疗水平。基于临床、多导睡眠图或多导睡眠图标准的下颌进展监测使外科医生能够满足每位患者的个性化需求。在拉伸10 - 25mm后，通常将牵张器保持在原位6个月，以确保适当的巩固。BIRD和LeFort I型截骨术治疗成人阻塞性睡眠呼吸暂停综合征的疗效显著，无论是否存在颌后畸形。此外，这种方法可能为患有严重心血管疾病或糖尿病的患者提供特别的优势。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Oral and Maxillofacial Surgery Cases Medicine-Otorhinolaryngology

CiteScore

0.60

自引率

0.00%

发文量

审稿时长

69 days

期刊介绍： Oral and Maxillofacial Surgery Cases is a surgical journal dedicated to publishing case reports and case series only which must be original, educational, rare conditions or findings, or clinically interesting to an international audience of surgeons and clinicians. Case series can be prospective or retrospective and examine the outcomes of management or mechanisms in more than one patient. Case reports may include new or modified methodology and treatment, uncommon findings, and mechanisms. All case reports and case series will be peer reviewed for acceptance for publication in the Journal.