儿童OSAHS的正畸治疗及美学效果(3)
2.2 正頜手术：对于一些严重颅面部畸形及下颌发育不足导致呼吸困难的OSAHS患儿，口腔矫治器不能取得良好的疗效，因此引入了正颌手术，如牵张成骨术，它通过激发机体组织再生的潜力延长下颌骨，从而改善上气道恢复其通气功能，解除呼吸受限并改善面型。Hiroshi Tomonari[21]等对患有小颌畸形的患儿采取下颌骨牵张成骨术联合滑动颏成形术进行正畸治疗并推下颌骨向前，有效地改善了牙颌面畸形和呼吸功能受损。
综上所述，儿童OSAHS是一种涉及多学科交叉治疗的疾病，应根据每位患儿的实际状况制订个性化的治疗方案，以达到更好的疗效。
[参考文献]
[1]Ramar K，Dort LC，Katz SG，et al. Clinical practice guideline for the treatment of obstructive sleep apnea and snoring with oral appliance therapy： an update for 2015[J]. J Clin Sleep Med，2015，11(7)：773-827.
, http://www.100md.com
[2]Tapia IE，Marcus CL，McDonough JM，et al.Airway resistance in children with obstructive sleep apnea syndrome[J].Sleep，2016，39(4)：793-799.
[3]Fleck RJ，Ishman SL，Shott SR，et al.Dynamic volume computed tomography imaging of the upper airway in obstructive sleep apnea[J].J Clin Sleep Med，2017，13(2)：189-196.
[4]Jiang YY.Correlation between hyoid bone position and airway dimensions in Chinese adolescents by cone beam computed tomography analysis[J]. Int J Oral Maxillofac Surg， 2016，45(7)：914-921.
, http://www.100md.com
[5]Banabilh SM.Orthodontic view in the diagnoses of obstructive sleep apnea[J].J Orthod Sci，2017，6(3)：81-85.
[6]Deng J，Gao X.A case-control study of craniofacial features of children with obstructed sleep apnea [J].Sleep Breath，2012，16(4)：1219-1227.
[7]Huynh NT，Desplats E， Almeida FR.Orthodontics treatments for managing obstructive sleep apnea syndrome in children： A systematic review and meta-analysis[J].Sleep Med Rev，2016，25：84-94.
, http://www.100md.com
[8]Roberts SD，Kapadia H，Greenlee G，et al Midfacial and dental changes associated with nasal positive airway pressure in children with obstructive sleep apnea and craniofacial conditions[J].J Clin Sleep Med，2016，12(4)：469-475.
[9]Jo SY，Lee SM，Lee KH，et al.Effect of long-term oral appliance therapy on obstruction pattern in patients with obstructive sleep apnea[J]. Eur Arch Otorhinolaryngol，2018， 275(5)：1327-1333.
[10]Banhiran W，Kittiphumwong P，Assanasen P，et al.Adjustable thermoplastic mandibular advancement device for obstructive sleep apnea：outcomes and practicability[J].Laryngoscope，2014，124(10)：2427-2432.
, http://www.100md.com
[11]Mintz SS，Kovacs R.The use of oral appliances in obstructive sleep apnea： a retrospective cohort study spanning 14 years of private practice experience[J].Sleep Breath，2018，22(2)：541-546.
[12]Tehranchi A，Ameli N，Najirad Z，et al.Comparison of the skeletal and dental changes of tooth-borne vs. bone-borne expansion devices in surgically assisted rapid palatal expansion：A finite element study[J].Dent Res J，2013，10(6)：777-783., 百拇医药(朱丽莎 孙世怡 包佳佳 李彪 任利玲)
综上所述，儿童OSAHS是一种涉及多学科交叉治疗的疾病，应根据每位患儿的实际状况制订个性化的治疗方案，以达到更好的疗效。
[参考文献]
[1]Ramar K，Dort LC，Katz SG，et al. Clinical practice guideline for the treatment of obstructive sleep apnea and snoring with oral appliance therapy： an update for 2015[J]. J Clin Sleep Med，2015，11(7)：773-827.
, http://www.100md.com
[2]Tapia IE，Marcus CL，McDonough JM，et al.Airway resistance in children with obstructive sleep apnea syndrome[J].Sleep，2016，39(4)：793-799.
[3]Fleck RJ，Ishman SL，Shott SR，et al.Dynamic volume computed tomography imaging of the upper airway in obstructive sleep apnea[J].J Clin Sleep Med，2017，13(2)：189-196.
[4]Jiang YY.Correlation between hyoid bone position and airway dimensions in Chinese adolescents by cone beam computed tomography analysis[J]. Int J Oral Maxillofac Surg， 2016，45(7)：914-921.
, http://www.100md.com
[5]Banabilh SM.Orthodontic view in the diagnoses of obstructive sleep apnea[J].J Orthod Sci，2017，6(3)：81-85.
[6]Deng J，Gao X.A case-control study of craniofacial features of children with obstructed sleep apnea [J].Sleep Breath，2012，16(4)：1219-1227.
[7]Huynh NT，Desplats E， Almeida FR.Orthodontics treatments for managing obstructive sleep apnea syndrome in children： A systematic review and meta-analysis[J].Sleep Med Rev，2016，25：84-94.
, http://www.100md.com
[8]Roberts SD，Kapadia H，Greenlee G，et al Midfacial and dental changes associated with nasal positive airway pressure in children with obstructive sleep apnea and craniofacial conditions[J].J Clin Sleep Med，2016，12(4)：469-475.
[9]Jo SY，Lee SM，Lee KH，et al.Effect of long-term oral appliance therapy on obstruction pattern in patients with obstructive sleep apnea[J]. Eur Arch Otorhinolaryngol，2018， 275(5)：1327-1333.
[10]Banhiran W，Kittiphumwong P，Assanasen P，et al.Adjustable thermoplastic mandibular advancement device for obstructive sleep apnea：outcomes and practicability[J].Laryngoscope，2014，124(10)：2427-2432.
, http://www.100md.com
[11]Mintz SS，Kovacs R.The use of oral appliances in obstructive sleep apnea： a retrospective cohort study spanning 14 years of private practice experience[J].Sleep Breath，2018，22(2)：541-546.
[12]Tehranchi A，Ameli N，Najirad Z，et al.Comparison of the skeletal and dental changes of tooth-borne vs. bone-borne expansion devices in surgically assisted rapid palatal expansion：A finite element study[J].Dent Res J，2013，10(6)：777-783., 百拇医药(朱丽莎 孙世怡 包佳佳 李彪 任利玲)