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德國2007年1月;口腔矯治器減輕一名三歲男童嚴重的阻塞性睡眠窒息症




Published online: January 5, 2007 Severe Obstructive Sleep Apnea Alleviated by Oral Appliance in a Three-Year-Old Boy

Joachim Schessla, Edmund Roseb, Rudolf Korinthenberga, Matthias Henschenc aDepartment of Pediatrics and Adolescent Medicine, Division of Neuropediatrics and Muscular Disorders, bDepartment of Orthodontics, and cDepartment of Pediatrics and Adolescent Medicine, Pediatric Pulmonology, University Hospital Freiburg, Freiburg, Germany

Abstract摘要

This clinical report describes a 3.5-year-old boy suffering from chronic daytime fatigue, accumulated snoring and dramatically appearing apnea during sleep. Oxycardiorespirography revealed a breathing pattern similar to repetitive obstructive apnea and an oxygen saturation periodically dropping to 80%. During tidal breathing, fiberoptic bronchoscopy showed aspiration of the aryepiglottic folds and the epiglottis during inspiration. Adenotonsillar hypertrophy was excluded. Due to the acknowledged side effects from various surgical approaches and nasal continuous positive airway pressure, a removable, functional Fraenkel II oral appliance was applied during sleep. Clinical assessment demonstrated resolution of the main respiratory symptoms, and oxycardiorespirography revealed a fundamental reduction in periodic obstructive apnea and desaturation. In conclusion, we consider the use of an oral functional appliance for severe obstructive sleep apnea in children to be a valuable alternative to other treatment methods.




德國2007年1月5日

口腔矯治器減輕一名三歲男童嚴重的阻塞性睡眠窒息症

Abstract摘要

  研究對象為有慢性日間疲勞、鼾症、阻塞性睡眠窒息症的一名3.5歲男童。Oxycardiorespirography(暫譯:氧心呼吸聲圖)顯示出一個類似重複阻塞性窒息的呼吸模式和週期性地降到80 %的氧飽和。潮式呼吸時,纖維支氣管鏡(fiberoptic bronchoscopy)顯示吸氣時杓狀會厭帶(aryepiglottic folds) 和會厭(epiglottis)二者的呼氣。排除了扁桃體腺樣體肥大(adenotonsillar hypertrophy)。由於已知各種手術方法和鼻持續氣道正壓(nasal continuous positive airway pressure)有副作用,所以採用可撤式Fraenkel II口腔矯治器。臨床評鑑顯示它減輕了週期性的阻塞性睡眠窒息和去飽和作用(desaturation)。

  結論是:我們認為口腔矯治器可替代其他治療方法,而針對有嚴重阻塞性睡眠窒息症的兒童使用。

  以上是該論文的簡介,牙套確實有效,但是礙於孩童發育和不斷換牙齒的情況需要常常花錢製作牙套,以及年幼無知、不愛使用等考量,實在不建議製作牙套

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