下颌前伸止鼾器对OSAHS患者颞下颌关节影响的MRI研究

发布时间：2018-03-13 17:41

本文选题：阻塞性睡眠呼吸暂停低通气综合征　切入点：颞下颌关节　出处：《昆明医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：[目的]研究轻、中度OSAHS患者戴用下颌前伸止鼾器治疗18个月前后颞下颌关节的磁共振影像学变化,探讨其对颞下颌关节改建的影响。[方法]选取20例轻、中度OSAHS患者,其中男性17例,女性3例,年龄25-59岁。均采用金属拉杆式下颌前伸止鼾器治疗,分别行治疗前和治疗18个月后双侧颞下颌关节MRI扫描。选取颞下颌关节斜矢状位图像采用钟点法评价关节盘位置,采用kurita分析法研究治疗前后髁状突、关节盘及关节窝之间位置关系的改变;斜冠状位图像观察关节盘有无内外侧移位。对所记录数据采用SPSS21.0软件进行配对t检验统计学分析。[结果]1. 20例OSAHS患者MRI检查可清晰显示颞下颌关节软硬组织的解剖结构和相互位置关系。2.20例OSAHS患者治疗前关节盘左侧位置为(8.50±2.07°),右侧位置为(8.53±1.15° )。经MASSD治疗18个月关节盘左侧位置为(8.92±1.50° ),右侧位置为(8.95±1.39° ),治疗前与治疗后对比,关节盘位置差异无统计学意义(P0.05)。3. MASSD治疗前与治疗18个月后,关节盘与关节窝位置关系(TD/TP)、髁状突与关节窝位置关系(TC/TP)、关节盘与髁状突的相对位置(TD/TC)治疗前后差异无统计学意义(P0.05)。4. MASSD治疗前与下颌前伸止鼾器治疗18个月后,斜冠状位观察存在关节盘内缘超出髁突内缘的现象。治疗前后盘髁内缘间距(ac)和盘髁外缘间距(bd)差异无统计学意义(P0.05)。[结论]1.MRI检查可清晰显示颞下全面颌关节软硬组织的解剖结构和相互位置关系,对诊断颞下颌关节病变有临床指导意义。2.轻、中度OSAHS患者戴用下颌前伸止鼾器治疗18个月前后对比显示颞下颌关节影像学无显著改变,提示该治疗方法对颞下颌关节改建无影响。
[Abstract]:[objective] to study the magnetic resonance imaging changes of temporomandibular joint (TMJ) in patients with mild and moderate OSAHS before and after 18 months of treatment with mandibular protruding and snore apparatus. [methods] Twenty patients with mild and moderate OSAHS were selected to study the effect of MRI on temporomandibular joint remodeling. There were 17 males and 3 females aged 25-59 years. Bilateral temporomandibular joint (TMJ) was scanned by MRI before treatment and 18 months after treatment. The position of TMJ was evaluated by hour method on oblique sagittal images of TMJ, and condyle was studied by kurita analysis before and after treatment. The change of the position relationship between the disc and the articular fossa; Oblique coronal images were used to observe the lateral and lateral displacement of the articular disc. The recorded data were analyzed by paired t test with SPSS21.0 software. [results] 1.The MRI examination of 20 patients with OSAHS could clearly show the release of soft and hard tissue of temporomandibular joint. The relationship between the dissection structure and the position of each other was 8.50 卤2.07 掳on the left side and 8.53 卤1.15 掳on the right side of the articular disc before and after the treatment of OSAHS. After 18 months of MASSD treatment, the left position of the articular disc was 8.92 卤1.50 掳, and the right position was 8.95 卤1.39 掳, which was compared with that before and after the treatment. There was no significant difference in the position of articular disc between the two groups before and after 18 months of treatment with MASSD. The relationship between the position of the disc and the articular fossa, the position of the condyle and the position of the articular fossa, the relative position of the disc and the condyle had no significant difference before and after treatment (P 0.05). 4. Before MASSD treatment and 18 months after the treatment of mandibular protruding and snoring apparatus, there was no significant difference in the relative position between the disc and the condyle. In oblique coronal position, there is a phenomenon that the inner edge of the disc exceeds the inner edge of the condyle. There is no significant difference in the distance between the inner edge of the disc condyle and the outer edge of the disc condyle before and after treatment (P 0.05). [conclusion] 1. MRI can clearly show the subtemporal mandibular joint soft and hard. The anatomical structure of the tissue and its relationship with each other, Clinical guidance for the diagnosis of temporomandibular joint lesions. 2. The contrast between mild and moderate OSAHS patients wearing mandibular protruding snoring apparatus before and after 18 months showed that there was no significant change in temporomandibular joint imaging. The results suggest that this treatment has no effect on temporomandibular joint remodeling.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R782.6

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