上颌下颌发育不全对阻塞性睡眠呼吸暂停下颌前移装置反应的影响：一项范围综述
Impact of maxillomandibular atresia on the response to mandibular advancement devices in obstructive sleep apnea: a scoping review.
文献信息
| PMID | 42789160 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Izabella P Manetta |
| 作者单位 | Department of Otolaryngology. Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil. izabella.manetta@fm.usp.br. |
| 期刊 | Sleep & breathing = Schlaf & Atmung |
| SCI 分区 | Q3 |
| IF | 2.8 |
| 研究类型 | 综述 Meta · 临床 |
| 所属专科 | 鼻科 |
中文摘要
目的： 梳理现有证据，探讨横向颅面改变对成人阻塞性睡眠呼吸暂停患者下颌前移装置治疗结局的影响，旨在识别知识空白并为未来研究和临床决策提供信息。
方法： 在六个数据库中进行系统文献检索。此外，检索了灰色文献来源，并筛查了包括ClinicalTrials.gov在内的临床试验注册库以获取随机对照试验方案。还筛查了所有纳入证据来源的参考文献列表，并咨询了该领域的专家。
结果： 去除重复后，文献检索共获得1,508条参考文献。九项研究和一份会议报告符合纳入标准。文献显示，横向颅面特征与下颌前移装置治疗结局之间存在异质性关联。大多数研究（n=7）未发现孤立的横向颅面测量值与治疗反应之间存在显著关联。两项研究报告较大的下颌横向尺寸与更好的治疗结局相关，而一项研究报告下颌横向尺寸较小的个体治疗反应更好。上颌宽度减小和不利的解剖平衡更常与更严重的阻塞性睡眠呼吸暂停或较差的治疗结局相关。
结论： 虽然一些研究表明阻塞性睡眠呼吸暂停患者对下颌前移装置的反应与下颌横向尺寸相关，但大多数研究并未发现这种关系。需要未来标准化且设计良好的研究来阐明这一解剖特征对这种常见阻塞性睡眠呼吸暂停治疗方法结局的影响。
英文摘要
PURPOSE: To map the existing evidence on the impact of transverse craniofacial alterations on mandibular advancement device treatment outcomes in adults with obstructive sleep apnea, with the objective of identifying knowledge gaps and informing future research and clinical decision-making.
METHODS: A systematic literature search was conducted in six databases. Additionally, gray literature sources were searched, and clinical trial registries, including ClinicalTrials.gov, were screened for RCT protocols. The reference lists of all included sources of evidence were also screened, and experts in the field were consulted.
RESULTS: The literature search yielded a total of 1,508 references after duplicate removal. Nine studies and one conference report were found eligible for inclusion. The literature demonstrated heterogeneous associations between transverse craniofacial characteristics and mandibular advancement device treatment outcomes. Most studies (n = 7) did not identify significant associations between isolated transverse craniofacial measurements and treatment response. Greater mandibular transverse dimensions were associated with better therapeutic outcomes in two studies, whereas one study reported better treatment response in individuals with smaller mandibular transverse dimensions. Reduced maxillary width and unfavorable anatomical balance were more frequently associated with greater obstructive sleep apnea severity or poorer treatment outcomes.
CONCLUSIONS: While some studies suggest that the response to mandibular advancement devices in obstructive sleep apnea is associated with transverse mandibular dimensions, most investigations have not identified this relationship. Future standardized and well-designed studies are needed to clarify the influence of this anatomical characteristic on the outcomes of this common treatment for obstructive sleep apnea.