“Dental surgeons have an important role to play in identifying patients at risk of OSA”

Dental Tribune | 2024-04-19 | 翻译由动脉网AI生成，点击反馈

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Anisha Hall Hoppe, Dental Tribune International

Anisha Hall Hoppe，《国际牙科论坛报》

Fri. 19. April 2024

自由的19.2024年4月

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Combining her expertise in both oral and maxillofacial surgery with sleep medicine, Dr Tan Mei Hui’s presentation at IDEM 2024 offered clinicians the chance to better understand the signs and symptoms of obstructive sleep apnoea (OSA) and tools for identifying appropriate treatment options. Prior to her presentation, Dental Tribune International spoke with Dr Tan, who holds leadership, consultant and lecturing positions at some of the foremost institutions in Singapore, about what dental surgeons, in particular, could look forward to in the lecture..

结合她在口腔颌面外科和睡眠医学方面的专业知识，TanMei Hui博士在IDEM 2024上的演讲为临床医生提供了更好地了解阻塞性睡眠呼吸暂停（OSA）的体征和症状以及确定适当治疗方案的工具的机会。在演讲之前，国际牙科论坛与谭博士进行了交谈，谭博士在新加坡一些最重要的机构担任领导、顾问和演讲职位，特别是牙科外科医生在演讲中可以期待什么。。

Dr Mei Hui Tan (Image: Mei Hui Tan)

Tan Mei Hui博士（图片：Tan Mei Hui）

Dr Tan, with your extensive background in oral and maxillofacial surgery and your current roles as a consultant and director of medical and academic organisations, how do you integrate your expertise in orthognathic surgery and facial aesthetics into the management and treatment of OSA?

Tan博士，您拥有丰富的口腔颌面外科背景，目前担任医疗和学术组织的顾问和主任，您如何将您在正颌外科和面部美学方面的专业知识整合到OSA的管理和治疗中？

One of the main risk factors for OSA is craniofacial restriction. For OSA patients with craniofacial restriction, maxillomandibular advancement (MMA) surgery would be able to correct the underlying cause of OSA, thereby successfully managing their OSA to improve their quality of sleep and life. With careful consideration of the patient’s facial features and the armamentarium of various osteotomy techniques available in orthognathic surgery, I am able to customise the MMA surgery for OSA patients in order to optimise treatment success as well as to achieve a balanced facial appearance for the patient..

OSA的主要危险因素之一是颅面受限。对于颅面受限的OSA患者，上颌骨前移（MMA）手术将能够纠正OSA的根本原因，从而成功管理其OSA以改善其睡眠和生活质量。通过仔细考虑患者的面部特征和正颌外科手术中可用的各种截骨术的设备，我能够为OSA患者定制MMA手术，以优化治疗成功率，并为患者实现平衡的面部外观。。

Given the low level of awareness and knowledge of OSA among the general population in Singapore, what strategies do you believe dental surgeons should employ to improve early identification and referral of suspected cases of OSA?

鉴于新加坡普通人群对OSA的认识和知识水平较低，您认为牙科医生应该采取哪些策略来改善OSA疑似病例的早期识别和转诊？

Dental surgeons have an important role to play in identifying patients at risk of OSA, as they are trained in the evaluation of craniofacial restriction, which is a major risk factor for OSA. Furthermore, dental surgeons are able to identify intra-oral features such as narrow and high-arched palate and large torus mandibularis, as well as bruxism, which are often associated with OSA.

牙科医生在识别OSA风险患者方面发挥着重要作用，因为他们接受了颅面限制评估的培训，颅面限制是OSA的主要风险因素。此外，牙科医生能够识别口腔内特征，例如狭窄和高弓形的上颚和大的下颌骨环，以及磨牙症，这些通常与OSA有关。

When patients present with such findings, the dental surgeon should administer the STOP-BANG questionnaire and refer those at moderate to severe risk for a sleep study..

当患者出现此类发现时，牙科医生应进行STOP-BANG问卷调查，并将中度至重度风险的患者转介进行睡眠研究。。

“Dental surgeons have an important role to play in identifying patients at risk of OSA, as they are trained in the evaluation of craniofacial restriction, which is a major risk factor.”

“牙科医生在识别OSA风险患者方面发挥着重要作用，因为他们接受了颅面限制评估的培训，颅面限制是一个主要的风险因素。”

In your presentation, you will be talking about various treatment options for OSA, ranging from conservative treatments to surgical interventions. Could you share one or two of these tailored treatment options?

在您的演讲中，您将讨论OSA的各种治疗选择，从保守治疗到手术干预。你能分享一下这些量身定制的治疗方案中的一个或两个吗？

Continuous positive airway pressure (CPAP) remains the gold standard treatment for OSA because of its high efficacy; however, it requires lifelong use, and many patients are unable to tolerate it. For patients who prefer an alternative conservative treatment, mandibular advancement devices remain the next best option after CPAP.

持续气道正压通气（CPAP）由于其高效性，仍然是OSA的金标准治疗方法；然而，它需要终身使用，许多患者无法忍受。对于喜欢替代保守治疗的患者，下颌前移装置仍然是CPAP后的下一个最佳选择。

Younger patients who may not want to use CPAP for decades may seek surgical alternatives to manage their OSA..

几十年来不想使用CPAP的年轻患者可能会寻求手术替代方案来管理他们的OSA。。

For patients who present with craniofacial restrictions contributing to OSA, MMA surgery is an appropriate treatment, as correcting the skeletal framework helps advance the pharyngeal tissue and tongue, thereby improving the posterior airway space. Every patient will vary in his or her risk factors for OSA, and clinical examination, together with nasal endoscopy, will help identify the causes of obstruction.

对于颅面受限导致OSA的患者，MMA手术是一种合适的治疗方法，因为纠正骨骼框架有助于促进咽组织和舌头，从而改善后气道空间。每位患者的OSA危险因素各不相同，临床检查和鼻内镜检查将有助于确定阻塞的原因。

Ultimately, we need to take into consideration each patient’s preferences and ensure that follow-up sleep testing is done to ensure treatment success..

最终，我们需要考虑每位患者的偏好，并确保进行后续睡眠测试以确保治疗成功。。

“Dental professionals will continue to play an important role in diagnosis and in appropriately referring patients for treatment.”

“牙科专业人员将继续在诊断和适当转诊患者接受治疗方面发挥重要作用。”

With the advancements in sleep studies and diagnostic tools, how do you see the future of OSA management developing, particularly in the context of oral and maxillofacial surgery, and what role do you envision dental professionals playing in this evolving landscape?

随着睡眠研究和诊断工具的进步，你如何看待OSA管理的未来发展，特别是在口腔颌面外科的背景下，以及你认为牙科专业人员在这个不断发展的环境中扮演什么角色？

With more and more home sleep studies available in the market and with increasing accuracy of the devices available, there will be better diagnosis and hence earlier treatment for patients with OSA. Already, we are starting to see more people in their 20s getting diagnosed with OSA. Dental professionals will continue to play an important role in diagnosis and in appropriately referring patients for treatment.

随着市场上越来越多的家庭睡眠研究以及可用设备的准确性不断提高，OSA患者将得到更好的诊断和早期治疗。我们已经开始看到更多20多岁的人被诊断出患有OSA。牙科专业人员将继续在诊断和适当转诊患者接受治疗方面发挥重要作用。

Those who are interested in sleep medicine can go for further training to equip themselves with the knowledge and skills to manage OSA patients. OSA is pushing more patients to seek corrective skeletal MMA surgery, and oral and maxillofacial surgeons will play a key role in providing a good surgical alternative for patients..

那些对睡眠医学感兴趣的人可以接受进一步的培训，以掌握管理OSA患者的知识和技能。OSA正在推动更多患者寻求矫正骨骼MMA手术，口腔颌面外科医生将在为患者提供良好的手术替代方案方面发挥关键作用。。

Do you have anything else you would like to add?

你还有什么要补充的吗？

Good sleep is a very important aspect of health, and I hope that, with increasing awareness of OSA, patients will be diagnosed and treated early to reduce the risks of medical comorbidities and the overall health burden in our population.

良好的睡眠是健康的一个非常重要的方面，我希望，随着人们对OSA认识的提高，患者将得到早期诊断和治疗，以降低医疗合并症的风险和我们人群的整体健康负担。

Editorial note:

编辑注释：

During the scientific conference at IDEM Singapore 2024, Dr Tan lectured on “Identifying obstructive sleep apnoea suspects and the management of obstructive sleep apnoea” on 19 April from 17:00 to 18:00.

在2024年新加坡IDEM科学会议期间，Tan博士于4月19日17:00至18:00就“识别阻塞性睡眠呼吸暂停嫌疑人和阻塞性睡眠呼吸暂停的管理”进行了演讲。

Topics:

主题：

Oral and Maxillofacial Surgery

口腔颌面外科

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标签：

Dental sleep medicine

牙科睡眠医学

IDEM 2024

Obstructive sleep apnea

阻塞性睡眠呼吸暂停

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