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Gesichtsskelettverlagernde Eingriffe beim OSAS: Mund- und kieferchirurgische Aspekte

  • Conference paper
Schlaf - Atmung - Kreislauf

Zusammenfassung

Nachdem eine Verengung bzw. der Verschluß im Bereich der oberen Atemwege als pathophysiologisches Korrelat des obstruktiven Schlafapnoesyndroms erkannt worden war, lag auch der Gedanke an operative Korrekturen in diesem Bereich zur Behandlung der Apnoe bzw. zur Beseitigung der Obstruktion nahe. Erster erfolgreicher Ansatz [15, 20] war die Tracheotomie, wobei die Obstruktion belassen und — sozusagen durch einen Kurzschluß — die direkte Verbindung der Luftröhre mit der Atemluft hergestellt wurde. In extremen Situationen findet dieses Prinzip nach wie vor Anwendung. Ferner gab es mehrere Versuche, Engstellen im Bereich der oberen Atemwege zu lokalisieren und gezielt zu beseitigen. Zu nennen ist hier insbesondere die Uvulopalatopharyngoplastik (UPPP), die in unterschiedlichen Variationen in großem Umfang durchgeführt wurde. Die Erfolgsquote ist relativ gering, da einerseits mit der operativen Korrektur der Weichteile auf Höhe des weichen Gaumens nur eine bestimmte Ebene einer möglichen Obstruktion erfaßt wird und andererseits durch chirurgische Weichteilkoirektur nur begrenzte Möglichkeiten zur Erweiterung des Pharynx bestehen. Zudem ist nach UPPP mit sekundären Veränderungen wie velopharyngealer Insuffizienz oder narbigen Strikturen zu rechnen. Eine polysomnographische Langzeituntersuchung [18] an 50 Patienten nach UPPP ergab nach einem halben Jahr eine Mißerfolgsquote von 40%, die nach 2 Jahren auf 60% anstieg.

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Authors
  1. W. Hochban
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  2. U. Brandenburg
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Editors and Affiliations

  1. Abt. Poliklinik im Zentrum für Innere Medizin, der Philipps-Universität, Baldingerstraße 1, 35033, Marburg, Germany

    Jörg Hermann Peter Priv.-Doz. Dr. med., Dr. rer. nat. , Thomas Penzel Dr. rer. physiol., Dipl.-Phys. , Werner Cassel Dipl.-Psych.  & Peter von Wichert Prof. Dr. med. , ,  & 

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© 1993 Springer-Verlag Berlin Heidelberg

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Hochban, W., Brandenburg, U. (1993). Gesichtsskelettverlagernde Eingriffe beim OSAS: Mund- und kieferchirurgische Aspekte. In: Peter, J.H., Penzel, T., Cassel, W., von Wichert, P. (eds) Schlaf - Atmung - Kreislauf. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-78303-6_18

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  • DOI: https://doi.org/10.1007/978-3-642-78303-6_18

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-56837-7

  • Online ISBN: 978-3-642-78303-6

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