Schneider, Matthias

Die chirurgische Therapie der Schlafapnoe ist nicht ohne Risiken und Nebenwirkungen. Dazu gehören Blutungen, Infektionen, Schmerzen, Sensibilitätsstörungen, Narbenbildung, Schluckbeschwerden, Sprechveränderungen oder ein Rezidiv der Obstruktion. Die in diesem Artikel vorgestellten Verfahren sollten daher nur nach einer sorgfältigen Diagnostik, Beratung und differenzialtherapeutischer Abwägung durchgeführt werden. Außerdem sollten sie mit anderen konservativen oder apparativen Therapiemethoden kombiniert werden, um den bestmöglichen Erfolg zu erzielen. Manuskripteingang: 03.04.2022, Manuskriptannahme: 04.04.2023 Schlagwörter: Umstellungsosteotomie, Tonsillektomie (TE), Hypoglossus-Stimulation, Uvulopalatopharyngoplastik (UPPP), Multi-Level-Chirurgie

The objective of this study was the registration of incidence and etiology of alveolar process fractures in combination with other maxillofacial or dental fractures. The investigation demonstrated that the prognosis depends on the kind of management as well as the volume of concomitant injury. In a retrospective study over a period from 1995 to 1997 we examine 75 patients of the department of maxillofacial surgery of the Technical University of Dresden with upper and lower jaw alveolar fractures. Amongst the craniofacial fractures the maxillary alveolar fractures are with the incidence of 10 per cent of all craniofacial fractures more than twice as alveolar fractures of the mandible with 4 per cent. In the most cases the alveolar fractures were associated with various fractures of middle face and mandible. Additional, the fractures of alveolar process occurred very often in combination with dental lesions, for example with dislocation (26%), root fractures (13%) and crown fractures (8%). The frontal teeth of the upper jaw were mostly affected in both dentitions phases. Traffic accident followed by violence mainly caused the traumatic injury. In 90% of all cases the reposition of the fractures took place at the same day of injury. Isolated alveolar fractures were mostly treated by a plastic brace, which corporate covered the teeth. In case of combined fractures tabular brace were preferably applied. The miniaturization of the osteosynthesis material enables an increased the functional stable fixation of fracture fragment. Especially important is an immediate careful, if necessary, open repositioning and fixation with braces around the teeth. The three weeks immobilization time follows the common principles of fracture treatment. The best prognosis for the affected teeth of jaw segment is given, if no additional dental trauma occurred. Complications were in the most cases a result of additional affection of periodontium. Schlagwörter: Alveolarfortsatzfraktur, Mittelgesichtsschädelfraktur, Unterkieferfraktur, Zahnfraktur