Changing practice: Trends in skeletal surgery for obstructive sleep apnea

Awad, Michael; Gouveia, Christopher J.; Zaghi, Soroush; Camacho, Macario; Liu, Stanley Yung‐Chuan

doi:10.1016/j.jcms.2018.11.005

Cited by 17 publications

(26 citation statements)

References 20 publications

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“…There is a growing interest in such surgery as demonstrated by the emerging amount of literature on this topic. 22 More fundamental research regarding the stability of fixation techniques in mandibular advancements beyond 15 mm is therefore justified. An ideal fixation method for these advancements should be investigated.…”

Section: Discussionmentioning

confidence: 99%

Stability of fixation methods in large mandibular advancements after sagittal split ramus osteotomy: an in vitro biomechanical study

Kuik

Ruiter

et al. 2021

British Journal of Oral and Maxillofacial Surgery

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Sagittal split ramus osteotomy (SSRO) with large mandibular advancements is a common surgical procedure and could be indicated for patients with sleep apnoea. As a large variety of fixation methods is used for the stabilisation of SSRO, a biomechanical test model was used to analyse which fixation technique was most stable. For this in vitro study, 80 polyurethane hemimandibles with a prefabricated SSRO were used as substrates. Loads in Newtons were recorded at displacements of the mandibular incisive edge at 1 mm, 3 mm and 5 mm. The samples were divided into two groups: mandibular advancements of 10 mm and 15 mm. In both groups, four fixation techniques were used: (A) one four-hole miniplate; (B) two four-hole miniplates; (C) one four-hole miniplate plus one bicortical screw; and (D) three bicortical screws in an inverted-L arrangement. In group 1, three bicortical screws resulted in the best stability, and in group 2, two miniplates resulted in the best stability. The use of two miniplates did not show significant differences between both groups. Other fixation methods showed more stability with 10 mm advancements. This study therefore suggests that in SSRO with advancements exceeding 10 mm, the use of two miniplates is the optimal means of providing rigid fixation.

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Section: Discussionmentioning

confidence: 99%

Stability of fixation methods in large mandibular advancements after sagittal split ramus osteotomy: an in vitro biomechanical study

Kuik

Ruiter

et al. 2021

British Journal of Oral and Maxillofacial Surgery

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Section: Surgical Treatment For Osamentioning

confidence: 99%

“…Eight papers suggest a positive impact of GA on OSA outcomes; however, evidence for genioplasty and genioglossus advancement is limited by heterogeneity in patient selection and surgical technique. 1793 A case series by Song et al evaluated the individual role of GA and identified a mean AHI reduction from 37.6 (24.2) to 20.4 (15.1) (41.7% reduction). 1794 After GA with HS, mean AHI reduced from 34.5 (22.1) to 15.3 (17.6) (55.7% reduction).…”

Section: Genioglossus Advancementmentioning

confidence: 99%

International Consensus Statement on Obstructive Sleep Apnea

Chang

Goldberg

Alt

et al. 2023

Int Forum Allergy Rhinol

119

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Background: Evaluation and interpretation of the literature on obstructive sleep apnea (OSA) allows for consolidation and determination of the key factors important for clinical management of the adult OSA patient. Toward this goal, an international collaborative of multidisciplinary experts in sleep apnea evaluation and treatment have produced the International Consensus statement on Obstructive Sleep Apnea (ICS:OSA). Methods: Using previously defined methodology, focal topics in OSA were assigned as literature review (LR), evidence-based review (EBR), or evidencebased review with recommendations (EBR-R) formats. Each topic incorporated the available and relevant evidence which was summarized and graded on study quality. Each topic and section underwent iterative review and the ICS:OSA was created and reviewed by all authors for consensus. Results: The ICS:OSA addresses OSA syndrome definitions, pathophysiology, epidemiology, risk factors for disease, screening methods, diagnostic testing types, multiple treatment modalities, and effects of OSA treatment on multiple OSA-associated comorbidities. Specific focus on outcomes with positive airway pressure (PAP) and surgical treatments were evaluated. Conclusion:This review of the literature consolidates the available knowledge and identifies the limitations of the current evidence on OSA. This effort aims to create a resource for OSA evidence-based practice and identify future research needs. Knowledge gaps and research opportunities include improving the metrics of OSA disease, determining the optimal OSA screening paradigms, developing strategies for PAP adherence and longitudinal care, enhancing selection of PAP alternatives and surgery, understanding health risk outcomes, and translating evidence into individualized approaches to therapy.

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“…Obstructive sleep apnea (OSA) is a common disorder that affects about 1/3 of the adult population but can be seen in all age groups [40][41][42][43][44][45]. It is characterized by repeated episodes of partial or complete obstruction of the upper airway during sleep, leading to disrupted sleep and decreased oxygen levels in the body.…”

Section: Orthognathic Surgery For Obstructive Sleep Apneamentioning

confidence: 99%

Current Trends in Orthognathic Surgery

Zammit,

Ettinger,

Sanati-Mehrizy

et al. 2023

Medicina

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Orthognathic surgery has evolved significantly over the past century. Osteotomies of the midface and mandible are contemporaneously used to perform independent or coordinated movements to address functional and aesthetic problems. Specific advances in the past twenty years include increasing fidelity with computer-assisted planning, the use of patient-specific fixation, expanding indications for management of upper airway obstruction, and shifts in orthodontic-surgical paradigms. This review article serves to highlight the contemporary practice of orthognathic surgery.

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Changing practice: Trends in skeletal surgery for obstructive sleep apnea

Cited by 17 publications

References 20 publications

Stability of fixation methods in large mandibular advancements after sagittal split ramus osteotomy: an in vitro biomechanical study

Stability of fixation methods in large mandibular advancements after sagittal split ramus osteotomy: an in vitro biomechanical study

International Consensus Statement on Obstructive Sleep Apnea

Current Trends in Orthognathic Surgery

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