Impact of Bimaxillary Advancement Surgery on the Upper Airway and on Obstructive Sleep Apnea Syndrome: a Meta-Analysis

Rojo-Sanchis, Carolina; Almerich‐Silla, José Manuel; Paredes-Gallardo, Vanessa; Montiel-Company, José María; Bellot-Arcís, Carlos

doi:10.1038/s41598-018-24142-3

Cited by 25 publications

(21 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The results obtained with MMA surgery in our patient are in agreement with the literature data on AHI reduction as the primary outcome; surgical success being defined by consensus as the percentage of patients with greater than 50% reduction AHI or fewer than 20 AHI events/hour and OSA cure less than 5 events/hour following surgery [10]. Several meta-analyses confirm the benefit of MMA surgery in enlargement of the upper airway, improvement of oximetric indicators and better quality of life measured on the Epworth sleepiness scale [10,16]. Reported rates of surgical success and cure are 85.5% and 38.5% respectively.…”

Section: Discussionsupporting

confidence: 89%

Persistent Daytime Sleepiness after Successful Maxillary-Mandibular Advancement Surgery: A Clinical Case Report

François¹,

Yachouh²,

Frapier³

et al. 2021

DOBCR

View full text Add to dashboard Cite

Background: Continuous positive airway pressure is a cost-effective treatment of obstructive sleep apnea (OSA), but in case of craniofacial anomalies, which have a recognized role in OSA development, maxillary-mandibular advancement surgery is a recommended therapeutic option. Clinical Presentation: We describe a patient with severe OSA (apnea-hypopnea index = 42) treated by maxillary-mandibular advancement (MMA) surgery. Effective results were confirmed by polysomnography at 6 months post-surgery with normalization of the polysomnographic parameters (apnea-hypopnea index = 17) but due to persistent sleepiness, the patient was unable to resume his work. Conclusion: Maxillary-mandibular surgery can be a valid option for treating severe OSA associated with craniofacial anomalies. However, our results emphasize the need of critically assessing surgical approaches and the need to redefine success for OSA management.

show abstract

Section: Discussionsupporting

confidence: 89%

Persistent Daytime Sleepiness after Successful Maxillary-Mandibular Advancement Surgery: A Clinical Case Report

François¹,

Yachouh²,

Frapier³

et al. 2021

DOBCR

View full text Add to dashboard Cite

show abstract

“…It is well known that OSA may be improved in patients with micromandible by mandibular advancement 6,7 . In recent years, sleep surgery by maxillomandibular advancement (MMA) for OSA has developed 8 . However, the mandibular body must be moved to the posterior position by orthognathic surgery in mandibular prognathism, so it is undeniable that the pharyngeal cavity is constricted and causes OSA.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and risk factors of silent obstructive sleep apnea in patients with dentofacial deformities

Jokaji¹,

Ooi

Takamichi

et al. 2021

Preprint

View full text Add to dashboard Cite

Objective Prevalence of silent obstructive sleep apnea (OSA) in patients with dentofacial deformities is unknown, although OSA is severe risk of airway obstruction in perioperative orthognathic surgery or complication after surgery. The aim of this study was to investigate prevalence and risk factors of silent OSA in patients with dentofacial deformities. Methods We analyzed 72 patients (24 male, 48 female) with dentofacial deformities without previous OSA symptoms. Polysomnography was performed before orthognathic surgery. Prevalence and risk factors of silent OSA were statistically analyzed as related to Apnea hypopnea index (AHI). Results Mean AHI was 1.6 (range: 0-12.1) /h. Three patients of 72 patients (4.1%) were diagnosed silent OSA. AHI during REM sleep phase 3.7 (0-32.3) was higher than AHI during NREM sleep phase 1.0 (0-9.7). AHI of male patients was higher than that of female. AHI was increased according to high BMI. AHI was higher in deep bite than open bite, edge to edge bite and nomal bite. AHI of mandibular asymmetry cases were higher than that of symmetry cases. Conclusions The prevalence of silent OSA was 4.1%. Obesity, male, deep bite, mandibular asymmetry and REM sleep phase were risk factors of silent OSA.

show abstract

“…34 The magnitude of skeletal movements completed in this study was comparable with the other studies. 27 At T4, the mean relapse at point A was 0.6 mm, the mean relapse at point B was 0.4 mm, and the mean relapse at point Pogonion was 0.6 mm. P-values show a (statistically) significant difference between time intervals T3 and T4, which proves that there is a very minimum (clinical) loss in the amount of advancement at all points.…”

Section: Skeletal Changes: All Subjects In Different Time Pointsmentioning

confidence: 86%

“…There is clear evidence that MMA surgery improves airway patency in patients with sleep apnea. 27 However, much of this research was conducted using a 2-dimensional cephalograms and without long-term follow-up observation. This study determines the short-and long-term airway and skeletal changes after MMA surgery with or without GTA via CBCT.…”

Section: The Current Questionmentioning

confidence: 99%

See 1 more Smart Citation

Impact on the Pharyngeal Airway Space after Maxillomandibular Advancement Procedure for Obstructive Sleep Apnea Patients

AlSaty¹

View full text Add to dashboard Cite

Background and Objectives: Obstructive sleep apnea (OSA) is a sleep-related breathing disorder, characterized by disrupted snoring and repetitive upper airway obstructions. Continuous positive airway pressure (CPAP) is considered the therapeutic mainstay for OSA patients. However, CPAP therapy has compliance limitations. An alternative treatment options is maxillomandibular advancement (MMA) surgical procedure. Genial tubercle advancement (GTA) is often performed concomitant with MMA for esthetic purposes. Cone-beam computed tomography (CBCT) provides the ability to visualize the upper airway and perform three-dimensional (3D) reconstructions. The purpose of this study is to evaluate the impact of MMA procedure with or without GTA on oropharyngeal airway space in OSA patients and the stability after completion of orthodontic treatment. Methods: A total of 25 patients (18 females and 7 males) with a mean age of 37.1 ± 17.3 years were included in the study. CBCT scans were taken before treatment (T1); after pre-surgical orthodontic treatment (T2); immediately after MMA procedure (T3); and at 10 months follow-up visit (T4). Thus, (T2-T1) represented changes due to orthodontic treatment only; (T3-T2) represented changes due to MMA procedure; and (T4-T3) represented changes due to follow-up after surgery. Each patient served as his/her own control. Fifteen of the individuals underwent MMA with GTA. All DICOM files were analyzed using Dolphin 3D Imaging software program to determine total airway volume (TAV), airway area (AA) and minimum axial area (MAA) at explicit regions along the posterior airway space. Dolphin 3D voxel-based superimposition was used to determine the amount of skeletal advancement with MMA and changes after surgery. Results: Significant increase in TAV, AA and MAA was found with MMA treatment (40.61%; 28.77%; and 56.40%, respectively, p<.05). Smaller but significant decrease in TAV, AA and MAA was found during the 10 months follow-up visit (20%; 9.7%; and 26.8%, respectively, p<.05). No significant differences were found in airway measurements with or without GTA procedure. No significant differences were found in any of the airway measurements with or without GTA procedure. The average forward movements of the maxilla, mandible and chin were 6.56 mm and 8.21 mm, 11.42 mm, respectively and less than 1mm relapse was found during the follow-up period. No correlation was found between the magnitudes of skeletal advancement and the change in oropharyngeal airway space (OPAS). Conclusions: Significant increase in OPAS can be expected with MMA surgery with or without GTA procedure in patients diagnosed with OSA. Significant forward movement of the maxilla, mandible and chin positions can be obtained with MMA procedure. A partial loss in OPAS was found during the 10 months follow-up period. The surgical movements were found to be stable with less than 1 mm of relapse during the follow-up period, which was not clinically significant. iii DEDICATIONS To my Father, Saud, even though you are not with us anymo...

show abstract

Impact of Bimaxillary Advancement Surgery on the Upper Airway and on Obstructive Sleep Apnea Syndrome: a Meta-Analysis

Cited by 25 publications

References 42 publications

Persistent Daytime Sleepiness after Successful Maxillary-Mandibular Advancement Surgery: A Clinical Case Report

Persistent Daytime Sleepiness after Successful Maxillary-Mandibular Advancement Surgery: A Clinical Case Report

Prevalence and risk factors of silent obstructive sleep apnea in patients with dentofacial deformities

Impact on the Pharyngeal Airway Space after Maxillomandibular Advancement Procedure for Obstructive Sleep Apnea Patients

Contact Info

Product

Resources

About