Improved Apnea-Hypopnea Index and Lowest Oxygen Saturation After Maxillomandibular Advancement With or Without Counterclockwise Rotation in Patients With Obstructive Sleep Apnea: A Meta-Analysis

Knudsen, Thorkild B.; Laulund, Anne Sofie; Ingerslev, Janne; Homøe, Preben; Pinholt, Else Marie

doi:10.1016/j.joms.2014.08.006

Cited by 51 publications

(42 citation statements)

References 27 publications

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“…Currently it is unknown if CCW rotational movements provide larger reductions in AHI beyond the significant reductions in AHI that have been observed with standard MMA. 52 The long-term results of this study show that MMA patients do not experience a significant number of treatment-related adverse outcomes. The few minor perioperative adverse events observed did not result in any significant long-term sequelae.…”

Section: Discussionmentioning

confidence: 64%

Long-Term Effectiveness and Safety of Maxillomandibular Advancement for Treatment of Obstructive Sleep Apnea

Boyd

Walters

Waite

et al. 2015

Journal of Clinical Sleep Medicine

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Section: Discussionmentioning

confidence: 64%

Long-Term Effectiveness and Safety of Maxillomandibular Advancement for Treatment of Obstructive Sleep Apnea

Boyd

Walters

Waite

et al. 2015

Journal of Clinical Sleep Medicine

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“…The prevalence of OSA is estimated between 2 and 4%, varying with obesity status, gender, and age of populations (2, 3), usually caused by repetitive pharynx dysfunction which leads to apnea and hypopnea that result in the down regulation of blood oxygen levels (4). Oxygen desaturation triggered by chronic hypoxia further causes repetitive arousals and significant changes in both transmural and intra-thoracic pressure.…”

Section: Introductionmentioning

confidence: 99%

“…The severity of OSA can be classified by the Apnea–Hypopnea Index (AHI), evaluating the episode frequency of apnea/hypopnea in 1 h (4), which can be used to predict the relative risk of OSA. For instance, a 10% weight loss is predicted to be correlated with a 26% decrease in the AHI (6).…”

Section: Introductionmentioning

confidence: 99%

Verifying the Relative Efficacy between Continuous Positive Airway Pressure Therapy and Its Alternatives for Obstructive Sleep Apnea: A Network Meta-analysis

Ting-wei

Zhou

et al. 2017

Front. Neurol.

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Obstructive sleep apnea (OSA) is a common breathing disorder, and continuous positive airway pressure (CPAP) therapy together with its alternatives has been developed to treat this disease. This network meta-analysis (NMA) was aimed to compare the efficacy of treatments for OSA. Cochrane Library, MEDLINE, and Embase were searched for eligible studies. A conventional and NMA was carried out to compare all therapies. Sleeping characteristics, including Apnea–Hypopnea Index (AHI), Epworth Sleepiness Scale (ESS), arterial oxygen saturation, and arousal index (AI), and changes of blood pressure were selected as outcomes. A total of 84 studies were finally included after rigorous screenings. For the primary outcomes of AHI and ESS, the value of auto-adjusting positive airway pressure (APAP), CPAP, and oral appliance (OA) all showed statistically reduction compared with inactive control (IC). Similar observation was obtained in AI, with treatments of the three active interventions. A lower effect of IC in SaO2 was exhibited when compared with APAP, CPAP, and OA. Similar statistically significant results were presented in 24 h systolic blood pressure and 24 h DBP when comparing with CPAP. Our NMA identified CPAP as the most efficacious treatment for OSA patients after the evaluation of sleeping characteristics and blood pressures. In addition, more clinical trials are needed for further investigation due to the existence of inconsistency observed in this study.

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“…As retrognathic development of the maxilla/mandible causes anatomic narrowing of the airway to contribute to OSA, surgical forward movements of the maxilla/mandible have shown effectiveness in resolving adult OSA to eliminate the lifelong need for PAP treatment. 56 In growing children, orthodontists/paedodontists may use functional/ orthopaedic appliance (similar to the adult mandibular advancement device [MAD]) to redirect mandibular growth into a more forward/ downward position and increase the opening of oropharyngeal airway. 17 Although substantial evidence has supported MAD as a first-line therapy in adults with mild-to-moderate OSA, there is only one RCT included in our systematic review comparing the effectiveness of oral appliance to no treatment in OSA children.…”

Section: Discussionmentioning

confidence: 99%

Management of paediatric obstructive sleep apnoea: A systematic review and network meta‐analysis

Lin

et al. 2019

Int J Paed Dentistry

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Background Obstructive sleep apnoea (OSA) affects many children, and adenotonsillar hypertrophy is the most common cause of paediatric OSA. Aim Despite the growing treatment options, there is no comprehensive comparison of all interventions. We aimed to compare and rank the effectiveness of various treatments in a network meta‐analysis. Design Literature was searched from inception to 13 May 2018 for paediatric OSA with adenotonsillar hypertrophy. The outcomes were the changes in apnoea‐hypopnea index (AHI), oxyhaemoglobin desaturation index (ODI), and lowest arterial oxygen saturation (SaO2). Frequentist approach to network meta‐analysis was used. Treatment hierarchy was summarized according to the surfaces under the cumulative ranking curves. Results Fourteen trials comprising 1064 paediatric OSA participants evaluating ten interventions (adenotonsillectomy, adenotonsillectomy + pharyngoplasty, adenotonsillotomy, antimicrobial therapy, steroids, leukotriene receptor antagonists [LTRAs], steroids + LTRAs, rapid maxillary expansion [RME], placebo, and no treatment) were identified for network meta‐analysis. In terms of effectiveness in AHI reduction, surgical approach was still the most effective intervention than no treatment. RME was one of the most effective interventions to improve lowest SaO2. No comparisons showed statistical significance in reducing ODI. Conclusions Irrespective of the intervention used, complete resolution of OSA was not achieved in most trials.

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Improved Apnea-Hypopnea Index and Lowest Oxygen Saturation After Maxillomandibular Advancement With or Without Counterclockwise Rotation in Patients With Obstructive Sleep Apnea: A Meta-Analysis

Cited by 51 publications

References 27 publications

Long-Term Effectiveness and Safety of Maxillomandibular Advancement for Treatment of Obstructive Sleep Apnea

Long-Term Effectiveness and Safety of Maxillomandibular Advancement for Treatment of Obstructive Sleep Apnea

Verifying the Relative Efficacy between Continuous Positive Airway Pressure Therapy and Its Alternatives for Obstructive Sleep Apnea: A Network Meta-analysis

Management of paediatric obstructive sleep apnoea: A systematic review and network meta‐analysis

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