Oromaxillofacial Surgery: Both a Treatment and a Possible Cause of Obstructive Sleep Apnea—A Narrative Review

Abstract

Obstructive sleep apnea (OSA) is a chronic, sleep-related breathing disorder. It is characterized by a nocturnal periodic decrease or complete stop in airflow due to partial or total collapse of the oropharyngeal tract. Surgical treatment of OSA is constantly evolving and improving, especially with the implementation of new technologies, and this is needed because of the very heterogeneous reasons for OSA due to the multiple sites of potential airway obstruction. Moreover, all of these surgical methods have advantages and disadvantages; hence, patients should be approached individually, and surgical therapies should be chosen carefully. Furthermore, while it is well-established that oromaxillofacial surgery (OMFS) provides various surgical modalities for treating OSA both in adults and children, a new aspect is emerging regarding the possibility that some of the surgeries from the OMFS domain are also causing OSA. The latest studies are suggesting that surgical treatment in the head and neck region for causes other than OSA could possibly have a major impact on the emergence of newly developed OSA, and this issue is still very scarcely mentioned in the literature. Both oncology, traumatology, and orthognathic surgeries could be potential risk factors for developing OSA. This is an important subject, and this review will focus on both the possibilities of OMFS treatments for OSA and on the OMFS treatments for other causes that could possibly be triggering OSA.

Metabolic Crossroads: Unveiling the Complex Interactions between Obstructive Sleep Apnoea and Metabolic Syndrome

“…Central adiposity is associated with parapharyngeal fat deposition and enlargement of surrounding soft tissues, which create a relative stenosis of the upper airway (UA), thereby increasing upper airway (UA) collapsibility and predisposing to apnoea [ 22 ]. UA collapsibility is accepted as the primary pathogenic mechanism in OSA, and susceptibility to collapse can be assessed by pharyngeal critical closing pressure (Pcrit), which is higher in obese patients [ 23 , 24 , 25 , 26 ]. Moreover, it is likely that the reduced lung volumes induced by central adiposity further impair UA patency in addition to compromising gas exchange [ 22 , 27 ].…”

O papel da cirurgia ortognática no tratamento da sindrome de apneia obstrutiva do sono – revisão de literatura

“…Essas deficiências podem contribuir para a obstrução das vias aéreas superiores durante o sono, levando aos sintomas característicos da SAOS, como ronco alto e interrupções na respiração. A expansão maxilar visa corrigir essa deficiência, aumentando o espaço disponível nas vias aéreas superiores e reduzindo a resistência ao fluxo de ar durante a respiração (Martinovic et al, 2023;Awad et al, 2019;Quah et al, 2023).…”

“…A ativação geralmente é realizada uma vez por dia, com pequenos incrementos de rotação do parafuso, visando a minimização de desconforto e a otimização dos resultados. O registro adequado das ativações realizadas pelo paciente, incluindo a data e a quantidade de rotações efetuadas, é essencial para o acompanhamento adequado do progresso do tratamento pelo ortodontista (Martinovic et al, 2023;Awad et al, 2019;Quah et al, 2023).…”

Long-term outcomes of cases after uvulopalatopharyngoplasty surgery: a retrospective study

“…When we look at the literature regarding postoperative polysomnographic findings of the UPPP surgery, a 50% decrease was observed in 50% of the patients. 4 OSAS and its treatment remain up-to-date as an area where research continues.…”