Patient's Perception of Nasal Function and Cosmesis After Maxillomandibular Advancement for Obstructive Sleep Apnea

Abdelwahab, Mohamed; Huang, Allen; Chou, Courtney; Fleury, Thomaz; Riley, Robert; Most, Sam P.; Liu, Stanley Yung‐Chuan

doi:10.1089/fpsam.2021.0411

Cited by 8 publications

(10 citation statements)

References 54 publications

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“…Over the years, targeted approaches to surgically manage OSA have given physicians more options to identify and treat patients more effectively 19‐27 . This concept, wherein surgical management of a chronic condition lowers overall health care use and economic burden, is not new.…”

Section: Discussionmentioning

confidence: 99%

“…Over the years, targeted approaches to surgically manage OSA have given physicians more options to identify and treat patients more effectively. [19][20][21][22][23][24][25][26][27] This concept, wherein surgical management of a chronic condition lowers overall health care use and economic burden, is not new. A Swedish study analyzing the difference in health care use in obese patients found bariatric surgery to be more cost-effective when compared to medical management and was associated with fewer lifetime events (transient ischemic attacks, type 2 diabetes).…”

Section: Discussionmentioning

confidence: 99%

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Value of Surgical and Nonsurgical Treatment for Sleep Apnea: A Closer Look at Health Care Utilization

Abdelwahab

Marques

Huang

et al. 2023

Otolaryngol.--head neck surg.

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Objective To determine how surgery, continuous positive airway pressure (CPAP), and no treatment impact health care utilization in patients who have obstructive sleep apnea (OSA). Study Design This is a retrospective cohort study of patients between the ages of 18 and 65 that were diagnosed with OSA (9th International Classification of Diseases) from January 2007 to December 2015. Data were collected over 2 years, and prediction models were generated to evaluate trends over time. Setting A population‐based study using real‐world data and insurance databases. Methods A total of 4,978,649 participants were identified, all with at least 25 months of continuous enrollment. Patients with previous soft tissue procedures not approved for OSA (nasal surgery), or without continuous insurance coverage were excluded. A total of 18,050 patients underwent surgery, 1,054,578 were untreated, and 799,370 received CPAP. IBM Marketscan Research database was utilized to describe patient‐specific clinical utilization, and expenditures, across outpatient, and inpatient services, and medication prescriptions. Results When the cost of the intervention was eliminated in the 2‐year follow‐up, the monthly payments of group 1 (surgery) were significantly less than group 3 (CPAP) in overall, inpatient, outpatient, and pharmaceutical payments (p < .001). The surgery group was associated with less cumulative payments compared to the other 2 groups when the cost of the intervention (CPAP or surgery) was eliminated in all comorbidities and age groups. Conclusion Treating OSA with surgery can lessen overall health care utilization compared to no treatment and CPAP.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Value of Surgical and Nonsurgical Treatment for Sleep Apnea: A Closer Look at Health Care Utilization

Abdelwahab

Marques

Huang

et al. 2023

Otolaryngol.--head neck surg.

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“…13 However, imaging of the airway rarely correlates with objective or subjective measures of OSA. 10 It has been documented that the degree of maxillary advancement is more predictive of surgical success when compared to the degree of mandibular advancement. 14 However, differences in response to MMA between OSA patients with class 2 versus 3 DFD have not been examined.…”

mentioning

confidence: 99%

“…With the updated Stanford Sleep Surgery Algorithm, surgical treatment of OSA continues to align with precision care 6,7 . What was once a linear phase I and 2 surgical approach, 8 is now on a patient‐centered continuum that aims to serve diverse phenotypes 9,10 . This new wave of phenotyping has improved the predictability of variable treatment modalities and has helped reduce the gap between providers and patient expectations.…”

mentioning

confidence: 99%

“…Anatomically, there is an abundance of imaging evidence portraying differences in the airway complex of patients with different dentofacial deformities (DFDs) 13 . However, imaging of the airway rarely correlates with objective or subjective measures of OSA 10 . It has been documented that the degree of maxillary advancement is more predictive of surgical success when compared to the degree of mandibular advancement 14 .…”

mentioning

confidence: 99%

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Maxillomandibular Advancement Efficacy in Obstructive Sleep Apnea Patients With Class 2 Versus 3 Dentofacial Deformity

Abdelwahab,

Taheri,

Eltahir

et al. 2023

Otolaryngol.--head neck surg.

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ObjectiveTo compare the efficacy of maxillomandibular advancement (MMA) for patients with obstructive sleep apnea (OSA) with class 2 versus 3 dentofacial deformities (DFDs).Study DesignRetrospective chart review.SettingTertiary sleep surgery center.MethodsPatients with OSA and DFD class 2 versus 3 undergoing MMA at Stanford Sleep Surgery between 2014 and 2021 were matched by preoperative body mass index (BMI), age, and sex. Postoperative outcome was compared with polysomnography measures and patient‐reported outcome measures (PROMs).ResultsTwenty‐eight matched subjects, 14 in each deformity group were identified and assessed. The mean age (standard deviation) was 34.29 (10.21) and 33.86 (10.23) for classes 2 and 3, respectively. The apnea‐hypopnea index (AHI) decreased from 43.42 (28.30) to 9.6 (5.29) (p < .001) and 37.17 (35.77) to 11.81 (15.74) (p = .042) in class 2 and 3 subjects, respectively. The oxygen desaturation index (ODI) changed from 30.48 (24.02) to 6.88 (3.39) (p = .024) and 11.43 (11.40) to 5.44 (7.96) (p = .85) in class 2 and 3 subjects, respectively. The Epworth sleepiness scale changed from 8.93 (5.28) to 3.91 (2.70) (p = .018) and 10.23 (4.38) to 4.22 (3.07) (p = .006) in class 2 and 3 subjects, respectively.ConclusionAmong age, sex, and BMI‐matched subjects, MMA is equally effective in both dentofacial class 2 and 3 groups, both objectively and subjectively. Preoperatively, dentofacial class 2 patients with OSA presented with the more severe disease with higher AHI and ODI. Dentofacial class 3 patients with OSA may require additional attention to improve nasal function outcomes.

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The readability of online patient education materials on maxillomandibular advancement surgery

Khan,

Walters,

Walker

et al. 2023

Sleep Breath

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Patient's Perception of Nasal Function and Cosmesis After Maxillomandibular Advancement for Obstructive Sleep Apnea

Cited by 8 publications

References 54 publications

Value of Surgical and Nonsurgical Treatment for Sleep Apnea: A Closer Look at Health Care Utilization

Value of Surgical and Nonsurgical Treatment for Sleep Apnea: A Closer Look at Health Care Utilization

Maxillomandibular Advancement Efficacy in Obstructive Sleep Apnea Patients With Class 2 Versus 3 Dentofacial Deformity

The readability of online patient education materials on maxillomandibular advancement surgery

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