Skeletal Surgery for Obstructive Sleep Apnea

Awad, Michael; Capasso, Robson

doi:10.1016/j.otc.2020.02.008

Cited by 13 publications

(20 citation statements)

References 29 publications

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“…For safe osteotomy, the use of a cutting guide has been reported. 9–11 The risk of nerve injury was reported to reduce to 2.5% at a safe distance of 7.06 mm from the inferior border of the mental foramen. 11…”

Section: Discussionmentioning

confidence: 99%

“…For safe osteotomy, the use of a cutting guide has been reported. [9][10][11] The risk of nerve injury was reported to reduce to 2.5% at a safe distance of 7.06 mm from the inferior border of the mental foramen. 11 To date, several studies have examined osteotomy evaluation methods and how they yield airway expansion; however, we focused on four points in this study.…”

Section: Discussionmentioning

confidence: 99%

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Useful Genioplasty for Repeated Recurrent Sleep Apnea of Congenital Anomalies and Its Evaluation

Kino

Ueda

Hirota

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Background: Congenital facial anomalies with hypoplasia of the midface or lower face are associated with obstructive apnea syndrome. Although such patients underwent bone advancement surgery and their sleep apnea improved in the short term, it often recurred several years after surgery. It is difficult to perform another major osteotomy because of impairment of the facial contour or prior orthodontic treatment. Genioplasty was performed for genioglossus muscle advancement in patients with congenital anomalies and repeated sleep apnea. In this study, we evaluated the usefulness of this procedure and the mechanism for the improvement of sleep apnea. Methods: Six patients were included: three with syndromic craniosynostosis, two with Treacher-Collins syndrome, and one with micrognathia by Goldenhar syndrome. Patients who had recurrence of sleep apnea after previous maxillomandibular osteotomies, or advancement and orthodontic treatment, received genioplasty for genioglossus muscle advancement. The patients were evaluated by body mass index, simple polysomnography, hyoid bone position on cephalogram, and the airway area on computed tomography images pre- and postoperatively. Results: Polysomnography showed a significant improvement in the apnea-hypopnea index. Cephalometric measurement showed significant results of the hyoid bone position from point B and the ramus plane. However, no significant results were obtained in the airway area assessment. Conclusions: Genioplasty for genioglossus muscle advancement can improve apnea-hypopnea index by moving the hyoid bone forward. Genioplasty was useful in patients with congenital anomalies who had a recurrence of sleep apnea after several procedures.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Useful Genioplasty for Repeated Recurrent Sleep Apnea of Congenital Anomalies and Its Evaluation

Kino

Ueda

Hirota

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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“…In addition, we showed that BCF significantly improved depending on the degree of OSA in type 2 diabetes patients with moderate/severe IMS. There are some influencing factors of inducing and progressing OSA, such as micrognathia, nasal septum deviation, tonsil swelling, adenoid hypertrophy and severe obesity [18][19][20][21] . Among them, severe obesity is known to be the most influential factor of OSA, because respiratory mechanical impairment leads to upper airway collapse during sleep 22 .…”

Section: Discussionmentioning

confidence: 99%

Therapeutic effect of laparoscopic sleeve gastrectomy on obstructive sleep apnea and relationship of type 2 diabetes in Japanese patients with severe obesity

Yanari

Sasaki

Umemura

et al. 2022

J of Diabetes Invest

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Aims/Introduction Obstructive sleep apnea (OSA) is among the most important obesity‐related diseases, and offers the potential for accelerated the early onset and progression of type 2 diabetes. The aim of the present study was to clarify the therapeutic effect of laparoscopic sleeve gastrectomy on OSA in severely obese Japanese patients, and to find correlations between OSA improvements and β‐cell function (BCF). Materials and Methods Between September 2013 and December 2019, 61 patients who underwent laparoscopic sleeve gastrectomy were enrolled. The apnea–hypopnea index (AHI) was used to diagnose OSA. The tongue area, uvula area and other parameters were measured using cone‐beam computed tomography. Regarding BCF parameters, the homeostasis model assessment of β‐cell function, insulinogenic, Matsuda and disposition indexes were used to evaluate the improvement in BCF. Improvement of OSA was defined as AHI <15. Results The improvement rate of OSA was 51.8% (29/56). The change in AHI was significantly correlated with the excess weight loss percentage (ρ = 0.501), changes in tongue area (ρ = 0.350) and uvula area (ρ = 0.341). Multivariate analysis showed that preoperative AHI and postoperative hemoglobin A1c were independent prognostic factors of OSA non‐improvement. The homeostasis model assessment of β‐cell function (P < 0.001), the insulinogenic index (P < 0.001) and the disposition index (P = 0.019) of patients with AHI of <15 were significantly higher than those in patients with AHI of ≥15. Conclusions Laparoscopic sleeve gastrectomy is a promising procedure for severely obese patients with OSA. BCF recovery was found to be significantly higher in patients with OSA improvement.

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“…The indications for mandibular orthognathic surgery have expanded to include addressing facial esthetic concerns, malocclusion, obstructive sleep apnea, oral incompetence, speech pathology, masticatory difficulties, temporomandibular disorders, and dental pathologies. 2,3 Patients with dentofacial deformities that lead to either functional and/or esthetic concerns that cannot be corrected with orthodontic treatment alone make up the majority of patients who benefit from bimaxillary orthognathic surgery. Common dentofacial deformities include prognathism and retrognathism that can range in severity.…”

Section: Indicationsmentioning

confidence: 99%

“…4,5 Maxillomandibular advancement offers multilevel expansion of the airway and is particularly helpful in patients with skeletal abnormalities contributing to obstructive sleep apnea with high rates of clinical success. 2,3,6 Classically, orthognathic surgery has been performed in conjunction with orthodontic treatment. Surgical treatment can be performed either following an initial course of orthodontic treatment or prior to the initiation of orthodontic treatment.…”

Section: Indicationsmentioning

confidence: 99%

Orthognathic Surgery of the Mandible

et al. 2021

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Orthognathic surgery performed in conjunction with orthodontic treatment is commonly performed to correct skeletal irregularities and realign the maxillomandibular relationship to improve occlusal function and facial esthetics. A thorough understanding of soft tissue esthetics, skeletal and occlusal relationships, and surgical techniques is required to obtain successful results. Surgical techniques have evolved greatly throughout history, as technological advances such as virtual surgical planning have become available and widely used to obtain predictable movements with minimized complications. The aim of this article is to review the orthognathic surgical procedures of the mandible, with particular attention to the indications, contraindications, preoperative assessment, surgical technique, and possible complications encountered.

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Skeletal Surgery for Obstructive Sleep Apnea

Cited by 13 publications

References 29 publications

Useful Genioplasty for Repeated Recurrent Sleep Apnea of Congenital Anomalies and Its Evaluation

Useful Genioplasty for Repeated Recurrent Sleep Apnea of Congenital Anomalies and Its Evaluation

Therapeutic effect of laparoscopic sleeve gastrectomy on obstructive sleep apnea and relationship of type 2 diabetes in Japanese patients with severe obesity

Orthognathic Surgery of the Mandible

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