Islam Shofiq, Aleem Fahd, Ormiston Ian W
Maxillofacial Surgery, Leicester Royal Infirmary, Infirmary Square, Leicester, East Midlands, LE1 5WW, UK.
Maxillofacial Surgery, Leicester Royal Infirmary, Infirmary Square, Leicester, East Midlands, LE1 5WW, UK.
J Craniomaxillofac Surg. 2014 Dec;42(8):1675-8. doi: 10.1016/j.jcms.2014.05.012. Epub 2014 May 27.
The primary aim of this study was to explore the predictive potential of the preoperative Kushida index score and subsequent outcome following maxillomandibular advancement surgery (MMA). Secondarily we looked at how well the Kushida values of our OSA patients matched the morphometric models diagnostic thresholds.
We performed a retrospective analysis of patients who underwent MMA for OSA at our institution. Kushida morphometric scores were calculated using the described formula: P + (Mx - Mn) + 3 × OJ + 3 × [Max (BMI - 25)] × (NC ÷ BMI). Regression analysis was performed to explore the possible association between Kushida index score and outcome variables of postoperative apnoea/hypopnea indices (AHI) and Epworth Sleepiness Scores (ESS).
We identified 28 patients with complete data available for analysis. The mean age was 45 years (SD 6) with mean BMI of 28 (SD 3). All, but one patient underwent bi-maxillary procedure with or without genioplasty, with a mean advancement of 8.5 mm (SD 2). The mean Kushida index score in our sample was 79 (SD 14). 89% of patients had postoperative AHI <15 in keeping with surgical success. We found no statistically significant relationship with Kushida morphometric model variables and overall score with either of our outcome variables.
The mean Kushida index score in our patients was in the range consistent with the morphometric models diagnostic cut-off for OSA. Kushida's morphometric model does not appear to be a good predictor of postoperative success in individuals following MMA. The morphometric model represents a clinical adjunct in the initial diagnostic work-up of OSA patients referred for surgery.
本研究的主要目的是探讨术前久志田指数评分的预测潜力以及颌骨前移手术（MMA）后的后续结果。其次，我们观察了阻塞性睡眠呼吸暂停（OSA）患者的久志田值与形态测量模型诊断阈值的匹配程度。
我们对在本机构接受MMA治疗OSA的患者进行了回顾性分析。使用下述公式计算久志田形态测量评分：P +（Mx - Mn）+ 3×OJ + 3×[Max（BMI - 25）]×（NC÷BMI）。进行回归分析以探讨久志田指数评分与术后呼吸暂停/低通气指数（AHI）和爱泼华嗜睡量表（ESS）等结果变量之间的可能关联。
我们确定了28例有完整数据可供分析的患者。平均年龄为45岁（标准差6），平均体重指数为28（标准差3）。除1例患者外，所有患者均接受了双颌手术，有或无颏成形术，平均前移量为8.5毫米（标准差2）。我们样本中的久志田指数平均评分为79（标准差14）。89%的患者术后AHI<15，符合手术成功标准。我们发现久志田形态测量模型变量和总分与我们的任何一个结果变量之间均无统计学上的显著关系。
我们患者的久志田指数平均评分处于与OSA形态测量模型诊断临界值一致的范围内。久志田的形态测量模型似乎不是MMA术后个体成功的良好预测指标。该形态测量模型是转诊接受手术的OSA患者初始诊断检查中的一项临床辅助手段。
