Butterfield Kevin J, Marks Patricia L G, McLean Laurie, Newton Jack
Chief, Division of Dentistry/Oral and Maxillofacial Surgery, Ottawa Hospital, and Assistant Professor, Department of Otolaryngology, University of Ottawa School of Medicine, Ottawa, Ontario, Canada.
Medical Student, University of Toronto, Toronto, Ontario, Canada.
J Oral Maxillofac Surg. 2016 Jun;74(6):1228-37. doi: 10.1016/j.joms.2016.01.043. Epub 2016 Jan 30.
Although maxillomandibular advancement (MMA) surgery is highly efficacious for the management of obstructive sleep apnea (OSA), little information exists regarding the subjective effect of this treatment modality. The present study was undertaken to investigate the effect of MMA on patient-perceived quality of life (QOL) in OSA.
A retrospective cohort study of patients treated with MMA for OSA from May 2010 to April 2015 was performed. The primary outcome measure was a change in the QOL detected using the Ottawa Sleep Apnea Questionnaire (OSA-Q), which assesses the MMA-related changes in QOL with a 5-point Likert scale. The secondary outcome measure was a change in the apnea hypopnea index (AHI).
Twenty-two patients participated in the present study. The mean maxillary and mandibular advancement were 8.36 and 11.08 mm, respectively. The AHI decreased from 42.4 to 6.9 events per hour postoperatively (P < .001). The QOL improved significantly after MMA (OSA-Q score 3.98 ± 0.35; P < 001). The sleep quality (4.35 ± 0.63), daytime function (4.13 ± 0.46), physical health (4.19 ± 0.45), mental and emotional health (4.02 ± 0.55), and sexual health (3.78 ± 0.62) categories all improved postoperatively (P < .001). The MMA-related side effects did not adversely affect the QOL.
MMA for OSA significantly improves patient's subjective overall QOL, with few MMA-related side effects.
尽管上颌下颌前移(MMA)手术在治疗阻塞性睡眠呼吸暂停(OSA)方面非常有效,但关于这种治疗方式的主观效果的信息却很少。本研究旨在调查MMA对OSA患者感知的生活质量(QOL)的影响。
对2010年5月至2015年4月接受MMA治疗的OSA患者进行了一项回顾性队列研究。主要结局指标是使用渥太华睡眠呼吸暂停问卷(OSA-Q)检测到的QOL变化,该问卷用5点李克特量表评估与MMA相关的QOL变化。次要结局指标是呼吸暂停低通气指数(AHI)的变化。
22名患者参与了本研究。上颌和下颌的平均前移量分别为8.36和11.08毫米。术后AHI从每小时42.4次降至6.9次(P <.001)。MMA后QOL显著改善(OSA-Q评分为3.98±0.35;P <0.001)。睡眠质量(4.35±0.63)、日间功能(4.13±0.46)、身体健康(4.19±0.45)、心理和情绪健康(4.02±0.55)以及性健康(3.78±0.62)类别术后均有改善(P <.001)。与MMA相关的副作用未对QOL产生不利影响。
用于OSA的MMA可显著改善患者的主观总体QOL,且与MMA相关的副作用很少。