Rosário Henrique Damian, Oliveira Gustavo Mussi Stefan, Freires Irlan Almeida, de Souza Matos Felipe, Paranhos Luiz Renato
Department of Orthodontics, Faculdades Integradas do Norte de Minas-FUNORTE, Florianópolis, SC, Brazil.
University of Louisville School of Dentistry, Louisville, KY, USA.
Eur Arch Otorhinolaryngol. 2017 Jan;274(1):35-44. doi: 10.1007/s00405-016-4015-4. Epub 2016 Mar 30.
Postsurgical changes of the airways have become a great point of interest because it has been reported that maxillomandibular advancement surgery can improve or eliminate obstructive sleep apnea; however, its treatment effectiveness is still controversial. The purpose of this systematic review and meta-analysis was to assess the effectiveness of maxillomandibular advancement surgery to increase upper airway volume in adults, comparing before and after treatment. Bibliographic searches of observational studies with no restriction of year or language were performed in the electronic databases PubMed, Scopus, ScienceDirect and SciELO for articles published up to April 2015. After verification of duplicate records, 1860 articles were examined. Of these, ten met the eligibility criteria, of which three were excluded for having poor methodological quality. The other seven articles were included in the systematic review and six in the meta-analysis, representing 83 patients. One study whose data were not given in absolute values was excluded from the meta-analysis. The meta-analysis showed a statistically significant difference between the averages of upper airway volume before and after surgery {7.86 cm [95 % CI (6.22, 9.49), p = 1.00)}. Clinical evidence suggests that the upper airway volume is increased after maxillomandibular advancement surgery.
气道的术后变化已成为一个备受关注的焦点，因为据报道，上颌下颌前徙手术可以改善或消除阻塞性睡眠呼吸暂停；然而，其治疗效果仍存在争议。本系统评价和荟萃分析的目的是评估上颌下颌前徙手术在增加成人上气道容积方面的有效性，比较治疗前后的情况。在电子数据库PubMed、Scopus、ScienceDirect和SciELO中对截至2015年4月发表的观察性研究进行了文献检索，不限年份和语言。在核实重复记录后，共审查了1860篇文章。其中，有10篇符合纳入标准，其中3篇因方法学质量较差而被排除。其他7篇文章被纳入系统评价，6篇被纳入荟萃分析，共83例患者。一项未给出绝对值数据的研究被排除在荟萃分析之外。荟萃分析显示，手术前后上气道容积平均值之间存在统计学显著差异{7.86 cm [95%CI(6.22, 9.49)，p = 1.00]}。临床证据表明，上颌下颌前徙手术后上气道容积增加。
