Tan Su Keng, Leung Wai Keung, Tang Alexander Tin Hong, Zwahlen Roger A
Center of Oral & Maxillofacial Surgery Studies, Faculty of Dentistry, Universiti Teknologi MARA Sungai Buloh Campus, Jalan Hospital, Selangor Darul Ehsan, Malaysia.
Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, PR China.
PLoS One. 2017 Jul 27;12(7):e0181146. doi: 10.1371/journal.pone.0181146. eCollection 2017.
Mandibular advancement surgery may positively affect pharyngeal airways and therefore potentially beneficial to obstructive sleep apnea (OSA).
To collect evidence from published systematic reviews that have evaluated pharyngeal airway changes related to mandibular advancement with or without maxillary procedures.
PubMed, EMBASE, Web of Science, and Cochrane Library were searched without limiting language or timeline. Eligible systematic reviews evaluating changes in pharyngeal airway dimensions and respiratory parameters after mandibular advancement with or without maxillary surgery were identified and included.
This overview has included eleven systematic reviews. Maxillomandibular advancement (MMA) increases linear, cross-sectional plane and volumetric measurements of pharyngeal airways significantly (p<0.0001), while reducing the apnea-hypopnea index (AHI) and the respiratory disturbance index (RDI) significantly (p<0.0001). Two systematic reviews included primary studies that have evaluated single-jaw mandibular advancement, but did not discuss their effect onto pharyngeal airways. Based on the included primary studies of those systematic reviews, single-jaw mandibular advancement was reported to significantly increase pharyngeal airway dimensions (p<0.05); however, conclusive long-term results were lacking.
MMA increases pharyngeal airway dimensions and is beneficial to patients suffering from OSA. However, more evidence is still needed to draw definite conclusion related to the effect of single-jaw mandibular advancement osteotomies on pharyngeal airways.
下颌前徙术可能对咽气道产生积极影响，因此对阻塞性睡眠呼吸暂停（OSA）可能有益。
从已发表的系统评价中收集证据，这些评价评估了与下颌前徙术相关的咽气道变化，无论是否进行上颌手术。
检索了PubMed、EMBASE、科学网和Cochrane图书馆，不限语言和时间范围。确定并纳入了评估下颌前徙术（无论是否进行上颌手术）后咽气道尺寸和呼吸参数变化的合格系统评价。
本综述纳入了11项系统评价。上颌下颌前徙术（MMA）显著增加了咽气道的线性、横断面平面和容积测量值（p<0.0001），同时显著降低了呼吸暂停低通气指数（AHI）和呼吸紊乱指数（RDI）（p<0.0001）。两项系统评价纳入了评估单颌下颌前徙术的初步研究，但未讨论其对咽气道的影响。根据这些系统评价中纳入的初步研究，单颌下颌前徙术据报道可显著增加咽气道尺寸（p<0.05）；然而，缺乏确凿的长期结果。
MMA增加了咽气道尺寸，对OSA患者有益。然而，仍需要更多证据才能就单颌下颌前徙截骨术对咽气道影响得出明确结论。
