John C R, Gandhi S, Sakharia A R, James T T
Department of Oral and Maxillofacial Surgery, Christian Dental College, Ludhiana, Punjab, India.
Department of Oral and Maxillofacial Surgery, Christian Dental College, Ludhiana, Punjab, India.
Int J Oral Maxillofac Surg. 2018 Dec;47(12):1561-1571. doi: 10.1016/j.ijom.2018.05.015. Epub 2018 Jun 2.
The primary objective of this review was to establish the effectiveness of maxillomandibular advancement (MMA) as a successful treatment modality in improving airway patency in patients with obstructive sleep apnoea (OSA). A systematic and detailed search was performed using PubMed Central, covering the period January 2000 to December 2015, with well-defined selection criteria. The authors independently conducted the study selection, data extraction, and assessed the risk of bias of the included studies. Twenty studies met the inclusion criteria. The outcome measures studied were the apnoea-hypopnoea index (AHI), respiratory disturbance index (RDI), Epworth Sleepiness Scale (ESS), lowest oxygen saturation (LSAT), and body mass index (BMI). The random-effects model was adopted for meta-analysis as moderate heterogeneity was identified. The analysis revealed significant changes in the outcome measures after the intervention. The results showed that the preoperative severity of OSA based on AHI and RDI significantly influences the outcome of MMA intervention, with a strong positive correlation between the pre MMA AHI values and the percentage change post intervention. The surgical success of MMA in patients with OSA was found to be 100% with respect to AHI and RDI scores. It is concluded that MMA is a successful treatment for OSA.
本综述的主要目的是确定上颌下颌前移术(MMA)作为一种成功的治疗方式,在改善阻塞性睡眠呼吸暂停(OSA)患者气道通畅方面的有效性。使用PubMed Central进行了系统而详细的检索,涵盖2000年1月至2015年12月期间,采用了明确的选择标准。作者独立进行了研究选择、数据提取,并评估了纳入研究的偏倚风险。20项研究符合纳入标准。所研究的结局指标包括呼吸暂停低通气指数(AHI)、呼吸紊乱指数(RDI)、爱泼华嗜睡量表(ESS)、最低血氧饱和度(LSAT)和体重指数(BMI)。由于发现存在中度异质性,因此采用随机效应模型进行荟萃分析。分析显示干预后结局指标有显著变化。结果表明,基于AHI和RDI的术前OSA严重程度显著影响MMA干预的结果,MMA术前AHI值与干预后百分比变化之间存在强正相关。就AHI和RDI评分而言,MMA在OSA患者中的手术成功率为100%。结论是,MMA是治疗OSA的一种成功方法。