Maxillomandibular Advancement for Obstructive Sleep Apnea Is Associated With Very Long-Term Overall Sleep-Related Quality-of-Life Improvement.

PURPOSE

We sought to evaluate the effect of maxillomandibular advancement (MMA) on long-term subjective quality of life (QOL) in obstructive sleep apnea (OSA).

PATIENTS AND METHODS

This was a retrospective cohort analysis of long-term postoperative QOL issues in patients who underwent MMA for polysomnogram-confirmed severe OSA (apnea-hypopnea index > 30). The inclusion criteria included a history of MMA in the treatment of OSA, willingness to complete the Ottawa Sleep Apnea Questionnaire (OSA-Q) survey, and minimum of 5-year follow-up. The OSA-Q was used to evaluate sleep quality, daytime function, physical health, mental and emotional health, and sexual health. The independent variable was time of follow-up, and the dependent variables were the responses to the OSA-Q. Data collection was completed, and statistical analyses were performed with the 1-sample Wilcoxon signed rank test with a median score of 3 (no change) to evaluate for significant changes in the categories. P < .05 was considered statistically significant.

RESULTS

A total of 27 of 51 eligible patients (53% response rate) responded to the questionnaire (15 men and 12 women). The average postoperative age was 59.1 ± 11.7 years, with an average follow-up period of 12.7 ± 3.8 years. Statistically significant long-term QOL improvements from MMA for OSA were found in overall QOL (mode, 4; P < .05) and in the categories of personal satisfaction (mode, 5; P < .01), sleep quality (mode, 4; P < .01), and functional outcomes (mode, 4; P < .05).

CONCLUSIONS

MMA for OSA provided significant improvement in overall patient QOL as well as personal satisfaction, sleep quality, and functional outcomes at very long-term follow-up at an average of more than 12 years after surgery. MMA for OSA produces significant very long-term subjective QOL improvement.