Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong.
Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong.
Int J Oral Maxillofac Surg. 2020 Mar;49(3):333-341. doi: 10.1016/j.ijom.2019.07.007. Epub 2019 Jul 26.
Skeletal advancement surgery with sagittal split ramus osteotomy (SSRO) or mandibular distraction osteogenesis (MDO) is effective in treating patients with obstructive sleep apnoea (OSA) and may improve their quality of life (QoL). This study aimed to evaluate the longitudinal QoL changes in moderate-to-severe OSA patients after skeletal advancement surgery. Eighteen patients were randomized to receive SSRO (n=9) or MDO (n=9) alone or as part of the skeletal advancement surgery. Baseline QoL was compared with that of a control group (n=36). QoL was compared between the SSRO group and MDO group over a period of 2 years postoperative. The Epworth Sleepiness Scale (ESS), Calgary Sleep Apnea Quality of Life Index (SAQLI), Functional Outcomes of Sleep Questionnaire (FOSQ), and Short Form Health Survey (SF-36) were used as instruments. The OSA group had worse ESS, SF-36, FOSQ, and SAQLI preoperatively than the control group. The MDO and SSRO groups showed significant improvements in ESS at all postoperative time points (P≤0.021). The FOSQ, SAQLI, and SF-36 of both groups at 2 years postoperative were similar to those of the control group. No differences in QoL were found between the SSRO and MDO groups. This study showed QoL was improved in patients with moderate-to-severe OSA after skeletal advancement surgery by SSRO or MDO.
经矢状劈开下颌升支截骨术(SSRO)或下颌骨牵引成骨术(MDO)的骨骼前移手术治疗阻塞性睡眠呼吸暂停(OSA)患者是有效的,并可能改善其生活质量(QoL)。本研究旨在评估中重度 OSA 患者在骨骼前移手术后的纵向 QoL 变化。18 名患者被随机分为接受 SSRO(n=9)或 MDO(n=9)单独治疗或作为骨骼前移手术的一部分。将基线 QoL 与对照组(n=36)进行比较。在术后 2 年内比较 SSRO 组和 MDO 组之间的 QoL。采用 Epworth 嗜睡量表(ESS)、卡尔加里睡眠呼吸暂停质量指数(SAQLI)、睡眠功能结果问卷(FOSQ)和健康调查简表(SF-36)作为评估工具。OSA 组在术前的 ESS、SF-36、FOSQ 和 SAQLI 均差于对照组。MDO 和 SSRO 组在所有术后时间点的 ESS 均有显著改善(P≤0.021)。两组在术后 2 年的 FOSQ、SAQLI 和 SF-36 与对照组相似。SSRO 和 MDO 两组之间的 QoL 没有差异。本研究表明,SSRO 或 MDO 的骨骼前移手术可改善中重度 OSA 患者的 QoL。