Yavari Niusha, Samieirad Sahand, Labafchi Ali, Rezaeetalab Fariba, Eshghpour Majid
Dentist, Student Research Committee, Mashhad Dental School, Mashhad University of Medical Sciences, Mashhad, Iran.
Assistant Professor, Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
J Oral Maxillofac Surg. 2020 Nov;78(11):2061-2069. doi: 10.1016/j.joms.2020.07.008. Epub 2020 Jul 15.
The aim of this study was to assess the impact of isolated mandibular setback surgery on the risk of obstructive sleep apnea (OSA), using the STOP-BANG questionnaire (SBQ).
The authors implemented a double-blinded prospective quasi-experimental study. All healthy patients with skeletal Class III deformity older than 18 years were included in this study. They were candidates for isolated mandibular setback surgery. The SBQ was completed by the pulmonologist, 1 week preoperatively (T0), and 1 and 6 months postoperatively (T1 and T2, respectively). The mandibular setback displacement was the study intervention. The risk of OSA on the basis of the SBQ was the outcome variable. Descriptive and bivariate statistics were computed and the significance level was set at .05.
The sample comprised 30 patients (15 females, 15 males) with the average age of 25.77 ± 4.76. The mean score of SBQ at T0 was 1.37 ± 0.85, which increased to 2.33 ± 1.52 at T1 interval. However, it decreased significantly to 1.47 ± 1.17 at T2 interval (P < .001). T0-T1 and T0-T2 score differences were observed to be higher in the group with a mandibular setback repositioning greater than or equal to 5 mm (P < .005).
An isolated mandibular setback surgery less than 5 mm does not increase the risk for OSA in a young healthy nonsmoker Class III patient, according to the SBQ. Moreover, there was a significant increase in the risk for OSA when the setback was greater than or equal to 5 mm, measured at the mandibular incisor edge. Therefore, clinicians should be careful and discuss this potential increased risk with the patients, when this movement is required by the treatment plan. Further clinical trials are needed to support the relevancy.
本研究旨在使用STOP-BANG问卷（SBQ）评估单纯下颌后缩手术对阻塞性睡眠呼吸暂停（OSA）风险的影响。
作者开展了一项双盲前瞻性准实验研究。本研究纳入了所有年龄超过18岁的健康Ⅲ类骨骼畸形患者。他们均为单纯下颌后缩手术的候选者。肺科医生在术前1周（T0）、术后1个月和6个月（分别为T1和T2）完成SBQ。下颌后缩移位是研究干预措施。基于SBQ的OSA风险是结果变量。计算描述性和双变量统计数据，显著性水平设定为0.05。
样本包括30例患者（15例女性，15例男性），平均年龄为25.77±4.76岁。SBQ在T0时的平均得分为1.37±0.85，在T1时增加至2.33±1.52。然而，在T2时显著下降至1.47±1.17（P<0.001）。在下颌后缩复位大于或等于5mm的组中，观察到T0-T1和T0-T2得分差异更高（P<0.005）。
根据SBQ，对于年轻健康的非吸烟Ⅲ类患者，小于5mm的单纯下颌后缩手术不会增加OSA风险。此外，在下颌切牙边缘测量，当后缩大于或等于5mm时，OSA风险显著增加。因此，当治疗计划需要这种移动时，临床医生应谨慎并与患者讨论这种潜在增加的风险。需要进一步的临床试验来支持其相关性。
