Division of Sleep Surgery, Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, California, USA.
Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
Facial Plast Surg Aesthet Med. 2023 Mar-Apr;25(2):132-140. doi: 10.1089/fpsam.2021.0411. Epub 2022 Sep 1.
Maxillomandibular advancement (MMA) remains one of the most effective surgeries for the treatment of obstructive sleep apnea (OSA), but it can be difficult to manage nasal and midfacial esthetics for patients requiring significant maxillary advancement. To evaluate changes in the Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) after the modified MMA approach. This prospective study was conducted on subjects undergoing MMA at a tertiary referral center from September 2020 to August 2021. Nasal function, cosmesis, and sleepiness were assessed perioperatively with the SCHNOS, visual analog scale for nasal function and cosmesis, and Epworth sleepiness scale (ESS). Objective polysomnography data were also investigated. Thirty-one subjects met inclusion criteria. After MMA, SCHNOS-O (obstruction domain) improved from 44.38 ± 26.21 to 19.03 ± -4.75 ( < 0.001). The SCHNOS-C (cosmesis domain) improved significantly from 13.95 ± 19.32 to 5.27 ± 8.93 ( = 0.029). Specific items evaluating self-esteem, nasal straightness, and symmetry showed significant improvement ( = 0.006, 0.025, 0.044). The ESS also improved from 9.41 ± 6.11 to 3.26 ± 3.03 ( < 0.001), and it correlated with nasal obstruction scores. In this study, patients' perception of nasal obstruction and appearance improved after applying the nasal modifications to MMA described for OSA.
下颌骨前伸术（MMA）仍然是治疗阻塞性睡眠呼吸暂停（OSA）最有效的手术之一，但对于需要进行显著上颌骨前伸的患者，管理其鼻部和中面部美学效果可能具有挑战性。本研究旨在评估改良 MMA 方法后标准化美容和健康鼻部结局调查（SCHNOS）的变化。这是一项前瞻性研究，于 2020 年 9 月至 2021 年 8 月在一家三级转诊中心对接受 MMA 的患者进行了研究。术前和术后通过 SCHNOS、鼻功能和美容视觉模拟评分（VAS）以及 Epworth 嗜睡量表（ESS）评估鼻部功能、美容效果和嗜睡情况。还对客观多导睡眠图数据进行了调查。31 名患者符合纳入标准。MMA 后，SCHNOS-O（阻塞域）从 44.38±26.21 改善至 19.03±-4.75（ < 0.001）。SCHNOS-C（美容域）也显著改善，从 13.95±19.32 改善至 5.27±8.93（ = 0.029）。评估自尊心、鼻直度和对称性的特定项目显示出显著改善（ = 0.006、0.025、0.044）。ESS 也从 9.41±6.11 改善至 3.26±3.03（ < 0.001），且与鼻部阻塞评分相关。在这项研究中，对接受 OSA 改良 MMA 的患者应用鼻部改良后，其对鼻部阻塞和外观的感知得到了改善。
