Valls-Ontañón A, Giralt-Hernando M, Zamora-Almeida G, Anitua E, Mazarro-Campos A, Hernández-Alfaro F
Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya (UIC), Barcelona, Spain; Institute of Maxillofacial Surgery, Teknon Medical Center, Barcelona, Spain.
Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya (UIC), Barcelona, Spain; Institute of Maxillofacial Surgery, Teknon Medical Center, Barcelona, Spain.
Int J Oral Maxillofac Surg. 2023 Dec;52(12):1255-1261. doi: 10.1016/j.ijom.2023.04.004. Epub 2023 May 19.
A prospective study was performed to assess the effect of orthognathic surgery on mild obstructive sleep apnoea (OSA) in patients with an underlying dentofacial deformity treated for occlusal and/or aesthetic reasons. As the main outcome variables, changes in upper airway volume and apnoea-hypopnoea index (AHI) were evaluated at 1 and 12 months of follow-up, in patients undergoing orthognathic surgery with widening movements of the maxillomandibular complex. Descriptive, bivariate, and correlation analyses were performed; significance was set at P < 0.05. Eighteen patients diagnosed with mild OSA were enroled (mean age 39.8 ± 10.0 years). An overall upper airway volume widening of 46.7% after orthognathic surgery was observed at 12 months of follow-up. The AHI decreased significantly from a median 7.7 events/hour preoperatively to 5.0 events/h at 12 months postoperative (P = 0.045), and the Epworth Sleepiness Scale score decreased from a median 9.5 preoperatively to 7 at 12 months postoperative (P = 0.009). A cure rate of 50% was obtained at 12 months of follow-up (P = 0.009). Despite the limited sample size, this study provides evidence that in patients with an underlying retrusive dentofacial deformity and mild OSA, a slight decrease in AHI is obtained after orthognathic surgery due to upper airway enlargement, which could be added as a beneficial effect of orthognathic surgery.
一项前瞻性研究旨在评估正颌手术对因咬合和/或美观原因接受治疗的潜在牙颌面畸形患者轻度阻塞性睡眠呼吸暂停(OSA)的影响。作为主要结局变量,对接受上颌下颌复合体扩宽移动正颌手术的患者在随访1个月和12个月时评估上气道容积和呼吸暂停低通气指数(AHI)的变化。进行了描述性、双变量和相关性分析;显著性设定为P<0.05。纳入了18例诊断为轻度OSA的患者(平均年龄39.8±10.0岁)。随访12个月时观察到正颌手术后上气道容积总体扩宽46.7%。AHI从术前中位数7.7次/小时显著降至术后12个月时的5.0次/小时(P=0.045),Epworth嗜睡量表评分从术前中位数9.5降至术后12个月时的7分(P=0.009)。随访12个月时治愈率为50%(P=0.009)。尽管样本量有限,但本研究提供了证据,表明对于有潜在后缩性牙颌面畸形和轻度OSA的患者,正颌手术后由于上气道扩大,AHI略有下降,这可作为正颌手术的一个有益效果。