Bègue Louis, Raoul Gwénaël, Barry Florent, Nicot Romain
Univ. Lille, CHU Lille, Service de Chirurgie Maxillo-Faciale et Stomatologie, 59000 Lille, France.
Univ. Lille, CHU Lille, INSERM, Service de Chirurgie Maxillo-Faciale et Stomatologie, U1008 - Advanced Drug Delivery Systems, 59000 Lille, France.
J Stomatol Oral Maxillofac Surg. 2025 Mar;126(2):102075. doi: 10.1016/j.jormas.2024.102075. Epub 2024 Sep 12.
OBJECTIVE/BACKGROUND: The aim of this study was to compare the efficacy of orthognathic surgery combined with soft tissue surgery with that of soft tissue surgery alone as curative treatments for moderate to severe obstructive sleep apnea (OSA) syndrome.
PATIENTS/METHODS: This retrospective cohort study included 50 patients aged ≥18 years who underwent orthognathic surgery combined with soft tissue surgery or soft tissue surgery alone for OSA syndrome (apnea-hypopnea index [AHI]: >15). The primary outcome was the improvement in AHI measured by overnight in-laboratory polysomnography before and at 6 months after the surgical treatment by. The secondary outcome was the postoperative AHI.
Twenty-eight (56 %) patients underwent orthognathic surgery combined with soft tissue surgery, while 22 (44 %) underwent soft tissue surgery only. There were no significant between-group differences in sex (p = 0.53), age (p = 0.08), body mass index (p = 0.42), and preoperative AHI (p = 0.17). The mean improvement in AHI at 6 months after surgery was significantly greater in the orthognathic surgery group than in the soft tissue surgery group (32.18 vs. 10.41; p < 0.0001). Similarly, the mean postoperative AHI was significantly lower in the orthognathic surgery group than in the soft tissue surgery group (8.46 vs. 29.62; p < 0.0001).
Compared with soft tissue surgery alone, orthognathic surgery combined with soft tissue surgery is more effective as curative treatment for OSA syndrome.
目的/背景：本研究旨在比较正颌手术联合软组织手术与单纯软组织手术治疗中度至重度阻塞性睡眠呼吸暂停（OSA）综合征的疗效。
患者/方法：这项回顾性队列研究纳入了50例年龄≥18岁、因OSA综合征（呼吸暂停低通气指数[AHI]：>15）接受正颌手术联合软组织手术或单纯软组织手术的患者。主要结局是通过手术治疗前及术后6个月在实验室进行的整夜多导睡眠图测量的AHI改善情况。次要结局是术后AHI。
28例（56%）患者接受了正颌手术联合软组织手术，而22例（44%）仅接受了软组织手术。两组在性别（p = 0.53）、年龄（p = 0.08）、体重指数（p = 0.42）和术前AHI（p = 0.17）方面无显著组间差异。正颌手术组术后6个月AHI的平均改善程度显著大于软组织手术组（32.18对10.41；p < 0.0001）。同样，正颌手术组术后平均AHI显著低于软组织手术组（8.46对29.62；p < 0.0001）。
与单纯软组织手术相比，正颌手术联合软组织手术作为OSA综合征的治疗方法更有效。
