Kongsong Wichuda, Rochanavibhata Sunisa, Changsiripun Chidsanu, Sinpitaksakul Phonkit, Chirakalwasan Naricha
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
J Craniomaxillofac Surg. 2025 Sep;53(9):1422-1430. doi: 10.1016/j.jcms.2025.05.015. Epub 2025 Jun 19.
This study aimed to assess the impact of orthognathic surgery on both subjective and objective obstructive sleep apnea (OSA) parameters and sleep quality in patients with skeletal class III. An upper airway evaluation was conducted using cone-beam computed tomography. Sleep quality was evaluated subjectively and objectively using the screening OSA questionnaires, the Functional Outcomes of Sleep Questionnaire, and sleep study testing. Data were collected from 23 patients at three time points: within 1 month before surgery (T0), within 1 month after surgery (T1), and 6 months after surgery (T2). Overall, there was a significant decrease in airway volume and minimal cross-sectional area at T1 and T2. Although there was partial recovery of these parameters at T2, they were not fully restored. No changes in subjective parameters were observed. Objective parameters showed significant increases in total apnea-hypopnea index (AHI) and obstructive AHI (ObsAHI) at T1. However, by T2, these values had decreased and were not significantly different from T0. Multivariable linear regression analysis found no associated variables for the change in ObsAHI. These findings suggest that while orthognathic surgery may initially impact upper airway morphology and objective sleep quality, some recovery and adaptation occur over time, though not to pre-surgery levels.
本研究旨在评估正颌手术对Ⅲ类骨型患者主观和客观阻塞性睡眠呼吸暂停(OSA)参数及睡眠质量的影响。使用锥形束计算机断层扫描进行上气道评估。通过筛查OSA问卷、睡眠功能结果问卷和睡眠研究测试对睡眠质量进行主观和客观评估。在三个时间点收集了23例患者的数据:手术前1个月内(T0)、手术后1个月内(T1)和手术后6个月(T2)。总体而言,T1和T2时气道容积和最小横截面积显著减小。尽管这些参数在T2时有部分恢复,但未完全恢复。主观参数未观察到变化。客观参数显示T1时总呼吸暂停低通气指数(AHI)和阻塞性AHI(ObsAHI)显著增加。然而,到T2时,这些值下降,且与T0无显著差异。多变量线性回归分析未发现与ObsAHI变化相关的变量。这些发现表明,虽然正颌手术最初可能会影响上气道形态和客观睡眠质量,但随着时间的推移会出现一些恢复和适应,尽管未恢复到手术前水平。