Maxillomandibular advancement for obstructive sleep apnea syndrome treatment: Long-term results

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• 作者：Auré ; lie Vigneron^a ; Renaud Tamisier^b ; ^{rtamisier@chu-grenoble.fr} ; Emmanuelle Orset^a ; Jean-Louis Pepin^b ; Georges Bettega^c ; ^{gbettega@ch-annecygenevois.fr}
• 关键词：Sleep apnea ; Obstructive ; Continuous positive airway pressure ; Orthognathic surgery
• 刊名：Journal of Cranio-Maxillofacial Surgery
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：45
• 期：2
• 页码：183-191
• 全文大小：1712 K
• 卷排序：45

文摘

We evaluated the long term effectiveness of maxillomandibular advancement (MMA) for OSAS treatment patients. This retrospective study reviewed the patients treated by MMA for OSAS between 1995 and 2009. They were evaluated by complete polysomnography, cephalometry and quality of life questionnaire. The minimum follow up was 3 years. Success rate was defined by an IAH <10 with at least a 50% reduction.Material and methods88 patients had MMA during this period. 34 accepted the evaluation (28 men, 6 women). Mean age was 52.4 ± 14. Mean follow-up was 12.5 years.ResultsLong term success rate was 28% for the entire group, postoperative IAH was reduced between 50 and 80% for all the patients except one. Success rate was 100% for young patients (age < 45), with BMI <25 and IAH <45 and SNB <75° and narrow retrobasinlingual space (<8 mm) and with preoperative orthodontics. Esthetic and sleep results were better with a moderate maxillary advancement and anterior impaction. There was no skeletal relapse. The major postoperative complication was inferior alveolar nerve hypoesthesia.ConclusionsMMA is an effective and stable treatment of OSAS in selected patients. Preoperative orthodontics is recommended.